Effect on caries in mentally handicapped children of addition of fluoride and bicarbonate‐phosphate to dietary sugar products

Abstract

Luoma, H. et alii: ElTect on caries in mentally handicapped children of addition of fluoride and bicarbonate-phcsphate to dietary sugar products. Scand. J. Dent. Res.ABSTRACT ~ Mentally handicapped children, aged 5-15 years and living in institutions, received fluoride supplement in several sugar products of their diet; in candies, marmalades, jams, fruit juices and in sweet desserts corresponding to 10 mg F as NaF per kg of tlie sugar (sucrose or glucose) of each product. To two of the four daily candies was also added a NaHCO, + KHjPO, mixture (mole ratio 9.8/1, resp.) to substitute for 2.5% of the sugar of the candy. The cotitrol children received the respective products without the additives. After stepwise exclusions of subjects for various reasons, e.g. for the absence of permanent teeth, low initial caries activity, strong medication, Down's syndrome, etc., the mean DMFS-increment in the remaining 43 control subjects was 4.5 and in the 41 test subjects 2.6 lesions/100 surfaces at risk,, i,e. 42% reduction. Caries arrestment had occurred in these test subjects after the first year, while in the respective controls it was continuously increasing. Among numerous oral and body parameters studied, only surface enamel fluoride in primary teeth was increased by the fluoride supplements and urinary phosphate and calcium excretion decreased.

Alterations by Mg and F of the Fermentative Dissolution of F-Varnished Enamel by a Streptococcal Layer Measured by a Microhardness Tester and a Proton Probe Microanalysis

“…On the other hand, DePaola et al [1975] and several others including our group [Seppd et al, 1982] have shown that when the enamel surface fluoride content (measured from labial surface) has been permanently elevated, it is associated with reduced caries when compared to the en amel with lower F content. Further, it has been shown that enamel, covered by artifi cial plaque, takes up most fluoride when this is available simultaneously with su crose [Ostrom et al, 1977;Luotna et al, 1983] and that fluoride given to children simultaneously with the attacking factor, the sucrose, arrests caries early [Luoma et al, 1979]. The final caries reduction ob tained by Luoma et al [1979] was 42%.…”

“…Further, it has been shown that enamel, covered by artifi cial plaque, takes up most fluoride when this is available simultaneously with su crose [Ostrom et al, 1977;Luotna et al, 1983] and that fluoride given to children simultaneously with the attacking factor, the sucrose, arrests caries early [Luoma et al, 1979]. The final caries reduction ob tained by Luoma et al [1979] was 42%. Hardvick et al [1981] published about an equal reduction in children who used fluo ride tablets with sucrose carrier.…”

Caries Inhibitory Effect of Fluoridated Sugar in a Trial In Indonesia

“…While this is well below toxic dose levels, the risk of later mild fluorosis in the younger children was to be avoided. A further factor leading to the decision to use 10ppm fluoride was that this concentration had been used successfully previously by Luoma et al 4 and in rat caries inhibition studies.…”

“…The use of sugar as a fluoride vehicle was first achieved successfully in vivo by Luoma 4 in Finland, where fluoride at a concentration of 10mg/kg was added to sugar used to prepare deserts and confections for children who were confined to an institution for the mentally handicapped. Total amounts consumed by the children were closely monitored to ensure that the intake of fluoride remained well within safe levels.…”

Protection by F, I, Sr, and Combinations against Fermentation Attack by Streptococcus sobrinus Artificial Plaque on Bovine Enamel

“…This finding is in line with the recent in vitro data of Larsen et al [1976], ten Cate and Duijsters [1983], and Margolis et al [1986], indicating that the presence of a low fluoride concentration in acid solu tion close to the enamel, i.e., during the acid attack, is highly protective. The combination of fluoride with sugar has been shown to be highly protective against caries in children [Luoma et al, 1979] and against experimental caries in vivo [Ostrom et al, 1977[Ostrom et al, , 1984. Further studies will be made to clarify, among other things, the minimum concentration of fluoride added with sugar in the fluid, either as such or with fluoride varnishing, needed to prevent completely the loss of minerals from the enamel.…”