Clinical Prospective Assessment of Genotoxic and Cytotoxic Effects of Fluoride Toothpaste and Mouthwash in Buccal Mucosal Cells

Abstract

Background: Fluorides are an essential component of oral hygiene products used to prevent dental decay. Therefore, a question arises about the potential harms of joint use of fluoridated toothpaste and mouthwashes regarding the increased amount of fluoride in the oral mucosa. Methods: This prospective, double-blinded parallel randomized clinical trial was conducted using a buccal micronucleus cytome assay (BMCyt assay). Forty-one participants were randomly assigned to the two groups. All participants used the same kinds of toothpaste for 12 weeks, designed explicitly for this study (non-fluoride, 1050 ppm F, and 1450 ppm F each for 4 weeks). Simultaneously, during the 3 months of the research, one group used mouthwash with fluoride (450 ppm) and another without fluoride. The buccal mucosal sampling was taken before using the tested products and after 4, 8, and 12 weeks of their use. Results: The frequency of micronuclei and the majority of other scored endpoints from the BMCyt assay showed no statistically significant differences within and between the studied groups. Comparing two groups, only statistically significant increases in the number of cells with nuclear buds (p = 0.048) and karyorrhexis (p = 0.020) at four weeks of usage were observed in the group that used mouthwash with fluoride. Conclusion: On the basis of the results, it can be concluded that simultaneous application of fluoridated toothpaste and fluoride mouthwash does not lead to cytogenetic damage in buccal mucosal cells.

Evaluation of possible role of fluoride in pathogenesis of oral submucous fibrosis: A pilot study

“…It can directly inhibit enzymes like enolase involved in glycolysis leading to ATP depletion and mitochondrial dysfunction 15 . This triggers the intrinsic apoptotic pathway in mucosal epithelial cells and fibroblasts 16 . Sustained apoptosis results in the release of profibrotic factors like TGF‐beta that stimulate fibroblasts and promote collagen deposition and extracellular matrix remodelling 17 …”

“…15 This triggers the intrinsic apoptotic pathway in mucosal epithelial cells and fibroblasts. 16 Sustained apoptosis results in the release of profibrotic factors like TGF-beta that stimulate fibroblasts and promote collagen deposition and extracellular matrix remodelling. 17 Fluoride-induced oxidative stress can also activate inflammatory pathways like NF-kB and increased expression of cytokines like IL-8 and COX-2.…”

Effect of Commercial Children’s Mouthrinses and Toothpastes on the Viability of Neonatal Human Melanocytes: An In Vitro Study

“…A previous in vivo study [25] showed that the concurrent use of toothpaste containing fluoride and fluoride mouthwash did not result in any cytotoxic or genotoxic effects on buccal mucosal cells. Another in vivo study further substantiated that the use of fluoridecontaining toothpastes did not induce cytotoxicity or genotoxicity in buccal epithelial cells; however, sodium lauryl sulfate (SLS)-containing toothpastes resulted in cytogenetic damage [26].…”