The results of a recent study by Whitford et al. [Caries Res 2002;36:256–265] with subjects whose drinking water was fluoridated led to two major conclusions: (1) Compared to the use of a placebo dentifrice, plaque fluoride concentrations ([F]) throughout much of the day are not significantly increased by the use of an F dentifrice but (2) they are positively related to plaque [Ca] (p = 0.0001). The present double-blind, double-crossover study with 16 subjects used the same protocol and was done to: (1) determine the effects of the use of an F dentifrice on salivary and plaque [F] in a community without water fluoridation and (2) further examine the relationship between plaque [Ca] and [F]. Following the use of an F dentifrice or placebo for one week, whole saliva and plaque were collected 1.0 and 12 h after the last use of the products. The study was repeated to include rinsing with a 20 mmol/l CaCl2 solution immediately before the use of the dentifrices. The CaCl2 rinse had only minor effects on salivary [Ca] and [F] and none on the plaque concentrations. Unlike the results found in the fluoridated community, all salivary and plaque [F] associated with the use of the F dentifrice were significantly higher than those associated with the use of the placebo. The results suggest that the cariostatic effectiveness of an F dentifrice should be greater in areas without water fluoridation. As noted previously, plaque [F] were positively related to plaque [Ca] (p = 0.0001).
Fluoride toothpastes are a risk factor for the development of dental fluorosis. Products with low fluoride content offer a higher security, but their effectiveness must be proven. The aim of this in vitro study was to compare two acidified toothpastes with low fluoride concentration (412 and 550 µg F/g) with neutral toothpastes. Bovine enamel blocks were selected by surface microhardness (SMH) and randomized to twelve groups of 13, according to the fluoride concentration in toothpaste (placebo, 275, 412, 550 or 1,100 µg F/g) and pH (7.0 or 5.5). Two commercially available toothpastes were also studied: a 1,100-µg F/g, pH 7.0 paste (positive control) and a children’s paste (500 µg F/g, pH 7.0). The blocks were subjected to pH cycling for 7 days. The toothpaste treatment was done twice daily. Surface and cross-sectional microhardnesses were assessed to calculate the percentage change of SMH (%SMH) and the mineral loss (ΔZ). The amount of fluoride, calcium and phosphorus in the solutions after the pH cycling was also analyzed. Compared to neutral toothpastes, the acidified toothpastes reduced the %SMH in all F concentrations. Higher F and lower Ca and P concentrations were found in solutions for the acidified toothpastes. Regarding ΔZ, only the positive control, 1,100-µg F/g (acidified and neutral) groups were not statistically different. The acidified toothpastes showed a dose-response relationship with all variables. For the low-fluoride toothpastes evaluated, only the 550-µg F/g acidified paste had the same anticariogenic action as the 1,100-µg F/g neutral paste.
Nano-hydroxyapatite formulations (with or without home->care product association) were as effective as the other treatments in reducing dentin hypersensitivity over three months.
This blind and randomized-controlled trial analysed chlorhexidine dentifrices in relation to dental plaque, gingivitis, bleeding, calculus and enamel extrinsic staining development. Volunteers in fixed orthodontic therapy used the following dentifrices: 1100 ppmF, NaF (group A, n=27); experimental, 1100 ppmF, NaF and chlorhexidine 0.95% (group B, n=28); and experimental, chlorhexidine 0.95% (group C, n=28). At baseline, after 6, 12 and 24 weeks, clinical examinations were carried out. The gingivitis, bleeding and plaque data were tested by anova and Tukey's post hoc tests. Stain and calculus data were analysed by Kruskal-Wallis and Dunn's post hoc tests (p<0.05). Plaque, gingivitis and bleeding scores improved in all three groups, but up to the 6 and 12 weeks examination the products containing chlorhexidine were statistically better. The chlorhexidine dentifrices significantly increased the mean of the stain index, although most of the patients did not notice the stains. The calculus index was not significantly modified. In summary, this study suggests that the use of dentifrices containing chlorhexidine seems to be effective for the treatment of gingivitis in orthodontic patients, although the intense motivating contact that the volunteers had with the researchers may have also played a role.
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