Estimation of fluoride ion concentration in urine after application of silver diamine fluoride in patients with severe early childhood caries.

BACKGROUND: Despite the University of California San Francisco, the American Academy of Pediatric Dentistry (AAPD), and the Food and Drug Administration having approved the use of silver diamine fluoride (SDF) in arresting dentinal caries, literature available on its systemic absorption is limited. AIM: This study aimed to assess any systemic absorption of fluoride ion following the topical application of SDF in young children. MATERIALS AND METHODS: Children aged between 3 and 6 years who were diagnosed with severe early childhood caries and required rehabilitation were recruited for the study. Before the onset of treatment for the arrest and control of caries, a baseline urine sample as a control was collected from the patient. In accordance with the manufacturer's instructions and AAPD guidelines, SDF was topically applied on a minimum of five carious teeth, following which additional urine samples were collected after 2 h and after 24 h, respectively, of application of SDF. The urine samples were stored at -20°C, and the estimation of fluoride ion concentrations in urine was then ascertained using a fluoride ion selective electrode. RESULTS: The results revealed that the fluoride concentration in urine before application of SDF was 0.66 mg/L ± 0.25 mg/L, and following 2 h of application, it was 1.13 mg/L ± 0.23. However, 24 h postapplication, the urinary fluoride concentration was reduced to 0.63 mg/L ± 0.20, which is close to the baseline value of the control sample. CONCLUSION: There was no significant systemic absorption of fluoride following the application of SDF, and it could be adopted as an effective and safe agent in the armamentarium for managing caries in young children.

Effect of Chewing Bicarbonate-containing Sugar-free Gum on the Salivary pH: An in vivo Study.

The objective of the study was to evaluate the effect of chewing gum on the salivary pH and to compare the effect of chewing bicarbonate-containing sugar-free gum on salivary pH against that of standard sugar-free gum. The experiment was carried out on 30 volunteers aged 20-22 years (mean age = 21 years) who fulfilled the inclusion criteria. The test gum was sugar-free greenmint-flavored bicarbonate-containing gum and the standard control was sugar-free spearmint-flavored gum. The pH was measured immediately using pH strips. According to statistical analysis, the mean salivary pH of the bicarbonate gum at 0, 5, 10, 15 and 20 minutes is 6.9713, 6.5667, 6.4267, 6.3867 and 6.3233 respectively. There is decrease in pH from 0 to 20 minutes. According to Bonferroni, there was no significant difference in pH from 0 to 20 minutes, 10 to 20 minutes and 15 to 20 minutes, but there was a significant difference in salivary pH from 5 to 20 minutes (p = 0.014). The mean salivary pH of the standard gum at 0, 5, 10, 15 and 20 minutes is 6.8767, 6.6067, 6.4200, 6.4027 and 6.3000 respectively. There is decrease in pH from 0 to 20 minutes. According to Bonferroni, there was no significant difference in pH from 0 to 20 minutes, 5 to 20 minutes, 10 to 20 minutes and 15 to 20 minutes. Thus, the higher salivary pH achieved with chewing bicarbonate gum compared with a standard sugar-free gum may have important oral health implications. How to cite this article: Ballal RK, Bhat SS, Ramdas SS, Ballal S. Effect of Chewing Bicarbonate-containing Sugar-free Gum on the Salivary pH: An in vivo Study. Int J Clin Pediatr Dent 2016;9(1):35-38.