The effect of fluoride slow-releasing devices on fluoride in plaque biofilms and saliva: a randomised controlled trial.

AIM: To investigate the effect of the fluoride sustained slow-releasing device (FSSRD) on F levels in unstimulated saliva and undisturbed plaque biofilms over 7 days. The investigation also aimed at studying the effect of patient age on fluoride (F) concentrations in dental plaque biofilms and unstimulated saliva while using the FSSRD. STUDY DESIGN: This was a randomised control double blind cross-over study. METHODS: Sixty-five participants between the ages of 6-35 years took part in this study. The mean age of all the participants was 19.22 years with 24 participants aged between 6-16 years (mean age=11.8 years) and 41 participants aged between 16-35 years (mean age=23.57 years). Plaque biofilms were collected using a modification of the plaque generating device (MPGD) [Robinson et al., 1997]. During the whole study period, including a 7 day washout period before the first leg, all participants were asked to use only non-fluoridated toothpaste and to avoid where possible high fluoride containing foods or drinks. Whenever possible, the FSSRD/placebo device (PD) was attached to the second permanent molar, while the MPGD was attached to the first permanent molars in the same upper dental quadrant. At the end of each leg of the study whole, mixed unstimulated saliva was collected from all participants and analysed for F concentration. STATISTICS: Statistical analysis using paired sample t-test was used to compare the results of F level between test and control groups, while, Spearman's correlation coefficient was used to test the relationship between patient's age and plaque weight against F concentration in plaque and saliva. RESULTS: There was no statistically significant difference in F concentration in plaque and saliva between the test and control groups when analysed using paired sample t-test (p>0.05). There was no correlation between patient's age and F concentration in dental plaque and saliva (p>0.05), in both the test and control groups. CONCLUSIONS: Our data showed no effect of the FSSRD in raising F concentrations in dental plaque and unstimulated whole saliva after 7 days. Such levels may require longer periods to become established.

Effect of CD4+ lymphocyte count, viral load, and duration of taking anti-retroviral treatment on presence of oral lesions in a sample of South African children with HIV+/AIDS.

AIMS: This was to determine the presence and types of oral mucosal lesions in a sample of HIV(+)/AIDS South African children taking antiretroviral therapy and to investigate the relationship between CD4(+) lymphocyte counts, viral load, duration of taking antiretroviral therapy (DART), and age on presence of oral lesions. METHODS: The samples consisted of 56 South African children aged 0-4 years (mean age =7.09 years) with HIV(+)/AID, infected at birth. Subjects were divided into two groups according to the presence of oral lesions with test group (patients with oral lesions) and control group (patients with no oral lesions). Children were also divided into two groups, those <6 years and those >6 years old to study the effect of age on presence of lesions. RESULTS: Oral Candidiasis was the most common lesion reported in 19/56 children, followed by Recurrent Herpetic Infection in 9 children. Other lesions such as Kaposi's sarcoma, Multifocal Epithelial Hyperplasia, Oral Hairy Leukoplakia, Linear Gingival Erythema, and oral ulceration were also present. A statistical significant difference in CD4(+) lymphocyte count (p value 0.005), and viral load (p value 0.002) was found between the oral lesion and no oral lesion groups, those with oral lesions having a significantly higher viral load and lower CD4+ count. No statisticaly significant difference between the two groups in terms of the DART effect (p value 0.811) was found. Furthermore, there was no effect of age groups on the presence of lesions in children with HIV(+)/AIDS. CONCLUSION: This study contributes to the relatively scant literature on the prevalence of oral lesions in children with HIV infection in South Africa and also the relationship of these lesions to the viral load and CD4(+) lymphocyte counts.