Approximal caries increment in adolescents in a low caries prevalence area in Sweden after a 3.5-year school-based fluoride varnish programme with Bifluorid 12 and Duraphat.

OBJECTIVES: To evaluate approximal caries increment among 12- to 16-year-olds in a low caries prevalence area in Sweden after a 3.5-year school-based fluoride (F) varnish programme with Bifluorid 12 and Duraphat. METHODS: The design was a RCT study with 1365 adolescents, divided into following four groups: Group 1 Bifluorid 12 two applications/year; Group 2 Duraphat two applications/year; Group 3 Bifluorid 12 four applications/year and Group 4 no F varnish at school. 1143 children (84%) completed the study. Approximal caries was registered on bitewing radiographs. RESULTS: There were no statistically significant differences in caries prevalence among the groups either at baseline or after 3.5 years . The caries increment for Group 1 was 1.34 ± 2.99 (mean ± SD), 1.24 ± 2.84 for Group 2, 1.07 ± 2.66 for Group 3 and 1.25 ± 2.75 for Group 4, with no statically significant differences either between Bifluorid 12 and Duraphat with the same frequency of F varnish applications or between the F groups and the control group. CONCLUSIONS: In an area with low caries prevalence in Sweden, the supplementary caries-preventive effect of school-based F varnish applications, to regular use of F toothpaste at home and to regular caries prevention given at the Public Dental Clinics, appears to be nonsignificant regarding approximal caries increment.

Prevalence of dental erosion and association with lifestyle factors in Swedish 20-year olds.

OBJECTIVE: To investigate the prevalence, distribution and severity of dental erosion and its association with lifestyle, oral and general health in young adults. MATERIALS AND METHODS: Four hundred and ninety-four individuals, 20-years of age, participated. Dental erosion in molars and maxillary incisors was evaluated. Caries, plaque and gingivitis were registered. Saliva samples were taken and the subjects were interviewed about behavioural and dietary habits and oral and general health. Body mass index (BMI) was calculated. The individuals were sub-divided into two groups according to the presence and absence of dental erosion: within the group with erosion was a sub-group of individuals with extensive erosion. RESULTS: Of the individuals 25% had no erosion, 75% had erosion and 18% had extensive erosion. Erosion was found in molars in 74% of the individuals and on buccal and palatal surfaces in maxillary incisors in 4% and 7%, respectively. Cupping was seen in 65% of individuals and severe erosion in molars in 1.6%. Compared to subjects with no erosion, those with extensive erosion had a higher consumption of soft drinks (p = 0.05), caries prevalence (p < 0.01), prevalence of mutans Streptococci (p < 0.01) and BMI (p < 0.05). Furthermore, subjects with erosion had higher caries prevalence (p < 0.01) and BMI (p < 0.01) than those with no erosion. CONCLUSIONS: Swedish young adults have a high prevalence of dental erosion, but the level of severe erosion is low. The study disclosed a relationship between dental erosion and behavioural factors, oral health and BMI.

Effect of a third application of toothpastes (1450 and 5000 ppm F), including a 'massage' method on fluoride retention and pH drop in plaque.

OBJECTIVE: The aim was to investigate fluoride (F) retention in plaque, saliva and pH drop in plaque using high-F toothpaste (5000 ppm F) or standard toothpaste (1450 ppm F) twice a day or 3-times a day. A method using the toothpaste as a 'lotion' and massaging the buccal surfaces with the fingertip was also evaluated. MATERIALS AND METHODS: The investigation had a randomized, single-blinded, cross-over design and 16 subjects participated in six brushing regimes: (1) 5000 ppm F; twice a day, (2) 5000 ppm; 3-times/day, (3) 5000 ppm; twice a day, plus the 'massage' method once a day, (4) 1450 ppm F; twice a day, (5) 1450 ppm; 3-times/day and (6) 1450 ppm; twice a day, plus the 'massage' method once a day. The outcome measure was F retention in plaque, saliva and the plaque-pH change after a sucrose rinse. RESULTS: The highest F concentration was found using high-F toothpaste (No 1-3) and differed significantly from those with 1450 ppm (No 4-6). Brushing with high-F toothpaste 3-times a day (No 2) resulted in a 3.6-times higher F saliva value compared with standard toothpaste twice a day (No 4) (p < 0.001). Increasing the frequency of application, from twice to 3-times a day, increased the F retention in plaque significantly when the two methods for application 3-times a day were pooled (p < 0.05). Brushing with 5000 and 1450 ppm toothpastes twice a day plus the 'massage' once a day resulted in the same F concentration in saliva and plaque as brushing 3-times a day with the same paste. CONCLUSION: A third application of toothpaste is increasing the F retention and toothpaste as a 'lotion' and massaging the buccal surfaces with the fingertip may be a simple and inexpensive way of delivering F a third time during the day.

Combination of high-fluoride toothpaste and no post-brushing water rinsing on enamel demineralization using an in-situ caries model with orthodontic bands.

OBJECTIVE: To compare the effects on enamel demineralization and fluoride (F) retention of two different brushing­rinsing regimens. MATERIAL AND METHODS: An in-situ caries model with orthodontic bands was used for 8­9 weeks. A total of 20 orthodontic patients participated. They were randomized into two groups: (1) a test group using 5000 ppm F (n = 10) with no post-brushing water rinsing; and (2) a control group using 1450 ppm F (n = 10) with three sessions of post-brushing water rinsing. Orthodontic stainless-steel bands were applied to the two upper first premolars, leaving 2­3 mm of space away from the exposed buccal surface in order to accumulate plaque and provoke initial caries development. The teeth were extracted after 8 and 9 weeks, then analysed using quantitative light-induced fluorescence (QLF). Additionally, oral F retention was compared for the two groups. RESULTS: In comparison to the control group, the test regimen resulted in a non-significant smaller QLF lesion area and a significantly lower average QLF loss of fluorescence (P < 0.05). The highest F retention concentration under the band was found in the test group (P < 0.001). CONCLUSIONS: The combination of using a 5000 ppm F toothpaste and no post-brushing water rinsing had a greater anti-caries potential and resulted in elevated oral F retention compared to a 1450 ppm F toothpaste with three sessions of post-brushing water rinsing.

Effect of oxybenzone on PGE2-production in vitro and on plaque and gingivitis in vivo.

OBJECTIVES: To study the effect of oxybenzone on prostaglandin E2 (PGE2) production in cell culture and to evaluate the effect of an oxybenzone-containing dentifrice on plaque and gingivitis in a 6-week clinical trial. MATERIAL AND METHODS: Human embryo palatal mesenchyme (HEPM) cells were used for testing the inhibition of IL-1beta-stimulated PGE2-production in vitro by different concentrations of oxybenzone. For the in vivo study, a total of 66 individuals with a Quigley & Hein plaque index of at least 1.5 and an Ainamo & Bay gingival index of at least 0.2 were included in a double-blind clinical trial with two cells and a parallel design. Two compositions of fluoride dentifrice were used, one with the addition of 0.5% oxybenzone, and one without. Plaque and gingival index were obtained at three time points: (1) at baseline, (2) after 3 weeks, and (3) after 6 weeks. RESULTS: A dose-dependent inhibition of PGE2-production was found in the HEPM cell culture following oxybenzone exposure. In the clinical trial, a 25% reduction of gingival index was observed in the oxybenzone group (p<0.001) after 6 weeks as compared with 2% for the placebo group. CONCLUSIONS: These findings indicate that PGE2-production is reduced by oxybenzone in vitro and that the use of oxybenzone in a dentifrice reduces gingivitis in vivo.