Effectiveness of fluoride-containing toothpastes associated with different technologies to remineralize enamel after pH cycling: an in vitro study.

BACKGROUND: To evaluate the efficacy of fluoride-containing toothpastes with different technologies to remineralize artificial caries lesions in enamel. METHODS: Bovine enamel blocks were divided into three thirds: intact (untreated), demineralized (artificial caries lesion), and treated (caries lesion, pH cycling with dentifrices). Enamel blocks were randomly distributed into five groups (n = 12): Fluoride-free toothpaste, Colgate Oral Care (NC); Arginine-containing toothpaste, Colgate Total Daily Repair (PC); Silicate-based fluoride toothpaste: REFIX technology, regenerador + sensitive (RDC), NR-5 technology, Regenerate Enamel Science (RES), and NOVAMIN technology, Sensodyne Repair and Protect (SRP). The specimens were submitted to a pH cycling model for 6 days. The efficacy of the toothpastes was estimated by calculating the surface microhardness recovery (%SMHR) and the fluorescence recovery (ΔFRE) with quantitative light-induced fluorescence. The cross-sectional micromorphology of the enamel surface was also assessed using scanning electron microscopy. Elemental analyses (weight%) were determined with an energy-dispersive X-ray spectrometer (EDS). The results were compared to that of the control (NC). Data were statistically analyzed (5%). RESULTS: %SMHR could be ranked as follows: RDC = PC = RES = SRP > NC. Significantly higher %SMHR and ΔFRE means were observed after enamel treatment with RDC (22.7 and 46.9, respectively). PC (%SMHR = 18.8) was as efficacious as RDC to recover the surface microhardness with a significantly lower mean of ΔFRE (19.5). Only RDC was able to promote the formation of a mineralized layer on the surface of enamel enriched with silicon on the surface. CONCLUSIONS: The silicate-based fluoride toothpaste containing REFIX technology demonstrated greater efficacy in the remineralizing artificial caries than the other products.

Nanoencapsulated fluoride as a remineralization option for dental erosion: an in vitro study.

OBJECTIVE: To compare the in vitro performance of different dentifrices indicated for dental erosion and a new dentifrice with controlled fluoride release system (NanoF) in terms of surface microhardness remineralization in enamel erosion lesions. MATERIALS AND METHODS: 72 human enamel specimens were divided into 6 groups (n = 12): PC (100% NaF - positive control); NC (Placebo - negative control); 50%nF (50% NanoF + 50% free NaF), 100%nF (100% NanoF); PN (Sensodyne® ProNamel™) and AG (Colgate® Sensitive Pro-Relief™). A surface microhardness analysis was performed before (SH0) and after (SH1) the erosion lesion formation. The blocks were submitted to a 5-day de-remineralization cycling model, consisting of 90 s immersion on 0.1% citric acid (4x/day) and 1 min treatment with dentifrice slurries along with 1 mL/block of human saliva (2x/day). Lastly, the final surface microhardness analysis (SH2) was measured and the percentage of surface microhardness remineralization (%SMHR) was calculated. Data were analysed with 2-way ANOVA and Tukey's test (p < .05). RESULTS: Statistically significant differences were observed for SH2 and %SMHR between NC and AG with the other groups (p < .05). The best %SMHR from the experimental groups was found in 100%nF and PN. CONCLUSION: Dentifrices with NanoF exhibited a surface microhardness remineralization similar to sodium fluoride (PC). Therefore, NanoF dentifrice can be an alternative to prevent and treat patients with dental erosion.

Efficacy of whitening toothpaste containing blue covarine: A double-blind controlled randomized clinical trial.

OBJECTIVE: This randomized clinical trial evaluated the efficacy and safety of a blue-covarine whitening toothpaste on tooth bleaching. SUBJECTS AND METHODS: Seventy-five subjects with shade mean C1 or darker were randomized into three groups (n = 25): CT-conventional toothpaste, WT-whitening toothpaste, and CP10-10% carbamide peroxide. Subjects from CT and WT brushed their teeth twice/day for 2 weeks. CP10 used bleaching gel for 4 hours/night for 2 weeks. Tooth shade and CIELab parameters were measured at baseline, after the first application, 2- and 4-week. ΔE*ab and ΔE00 were calculated. Subjects' perception about tooth color appearance, tooth sensitivity (TS), and gingival irritation (GI) were also assessed. RESULTS: At all evaluation periods, it was not observed differences between WT and CT considering tooth shade (P > 0.7) or CIELab parameters (P > 0.3). At 2- and 4-week, ΔE*ab and ΔE00 were higher for CP10 than WT or CT (P = 0.001). WT and CT reported major dissatisfaction with tooth color appearance than CP10 (P = 0.001). At 1- and 2-week, WT experienced GI and TS similar to CT, both lower than CP10 (P < 0.01). CONCLUSION: There were no significant differences in the whitening efficacy between whitening and conventional toothpastes. Neither of the dentifrices was as effective as at-home bleaching. CLINICAL SIGNIFICANCE: The silica-based toothpaste containing blue covarine evaluated in this study did not give significant tooth whitening benefits over 2 weeks of use.

Molar-incisor hypomineralization (MIH), dental fluorosis, and caries in rural areas with different fluoride levels in the drinking water.

AIM: This study determined the prevalence of molar-incisor hypomineralization (MIH) and its association with dental fluorosis and caries in children living in rural areas in north-eastern Brazil who are exposed to residual fluoride (F) levels in the drinking water. DESIGN: A census was carried out with 610 schoolchildren aged 6 to 12 years. The European Academy of Paediatric Dentistry criteria, Thysltrup and Fejerskov index, and World Health Organization index were used for diagnosis of MIH, dental fluorosis, and caries detection, respectively. The association between the outcome and exposure variables was determined by robust Poisson regression (P < .05). RESULTS: Water F-levels varied from 0.06 to 1.98 ppm. MIH was not related to fluoride levels in the drinking water, but it showed an inverse and direct correlation with dental caries and fluorosis, respectively. Children with MIH had a higher DMFT, and severe MIH cases were most frequent in children with dental fluorosis. CONCLUSION: Drinking water F-levels were not directly related to the occurrence of MIH in schoolchildren. The severity of MIH, however, was likely to be associated with dental fluorosis in areas with moderate to high fluoride levels in the drinking water.

European Organization for Caries Research Workshop: Methodology for Determination of Potentially Available Fluoride in Toothpastes.

Toothpastes are the most universally accepted form of fluoride delivery for caries prevention. To provide anti-caries benefits, they must be able to release fluoride during the time of tooth brushing or post brushing into the oral cavity. However, there is no standard accepted procedure to measure how much fluoride in a toothpaste may be (bio) available for release. The European Organization for Caries Research proposed and supported a workshop with experts in fluoride analysis in toothpastes and representatives from industry. The objective of the workshop was to discuss issues surrounding fluoride analysis in toothpaste and reach consensus on terminology and best practices, wherever the available evidence allowed it. Participants received a background paper and heard presentations followed by structured discussion to define the problem. The group also reviewed evidence on the validity, reliability and feasibility of each technique (namely chromatography and fluoride electroanalysis) and discussed their strengths and limitations. Participants were able to reach a consensus on terminology and were also able to identify and summarize the advantages and disadvantages of each technique. However, they agreed that most currently available methods were developed for regulatory agencies several decades ago, utilizing the best available data from clinical trials then, but require to be updated. They also agreed that although significant advances to our understanding of the mechanism of action of fluoride in toothpaste have been achieved over the past 4 decades, this clearly is an extraordinarily complex subject and more work remains to be done.

Erosive potential of soy-based beverages on dental enamel.

BACKGROUND: This study aimed to investigate the erosive potential of soy-based beverages in comparison to fruit juices of the same flavor. METHODS: Human enamel blocks were randomly divided into 9 groups (n = 8), according to the beverage category (soy or non-soy juices). The initial pH, TA and ß at the original pH value were measured in triplicate. The composition of calcium, phosphate and total protein was analyzed using the specific colorimetric method. The fluoride analysis was performed using a selective electrode. The degree of saturation (DS) and the critical pH (CpH) of each beverage with respect to hydroxyapatite (HAp) and fluorapatite (FAp) were calculated using the computational software. Enamel samples were immersed into 67.5 mL of each drink for 120 minutes. Enamel surface loss (ESL) and differences in surface roughness (ΔRaE-S) were analyzed by a 3D non-contact profilometer. RESULTS: Non-soy beverages exhibited the lowest pH values (2.93 to 3.40). The highest values of calcium concentration were founded in soy-based formulations. Juices with soy in their composition tend to have high DS when compared with non-soy based beverages (p = .0571). Soy beverages produced less ESL than non-soy beverages (p < .05). ΔRaE-S was not significantly different between the categories. The ESL and ΔRaE-S were positively correlated with initial pH and buffering capacity in soy-based beverages. On the other hand, in non-soy beverages, the ESL was negatively correlated with the TA to 7.0 and the fluoride composition whereas the ΔRaE-S was negatively correlated with the TA to 5.5. CONCLUSIONS: The erosive potential of soy beverages was lower than non-soy based beverages.

A randomized triple-blind crossover trial of a hydrocolloid-containing dentifrice as a controlled-release system for fluoride.

OBJECTIVE: To evaluate retention of intraoral fluoride in biofilm and saliva, an experimental dentifrice containing hydrocolloid (tara gum) was used as a controlled-release system for fluoride (F). MATERIALS AND METHODS: In a triple-blind randomized crossover trial with washout, 18 individuals used the following different dentifrices for a week: 100-TGF (sodium fluoride NaF associated with tara gum, 1100 mg/L), 50-TGF (50% NaF associated with tara gum + 50% free NaF, 1100 mg/L), PC (free NaF, 1100 mg/L), TG (with tara gum and without F), and placebo (without F or tara gum). On the seventh day of dentifrice use, biofilm was collected at 1 and 12 h, and saliva was collected up to 60 min and 12 h after the last toothbrushing. F concentrations were determined by physico-chemical analysis of fluoride using the hexamethyldisiloxane-facilitated diffusion technique. Data were subjected to two-way analysis of variance (repeated measures) and Spearman's correlation coefficient (p < 0.05) testing. RESULTS: No significant difference was observed with the same dentifrice regarding F retention in biofilm at 1 and 12 h after toothbrushing for the 100-TGF, placebo, and TG groups (p > 0.05). The highest area under the curve values in saliva were found for the 50-TGF, 100-TGF, and PC groups. CONCLUSION: The dentifrice containing hydrocolloid as a controlled-release system for F promoted F retention in the oral cavity, even at 12 h after brushing. CLINICAL RELEVANCE: Hydrocolloid added to dentifrices as a controlled-release system for F might contribute to a higher anti-caries effect. TRIAL REGISTRATION: NCT02809014.

In situ effect of a CPP-ACP chewing gum on enamel erosion associated or not with abrasion.

OBJECTIVES: The purpose of this study is to analyze the in situ effect of a casein phosphopeptide-stabilized amorphous calcium phosphate (CPP-ACP) chewing gum on human enamel erosion lesion associated or not with abrasion. MATERIAL AND METHODS: A three-way crossover study of 7 days was conducted involving 10 volunteers subjected to the same protocol: (G1) CPP-ACP sugar-free chewing gum, (G2) regular sugar-free chewing gum without CPP-ACP, and (G3) saliva-no chewing gum. An abrasion test was included in each phase. A 3D non-contact profilometry measurement of lesion depth and surface roughness was obtained of sound and eroded surfaces. A salivary calcium concentration was determined for all volunteers. ANOVA followed by Tukey's test were used with a p < 0.05. RESULTS: The enamel depth and the enamel surface roughness of the CPP-ACP gum group were significantly lower than the others (ANOVA, p < 0.05). No significant differences were observed between the treatments when associated with abrasion (p > 0.05). A positive and significant correlation was seen between the lesion depth and enamel surface roughness for GI (r = 0.87, p = 0.00) and GIII (r = 0.79, p = 0.00) groups. The estimated total calcium presented in the saliva after the chewed CPP-ACP gum showed no statistical significance between the mean absorbance values at the different time collections (p > 0.05). CONCLUSIONS: It is demonstrated that the incorporation of the CPP-ACP into a sugar-free gum significantly increased the remineralization/protection of eroded enamel surface. CLINICAL RELEVANCE: The CPP-ACP added to gum may be a suitable alternative vehicle, to deliver calcium ions to saliva and therefore protecting enamel.

Fluoride varnishes containing calcium glycerophosphate: fluoride uptake and the effect on in vitro enamel erosion.

OBJECTIVES: Calcium glycerophosphate (CaGP) was added to fluoride varnishes to analyze their preventive effect on initial enamel erosion and fluoride uptake: potassium hydroxide (KOH)-soluble and KOH-insoluble fluoride bound to enamel. MATERIALS AND METHODS: This study was carried out in two parts. Part 1: 108 enamel samples were randomly distributed into six varnish groups: base varnish (no active ingredients); Duraphat® (2.26%NaF); Duofluorid® (5.63%NaF/CaF2); experimental varnish 1 (1%CaGP/5.63 NaF/CaF2); experimental varnish 2 (5%CaGP/5.63%NaF/CaF2); and no varnish. Cyclic demineralization (90 s; citric acid, pH = 3.6) and remineralization (4 h) was made once a day, for 3 days. Change in surface microhardness (SMH) was measured. Part 2: 60 enamel samples were cut in half and received no varnish (control) or a layer of varnish: Duraphat®, Duofluorid®, experimental varnishes 1 and 2. Then, KOH-soluble and KOH-insoluble fluoride were analyzed using an electrode. RESULTS: After cyclic demineralization, SMH decreased in all samples, but Duraphat® caused less hardness loss. No difference was observed between varnishes containing CaGP and the other varnishes. Similar amounts of KOH-soluble and insoluble fluoride was found in experimental varnish 1 and Duofluorid®, while lower values were found for experimental varnish 2 and Duraphat®. CONCLUSION: The addition of CaGP to fluoride varnishes did not increase fluoride bound to enamel and did not enhance their protection against initial enamel erosion. CLINICAL RELEVANCE: We observe that the fluoride varnishes containing CaGP do not promote greater amounts of fluoride bound to enamel and that fluoride bound to enamel may not be closely related to erosion prevention.

The effect of pH and fluoride concentration of liquid dentifrices on caries progression.

OBJECTIVE: This randomized clinical trial evaluated the effect of pH and fluoride concentration of liquid dentifrices (LD) on caries progression and fluoride uptake in the toenails of 2-4-year-old children. MATERIALS AND METHODS: Schoolchildren living in a fluoridated area, with (A) or without (I) active caries lesions, were randomly allocated into three groups according to the LD they would use over 12 months: group 1 (n = 48-A/56-I): 550 µg fluoride (F)/g, pH 4.5; group 2 (n = 56-A/48-I) 1,100 µg F/g, pH 7.0; and group 3 (n = 52-A/55-I): 550 µg F/g, pH 7.0. The number of lesions becoming active/cavities or inactive was clinically evaluated by determining progression or regression. Additionally, white spot lesions were evaluated by the quantitative light-induced fluorescence (QLF) method in 75 children. Toenail fluoride concentration was also evaluated. Data were analyzed by ANOVA and followed by Dunn's test or ANCOVA followed by Tukey's test (p < 0.05). RESULTS: Caries net increment followed a decreasing pattern according to the dentifrice used (G1 < G2 < G3), regardless caries activity, but significant differences were detected only for caries progression and net increment (G1 < G3) for the caries-active group when evaluated through visual inspection. For the regression, the values found for the three groups were more similar, without significant differences. QLF analysis detected no significant difference between groups 1 and 2, but they performed significantly better than group 3. A significantly lower toenail fluoride concentration was observed when children used the low-fluoride dentifrices. CONCLUSION: The low-fluoride acidic LD has good potential to prevent caries and reduce fluoride intake. CLINICAL RELEVANCE: The low-F acidic dentifrice combines the desirable characteristics of caries prevention and reduced fluoride intake-for a product to be used by children, regardless their caries status.

Assessment of groundwater quality in a region of endemic fluorosis in the northeast of Brazil.

The aim of this study was to estimate the risk for caries and fluorosis in a desertification area, applying the calcium/fluoride concentration ratio of underground water and the quality of water in a selected geographical region. This study was performed in the municipality of São João do Rio do Peixe, located in the tropical semiarid lands of Brazil. A total of 111 groundwater samples were collected. Fluoride concentration varied from 0.11 to 9.33 mg/L. Thirty percent of all samples analyzed showed values above 1.5 mg/L, while 64 % were above the ideal limit of 0.7 mg/L. Mean calcium concentration was 47.6 mg/L, and 14.4 % of all samples presented values above the WHO acceptable limits. The proportional value of calcium/fluoride in water showed that only 12 % of the samples were suitable for dental caries prevention with minimal risk for dental fluorosis. Mapping of the fluoride distribution indicated that approximately 2,465 people could be affected by dental fluorosis and 1,057 people might be affected by skeletal fluorosis. It can be concluded that, in addition to fluoride, many water parameters were not suitable for the drinking water. Mapping out calcium/fluoride ratio may indicate areas of water suitability for caries control, whereas the fluoride concentration solely can indicate the areas with the risk for fluorosis. This approach can be relevant for health authorities for identifying communities where dental caries or dental fluorosis is prevalent.

Dental Caries, Tooth Loss and Quality of Life of Individuals Exposed to Social Risk Factors in Northeast Brazil.

This study aimed to investigate the impact of dental caries and tooth loss on oral health-related quality of life (OHRQoL) in socioeconomically disadvantaged people. A population-based, cross-sectional survey was conducted in 28 cities at social risk in Northeast Brazil. All permanent residents aged 12, 15-19, 35-44, and 65-74 years were eligible, and 3063 were included. Participants answered a questionnaire on socioeconomic status, beliefs, and behaviors. Trained local dentists performed oral clinical examinations during home visits. Caries and tooth loss were evaluated using the decayed, missing, and filled teeth (DMFT) index and OHRQoL was evaluated using the Oral Health Impact Profile-14 (OHIP-14). Poisson regression analysis was performed to assess the relationship between individual domains, OHIP-14 scores, dental caries, tooth loss, and socioeconomic/demographic characteristics. Mean DMFT (standard deviation) scores were 2.68 (4.01), 4.84 (4.30), 15.35 (7.26), and 26.72 (8.03) for groups aged 12, 15-19, 35-44, and 65-74 years, respectively. Most participants (70%) were partially edentulous and 13% were completely edentulous. Caries and tooth loss significantly increased with age and impacted OHRQoL. Physical pain (5.8%) and psychological discomfort (5.8%) were the most commonly reported on the OHIP-14. Untreated caries (prevalence ratio (PR), 1.54; 95% confidence interval (CI), 1.37-1.72) and edentulism (PR, 1.29; 95% CI, 1.08-1.53) had a significant negative impact on OHRQoL. Income, level of education, sex, age, and oral hygiene habits were also related to OHRQoL. There was a high prevalence of dental caries and edentulism in all age groups except 12-year-olds. OHRQoL was negatively impacted by these oral conditions across the lifespan, with a trend towards more negative scores and higher impact in older adults.

Level of natural fluoride in public water supply: geographical and meteorological factors in Brazil's Northeast.

This study analyzed the relationships between the concentration of natural fluoride in public water supply and meteorological and hydrographic factors in a northeastern region of Brazil. This was a descriptive, analytical, ecological, longitudinal, and field study conducted by collecting water in 23 municipalities (2019 to 2020) of four macroregions of Paraíba (Brazil): coast (1), borborema (2), agreste (3), and outback (4). Four collection sites were selected per municipality: two near and two distant from the water treatment plant. Fluoride concentration was determined using a combined ion-specific electrode and classified according to the Collaborating Center of the Ministry of Health in Oral Health Surveillance. Meteorological, hydrographic, and population characteristics were also collected. All analyzed samples showed natural fluoride; macroregions 2 and 4 showed the highest mean fluoride concentration, macroregion 4 presented the highest mean temperature, and all macroregions showed a similar pattern of precipitation. The mean fluoride concentration of the four macroregions was below the appropriate value to prevent caries. An increase in precipitation would decrease the fluoride concentration in water. In conclusion, the concentration of natural fluoride varied according to meteorological and hydrographic factors. The concentration in surface waters increased during periods of low precipitation. Therefore, this study provided important information to support implementation of community water fluoridation in this region.

Consensus for teaching dental caries in the Portuguese Language at Brazilian dental schools.

The aim of this paper was to present a summary of the process of developing and preparing the final documents of the national consensus for teaching undergraduate Brazilian dental students the dental caries curriculum in the Portuguese language. The final document was developed in three steps: a) The ABENO and LAOHA cariology group invited experts from all five regions of Brazil to participate in the discussion. The theoretical support for crafting the first draft of the consensus was based on two publications: National Curriculum Guidelines of the Dentistry graduation in Brazil, Ministry of Education (2021) and the competences described in the European Core Curriculum for Cariology (ORCA-ADEE, 2011); b) The group of experts was divided into 5 working groups: G1-Domain, Main and Specific Competences, G2-Essential knowledge, G3-Life course perspective, G4-Social determinants and dental caries, G5- Glossary. The document was finalized by thoroughly reviewing the process using Delphi methodology; c) The 5-chapter document (one from each working group) was submitted to three open public consultations in 2022 (May-June, August, and October) using Google-forms. The suggestions (content/wording) were discussed within the group as: totally accepted, partially accepted, and rejected. A total of 192 suggestions were registered from 31 dental schools in all regions of Brazil. The number of suggestions received per Group were: 84, 28, 26, 24, 30 suggestions for G1, G2, G3, G4 and G5, respectively. The majority of suggestions were totally accepted by the group of experts (n = 172, 89.6%), 15 were partially accepted (7.8%), and 5 were rejected. Conclusion The final document could be considered to be the first national consensus for teaching the dental caries curriculum in Brazil.

Core Cariology Curriculum Framework in Spanish for Latin American dental schools: development and consensus.

The aim of this study was to develop and achieve consensus on a cariology teaching framework for dental schools in Latin American Spanish-speaking countries. The Delphi process, with a ≥8 0% pre-defined participants' agreement, included three phases and a Coordinating Group. During the Preparation phase three panels of experts were selected and invited to participate: a) Regional academic/professional Dental Associations (Associations-Panel): n = 12; b) Regional Dental Schools (Dental-Schools-Panel): existing dental schools (n = 263) from the 19 Spanish-speaking regional countries; c) International academic/professional associations Peer Experts (Peer-Panel): n = 4. Based on consensus documents from Europe, Colombia, the Caribbean, USA, Chile and Spain, and updated scientific evidence, the Coordinating Group developed a baseline framework proposal of domains, main competencies (MC) and specific competencies (SC). The Consultation-Agreement and Consensus phases included three rounds of questionnaires with a step-wise sharing of the MC updated version of the consensus framework with the Dental-Schools-Panel and including SC with the Associations-Panel. Diverse communication strategies were used ( e.g ., independent google-form questionnaires and workshops). Consensus was reached after an on-site Associations-Panel workshop and secret voting, followed by an online meeting with the Peers-Panel. A total of 127 academic/professional institutions participated (Associations-Panel: 11, 91.6%; Dental-Schools-Panel: 112, 42.6%, all countries; Peers-Panel: 4, 100%). The baseline Cariology teaching framework of 5 domains, 10 MC and 92 SC underwent modifications after agreements for a final consensus framework consisting of 5 domains, 10 MC and 85 SC. A Core Cariology curriculum framework in Spanish for Latin American Dental Schools was successfully developed and agreed upon with regional dental academic and professional institutions.

Prevalence of dental anomalies in patients with cleft lip and palate, Paraiba, Brazil: clinic and radiographic study.

The aim of this study is to investigate the prevalence of dental anomalies in a group of individuals with different types of clefts attending the reference service in orthodontics for the care of patients with clefts in Paraiba state, northeastern Brazil. This was a cross-sectional, observational study. Two previously trained examiners (kappa = 0.89) performed the clinical examination of 76 patients with post and incisive transforamen unilateral or bilateral clefts, of both sexes, aged 4 to 32 years, and the analysis of periapical and panoramic radiographs from archived records of these patients. Only the upper front teeth were evaluated. Data were processed by descriptive statistics and subjected to statistical Chi-square test considered significant at 5%. Among the patients evaluated, males (57.9%) and left unilateral transforamen clefts (40.8%) were prevalent. Of the total 76 patients examined, 56 (73.68%) had at least one dental anomaly, the most frequent being agenesis (31.6%) and conical teeth (28.9%). The presence of anomalies differed significantly between the cleft and the contralateral sides (p<0.00001). The diagnosis and treatment of patients with clefts should therefore receive more attention. It is suggested that clinical and radiographic examination be performed together with careful planning and implementation of specialist services in an effort to provide early and adequate detection and treatment.

Impact of the first thousand days of life on dental caries through the life course: a transdisciplinary approach.

This review aimed to describe the importance of the first 1000 days of a child's life as a golden period for interventions and actions to prevent dental caries and other chronic non-communicable diseases (NCDs) throughout the life course and highlight that the first 450 days of life could be even more important for oral health. During the first 1000 days of life (pregnancy and first two years of life), health care providers can identify unhealthy lifestyles, behaviors, and their determinants. Bearing in mind contextual factors like socioeconomic conditions and cultural aspects, this is a unique period to work together with the family and identify opportunities for adopting healthy habits that might last throughout the life of the expected or newborn child. This is a "window of opportunity" for the prevention of chronic NCDs of both systemic and oral origin, such as overweight, obesity, diabetes, cardiovascular diseases, and dental caries. In fact, to effectively prevent dental caries, pregnancy and the first 6 months of a child's life (first 450 days) should be considered the critical period to work together with families to facilitate the adoption of healthy habits. Knowledge about the first thousand days of life is essential and represents a crucial period for the implementation of actions and interventions that will guarantee good oral and general health development that can persist throughout life.

Effect of dentifrices with different pH and fluoride concentrations on fluoride levels in biofilm and nails: an RCT.

PURPOSE: to evaluate the effect of dentifrice pH and fluoride concentration ([F]) on fluoride uptake on the biofilm and nails of children from a non-fluoridated area. METHODS: two hundred and twenty-eight two- to four-year-old children were randomly allocated into 3 groups according to the type of dentifrice: G1: 1100 µg F/g, pH 4.5 (n = 76); G2: 750 µg F/g, pH 4.5 (n = 74); and G3: 1100 µg F/g, pH 7.0 (n = 78). Nails were collected at 4, 8, and 12 months after starting dentifrice use and biofilm was collected 5 and 60 minutes after toothbrushing. The concentrations of F in nails and biofilm were analyzed by HMDS facilitated diffusion. Data were analyzed by Kruskal-Wallis/Mann-Whitney's test and the comparison between biofilm collection times was done using Wilcoxon test (p £ 0.05). RESULTS: a significant reduction of [F] in biofilm was observed 60 minutes after toothbrushing, regardless of the dentifrice used. However, 5 minutes after toothbrushing, G1 had a significantly higher [F] compared to G2 and G3, and 60 minutes after toothbrushing, [F] was significantly higher for G1 and G2 compared to G3. G1 and G3 had significantly higher [F] in the nails compared to G2. CONCLUSION: a lower dentifrice concentration is a relevant factor for the reduction of excessive fluoride intake. The use of a low-F acidified dentifrice combines the reduction of fluoride uptake with caries prevention by leading to greater incorporation of F into the biofilm over time.

Shear bond strengths of three glass ionomer cements to enamel and dentine.

OBJECTIVES: The shear bond strength of three glass ionomer cements (GIC) to enamel and dentine was evaluated. STUDY DESIGN: Sound permanent human molars (n=12) were grinded perpendicular to their axial axes, exposing smooth, flat enamel and dentine surfaces. The teeth were embedded in resin and conditioned with polyacrylic acid (25%; 10s). Twenty four specimens of each GIC: Fuji IX (FJ-GC), Ketac Molar Easymix (KM-3M ESPE) and Maxxion (MX-FGM) were prepared according to the Atraumatic Restorative Treatment (ART) (12 enamel and 12 dentine), in a bonding area of 4.91 mm² and immersed in water (37°C, 24h). The shear bond strength was tested in a universal testing machine. Non-parametric statistical tests (Friedman and post-hoc Wilcoxon Signed Ranks) were carried out (p=0.05). RESULTS: The mean (±sd) of shear bond strength (MPa), on enamel and dentine, were: KM (6.4±1.4 and 7.6±1.5), FJ (5.9±1.5 and 6.0±1.9) and MX (4.2±1.5 and 4.9±1.5), respectively. There was a statistically significant difference between the GICs in both groups: enamel (p=0.004) and dentine (p=0.002). The lowest shear bond value for enamel was with MX and the highest for dentine was KM (p<0.05). CONCLUSION: It is concluded that KM has the best adhesion to both enamel and dentine, followed by FJ and MX.

Fluoride concentration and pH of pediatric medicines regularly and long-term used by children.

OBJECTIVES: Our aim in this study was to determine the fluoride concentration and pH of 71 pediatric medicines regularly and long-term used by children. STUDY DESIGN: The fluoride concentration was evaluated by selective electrode of fluoride (Orion). The pH was confronted using specific electrode (Orion) coupled to a potentiometer (Orion). The analyses were accomplished in duplicate. Pearson 's correlation and Kruskal-Wallis test were used. P-values below 5% were considered statistically significant. RESULTS: Medicine pH averages±SD varied from 2.3±0.01 to up 10.6±0.02. Values below critical pH were observed in 42.25% (n=30) of presentations, with 25.35% (n=18) below 4.5 pH. Most medicines (84.5%) presented fluoride concentration below 0.05 mg/L. CONCLUSIONS: Among the pediatric medicines evaluated, this study has showed that 2-4 times-a-day posology and syrup formulations presented lowest pH and fluoride concentration, resulting in factors that predict highest cariogenic and erosive potential.