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Wong MCM, Zhang R, Luo BW, Glenny AM, Worthington HV, Lo ECM. Topical fluoride as a cause of dental fluorosis in children. Cochrane Database Syst Rev 2024; 6:CD007693. [PMID: 38899538 PMCID: PMC11187792 DOI: 10.1002/14651858.cd007693.pub3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/21/2024]
Abstract
BACKGROUND This is an update of a review first published in 2010. Use of topical fluoride has become more common over time. Excessive fluoride consumption from topical fluorides in young children could potentially lead to dental fluorosis in permanent teeth. OBJECTIVES To describe the relationship between the use of topical fluorides in young children and the risk of developing dental fluorosis in permanent teeth. SEARCH METHODS We carried out electronic searches of the Cochrane Oral Health Trials Register, CENTRAL, MEDLINE, Embase, three other databases, and two trials registers. We searched the reference lists of relevant articles. The latest search date was 28 July 2022. SELECTION CRITERIA We included randomized controlled trials (RCTs), quasi-RCTs, cohort studies, case-control studies, and cross-sectional surveys comparing fluoride toothpaste, mouth rinses, gels, foams, paint-on solutions, and varnishes to a different fluoride therapy, placebo, or no intervention. Upon the introduction of topical fluorides, the target population was children under six years of age. DATA COLLECTION AND ANALYSIS We used standard methodological procedures expected by Cochrane and used GRADE to assess the certainty of the evidence. The primary outcome measure was the percentage prevalence of fluorosis in the permanent teeth. Two authors extracted data from all included studies. In cases where both adjusted and unadjusted risk ratios or odds ratios were reported, we used the adjusted value in the meta-analysis. MAIN RESULTS We included 43 studies: three RCTs, four cohort studies, 10 case-control studies, and 26 cross-sectional surveys. We judged all three RCTs, one cohort study, one case-control study, and six cross-sectional studies to have some concerns for risk of bias. We judged all other observational studies to be at high risk of bias. We grouped the studies into five comparisons. Comparison 1. Age at which children started toothbrushing with fluoride toothpaste Two cohort studies (260 children) provided very uncertain evidence regarding the association between children starting to use fluoride toothpaste for brushing at or before 12 months versus after 12 months and the development of fluorosis (risk ratio (RR) 0.98, 95% confidence interval (CI) 0.81 to 1.18; very low-certainty evidence). Similarly, evidence from one cohort study (3939 children) and two cross-sectional studies (1484 children) provided very uncertain evidence regarding the association between children starting to use fluoride toothpaste for brushing before or after the age of 24 months (RR 0.83, 95% CI 0.61 to 1.13; very low-certainty evidence) or before or after four years (odds ratio (OR) 1.60, 95% CI 0.77 to 3.35; very low-certainty evidence), respectively. Comparison 2. Frequency of toothbrushing with fluoride toothpaste Two case-control studies (258 children) provided very uncertain evidence regarding the association between children brushing less than twice per day versus twice or more per day and the development of fluorosis (OR 1.63, 95% CI 0.81 to 3.28; very low-certainty evidence). Two cross-sectional surveys (1693 children) demonstrated that brushing less than once per day versus once or more per day may be associated with a decrease in the development of fluorosis in children (OR 0.62, 95% CI 0.53 to 0.74; low-certainty evidence). Comparison 3. Amount of fluoride toothpaste used for toothbrushing Two case-control studies (258 children) provided very uncertain evidence regarding the association between children using less than half a brush of toothpaste, versus half or more of the brush, and the development of fluorosis (OR 0.77, 95% CI 0.41 to 1.46; very low-certainty evidence). The evidence from cross-sectional surveys was also very uncertain (OR 0.92, 95% CI 0.66 to 1.28; 3 studies, 2037 children; very low-certainty evidence). Comparison 4. Fluoride concentration in toothpaste There was evidence from two RCTs (1968 children) that lower fluoride concentration in the toothpaste used by children under six years of age likely reduces the risk of developing fluorosis: 550 parts per million (ppm) fluoride versus 1000 ppm (RR 0.75, 95% CI 0.57 to 0.99; moderate-certainty evidence); 440 ppm fluoride versus 1450 ppm (RR 0.72, 95% CI 0.58 to 0.89; moderate-certainty evidence). The age at which the toothbrushing commenced was 24 months and 12 months, respectively. Two case-control studies (258 children) provided very uncertain evidence regarding the association between fluoride concentrations under 1000 ppm, versus concentrations of 1000 ppm or above, and the development of fluorosis (OR 0.89, 95% CI 0.52 to 1.52; very low-certainty evidence). Comparison 5. Age at which topical fluoride varnish was applied There was evidence from one RCT (123 children) that there may be little to no difference between a fluoride varnish application before four years, versus no application, and the development of fluorosis (RR 0.77, 95% CI 0.45 to 1.31; low-certainty evidence). There was low-certainty evidence from two cross-sectional surveys (982 children) that the application of topical fluoride varnish before four years of age may be associated with the development of fluorosis in children (OR 2.18, 95% CI 1.46 to 3.25). AUTHORS' CONCLUSIONS Most evidence identified mild fluorosis as a potential adverse outcome of using topical fluoride at an early age. There is low- to very low-certainty and inconclusive evidence on the risk of having fluorosis in permanent teeth for: when a child starts receiving topical fluoride varnish application; toothbrushing with fluoride toothpaste; the amount of toothpaste used by the child; and the frequency of toothbrushing. Moderate-certainty evidence from RCTs showed that children who brushed with 1000 ppm or more fluoride toothpaste from one to two years of age until five to six years of age probably had an increased chance of developing dental fluorosis in permanent teeth. It is unethical to propose new RCTs to assess the development of dental fluorosis. However, future RCTs focusing on dental caries prevention could record children's exposure to topical fluoride sources in early life and evaluate the dental fluorosis in their permanent teeth as a long-term outcome. In the absence of these studies and methods, further research in this area will come from observational studies. Attention needs to be given to the choice of study design, bearing in mind that prospective controlled studies will be less susceptible to bias than retrospective and uncontrolled studies.
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Affiliation(s)
- May Chun Mei Wong
- Applied Oral Sciences and Community Dental Care, Faculty of Dentistry, The University of Hong Kong, Hong Kong SAR, China
| | - Rui Zhang
- Applied Oral Sciences and Community Dental Care, Faculty of Dentistry, The University of Hong Kong, Hong Kong SAR, China
| | - Bella Weijia Luo
- Restorative Dental Sciences, Faculty of Dentistry, The University of Hong Kong, Hong Kong SAR, China
| | - Anne-Marie Glenny
- Division of Dentistry, School of Medical Sciences, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester, UK
| | - Helen V Worthington
- Cochrane Oral Health, Division of Dentistry, School of Medical Sciences, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester, UK
| | - Edward Chin Man Lo
- Applied Oral Sciences and Community Dental Care, Faculty of Dentistry, The University of Hong Kong, Hong Kong SAR, China
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India Aldana S, Colicino E, Cantoral Preciado A, Tolentino M, Baccarelli AA, Wright RO, Téllez Rojo MM, Valvi D. Longitudinal associations between early-life fluoride exposures and cardiometabolic outcomes in school-aged children. ENVIRONMENT INTERNATIONAL 2024; 183:108375. [PMID: 38128386 PMCID: PMC10842303 DOI: 10.1016/j.envint.2023.108375] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/12/2023] [Revised: 11/06/2023] [Accepted: 12/06/2023] [Indexed: 12/23/2023]
Abstract
BACKGROUND/AIM Fluoride is a natural mineral present in food, water, and dental products, constituting ubiquitous long-term exposure in early childhood and across the lifespan. Experimental evidence shows fluoride-induced lipid disturbances with potential implications for cardiometabolic health. However, epidemiological studies are scarce. For the first time, we evaluated associations between repeated fluoride measures and cardiometabolic outcomes in children. METHODS We studied ∼ 500 Mexican children from the Programming Research in Obesity, Growth, Environment and Social Stressors (PROGRESS) cohort with measurements on urinary fluoride at age 4, and dietary fluoride at ages 4, 6, and 8 years approximately. We used covariate-adjusted linear mixed-effects and linear regression models to assess fluoride associations with multiple cardiometabolic outcomes (ages 4-8): lipids (total cholesterol, HDL, LDL, and triglycerides), glucose, HbA1c, adipokines (leptin and adiponectin), body fat, and age- and sex-specific z-scores of body mass index (zBMI), waist circumference, and blood pressure. RESULTS Dietary fluoride intake at age 4 was associated with annual increases in triglycerides [β per-fluoride-doubling = 2.02 (95 % CI: 0.37, 3.69)], cholesterol [β = 1.46 (95 % CI: 0.52, 2.39)], HDL [β = 0.39 (95 % CI: 0.02, 0.76)], LDL [β = 0.87 (95 % CI: 0.02, 1.71)], and HbA1c [β = 0.76 (95 % CI: 0.28, 1.24)], and decreased leptin [β = -3.58 (95 % CI: -6.34, -0.75)] between the ages 4 and 8. In cross-sectional analyses at age 8, higher tertiles of fluoride exposure were associated with increases in zBMI, triglycerides, glucose, and leptin (p-tertile trend < 0.05). Stronger associations were observed in boys at year 8 and in girls prior to year 8 (p-sex interaction < 0.05). Fewer but consistent associations were observed for urinary fluoride at age 4, indicating increased annual changes in HDL and HbA1c with higher fluoride levels. CONCLUSION Dietary fluoride exposures in early- and mid-childhood were associated with adverse cardiometabolic outcomes in school-aged children. Further research is needed to elucidate whether these associations persist at later ages.
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Affiliation(s)
- Sandra India Aldana
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
| | - Elena Colicino
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | | | - Maricruz Tolentino
- Department of Nutrition, National Institute of Perinatology, Mexico City, Mexico
| | - Andrea A Baccarelli
- Departments of Environmental Health Sciences and Epidemiology, Columbia University Mailman School of Public Health, New York, NY, USA
| | - Robert O Wright
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Martha María Téllez Rojo
- Center for Nutrition and Health Research, National Institute of Public Health, Cuernavaca, Morelos, Mexico
| | - Damaskini Valvi
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, NY, USA
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Mankar N, Kumbhare S, Nikhade P, Mahapatra J, Agrawal P. Role of Fluoride in Dentistry: A Narrative Review. Cureus 2023; 15:e50884. [PMID: 38249196 PMCID: PMC10799546 DOI: 10.7759/cureus.50884] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2023] [Accepted: 12/19/2023] [Indexed: 01/23/2024] Open
Abstract
Fluoride has performed a central role in the growth over the last fifty years. This report examines the present state of knowledge about fluoride's involvement in preventing dental caries. In recent years, our knowledge of the development of dental caries and the manner of operation of fluoride has been shifted. Dental caries is a constant procedure for enamel demineralization and remineralization, and fluoride plays an important part in this action by acting at the plaque-enamel contact. Fluoride's major method of action is now recognized as posteruptive. Fluoride's post-eruptive activity has led to the development of novel fluoride delivery systems. The importance of various fluoride delivery techniques on a population and societal level is discussed, along with suggestions.
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Affiliation(s)
- Nikhil Mankar
- Conservative Dentistry and Endodontics, Sharad Pawar Dental College and Hospital, Datta Meghe Institute of Higher Education and Research, Wardha, IND
| | - Saloni Kumbhare
- Conservative Dentistry and Endodontics, Sharad Pawar Dental College and Hospital, Datta Meghe Institute of Higher Education and Research, Wardha, IND
| | - Pradnya Nikhade
- Conservative Dentistry and Endodontics, Sharad Pawar Dental College and Hospital, Datta Meghe Institute of Higher Education and Research, Wardha, IND
| | - Joyeeta Mahapatra
- Conservative Dentistry and Endodontics, Sharad Pawar Dental College and Hospital, Datta Meghe Institute of Higher Education and Research, Wardha, IND
| | - Paridhi Agrawal
- Conservative Dentistry and Endodontics, Sharad Pawar Dental College and Hospital, Datta Meghe Institute of Higher Education and Research, Wardha, IND
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Puty B, Bittencourt LO, Lima LAO, Plaça JR, Dionizio A, Buzalaf MAR, Gomes BD, de Oliveira EHC, Lima RR. Unraveling molecular characteristic of fluoride neurotoxicity on U87 glial-like cells: insights from transcriptomic and proteomic approach. Front Cell Neurosci 2023; 17:1153198. [PMID: 37362003 PMCID: PMC10289037 DOI: 10.3389/fncel.2023.1153198] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2023] [Accepted: 05/19/2023] [Indexed: 06/28/2023] Open
Abstract
The potential of fluoride (F) as a neurotoxicant in humans is still controversial in the literature. However, recent studies have raised the debate by showing different mechanism of F-induced neurotoxicity, as oxidative stress, energy metabolism and inflammation in the central nervous system (CNS). In the present study, we investigated the mechanistic action of two F concentration (0.095 and 0.22 μg/ml) on gene and protein profile network using a human glial cell in vitro model over 10 days of exposure. A total of 823 genes and 2,084 genes were modulated after exposure to 0.095 and 0.22 μg/ml F, respectively. Among them, 168 were found to be modulated by both concentrations. The number of changes in protein expression induced by F were 20 and 10, respectively. Gene ontology annotations showed that the main terms were related to cellular metabolism, protein modification and cell death regulation pathways, such as the MAP kinase (MAPK) cascade, in a concentration independent manner. Proteomics confirmed the changes in energy metabolism and also provided evidence of F-induced changes in cytoskeleton components of glial cells. Our results not only reveal that F has the potential to modulate gene and protein profiles in human U87 glial-like cells overexposed to F, but also identify a possible role of this ion in cytoskeleton disorganization.
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Affiliation(s)
- Bruna Puty
- Laboratory of Functional and Structural Biology, Institute of Biological Sciences, Federal University of Pará, Belém, Brazil
- Laboratory of Cell Culture and Cytogenetics, Environmental Section, Evandro Chagas Institute, Ananindeua, Brazil
| | - Leonardo Oliveira Bittencourt
- Laboratory of Functional and Structural Biology, Institute of Biological Sciences, Federal University of Pará, Belém, Brazil
| | - Leidiane Alencar Oliveira Lima
- Laboratory of Functional and Structural Biology, Institute of Biological Sciences, Federal University of Pará, Belém, Brazil
| | - Jéssica Rodrigues Plaça
- National Institute of Science and Technology in Stem Cell and Cell Therapy (INCT/CNPq) and Center for Cell-Based Therapy, Centro de Pesquisa, Inovacão e Desenvolvimento/Fundacão de Amparo á Pesuisa do Estado de São Paulo (CEPID/FAPESP), Ribeirão Preto, Brazil
| | - Aline Dionizio
- Department of Biological Sciences, Bauru School of Dentistry, University of São Paulo, Bauru, Brazil
| | | | - Bruno Duarte Gomes
- Laboratory of Neurophysiology Eduardo Oswaldo Cruz, Institute of Biological Sciences, Federal University of Pará, Belém, Brazil
| | | | - Rafael Rodrigues Lima
- Laboratory of Functional and Structural Biology, Institute of Biological Sciences, Federal University of Pará, Belém, Brazil
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Thabrez M, Parimalarenganayaki S, Brindha K, Elango L. Fuzzy logic-based health risk assessment of fluoride in groundwater used as drinking source in Sira region, Tumkur, India. ENVIRONMENTAL GEOCHEMISTRY AND HEALTH 2023; 45:3947-3969. [PMID: 36626074 DOI: 10.1007/s10653-022-01474-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/19/2022] [Accepted: 12/29/2022] [Indexed: 06/01/2023]
Abstract
Fluoride contamination in drinking water is a serious public health concern across the world, and more than 90 million people in India are affected by health risks associated with fluoride. Though the fatality due to fluoride chronic toxicity is uncommon, the exposure to fluoride at different concentration levels shows various adverse health effects such as dental and skeletal fluorosis, multiorgan failure, cognitive and behavioural effects. Hence, the objectives of the present study are to understand the hydrogeochemistry and drinking water suitability of groundwater of the Sira region, Karnataka, India, and to understand the occurrence of fluoride and its health risks using the United State Environmental Protection Agency (US EPA) method and fuzzy logic concepts. Forty-six samples were collected from each pre and post-monsoon season. The hydrogeochemistry studied through Chadha's diagram and Gibb's diagram indicated that the groundwater in this region is of Na-Cl type and the hydrogeochemistry is majorly controlled by rock-water interaction and followed by evaporative dominance. Water quality parameters were compared with drinking water standards guidelines, and the results showed that around 50% of the samples were contaminated with fluoride. The occurrence of high levels of fluoride in the study region is associated to the presence of granitic rocks and it is influenced by high pH and low calcium dissolution in the groundwater. Based on US EPA method, the order of population group under the risk of dental and skeletal fluorosis, is children > adolescents > adults. A fuzzy inference system model is developed to assess the health risk due to fluoride and its output gives severity levels of each type of health risk, i.e. dental caries, dental fluorosis and skeletal fluorosis. The results of the application of the fuzzy inference system model in the Sira region showed that the children (< 8 Yr.) are more susceptible to the moderate risk of dental caries, dental fluorosis and skeletal fluorosis. Whereas adolescents (8-18 Yr.) and adults (> 18 Yr.) are less susceptible to low-very low risk. Hence, health risks associated with fluoride can be better addressed with the help of a fuzzy inference system model which can be used for more reliable and grounded results to improve the quality of decision-making.
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Affiliation(s)
- M Thabrez
- School of Civil Engineering, Vellore Institute of Technology, Vellore, Tamilnadu, India
| | - S Parimalarenganayaki
- School of Civil Engineering, Vellore Institute of Technology, Vellore, Tamilnadu, India.
| | - K Brindha
- Institute of Geological Sciences, Freie Universität, Berlin, Germany
| | - L Elango
- Department of Geology, Anna University, Chennai, Tamilnadu, India
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Al-Zain AO, Fakhry LM, Tallab RA, Natto ZS. Attitude, Practice, and Knowledge Regarding Fluoridated Toothpaste, Brushing, and Rinse Usage Among Residents of Jeddah City in Saudi Arabia. Patient Prefer Adherence 2023; 17:23-39. [PMID: 36636286 PMCID: PMC9830058 DOI: 10.2147/ppa.s389413] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/10/2022] [Accepted: 12/15/2022] [Indexed: 01/06/2023] Open
Abstract
PURPOSE To evaluate and compare the attitude, practice, and knowledge of individuals who use fluoridated and non-fluoridated toothpaste in Jeddah city, Saudi Arabia. METHODS A digital questionnaire composed of 43 questions were formulated. The questionnaire was divided into five sections: eligibility questions, demographic data, attitude, practice, and knowledge. Content and face validation were done, and convenience sampling was used. The inclusion criteria were any citizen and resident who lives in Jeddah city, Saudi Arabia. Descriptive statistics, Chi-square, and Fischer's tests were conducted to compare fluoridated and non-fluoridated toothpaste users (α=0.05). RESULTS A total of 473 completed participants' responses were collected. Attitude: 41.8% of fluoridated toothpaste users reported that it was "very important" to rinse to remove the toothpaste compared to non-fluoridated toothpaste users (58.3%) (P-value<0.001). Healthy teeth were the most important to fluoridated toothpaste users (69.1%) (P <0.001). Practice: 28.6% of non-fluoridated toothpaste users have been using non-fluoridated toothpaste for >1 year, and 35.7% of them <2 years. 73.8% of fluoridated toothpaste users used whitening toothpaste. Significantly higher non-fluoridated toothpaste users (29%) used organic toothpaste (P<0.001). KNOWLEDGE 57% of fluoridated toothpaste users believed that a good diet, tooth brushing, and fluoridated toothpaste are important to prevent caries, and the fluoride would strengthen the teeth (P<0.001). Approximately 60% of non-fluoridated toothpaste users did not know the proper age to start using fluoridated toothpaste (P<0.001). Also, 47.6% of non-fluoridated toothpaste users avoid using fluoride because it is toxic. CONCLUSION Significantly higher number of Jeddah residents that used fluoridated toothpaste had a better attitude and knowledge than non-fluoridated toothpaste users. Nonetheless, most residents had similar oral hygiene practices. It is suggested to execute educational campaigns to explain the importance of fluoridated toothpaste to the population. Also, individuals should take caution from the source of obtaining their dental information and consult their dentist.
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Affiliation(s)
- Afnan O Al-Zain
- Restorative Dentistry Department, King Abdulaziz University Faculty of Dentistry, Jeddah, Saudi Arabia
| | - Layan M Fakhry
- King Abdulaziz University Faculty of Dentistry, Jeddah, Saudi Arabia
| | - Renad A Tallab
- King Abdulaziz University Faculty of Dentistry, Jeddah, Saudi Arabia
| | - Zuhair S Natto
- Department of Public Health, King Abdulaziz University Faculty of Dentistry, Jeddah, Saudi Arabia
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Chan AKY, Tamrakar M, Jiang CM, Tsang YC, Leung KCM, Chu CH. Clinical evidence for professionally applied fluoride therapy to prevent and arrest dental caries in older adults: A systematic review. J Dent 2022; 125:104273. [PMID: 36058347 DOI: 10.1016/j.jdent.2022.104273] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2022] [Revised: 07/06/2022] [Accepted: 08/25/2022] [Indexed: 01/13/2023] Open
Abstract
OBJECTIVE To assess the clinical evidence for professionally applied fluoride therapy to prevent and arrest caries in older adults. DATA/SOURCES Two independent researchers searched the English literature published up to 31st Dec 2021 in five databases (PubMed, Scopus, the Cochrane Library, EMBASE, and Web of Science) for clinical trials with a comparison group on professionally applied fluoride therapy for caries prevention or arrest at older adults aged ≥60 years with any follow-up period. The outcomes were the mean difference in the number of new caries/caries-prevented fraction and caries arrest rate. The Cochrane guidelines were used for the risk of bias assessment. STUDY SELECTION/RESULTS Five hundred and twenty-seven studies were identified, and seven studies were finally included. Five studies were rated as having 'low risk'. The root caries-prevented fraction of 38% silver diamine fluoride (SDF) solution, 5% sodium fluoride (NaF) varnish, and 1.23% acidulated phosphate fluoride (APF) gel were 25-71%, 64%, and 32%, respectively. Meta-analysis indicated a decrease in the number of new root caries by 0.55 (95% CI: 0.32-0.78; p < 0.001) and an overall proportion of arrested root caries of 42% (95% CI: 33% to 49%; p < 0.001) after receiving 38% SDF application at the 24-month follow-up. CONCLUSIONS According to the findings, 5% NaF varnish and 1.23% APF gel prevented root caries, whereas 38% SDF solution prevented and arrested root caries in older adults. More well-designed clinical trials should be conducted to investigate various methods in caries prevention and arrest in older adults. CLINICAL SIGNIFICANCE Preventive measures effective in other age groups may not suit older adults, as caries type and associated risk factors vary. To date, no systematic review has evaluated professionally applied fluoride therapy in older adults. Evidence from clinical trials in older adults could aid clinical practice and public health measures. The International Prospective Register of Systematic Reviews (PROSPERO) registration number: CRD42022307025.
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Affiliation(s)
- Alice Kit Ying Chan
- Faculty of Dentistry, The University of Hong Kong, 3/F, The Prince Philip Dental Hospital, 34, Hospital Road, Sai Ying Pun, Hong Kong, China
| | - Manisha Tamrakar
- Faculty of Dentistry, The University of Hong Kong, 3/F, The Prince Philip Dental Hospital, 34, Hospital Road, Sai Ying Pun, Hong Kong, China
| | - Chloe Meng Jiang
- Faculty of Dentistry, The University of Hong Kong, 3/F, The Prince Philip Dental Hospital, 34, Hospital Road, Sai Ying Pun, Hong Kong, China
| | - Yiu Cheung Tsang
- Faculty of Dentistry, The University of Hong Kong, 3/F, The Prince Philip Dental Hospital, 34, Hospital Road, Sai Ying Pun, Hong Kong, China
| | - Katherine Chiu Man Leung
- Faculty of Dentistry, The University of Hong Kong, 3/F, The Prince Philip Dental Hospital, 34, Hospital Road, Sai Ying Pun, Hong Kong, China
| | - Chun Hung Chu
- Faculty of Dentistry, The University of Hong Kong, 3/F, The Prince Philip Dental Hospital, 34, Hospital Road, Sai Ying Pun, Hong Kong, China.
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Ba Y, Yang S, Yu S, Hou X, Du Y, Gao M, Zuo J, Sun L, Fu X, Li Z, Huang H, Zhou G, Yu F. Role of Glycolysis/Gluconeogenesis and HIF-1 Signaling Pathways in Rats with Dental Fluorosis Integrated Proteomics and Metabolomics Analysis. Int J Mol Sci 2022; 23:ijms23158266. [PMID: 35897842 PMCID: PMC9332816 DOI: 10.3390/ijms23158266] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2022] [Revised: 07/23/2022] [Accepted: 07/25/2022] [Indexed: 02/07/2023] Open
Abstract
Fluoride is widely distributed, and excessive intake will lead to dental fluorosis. In this study, six offspring rats administrated 100 mg/L sodium fluoride were defined as the dental fluorosis group, and eight offspring rats who received pure water were defined as the control group. Differentially expressed proteins and metabolites extracted from peripheral blood were identified using the liquid chromatography tandem mass spectrometry and gas chromatography mass spectrometry, with the judgment criteria of fold change >1.2 or <0.83 and p < 0.05. A coexpression enrichment analysis using OmicsBean was conducted on the identified proteins and metabolites, and a false discovery rate (FDR) < 0.05 was considered significant. Human Protein Atlas was used to determine the subcellular distribution of hub proteins. The Gene Cards was used to verify results. A total of 123 up-regulated and 46 down-regulated proteins, and 12 up-regulated and 2 down-regulated metabolites were identified. The significant coexpression pathways were the HIF-1 (FDR = 1.86 × 10−3) and glycolysis/gluconeogenesis (FDR = 1.14 × 10−10). The results of validation analysis showed the proteins related to fluorine were mainly enriched in the cytoplasm and extrinsic component of the cytoplasmic side of the plasma membrane. The HIF-1 pathway (FDR = 1.01 × 10−7) was also identified. Therefore, the HIF-1 and glycolysis/gluconeogenesis pathways were significantly correlated with dental fluorosis.
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Ozcan S, Yikici C. Remineralization activities of toothpastes with and without aloe vera with different ratios of fluoride on demineralized enamel: An In-vitro study. Niger J Clin Pract 2022; 25:1563-1570. [DOI: 10.4103/njcp.njcp_132_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Liu Y, Huang Y, Fan C, Chi Z, Bai M, Sun L, Yang L, Yu C, Song Z, Yang X, Yi J, Wang S, Liu L, Wang G, Zheng L. Ursolic Acid Targets Glucosyltransferase and Inhibits Its Activity to Prevent Streptococcus mutans Biofilm Formation. Front Microbiol 2021; 12:743305. [PMID: 34646258 PMCID: PMC8503646 DOI: 10.3389/fmicb.2021.743305] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2021] [Accepted: 08/24/2021] [Indexed: 11/13/2022] Open
Abstract
Streptococcus mutans (S. mutans), the prime pathogen of dental caries, can secrete glucosyltransferases (GTFs) to synthesize extracellular polysaccharides (EPSs), which are the virulence determinants of cariogenic biofilms. Ursolic acid, a type of pentacyclic triterpene natural compound, has shown potential antibiofilm effects on S. mutans. To investigate the mechanisms of ursolic acid-mediated inhibition of S. mutans biofilm formation, we first demonstrated that ursolic acid could decrease the viability and structural integrity of biofilms, as evidenced by XTT, crystal violet, and live/dead staining assays. Then, we further revealed that ursolic acid could compete with the inherent substrate to occupy the catalytic center of GTFs to inhibit EPS formation, and this was confirmed by GTF activity assays, computer simulations, site-directed mutagenesis, and capillary electrophoresis (CE). In conclusion, ursolic acid can decrease bacterial viability and prevent S. mutans biofilm formation by binding and inhibiting the activity of GTFs.
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Affiliation(s)
- Yucui Liu
- National Engineering Laboratory for Druggable Gene and Protein Screening, Northeast Normal University, Changchun, China.,State Key Laboratory of Microbial Technology, Shandong University, Qingdao, China
| | - Yanxin Huang
- NMPA Key Laboratory for Quality Control of Cell and Gene Therapy Medicine Products, Northeast Normal University, Changchun, China
| | - Cong Fan
- National Engineering Laboratory for Druggable Gene and Protein Screening, Northeast Normal University, Changchun, China.,Guangdong Provincial Key Laboratory of Malignant Tumor Epigenetics and Gene Regulation, Department of Medical Research Center, Sun Yat-Sen Memorial Hospital, Guangzhou, China
| | - Zhongmei Chi
- Faculty of Chemistry, Northeast Normal University, Changchun, China
| | - Miao Bai
- National Engineering Laboratory for Druggable Gene and Protein Screening, Northeast Normal University, Changchun, China
| | - Luguo Sun
- NMPA Key Laboratory for Quality Control of Cell and Gene Therapy Medicine Products, Northeast Normal University, Changchun, China
| | - Li Yang
- Faculty of Chemistry, Northeast Normal University, Changchun, China
| | - Chunlei Yu
- National Engineering Laboratory for Druggable Gene and Protein Screening, Northeast Normal University, Changchun, China
| | - Zhenbo Song
- National Engineering Laboratory for Druggable Gene and Protein Screening, Northeast Normal University, Changchun, China
| | - Xiaoguang Yang
- National Engineering Laboratory for Druggable Gene and Protein Screening, Northeast Normal University, Changchun, China.,NMPA Key Laboratory for Quality Control of Cell and Gene Therapy Medicine Products, Northeast Normal University, Changchun, China
| | - Jingwen Yi
- National Engineering Laboratory for Druggable Gene and Protein Screening, Northeast Normal University, Changchun, China.,NMPA Key Laboratory for Quality Control of Cell and Gene Therapy Medicine Products, Northeast Normal University, Changchun, China
| | - Shuyue Wang
- National Engineering Laboratory for Druggable Gene and Protein Screening, Northeast Normal University, Changchun, China
| | - Lei Liu
- National Engineering Laboratory for Druggable Gene and Protein Screening, Northeast Normal University, Changchun, China
| | - Guannan Wang
- National Engineering Laboratory for Druggable Gene and Protein Screening, Northeast Normal University, Changchun, China
| | - Lihua Zheng
- National Engineering Laboratory for Druggable Gene and Protein Screening, Northeast Normal University, Changchun, China
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11
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Coclete GEG, Delbem ACB, Sampaio C, Danelon M, Monteiro DR, Pessan JP. Use of fluoridated dentifrices by children in Araçatuba, Brazil: factors affecting brushing habits and amount applied on the brush. Eur Arch Paediatr Dent 2021; 22:979-984. [PMID: 34536205 DOI: 10.1007/s40368-021-00663-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2021] [Accepted: 08/24/2021] [Indexed: 11/30/2022]
Abstract
PURPOSE To evaluate the type and the amount of fluoridated dentifrice applied on children's toothbrushes by parents/guardians according to descriptions typically recommended by scientific societies, as well as to assess the influence of demographic and socioeconomic variables on dentifrice use. METHODS Parents/guardians of children (0-7 years old; n = 306; convenience sample) attending vaccination centres from Araçatuba (Brazil), answered to a structured questionnaire comprising items related to interviewees' education, child's age, gender, brushing habits and use of fluoridated dentifrice. The amount of toothpaste used by children during toothbrushing was estimated using a portable scale. Similarly, the interviewees were requested to apply dentifrices on toothbrushes according to eight descriptions, ranging from "smear" to "all bristles", following a random sequence. Data were submitted to Mann-Whitney's, Kruskal-Wallis' and Friedman's tests, and Spearman's correlation coefficient (p < 0.05). RESULTS The type of toothpaste and the amount of product used at home were not affected by the respondents' educational level or family income. However, child's age was significantly correlated with the amount of toothpaste placed on the toothbrush (r = 0.324, p < 0.001). Also, the amount of toothpaste placed on the toothbrush increased according to what would be expected from the descriptions, although wide variations were observed within each description, with large interquartile and overall ranges. CONCLUSION The amount and the type of dentifrice used by children were influenced by their age, while parents/caregivers' interpretation on verbal instructions regarding appropriate dentifrice quantities varied widely. This reinforces the need for educative measures on the appropriate use by dentifrices by children.
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Affiliation(s)
- G E G Coclete
- Department of Preventive and Restorative Dentistry, School of Dentistry, Araçatuba, São Paulo State University (UNESP), Rua José Bonifácio 1193, Araçatuba, SP, 16015-050, Brazil
| | - A C B Delbem
- Department of Preventive and Restorative Dentistry, School of Dentistry, Araçatuba, São Paulo State University (UNESP), Rua José Bonifácio 1193, Araçatuba, SP, 16015-050, Brazil
| | - C Sampaio
- Department of Preventive and Restorative Dentistry, School of Dentistry, Araçatuba, São Paulo State University (UNESP), Rua José Bonifácio 1193, Araçatuba, SP, 16015-050, Brazil
| | - M Danelon
- Department of Preventive and Restorative Dentistry, School of Dentistry, Araçatuba, São Paulo State University (UNESP), Rua José Bonifácio 1193, Araçatuba, SP, 16015-050, Brazil
| | - D R Monteiro
- Department of Preventive and Restorative Dentistry, School of Dentistry, Araçatuba, São Paulo State University (UNESP), Rua José Bonifácio 1193, Araçatuba, SP, 16015-050, Brazil.,Graduate Program in Dentistry (GPD, Master's Degree), University of Western São Paulo (UNOESTE), Presidente Prudente, SP, Brazil
| | - J P Pessan
- Department of Preventive and Restorative Dentistry, School of Dentistry, Araçatuba, São Paulo State University (UNESP), Rua José Bonifácio 1193, Araçatuba, SP, 16015-050, Brazil.
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12
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Jullien S. Prophylaxis of caries with fluoride for children under five years. BMC Pediatr 2021; 21:351. [PMID: 34496756 PMCID: PMC8424787 DOI: 10.1186/s12887-021-02702-3] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/26/2021] [Accepted: 05/05/2021] [Indexed: 12/02/2022] Open
Abstract
We looked at existing recommendations and supporting evidence on the effectiveness and potential harms of the different fluoride interventions in preventing dental caries in children under 5 years of age. We conducted a literature search up to the 12th of September 2019 by using key terms and manual search in selected sources. We summarized the recommendations and the strength of the recommendation when and as reported by the authors. We summarized the main findings of systematic reviews with the certainty of the evidence as reported. Water fluoridation has been widely implemented worldwide for several decades and evidence shows it reduces the prevalence of dental caries. Salt or milk fluoridation are other collective fluoride interventions that are also effective to prevent dental caries in children. The evidence of effects of oral fluoride supplements for caries prevention is limited and inconsistent. The use of fluoride toothpastes has consistently been proven to be effective in the prevention of dental caries. The evidence for the effects of the different levels of fluoride concentration in toothpastes is more limited. Topical fluorides (gels and varnishes) are effective in preventing dental caries and are mainly recommended to children with high risk of dental caries. Early childhood intake of fluoride supplements and fluoride level of 0.7 ppm (ppm) in drinking water are associated with the risk of dental fluorosis, ranging from minor forms to severe forms that are of aesthetic concerns.
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Affiliation(s)
- Sophie Jullien
- Barcelona Institute for Global Health, University of Barcelona, Barcelona, Spain.
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13
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Skinner J, Dimitropoulos Y, Sohn W, Holden A, Rambaldini B, Spallek H, Ummer-Christian R, Marshall S, Raymond K, AO TC, Gwynne K. Child Fluoride Varnish Programs Implementation: A Consensus Workshop and Actions to Increase Scale-Up in Australia. Healthcare (Basel) 2021; 9:healthcare9081029. [PMID: 34442166 PMCID: PMC8392282 DOI: 10.3390/healthcare9081029] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2021] [Revised: 07/20/2021] [Accepted: 07/22/2021] [Indexed: 11/16/2022] Open
Abstract
This paper presents the findings of the National Fluoride Varnish Workshop in 2018 along with subsequent actions to scale-up the use of fluoride varnish nationally in Australia. The use of fluoride varnish programs to prevent dental caries in high-risk child populations is an evidence-based population health approach used internationally. Such programs have not been implemented at scale nationally in Australia. A National Fluoride Varnish Consensus Workshop was held in Sydney in November 2018 with an aim of sharing the current work in this area being undertaken by various Australian jurisdictions and seeking consensus on key actions to improve the scale-up nationally. Forty-four people attended the Workshop with oral health representatives from all Australian state and territory health departments, as well as the Australian Dental Association (ADA) at both NSW branch and Federal levels. There was strong support for further scale-up of fluoride varnish programs nationally and to see the wider use of having non-dental professionals apply the varnish. This case study identifies key actions required to ensure scale-up of systematic fluoride varnish programs as part of a strategic population oral health approach to preventing dental caries among high-risk children who may not routinely access dental care.
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Affiliation(s)
- John Skinner
- Poche Centre for Indigenous Health, The University of Sydney, Room 224 Edward Ford Building, Sydney 2006, Australia; (Y.D.); (B.R.); (T.C.A.); (K.G.)
- Correspondence: ; Tel.: +61-4889-27557
| | - Yvonne Dimitropoulos
- Poche Centre for Indigenous Health, The University of Sydney, Room 224 Edward Ford Building, Sydney 2006, Australia; (Y.D.); (B.R.); (T.C.A.); (K.G.)
| | - Woosung Sohn
- The University of Sydney School of Dentistry, 2 Chalmers St, Surry Hills 2010, Australia; (W.S.); (A.H.); (H.S.)
| | - Alexander Holden
- The University of Sydney School of Dentistry, 2 Chalmers St, Surry Hills 2010, Australia; (W.S.); (A.H.); (H.S.)
| | - Boe Rambaldini
- Poche Centre for Indigenous Health, The University of Sydney, Room 224 Edward Ford Building, Sydney 2006, Australia; (Y.D.); (B.R.); (T.C.A.); (K.G.)
| | - Heiko Spallek
- The University of Sydney School of Dentistry, 2 Chalmers St, Surry Hills 2010, Australia; (W.S.); (A.H.); (H.S.)
| | - Rahila Ummer-Christian
- Fluoride Varnish Initiative, Loddon Mallee Aboriginal Reference Group, Bendigo 3550, Australia;
| | - Stuart Marshall
- Statewide Dental Services, SA Dental, Level 5 Roma Mitchell House, 136 North Tce, Adelaide 5000, Australia;
| | - Kate Raymond
- Department of Health, Northern Territory Government, Level 7 Manunda Place, 38 Cavenagh Street, Darwin 0800, Australia;
| | - Tom Calma AO
- Poche Centre for Indigenous Health, The University of Sydney, Room 224 Edward Ford Building, Sydney 2006, Australia; (Y.D.); (B.R.); (T.C.A.); (K.G.)
| | - Kylie Gwynne
- Poche Centre for Indigenous Health, The University of Sydney, Room 224 Edward Ford Building, Sydney 2006, Australia; (Y.D.); (B.R.); (T.C.A.); (K.G.)
- Faculty of Medicine, Health and Human Sciences, Macquarie University, Sydney 2113, Australia
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14
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Jandu J, Dzyuba N, Barry S. White enamel lesions in children: considering caries, chronological and congenital causes and their consequent care. Br Dent J 2021; 230:523-527. [PMID: 33893425 DOI: 10.1038/s41415-021-2838-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2020] [Accepted: 08/31/2020] [Indexed: 11/09/2022]
Abstract
White enamel lesions are a common presentation to the general dentist and aesthetic concerns are the most frequent presenting problem. Aetiology may be multifactorial and management of such lesions is heavily dependent on the cause. In the paediatric patient, differentiating white lesions caused by caries, fluorosis and genetic and developmental disorders is key to offering optimal long-term treatment outcomes. Early intervention allows for carefully planned management of less common disorders. Many of these disorders exist along a spectrum, and white lesions offer a useful clue to prompt intervention and referral to the relevant specialists. This article overviews common white lesions of the teeth and outlines the hierarchy of management options available.
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Affiliation(s)
- Jai Jandu
- Division of Dentistry, University of Manchester, UK
| | | | - Siobhan Barry
- Division of Dentistry, University of Manchester, UK; University Dental Hospital Manchester, Manchester, UK.
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15
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Fan M, Yang J, Xu HHK, Weir MD, Tao S, Yu Z, Liu Y, Li M, Zhou X, Liang K, Li J. Remineralization effectiveness of adhesive containing amorphous calcium phosphate nanoparticles on artificial initial enamel caries in a biofilm-challenged environment. Clin Oral Investig 2021; 25:5375-5390. [PMID: 33891172 DOI: 10.1007/s00784-021-03846-3] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2020] [Accepted: 02/16/2021] [Indexed: 02/05/2023]
Abstract
OBJECTIVES Dental caries is closely associated with acid-producing bacteria, and Streptococcus mutans is one of the primary etiological agents. Bacterial accumulation and dental demineralization lead to destruction of bonding interface, thus limiting the longevity of composite. The present study investigated remineralization effectiveness of adhesive containing nanoparticles of amorphous calcium phosphate (NACP) in a stimulated oral biofilm environment. METHODS The enamel blocks were immersed in demineralization solution for 72 h to imitate artificial initial carious lesion and then subjected to a Streptococcus mutans biofilm for 24 h. All the samples then underwent 4-h demineralization in brain heart infusion broth with sucrose (BHIS) and 20-h remineralization in artificial saliva (AS) for 7 days. The daily pH of BHIS after 4-h incubation, lactic acid production, colony-forming unit (CFU) count, and content of calcium (Ca) and phosphate (P) in biofilm were evaluated. Meanwhile, the remineralization effectiveness of enamel was analyzed by X-ray diffraction (XRD), surface microhardness testing, transverse microradiography (TMR) and scanning electron microscopy (SEM). RESULTS The NACP adhesive released abundant Ca and P, achieved acid neutralization, reduced lactic acid production, and lowered CFU count (P < 0.05). Enamel treated with NACP adhesive demonstrated the best remineralization effectiveness with remineralization value of 52.29 ± 4.79% according to TMR. Better microhardness recovery of cross sections and ample mineral deposits were also observed in NACP group. CONCLUSIONS The NACP adhesive exhibited good performance in remineralizing initial enamel lesion with cariogenic biofilm. SIGNIFICANCE The NACP adhesive is promising to be applied for the protection of bonding interface, prevention of secondary caries, and longevity prolonging of the restoration.
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Affiliation(s)
- Menglin Fan
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, Department of Cariology and Endodontics, West China Hospital of Stomatology, Sichuan University, No. 14, 3rd section, Renmin Road South, Chengdu, 610041, Sichuan, China
| | - Jiaojiao Yang
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, Department of Cariology and Endodontics, West China Hospital of Stomatology, Sichuan University, No. 14, 3rd section, Renmin Road South, Chengdu, 610041, Sichuan, China
| | - Hockin H K Xu
- Department of Advanced Oral Sciences and Therapeutics, University of Maryland School of Dentistry, Baltimore, MD, 21201, USA.,Center for Stem Cell Biology & Regenerative Medicine, University of Maryland School of Medicine, Baltimore, MD, 21201, USA
| | - Michael D Weir
- Department of Advanced Oral Sciences and Therapeutics, University of Maryland School of Dentistry, Baltimore, MD, 21201, USA
| | - Siying Tao
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, Department of Cariology and Endodontics, West China Hospital of Stomatology, Sichuan University, No. 14, 3rd section, Renmin Road South, Chengdu, 610041, Sichuan, China
| | - Zhaohan Yu
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, Department of Cariology and Endodontics, West China Hospital of Stomatology, Sichuan University, No. 14, 3rd section, Renmin Road South, Chengdu, 610041, Sichuan, China
| | - Yifang Liu
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, Department of Cariology and Endodontics, West China Hospital of Stomatology, Sichuan University, No. 14, 3rd section, Renmin Road South, Chengdu, 610041, Sichuan, China
| | - Meng Li
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, Department of Cariology and Endodontics, West China Hospital of Stomatology, Sichuan University, No. 14, 3rd section, Renmin Road South, Chengdu, 610041, Sichuan, China
| | - Xuedong Zhou
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, Department of Cariology and Endodontics, West China Hospital of Stomatology, Sichuan University, No. 14, 3rd section, Renmin Road South, Chengdu, 610041, Sichuan, China
| | - Kunneng Liang
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, Department of Cariology and Endodontics, West China Hospital of Stomatology, Sichuan University, No. 14, 3rd section, Renmin Road South, Chengdu, 610041, Sichuan, China. .,Department of Advanced Oral Sciences and Therapeutics, University of Maryland School of Dentistry, Baltimore, MD, 21201, USA.
| | - Jiyao Li
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, Department of Cariology and Endodontics, West China Hospital of Stomatology, Sichuan University, No. 14, 3rd section, Renmin Road South, Chengdu, 610041, Sichuan, China.
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16
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Rajendiran M, Trivedi HM, Chen D, Gajendrareddy P, Chen L. Recent Development of Active Ingredients in Mouthwashes and Toothpastes for Periodontal Diseases. Molecules 2021; 26:molecules26072001. [PMID: 33916013 PMCID: PMC8037529 DOI: 10.3390/molecules26072001] [Citation(s) in RCA: 30] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2021] [Revised: 03/22/2021] [Accepted: 03/26/2021] [Indexed: 01/01/2023] Open
Abstract
Periodontal diseases like gingivitis and periodontitis are primarily caused by dental plaque. Several antiplaque and anti-microbial agents have been successfully incorporated into toothpastes and mouthwashes to control plaque biofilms and to prevent and treat gingivitis and periodontitis. The aim of this article was to review recent developments in the antiplaque, anti-gingivitis, and anti-periodontitis properties of some common compounds in toothpastes and mouthwashes by evaluating basic and clinical studies, especially the ones published in the past five years. The common active ingredients in toothpastes and mouthwashes included in this review are chlorhexidine, cetylpyridinium chloride, sodium fluoride, stannous fluoride, stannous chloride, zinc oxide, zinc chloride, and two herbs—licorice and curcumin. We believe this comprehensive review will provide useful up-to-date information for dental care professionals and the general public regarding the major oral care products on the market that are in daily use.
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Affiliation(s)
- Meenakshi Rajendiran
- The Center for Wound Healing and Tissue Regeneration, Department of Periodontics, College of Dentistry, University of Illinois at Chicago, Chicago, IL 60612, USA;
| | - Harsh M Trivedi
- Colgate-Palmolive Company, Piscataway, NJ 08854, USA; (H.M.T.); (D.C.)
| | - Dandan Chen
- Colgate-Palmolive Company, Piscataway, NJ 08854, USA; (H.M.T.); (D.C.)
| | - Praveen Gajendrareddy
- The Center for Wound Healing and Tissue Regeneration, Department of Periodontics, College of Dentistry, University of Illinois at Chicago, Chicago, IL 60612, USA;
- Correspondence: (P.G.); (L.C.); Tel.: +1-312-413-8405 (P.G.); +1-312-413-5387 (L.C.)
| | - Lin Chen
- The Center for Wound Healing and Tissue Regeneration, Department of Periodontics, College of Dentistry, University of Illinois at Chicago, Chicago, IL 60612, USA;
- Correspondence: (P.G.); (L.C.); Tel.: +1-312-413-8405 (P.G.); +1-312-413-5387 (L.C.)
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17
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Malysheva K, Kwaśniak K, Gnilitskyi I, Barylyak A, Zinchenko V, Fahmi A, Korchynskyi O, Bobitski Y. Functionalization of Polycaprolactone Electrospun Osteoplastic Scaffolds with Fluorapatite and Hydroxyapatite Nanoparticles: Biocompatibility Comparison of Human Versus Mouse Mesenchymal Stem Cells. MATERIALS (BASEL, SWITZERLAND) 2021; 14:1333. [PMID: 33802003 PMCID: PMC8001513 DOI: 10.3390/ma14061333] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/31/2021] [Revised: 03/02/2021] [Accepted: 03/04/2021] [Indexed: 12/11/2022]
Abstract
A capability for effective tissue reparation is a living requirement for all multicellular organisms. Bone exits as a precisely orchestrated balance of bioactivities of bone forming osteoblasts and bone resorbing osteoclasts. The main feature of osteoblasts is their capability to produce massive extracellular matrix enriched with calcium phosphate minerals. Hydroxyapatite and its composites represent the most common form of bone mineral providing mechanical strength and significant osteoinductive properties. Herein, hydroxyapatite and fluorapatite functionalized composite scaffolds based on electrospun polycaprolactone have been successfully fabricated. Physicochemical properties, biocompatibility and osteoinductivity of generated matrices have been validated. Both the hydroxyapatite and fluorapatite containing polycaprolactone composite scaffolds demonstrated good biocompatibility towards mesenchymal stem cells. Moreover, the presence of both hydroxyapatite and fluorapatite nanoparticles increased scaffolds' wettability. Furthermore, incorporation of fluorapatite nanoparticles enhanced the ability of the composite scaffolds to interact and support the mesenchymal stem cells attachment to their surfaces as compared to hydroxyapatite enriched composite scaffolds. The study of osteoinductive properties showed the capacity of fluorapatite and hydroxyapatite containing composite scaffolds to potentiate the stimulation of early stages of mesenchymal stem cells' osteoblast differentiation. Therefore, polycaprolactone based composite scaffolds functionalized with fluorapatite nanoparticles generates a promising platform for future bone tissue engineering applications.
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Affiliation(s)
- Khrystyna Malysheva
- Department of Human Immunology, Faculty of Medicine, University of Rzeszow, Warzywna 1A, 35-959 Rzeszow, Poland; (K.M.); (K.K.)
- Centre for Innovative Research in Medical and Natural Sciences, Faculty of Medicine, University of Rzeszow, Warzywna 1A, 35-959 Rzeszow, Poland
| | - Konrad Kwaśniak
- Department of Human Immunology, Faculty of Medicine, University of Rzeszow, Warzywna 1A, 35-959 Rzeszow, Poland; (K.M.); (K.K.)
- Centre for Innovative Research in Medical and Natural Sciences, Faculty of Medicine, University of Rzeszow, Warzywna 1A, 35-959 Rzeszow, Poland
| | - Iaroslav Gnilitskyi
- “NoviNano Lab” LLC, Pasternaka 5, 79015 Lviv, Ukraine;
- Department of Photonics, Lviv Polytechnic National University, S. Bandera 12, 79013 Lviv, Ukraine;
| | - Adriana Barylyak
- Department of Therapeutic Dentistry, Danylo Halytsky Lviv National Medical University, Pekarska 69b, 79010 Lviv, Ukraine;
| | - Viktor Zinchenko
- Department of Chemistry of Functional Inorganic Materials, Bogatsky Physico-Chemical Institute of the National Academy of Sciences of Ukraine, Lustdorfska doroga 86, 65080 Odessa, Ukraine;
| | - Amir Fahmi
- Faculty of Technology and Bionics, Rhine-Waal University of Applied Science, Marie-Curie 1, 47533 Kleve, Germany;
| | - Olexandr Korchynskyi
- Department of Human Immunology, Faculty of Medicine, University of Rzeszow, Warzywna 1A, 35-959 Rzeszow, Poland; (K.M.); (K.K.)
- Centre for Innovative Research in Medical and Natural Sciences, Faculty of Medicine, University of Rzeszow, Warzywna 1A, 35-959 Rzeszow, Poland
- Department of Biotechnology and Radiology, S.Gzhytskyi National University of Veterinary Medicine and Biotechnologies, 79010 Lviv, Ukraine
- Department of Molecular Immunology, Palladin Institute of Biochemistry of the National Academy of Sciences of Ukraine, 01161 Kyiv, Ukraine
| | - Yaroslav Bobitski
- Department of Photonics, Lviv Polytechnic National University, S. Bandera 12, 79013 Lviv, Ukraine;
- Institute of Physics, Centrum of Microelectronics and Nanotechnology, University of Rzeszow, S. Pigonia 1, 35-959 Rzeszow, Poland
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18
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Yu L, Yu X, Li Y, Li J, Hua F, Song G. Is it necessary for children to receive professional fluoride in addition to regular fluoride toothpaste? Protocol for a systematic review. BMJ Open 2020; 10:e037422. [PMID: 32958490 PMCID: PMC7507841 DOI: 10.1136/bmjopen-2020-037422] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
Abstract
INTRODUCTION Regular toothbrushing with fluoride toothpaste is a fundamental intervention for caries prevention. Professional fluoride application (PFA) is widely considered a beneficial supplement to the routine use of fluoride toothpaste. However, some recent studies have failed to demonstrate the preventive effect of PFA. In addition, an increasing number of studies have highlighted the potential adverse effects of fluoride. However, little information exists on the effectiveness of additional PFA. The objective of this review is to systematically analyse the efficacy of PFA in addition to regular fluoride toothpaste among children under the age of 16. METHOD AND ANALYSIS We will search the PubMed, Embase, Google Scholar and Cochrane Central Register of Controlled Trials databases for randomised controlled trials without language or publication date restrictions. Additional studies will be identified by manually searching the reference lists of the included studies and relevant reviews. At least two authors will carry out the selection of studies independently and in duplicate. The Cochrane Risk of Bias tool will be used to assess the risk of bias of the included studies. The random effects model will be used for meta-analyses. The data synthesis will be conducted using Review Manager software (RevMan V.5.3). The Grading of Recommendation, Assessment, Development and Evaluation will be used to assess the quality of supporting evidence for each major comparison. ETHICS AND DISSEMINATION There is no need for ethical approval. The results of this review will be disseminated through peer-reviewed publications and social networks. PROSPERO REGISTRATION NUMBER CRD42020165270.
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Affiliation(s)
- Lintong Yu
- Department of Paediatric Dentistry, Hubei-MOST KLOS & KLOBM, School & Hospital of Stomatology, Wuhan University, Wuhan, China
| | - Xueqian Yu
- Library, Hubei-MOST KLOS & KLOBM, School & Hospital of Stomatology, Wuhan University, Wuhan, China
| | - Yueyang Li
- Wuhan Children's Hospital (Wuhan Maternal and Child Healthcare Hospital), Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Jun Li
- Library, Hubei-MOST KLOS & KLOBM, School & Hospital of Stomatology, Wuhan University, Wuhan, China
| | - Fang Hua
- Centre for Evidence-Based Stomatology, Hubei-MOST KLOS & KLOBM, School & Hospital of Stomatology, Wuhan University, Wuhan, China
- Division of Dentistry, School of Medical Sciences, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester Academic Health Science Centre, Manchester, UK
| | - Guangtai Song
- Department of Paediatric Dentistry, Hubei-MOST KLOS & KLOBM, School & Hospital of Stomatology, Wuhan University, Wuhan, China
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19
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Siddiq H, Pentapati KC, Acharya S. Children's perception of other children with dental fluorosis - A cross-sectional study. J Oral Biol Craniofac Res 2020; 10:72-77. [PMID: 32123661 DOI: 10.1016/j.jobcr.2020.02.005] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2019] [Accepted: 02/13/2020] [Indexed: 10/25/2022] Open
Abstract
Background Dental appearance may influence how others perceive individuals. This study would help to understand whether young people make judgments about other young people with dental fluorosis. Aim We aimed to evaluate the perception of children aged 12-15 years about other children with visible dental fluorosis. Materials and methods A self-administered social attribute questionnaire was used to capture dental appearance-related judgments of 455 children aged 12-15 years, from 6 schools. All the children were given either a set of full-face photographs of a boy and a girl, without dental fluorosis or digitally modified anterior teeth to show visible dental fluorosis. The Total Attribute Score (TAS) was measured by totaling the participant's ratings for each characteristic, ranging from 11 (most negative score) and 44 (most positive). Results A total of 437 children participated, 53.8% (235) were males with a mean age of 13.99 ± 0.825. The mean TAS for photographs with fluorosis (25.9 ± 4.73) was significantly lower than without fluorosis (34.8 ± 4.83) (p < 0.001). Concerning gender, age, and SES, photos with fluorosis had significantly lower mean TAS than without fluorosis (p < 0.001, <0.001, <0.001 and < 0.001), respectively. Conclusion Children in our study perceived that fluorosis could have a negative impact on their appearance.
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Affiliation(s)
- Hanan Siddiq
- Department of Public Health Dentistry, Manipal College of Dental Sciences, Manipal, Manipal Academy of Higher Education, Manipal, Karnataka, India
| | - Kalyana-Chakravarthy Pentapati
- Department of Public Health Dentistry, Manipal College of Dental Sciences, Manipal, Manipal Academy of Higher Education, Manipal, Karnataka, India
| | - Shashidhar Acharya
- Department of Public Health Dentistry, Manipal College of Dental Sciences, Manipal, Manipal Academy of Higher Education, Manipal, Karnataka, India
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Guidelines on the use of fluoride for caries prevention in children: an updated EAPD policy document. Eur Arch Paediatr Dent 2019; 20:507-516. [PMID: 31631242 DOI: 10.1007/s40368-019-00464-2] [Citation(s) in RCA: 103] [Impact Index Per Article: 20.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2019] [Accepted: 06/21/2019] [Indexed: 10/25/2022]
Abstract
AIM To update the exisitng European Academy of Paediatric Dentistry (EAPD) 2009 fluoride guidelines. METHODS Experts met in Athens, Greece duirng November 2018 for the following groups: I Fluoride toothpastes, II Fluoride gels, rinses and varnishes, III Fluoridated milk, fluoridated salt, tablets/lozenges and drops, IV Water fluoridation. Systematic reviews and meta-analyses were reviewed and discussed for each of the groups. The GRADE system was used to assess the quality of evidence which was judged as HIGH, MODERATE, LOW or VERY LOW based on the assessment of eight criteria which can influence the confidence of the results. Following the quality assessment, GRADE was then used to indicate the strength of recommendation for each fluoride agent as STRONG or WEAK/CONDITIONAL. RESULTS Parents must be strongly advised to apply an age-related amount of toothpaste and assist/supervise tooth brushing until at least 7 years of age. The EAPD strongly endorses the daily use of fluoride as a major part of any comprehensive programme for the prevention and control of dental caries in children. Regardless of the type of programme, community or individually based, the use of fluoride must be balanced between the estimation of caries-risk and the possible risks of adverse effects of the fluorides. Fluoride use is considered safe when the manufacturer's instructions are followed. Preventive programmes should be re-evaluated at regular intervals and adapted to a patient's or population's needs and risks. CONCLUSIONS For the majority of European Countries, the EAPD recommends the appropriate use of fluoride toothpaste in conjunction with good oral hygiene to be the basic fluoride regimen.
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Joury E. Syria Profile of the Epidemiology and Management of Early Childhood Caries Before and During the Time of Crisis. Front Public Health 2019; 7:271. [PMID: 31612125 PMCID: PMC6768970 DOI: 10.3389/fpubh.2019.00271] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2019] [Accepted: 09/09/2019] [Indexed: 11/16/2022] Open
Abstract
Syria has witnessed the greatest humanitarian crisis of forcibly displaced population since World War II. The present review aimed to outline Syria's profile of the epidemiology and management of early childhood caries (ECC). Before the crisis, the burden of ECC amongst Syrian pre-schoolers had been growing in prevalence and severity. Comparable data showed an increase in the burden of ECC amongst Syrian children aged five years, rising from 74% in 1991 to 81% in 2011, with a dmft value of 8.6. A similar increase was observed in the burden of ECC amongst Syrian children aged three years, rising from 50% in 1991 to 56% in 2011, with a dmft value of 6.1. Whilst there are no data on the burden of ECC during the current crisis, estimates could be extrapolated from data on the current burden of dental caries amongst Syrian primary school children living inside Syria or in informal settlements outside Syria. Such data suggested that the burden of ECC might have further increased amongst Syrian pre-schoolers during the crisis time. This is due to the crisis exacerbating effect on ECC risk factors, in terms of increasing the existing high sugar intake amongst Syrian pre-schoolers as well as increasing different barriers Syrian families face to fresh foods, sugar-free medicines, oral hygiene and fluoride products and accessing essential preventative dental care. Tackling the growing burden of ECC amongst Syrian pre-schoolers should not be postponed till post-crisis time. The seed work for relevant public health interventions could start and be embedded in different health and social initiatives taking place during the time of crisis. A number of public health interventions informed by relevant international and local (Syrian) studies conducted during the time of crisis have been suggested to tackle the burden of ECC amongst Syrian young children. They include a mix of upstream, midstream, and downstream interventions that aim to reduce sugar intake, improve feeding and oral hygiene practices, increase access to an appropriate source of fluoride and build the capacity of the Syrian dental and wider workforce to tackle the growing burden of ECC in Syrian pre-schoolers.
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Affiliation(s)
- Easter Joury
- Centre for Dental Public Health and Primary Care, Institute of Dentistry, Queen Mary University of London, London, United Kingdom
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Ranasinghe N, Kruger E, Tennant M. Spatial distribution of groundwater fluoride levels and population at risk for dental caries and dental fluorosis in Sri Lanka. Int Dent J 2019; 69:295-302. [PMID: 30843611 PMCID: PMC9379046 DOI: 10.1111/idj.12476] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2024] Open
Abstract
OBJECTIVES To investigate the distribution of groundwater fluoride levels in Sri Lanka in relation to its population distribution to determine the population at risk for dental caries or dental fluorosis. METHODS The study used the most upgraded spatial distribution map of groundwater fluoride levels in Sri Lanka, and it was overlaid with a census of population data of the country. RESULTS The results indicated that 12% of children aged <12 years were at risk for dental fluorosis, while 81.4% of those who lived in low-fluoride zones were vulnerable for development of dental decay. Overall, 82.4% of the country's population lived in low-fluoride zones and 11.2% were at risk of potential health hazards posed by ingestion of excessive fluoride. CONCLUSION The spatial approach provides a useful decision-support tool for developing an oral health strategy of safe fluoride use based on predicted oral health risks in communities.
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Affiliation(s)
- Nirosha Ranasinghe
- International Research Collaborative – Oral Health And Equity, Department of Anatomy, Physiology and Human Biology, School of Human Sciences, The University of Western Australia, Crawley, WA, Australia
| | - Estie Kruger
- International Research Collaborative – Oral Health And Equity, Department of Anatomy, Physiology and Human Biology, School of Human Sciences, The University of Western Australia, Crawley, WA, Australia
| | - Marc Tennant
- International Research Collaborative – Oral Health And Equity, Department of Anatomy, Physiology and Human Biology, School of Human Sciences, The University of Western Australia, Crawley, WA, Australia
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Walsh T, Worthington HV, Glenny A, Marinho VCC, Jeroncic A. Fluoride toothpastes of different concentrations for preventing dental caries. Cochrane Database Syst Rev 2019; 3:CD007868. [PMID: 30829399 PMCID: PMC6398117 DOI: 10.1002/14651858.cd007868.pub3] [Citation(s) in RCA: 177] [Impact Index Per Article: 35.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
BACKGROUND Caries (dental decay) is a disease of the hard tissues of the teeth caused by an imbalance, over time, in the interactions between cariogenic bacteria in dental plaque and fermentable carbohydrates (mainly sugars). Regular toothbrushing with fluoride toothpaste is the principal non-professional intervention to prevent caries, but the caries-preventive effect varies according to different concentrations of fluoride in toothpaste, with higher concentrations associated with increased caries control. Toothpastes with higher fluoride concentration increases the risk of fluorosis (enamel defects) in developing teeth. This is an update of the Cochrane Review first published in 2010. OBJECTIVES To determine and compare the effects of toothpastes of different fluoride concentrations (parts per million (ppm)) in preventing dental caries in children, adolescents, and adults. SEARCH METHODS Cochrane Oral Health's Information Specialist searched the following databases: Cochrane Oral Health's Trials Register (to 15 August 2018); the Cochrane Central Register of Controlled Trials (CENTRAL; 2018, Issue 7) in the Cochrane Library (searched 15 August 2018); MEDLINE Ovid (1946 to 15 August 2018); and Embase Ovid (1980 to 15 August 2018). The US National Institutes of Health Ongoing Trials Register (ClinicalTrials.gov) and the World Health Organization International Clinical Trials Registry Platform were searched for ongoing trials (15 August 2018). No restrictions were placed on the language or date of publication when searching the electronic databases. SELECTION CRITERIA Randomised controlled trials that compared toothbrushing with fluoride toothpaste with toothbrushing with a non-fluoride toothpaste or toothpaste of a different fluoride concentration, with a follow-up period of at least 1 year. The primary outcome was caries increment measured by the change from baseline in the decayed, (missing), and filled surfaces or teeth index in all permanent or primary teeth (D(M)FS/T or d(m)fs/t). DATA COLLECTION AND ANALYSIS Two members of the review team, independently and in duplicate, undertook the selection of studies, data extraction, and risk of bias assessment. We graded the certainty of the evidence through discussion and consensus. The primary effect measure was the mean difference (MD) or standardised mean difference (SMD) caries increment. Where it was appropriate to pool data, we used random-effects pairwise or network meta-analysis. MAIN RESULTS We included 96 studies published between 1955 and 2014 in this updated review. Seven studies with 11,356 randomised participants (7047 evaluated) reported the effects of fluoride toothpaste up to 1500 ppm on the primary dentition; one study with 2500 randomised participants (2008 evaluated) reported the effects of 1450 ppm fluoride toothpaste on the primary and permanent dentition; 85 studies with 48,804 randomised participants (40,066 evaluated) reported the effects of toothpaste up to 2400 ppm on the immature permanent dentition; and three studies with 2675 randomised participants (2162 evaluated) reported the effects of up to 1100 ppm fluoride toothpaste on the mature permanent dentition. Follow-up in most studies was 36 months.In the primary dentition of young children, 1500 ppm fluoride toothpaste reduces caries increment when compared with non-fluoride toothpaste (MD -1.86 dfs, 95% confidence interval (CI) -2.51 to -1.21; 998 participants, one study, moderate-certainty evidence); the caries-preventive effects for the head-to-head comparison of 1055 ppm versus 550 ppm fluoride toothpaste are similar (MD -0.05, dmfs, 95% CI -0.38 to 0.28; 1958 participants, two studies, moderate-certainty evidence), but toothbrushing with 1450 ppm fluoride toothpaste slightly reduces decayed, missing, filled teeth (dmft) increment when compared with 440 ppm fluoride toothpaste (MD -0.34, dmft, 95%CI -0.59 to -0.09; 2362 participants, one study, moderate-certainty evidence). The certainty of the remaining evidence for this comparison was judged to be low.We included 81 studies in the network meta-analysis of D(M)FS increment in the permanent dentition of children and adolescents. The network included 21 different comparisons of seven fluoride concentrations. The certainty of the evidence was judged to be low with the following exceptions: there was high- and moderate-certainty evidence that 1000 to 1250 ppm or 1450 to 1500 ppm fluoride toothpaste reduces caries increments when compared with non-fluoride toothpaste (SMD -0.28, 95% CI -0.32 to -0.25, 55 studies; and SMD -0.36, 95% CI -0.43 to -0.29, four studies); there was moderate-certainty evidence that 1450 to 1500 ppm fluoride toothpaste slightly reduces caries increments when compared to 1000 to 1250 ppm (SMD -0.08, 95% CI -0.14 to -0.01, 10 studies); and moderate-certainty evidence that the caries increments are similar for 1700 to 2200 ppm and 2400 to 2800 ppm fluoride toothpaste when compared to 1450 to 1500 ppm (SMD 0.04, 95% CI -0.07 to 0.15, indirect evidence only; SMD -0.05, 95% CI -0.14 to 0.05, two studies).In the adult permanent dentition, 1000 or 1100 ppm fluoride toothpaste reduces DMFS increment when compared with non-fluoride toothpaste in adults of all ages (MD -0.53, 95% CI -1.02 to -0.04; 2162 participants, three studies, moderate-certainty evidence). The evidence for DMFT was low certainty.Only a minority of studies assessed adverse effects of toothpaste. When reported, effects such as soft tissue damage and tooth staining were minimal. AUTHORS' CONCLUSIONS This Cochrane Review supports the benefits of using fluoride toothpaste in preventing caries when compared to non-fluoride toothpaste. Evidence for the effects of different fluoride concentrations is more limited, but a dose-response effect was observed for D(M)FS in children and adolescents. For many comparisons of different concentrations the caries-preventive effects and our confidence in these effect estimates are uncertain and could be challenged by further research. The choice of fluoride toothpaste concentration for young children should be balanced against the risk of fluorosis.
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Affiliation(s)
- Tanya Walsh
- The University of ManchesterDivision of Dentistry, School of Medical Sciences, Faculty of Biology, Medicine and HealthCoupland Building 3Oxford RoadManchesterUKM13 9PL
| | - Helen V Worthington
- Division of Dentistry, School of Medical Sciences, Faculty of Biology, Medicine and Health, The University of ManchesterCochrane Oral HealthCoupland Building 3Oxford RoadManchesterUKM13 9PL
| | - Anne‐Marie Glenny
- The University of ManchesterDivision of Dentistry, School of Medical Sciences, Faculty of Biology, Medicine and HealthCoupland Building 3Oxford RoadManchesterUKM13 9PL
| | - Valeria CC Marinho
- Queen Mary University of LondonClinical and Diagnostic Oral Sciences, Barts and The London School of Medicine and DentistryTurner StreetWhitechapelLondonUKE1 2AD
| | - Ana Jeroncic
- University of Split School of MedicineDepartment of Research in Biomedicine and HealthSoltanska 2SplitCroatia21000
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Abstract
We focus on scalable public health interventions that prevent and delay the development of caries and enhance resistance to dental caries lesions. These interventions should occur throughout the life cycle, and need to be age appropriate. Mitigating disease transmission and enhancing resistance are achieved through use of various fluorides, sugar substitutes, mechanical barriers such as pit-and-fissure sealants, and antimicrobials. A key aspect is counseling and other behavioral interventions that are designed to promote use of disease transmission-inhibiting and tooth resistance-enhancing agents. Advocacy for public water fluoridation and sugar taxes is an appropriate dental public health activity.
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Affiliation(s)
- Jeremy A Horst
- Department of Biochemistry and Biophysics, University of California San Francisco, 1700 4th Street, QB3 Room 404, San Francisco, CA 94158, USA
| | - Jason M Tanzer
- Section on Oral Medicine, Department of Oral and Maxillofacial Diagnostic Sciences, University of Connecticut Health, University of Connecticut, 263 Farmington Avenue, Farmington, CT 06030, USA
| | - Peter M Milgrom
- Department of Oral Health Sciences, University of Washington, Box 357475, Seattle, WA 98195-7475, USA.
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Beltrame A, Suchyta D, Abd Alraheam I, Mohammed A, Schoenfisch M, Walter R, Almeida I, Souza L, Miguez P. Effect of Phosphorylated Chitosan on Dentin Erosion: An in vitro Study. Caries Res 2018; 52:378-386. [DOI: 10.1159/000486521] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2017] [Accepted: 12/23/2017] [Indexed: 11/19/2022] Open
Abstract
The aim of this study was to evaluate the antierosive effect of phosphorylated chitosan in dentin. Bovine dentin specimens were randomly distributed into the following groups: (1) no treatment (NoTx/negative control), (2) phosphate-buffered saline solution (PBS), (3) AmF/NaF/SnCl2 (positive control), (4) 0.5% chitosan solution (Chi), (5) 0.5% neutral phosphorylated (NP)-Chi, and (6) 0.5% alkaline phosphorylated (AP)-Chi. The specimens were submitted to de-remineralization treatment cycles for 5 days: 0.5% citric acid (2 min), remineralizing solution (30 min), and surface treatment according to assigned groups (2 min, 6×/day). The loss of dentin surface was measured by profilometry. Hardness and modulus of elasticity were measured using a nanoindenter equipped with a Berkovich diamond tip. The dentin surface was analyzed by scanning electron microscopy (SEM). The largest loss of dentin was observed in the No Tx and PBS groups (approx. 25 µm). The group treated with AmF/NaF/SnCl2 showed less loss of dentin (67% reduction vs. NoTx and PBS), followed by the groups treated with NP-Chi and AP-Chi (33% reduction), and Chi (18% reduction). Nanohardness and modulus of elasticity were similar in the NoTx and PBS groups, with a small increase in stiffness in all other groups. SEM revealed that the experimental solution of AP-Chi had a favorable effect on maintaining the integrity of collagen fibrils. AmF/NaF/SnCl2 showed a preserved mineralized collagen surface. Further studies are warranted to explore this nontoxic phosphorylated chitosan polymer as an effective agent in the prevention and treatment of dental erosion.
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Tickle M, O'Neill C, Donaldson M, Birch S, Noble S, Killough S, Murphy L, Greer M, Brodison J, Verghis R, Worthington HV. A randomised controlled trial to measure the effects and costs of a dental caries prevention regime for young children attending primary care dental services: the Northern Ireland Caries Prevention In Practice (NIC-PIP) trial. Health Technol Assess 2018; 20:1-96. [PMID: 27685609 DOI: 10.3310/hta20710] [Citation(s) in RCA: 33] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND Dental caries is the most common disease of childhood. The NHS guidelines promote preventative care in dental practices, particularly for young children. However, the cost-effectiveness of this policy has not been established. OBJECTIVE To measure the effects and costs of a composite fluoride intervention designed to prevent caries in young children attending dental services. DESIGN The study was a two-arm, parallel-group, randomised controlled trial, with an allocation ratio of 1 : 1. Randomisation was by clinical trials unit, using randomised permuted blocks. Children/families were not blinded; however, outcome assessment was blinded to group assessment. SETTING The study took place in 22 NHS dental practices in Northern Ireland, UK. PARTICIPANTS The study participants were children aged 2-3 years, who were caries free at baseline. INTERVENTIONS The intervention was composite in nature, comprising a varnish containing 22,600 parts per million (p.p.m.) fluoride, a toothbrush and a 50-ml tube of toothpaste containing 1450 p.p.m. fluoride; plus standardised, evidence-based prevention advice provided at 6-monthly intervals over 3 years. The control group received the prevention advice alone. MAIN OUTCOME MEASURES The primary outcome measure was conversion from caries-free to caries-active states. Secondary outcome measures were the number of decayed, missing or filled tooth surfaces in primary dentition (dmfs) in caries-active children, the number of episodes of pain, the number of extracted teeth and the costs of care. Adverse reactions (ARs) were recorded. RESULTS A total of 1248 children (624 randomised to each group) were recruited and 1096 (549 in the intervention group and 547 in the control group) were included in the final analyses. A total of 87% of the intervention children and 85% of control children attended every 6-month visit (p = 0.77). In total, 187 (34%) children in the intervention group converted to caries active, compared with 213 (39%) in the control group [odds ratio (OR) 0.81, 95% confidence interval (CI) 0.64 to 1.04; p = 0.11]. The mean number of tooth surfaces affected by caries was 7.2 in the intervention group, compared with 9.6 in the control group (p = 0.007). There was no significant difference in the number of episodes of pain between groups (p = 0.81). However, 164 out of the total of 400 (41%) children who converted to caries active reported toothache, compared with 62 out of 696 (9%) caries-free children (OR 7.1 95% CI 5.1 to 9.9; p < 0.001). There was no statistically significant difference in the number of teeth extracted in caries-active children (p = 0.95). Ten children in the intervention group had ARs of a minor nature. The average direct dental care cost was £155.74 for the intervention group and £48.21 for the control group over 3 years (p < 0.05). The mean cost per carious surface avoided over the 3 years was estimated at £251.00. LIMITATIONS The usual limitations of a trial such as generalisability and understanding the underlying reasons for the outcomes apply. There is no mean willingness-to-pay threshold available to enable assessment of value for money. CONCLUSIONS A statistically significant effect could not be demonstrated for the primary outcome. Once caries develop, pain is likely. There was a statistically significant difference in dmfs in caries-active children in favour of the intervention. Although adequately powered, the effect size of the intervention was small and of questionable clinical and economic benefit. FUTURE WORK Future work should assess the caries prevention effects of interventions to reduce sugar consumption at the population and individual levels. Interventions designed to arrest the disease once it is established need to be developed and tested in practice. TRIAL REGISTRATION Current Controlled Trials ISRCTN36180119 and EudraCT 2009-010725-39. FUNDING This project was funded by the National Institute for Health Research (NIHR) Health Technology Assessment programme and will be published in full in Health Technology Assessment; Vol. 20, No. 71. See the NIHR Journals Library website for further project information.
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Affiliation(s)
- Martin Tickle
- School of Dentistry, University of Manchester, Manchester, UK
| | - Ciaran O'Neill
- J.E. Cairnes School of Business and Economics, National University of Ireland, Galway, Ireland
| | | | - Stephen Birch
- Centre for Health Economics, University of Manchester, Manchester, UK
| | | | - Seamus Killough
- General Dental Practitioner, Ballycastle, UK.,British Dental Association Northern Ireland, Belfast, UK
| | - Lynn Murphy
- Northern Ireland Clinical Trials Unit, Belfast Health & Social Care Trust, Belfast, UK
| | - Margaret Greer
- Northern Ireland Clinical Trials Unit, Belfast Health & Social Care Trust, Belfast, UK
| | | | - Rejina Verghis
- Northern Ireland Clinical Trials Unit, Belfast Health & Social Care Trust, Belfast, UK
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Xiaotong W, Nanquan R, Jing X, Yuming Z, Lihong G. [Remineralization effect of casein phosphopeptide-amorphous calcium phosphate for enamel demineralization: a system review]. HUA XI KOU QIANG YI XUE ZA ZHI = HUAXI KOUQIANG YIXUE ZAZHI = WEST CHINA JOURNAL OF STOMATOLOGY 2017; 35:629-635. [PMID: 29333778 PMCID: PMC7041152 DOI: 10.7518/hxkq.2017.06.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 01/17/2017] [Revised: 09/08/2017] [Indexed: 06/07/2023]
Abstract
OBJECTIVE This study aims to assess the remineralization effect of casein phosphopeptide (CPP)-amorphous calcium phosphate (ACP) on enamel demineralization by performing system review of randomized controlled trials (RCT) involving the treatment of enamel demineralization with CPP-ACP. METHODS The study was developed based on the
Cochrane handbook for systematic reviews of interventions (Version 5.1.0) and included the following: search strategy, selection criteria, data extraction, and risk of bias assessment. We searched electronic databases such as PubMed, Embase, Cochrane Library, CNKI, Wanfang and VIP up to September 2016. RCT of treating enamel demineralization with CPP-ACP were included. Data extraction and domain-based risk of bias assessment were independently performed by two reviewers. RESULTS Twelve RCTs were included. Because of the difference of experimental design and evaluation standards, the quantitative analysis can not be carried out. CONCLUSIONS There is no strong evidence that CPP-ACP is superior to conventional fluoride formulations in enamel remineralization. However, due to the limitations of sample size, follow-up time and study design, more high quality and large-sample RCT are needed to further verify the evidence.
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Affiliation(s)
- Wang Xiaotong
- Dept. of Pediatric Dentistry, Peking University School and Hospital of Stomatology, Beijing 100081, China
| | - Rao Nanquan
- Dept. of Pediatric Dentistry, Peking University School and Hospital of Stomatology, Beijing 100081, China
| | - Xie Jing
- Dept. of Pediatric Dentistry, Peking University School and Hospital of Stomatology, Beijing 100081, China
| | - Zhao Yuming
- Dept. of Pediatric Dentistry, Peking University School and Hospital of Stomatology, Beijing 100081, China
| | - Ge Lihong
- Dept. of Pediatric Dentistry, Peking University School and Hospital of Stomatology, Beijing 100081, China
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Takahashi R, Ota E, Hoshi K, Naito T, Toyoshima Y, Yuasa H, Mori R, Nango E. Fluoride supplementation (with tablets, drops, lozenges or chewing gum) in pregnant women for preventing dental caries in the primary teeth of their children. Cochrane Database Syst Rev 2017; 10:CD011850. [PMID: 29059464 PMCID: PMC6485723 DOI: 10.1002/14651858.cd011850.pub2] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
BACKGROUND Dental caries (tooth decay) is one of the most common chronic childhood diseases. Caries prevalence in most industrialised countries has declined among children over the past few decades. The probable reasons for the decline are the widespread use of fluoride toothpaste, followed by artificial water fluoridation, oral health education and a slight decrease in sugar consumption overall. However, in regions without water fluoridation, fluoride supplementation for pregnant women may be an effective way to increase fluoride intake during pregnancy. If fluoride supplements taken by pregnant women improve neonatal outcomes, pregnant women with no access to a fluoridated drinking water supply can obtain the benefits of systemic fluoridation. OBJECTIVES To evaluate the effects of women taking fluoride supplements (tablets, drops, lozenges or chewing gum) compared with no fluoride supplementation during pregnancy to prevent caries in the primary teeth of their children. SEARCH METHODS Cochrane Oral Health's Information Specialist searched the following databases: Cochrane Oral Health's Trials Register (to 25 January 2017); the Cochrane Central Register of Controlled Trials (CENTRAL; 2016, Issue 11) in the Cochrane Library (searched 25 January 2017); MEDLINE Ovid (1946 to 25 January 2017); Embase Ovid (1980 to 25 January 2017); LILACS BIREME Virtual Health Library (Latin American and Caribbean Health Science Information database; 1982 to 25 January 2017); and CINAHL EBSCO (Cumulative Index to Nursing and Allied Health Literature; 1937 to 25 January 2017). We searched the US National Institutes of Health Ongoing Trials Register (ClinicalTrials.gov) and the World Health Organization International Clinical Trials Registry Platform for ongoing trials to 25 January 2017. No restrictions were placed on the language or date of publication when searching the electronic databases. SELECTION CRITERIA Randomised controlled trials (RCTs) of fluoride supplements (tablets, drops, lozenges or chewing gum) administered to women during pregnancy with the aim of preventing caries in the primary teeth of their children. DATA COLLECTION AND ANALYSIS Two review authors independently screened the titles and abstracts (when available) of all reports identified through electronic searches. Two review authors independently extracted data and assessed risk of bias, as well as evaluating overall quality of the evidence utilising the GRADE approach. We could not conduct data synthesis as only one study was included in the analysis. MAIN RESULTS Only one RCT met the inclusion criteria for this review. This RCT showed no statistical difference on decayed or filled primary tooth surfaces (dfs) and the percentage of children with caries at 3 years (risk ratio (RR) 1.46, 95% confidence interval (CI) 0.75 to 2.85; participants = 938, very low quality of evidence) and 5 years old (RR 0.84, 95% CI 0.53 to 1.33; participants = 798, very low quality of evidence). The incidence of fluorosis at 5 years was similar between the group taking fluoride supplements (tablets) during the last 6 months of pregnancy and the placebo group. AUTHORS' CONCLUSIONS There is no evidence that fluoride supplements taken by women during pregnancy are effective in preventing dental caries in their offspring.
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Affiliation(s)
- Rena Takahashi
- Tokyo Medical and Dental UniversityCariology and Operative Dentistry, Graduate School of Medical and Dental Sciences1‐5‐45, YushimaBunkyo‐kuTokyoJapan113‐8549
| | - Erika Ota
- St. Luke's International University, Graduate School of Nursing SciencesGlobal Health Nursing10‐1 Akashi‐choChuo‐KuTokyoJapan104‐0044
| | - Keika Hoshi
- Kitasato University, School of MedicineDepartment of Hygiene1‐15‐1 KitasatoMinami‐ku, SagamiharaKanagawaJapan252‐0374
| | - Toru Naito
- Fukuoka Dental CollegeDepartment of Geriatric DentistryTamura 2‐15‐1SawaraFukuokaJapan814‐0175
| | - Yoshihiro Toyoshima
- The Dai‐ichi Life Insurance Company, LimitedHuman Resource Department, Hibiya Employee Clinic13‐1, Yurakucho 1‐chome, Chiyoda‐kuTokyoTokyoJapan100‐8411
| | - Hidemichi Yuasa
- National Hospital Organization Toyohashi Medical CenterDepartment of Oral and Maxillofacial Surgery50 HamamichigamiImure‐choToyohashiAichiJapan440‐8510
| | - Rintaro Mori
- National Center for Child Health and DevelopmentDepartment of Health Policy2‐10‐1 OkuraSetagaya‐kuTokyoTokyoJapan157‐0074
| | - Eishu Nango
- Tokyo Kita Medical CenterDepartment of General Medicine4‐17‐56, Akabanedai Kita‐kuTokyoJapan115‐0053
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Antibacterial effect on mature biofilms of oral streptococci and antioxidant activity of 3β,6β,16β-trihydroxylup-20(29)-ene from Combretum leprosum. Med Chem Res 2017. [DOI: 10.1007/s00044-017-2022-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
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Zohoori FV, Maguire A. Determining an Upper Reference Value for the Urinary Fluoride-Creatinine Ratio in Healthy Children Younger than 7 Years. Caries Res 2017; 51:283-289. [PMID: 28535503 DOI: 10.1159/000472263] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2016] [Accepted: 03/21/2017] [Indexed: 11/19/2022] Open
Abstract
The urinary fluoride/creatinine ratio (UF/Cr) in a spot urine sample could be a useful systemic F exposure monitoring tool. No reference value for UF/Cr currently exists, therefore this study aimed to establish an upper reference value for a UF/Cr, corresponding to excessive systemic F exposure, i.e., >0.07 mg F/kg body weight (b.w.)/day, in children. Subsidiary aims were to examine the relationship between (i) total daily F intake (TDFI) and 24-h urinary F excretion (DUFE); (ii) DUFE and UF/Cr, and (iii) TDFI and UF/Cr. Simultaneously collected TDFI, DUFE, and urinary creatinine (UCr) data in children <7 years were taken from UK studies conducted from 2002 to 2014 in order to calculate UF/Cr (mg/g) for each child. For the 158 children (mean age 5.8 years) included in the data analysis, mean TDFI and DUFE were 0.049 (SD 0.033) and 0.016 (SD 0.008) mg/kg b.w./day, respectively, and the mean UF/Cr was 1.21 (SD 0.61) mg/g. Significant (p < 0.001) positive linear correlations were found between TDFI and DUFE, DUFE and UF/Cr, and TDFI and UF/Cr. The estimated upper reference value for UF/Cr was 1.69 mg/g; this was significantly (p = 0.019) higher than the UF/Cr (1.29) associated with optimal F exposure (0.05-0.07 mg/kg b.w./day). In conclusion, the strong positive correlation between TDFI and UF/Cr confirms the strong association of these 2 F exposure variables and the value of a spot urine sample for prediction of TDFI (i.e., the most important risk factor in determining fluorosis occurrence and severity) in young children. Establishing an estimation of an upper reference value of 1.69 mg/g for UF/Cr in spot urine samples could simplify and facilitate their use as a valuable tool in large epidemiological studies.
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Affiliation(s)
- F Vida Zohoori
- School of Health and Social Care, Teesside University, Middlesbrough, UK
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Marinho VCC, Chong LY, Worthington HV, Walsh T. Fluoride mouthrinses for preventing dental caries in children and adolescents. Cochrane Database Syst Rev 2016; 7:CD002284. [PMID: 27472005 PMCID: PMC6457869 DOI: 10.1002/14651858.cd002284.pub2] [Citation(s) in RCA: 90] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
BACKGROUND Fluoride mouthrinses have been used extensively as a caries-preventive intervention in school-based programmes and by individuals at home. This is an update of the Cochrane review of fluoride mouthrinses for preventing dental caries in children and adolescents that was first published in 2003. OBJECTIVES The primary objective is to determine the effectiveness and safety of fluoride mouthrinses in preventing dental caries in the child and adolescent population.The secondary objective is to examine whether the effect of fluoride rinses is influenced by:• initial level of caries severity;• background exposure to fluoride in water (or salt), toothpastes or reported fluoride sources other than the study option(s); or• fluoride concentration (ppm F) or frequency of use (times per year). SEARCH METHODS We searched the following electronic databases: Cochrane Oral Health's Trials Register (whole database, to 22 April 2016), the Cochrane Central Register of Controlled Trials (CENTRAL) (the Cochrane Library, 2016, Issue 3), MEDLINE Ovid (1946 to 22 April 2016), Embase Ovid (1980 to 22 April 2016), CINAHL EBSCO (the Cumulative Index to Nursing and Allied Health Literature, 1937 to 22 April 2016), LILACS BIREME (Latin American and Caribbean Health Science Information Database, 1982 to 22 April 2016), BBO BIREME (Bibliografia Brasileira de Odontologia; from 1986 to 22 April 2016), Proquest Dissertations and Theses (1861 to 22 April 2016) and Web of Science Conference Proceedings (1990 to 22 April 2016). We undertook a search for ongoing trials on the US National Institutes of Health Trials Register (http://clinicaltrials.gov) and the World Health Organization International Clinical Trials Registry Platform. We placed no restrictions on language or date of publication when searching electronic databases. We also searched reference lists of articles and contacted selected authors and manufacturers. SELECTION CRITERIA Randomised or quasi-randomised controlled trials where blind outcome assessment was stated or indicated, comparing fluoride mouthrinse with placebo or no treatment in children up to 16 years of age. Study duration had to be at least one year. The main outcome was caries increment measured by the change in decayed, missing and filled tooth surfaces in permanent teeth (D(M)FS). DATA COLLECTION AND ANALYSIS At least two review authors independently performed study selection, data extraction and risk of bias assessment. We contacted study authors for additional information when required. The primary measure of effect was the prevented fraction (PF), that is, the difference in mean caries increments between treatment and control groups expressed as a percentage of the mean increment in the control group. We conducted random-effects meta-analyses where data could be pooled. We examined potential sources of heterogeneity in random-effects metaregression analyses. We collected adverse effects information from the included trials. MAIN RESULTS In this review, we included 37 trials involving 15,813 children and adolescents. All trials tested supervised use of fluoride mouthrinse in schools, with two studies also including home use. Almost all children received a fluoride rinse formulated with sodium fluoride (NaF), mostly on either a daily or weekly/fortnightly basis and at two main strengths, 230 or 900 ppm F, respectively. Most studies (28) were at high risk of bias, and nine were at unclear risk of bias.From the 35 trials (15,305 participants) that contributed data on permanent tooth surface for meta-analysis, the D(M)FS pooled PF was 27% (95% confidence interval (CI), 23% to 30%; I(2) = 42%) (moderate quality evidence). We found no significant association between estimates of D(M)FS prevented fractions and baseline caries severity, background exposure to fluorides, rinsing frequency or fluoride concentration in metaregression analyses. A funnel plot of the 35 studies in the D(M)FS PF meta-analysis indicated no relationship between prevented fraction and study precision (no evidence of reporting bias). The pooled estimate of D(M)FT PF was 23% (95% CI, 18% to 29%; I² = 54%), from the 13 trials that contributed data for the permanent teeth meta-analysis (moderate quality evidence).We found limited information concerning possible adverse effects or acceptability of the treatment regimen in the included trials. Three trials incompletely reported data on tooth staining, and one trial incompletely reported information on mucosal irritation/allergic reaction. None of the trials reported on acute adverse symptoms during treatment. AUTHORS' CONCLUSIONS This review found that supervised regular use of fluoride mouthrinse by children and adolescents is associated with a large reduction in caries increment in permanent teeth. We are moderately certain of the size of the effect. Most of the evidence evaluated use of fluoride mouthrinse supervised in a school setting, but the findings may be applicable to children in other settings with supervised or unsupervised rinsing, although the size of the caries-preventive effect is less clear. Any future research on fluoride mouthrinses should focus on head-to-head comparisons between different fluoride rinse features or fluoride rinses against other preventive strategies, and should evaluate adverse effects and acceptability.
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Affiliation(s)
- Valeria C C Marinho
- Clinical and Diagnostic Oral Sciences, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, Turner Street, Whitechapel, London, UK, E1 2AD
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Dang MH, Jung JE, Lee DW, Song KY, Jeon JG. Recovery of Acid Production in Streptococcus mutans Biofilms after Short-Term Fluoride Treatment. Caries Res 2016; 50:363-71. [DOI: 10.1159/000446408] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2016] [Accepted: 04/20/2016] [Indexed: 11/19/2022] Open
Abstract
Fluoride is commonly used as an ingredient of topical oral hygiene measures. Despite the anti-acidogenic activities of fluoride against cariogenic biofilms, the recovery of the biofilms from fluoride damage is unclear. Herein, we investigated the recovery of acid production in Streptococcus mutans biofilms after short-term or during periodic 1-min fluoride treatments. For this study, 46-hour-old S. mutans biofilms were treated with fluoride (0-2,000 ppm F-) for 1-8 min and then incubated in saliva for 0-100 min. The 74-hour-old biofilms were also periodically treated with the fluoride concentration during biofilm formation (1 min/treatment). Changes in acidogenicity and viability were determined via pH drop and colony-forming unit assays, respectively. In this study, acid production after a 1-min fluoride treatment was recovered as saliva incubation time increased, which followed a linear pattern of concentration dependence (R = 0.99, R2 = 0.98). The recovery pattern was in a biphasic pattern, with an initial rapid rate followed by a second slow recovery. Furthermore, recovery from fluoride damage was retarded in a concentration-dependent manner as treatment time increased. In periodic 1-min fluoride treatments, acid production in the biofilms was not diminished during the non-fluoride treatment period; however, it was reduced in a concentration-dependent manner during the fluoride treatment period. The viability of the biofilm cells did not change, even at high fluoride concentrations. Collectively, our results suggest that brief fluoride treatment does not sustain anti-acidogenic activity against S. mutans in biofilms since the damage is recoverable with time.
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Chlorhexidine versus topical fluoride treatment for the prevention and management of dental caries in children and adolescents. Hippokratia 2016. [DOI: 10.1002/14651858.cd009962.pub2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
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Abstract
UNLABELLED Data SOURCES Cochrane Oral Health Group Trials Register, the Cochrane Central Register of Controlled Trials (CENTRAL), Medline , Embase, CINAHL, LILACS, ProQuest Dissertations and Theses, the Web of Science Conference Proceedings, ClinicalTrials.gov and the WHO International Clinical Trials Registry Platform. STUDY SELECTION Randomised or quasi-randomised controlled trials comparing topically applied fluoride gel with placebo or no treatment in children up to 16 years were considered. Studies had to be at least one year in duration with a frequency of application of at least once a year with blind outcome assessment. The main outcome was caries increment measured by the change in decayed, missing and filled tooth surfaces in both permanent and primary teeth (D(M)FS and d(e/m)fs). DATA EXTRACTION AND SYNTHESIS At least two reviewers extracted data and assessed risk of bias. The primary measure of effect was the prevented fraction (PF). Where data could be pooled random-effects meta-analyses were conducted. Potential sources of heterogeneity were examined in random-effects meta-regression analyses. RESULTS Twenty-eight trials involving 9140 children and adolescents were included. Most of the studies (20) were at high risk of bias, with eight at unclear risk of bias. Twenty-five trials (8479 participants) provided data for meta-analysis on permanent teeth, with a D(M)FS pooled prevented fraction (PF) estimate of 28% (95% CI; 19-36%; P < 0.0001; with substantial heterogeneity (P < 0.0001; I(2) = 82%); moderate quality evidence). Subgroup and metaregression analyses suggested no significant association between estimates of D(M)FS prevented fractions and the prespecified trial characteristics. However, the effect of fluoride gel varied according to the type of control group used, with D(M)FS PF on average being 17% (95% CI 3% to 31%; P = 0.018) higher in non-placebo-controlled trials (the reduction in caries was 38% (95% CI 24% to 52%; P < 0.0001, 2808 participants) for the ten trials with no treatment as control group, and 21% (95% CI 15% to 28%; P < 0.0001, 5671 participants) for the 15 placebo-controlled trials.A funnel plot of the 25 trials in the D(M)FS PF meta-analysis indicated a relationship between prevented fraction and study precision, with an apparent lack of small studies with statistically significant large effects.For primary teeth the d(e/m)fs pooled prevented fraction estimate for the three trials (1254 participants) = 20% (95%CI; 1% - 38%; P = 0.04; with no heterogeneity (P = 0.54; I(2) = 0%); low quality evidence).There was limited reporting of adverse events. Only two trials reported information on acute toxicity signs and symptoms during the application of the gel (risk difference 0.01, 95% CI -0.01 to 0.02; P = 0.36; with no heterogeneity (P = 36; I(2) = 0%); 490 participants; very low quality evidence). None of the trials reported information on tooth staining, mucosal irritation or allergic reaction. CONCLUSIONS The conclusions of this updated review remain the same as those when it was first published. There is moderate quality evidence of a large caries-inhibiting effect of fluoride gel in the permanent dentition. Information concerning the caries-preventive effect of fluoride gel on the primary dentition, which also shows a large effect, is based on low quality evidence from only three placebo-controlled trials. There is little information on adverse effects or on acceptability of treatment. Future trials should include assessment of potential adverse effects.
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Affiliation(s)
- Derek Richards
- Centre for Evidence-based Dentistry, Dental Health Services Research Unit, Dundee University, Scotland, UK
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Pieper K, Winter J, Krutisch M, Völkner-Stetefeld P, Jablonski-Momeni A. Prevention in kindergartens with 500 ppm fluoride toothpaste—a randomized clinical trial. Clin Oral Investig 2015; 20:1159-64. [DOI: 10.1007/s00784-015-1604-3] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2015] [Accepted: 09/14/2015] [Indexed: 10/23/2022]
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Fluoride toothpaste efficacy and safety in children younger than 6 years: a systematic review. J Am Dent Assoc 2015; 145:182-9. [PMID: 24487610 DOI: 10.14219/jada.2013.37] [Citation(s) in RCA: 79] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
BACKGROUND The authors conducted a systematic review to assess the efficacy and safety of fluoride toothpaste use in children younger than 6 years. METHODS The authors defined research questions to formulate a search strategy. They screened studies, extracted data and assessed risk of bias systematically. They conducted meta-analyses to determine the effects of brushing with fluoride toothpaste. RESULTS Use of fluoride toothpaste brushing had a statistically significant effect on mean decayed, missing and filled primary tooth surfaces and decayed, missing and filled primary teeth for populations at high risk of developing caries (standard mean difference [95 percent confidence interval {CI}], -0.25 [-0.36 to -0.14] and -0.19 [-0.32 to -0.06], respectively). The effects of using different fluoride concentration toothpastes on caries varied. Study findings showed either a decrease in the odds of having fluorosis (odds ratio [OR] [95 percent CI] = 0.66 [0.48-0.90]) when the use of fluoride toothpaste was initiated after 24 months or no statistically significant difference (OR [95 percent CI] = 0.92 [0.71-1.18]). Beginning use after 12 or 14 months of age decreased the risk of fluorosis (OR = 0.70 [0.57-0.88]). CONCLUSIONS Limited scientific evidence demonstrates that for children younger than 6 years, fluoride toothpaste use is effective in caries control. Ingesting pea-sized amounts or more can lead to mild fluorosis. Practical Implications. To minimize the risk of fluorosis in children while maximizing the caries-prevention benefit for all age groups, the appropriate amount of fluoride toothpaste should be used by all children regardless of age. Dentists should counsel caregivers by using oral description, visual aids and actual demonstration to help ensure that the appropriate amount of toothpaste is used.
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U.S. Public Health Service Recommendation for Fluoride Concentration in Drinking Water for the Prevention of Dental Caries. Public Health Rep 2015; 130:318-31. [PMID: 26346489 PMCID: PMC4547570 DOI: 10.1177/003335491513000408] [Citation(s) in RCA: 181] [Impact Index Per Article: 20.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023] Open
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Marinho VCC, Worthington HV, Walsh T, Chong LY. Fluoride gels for preventing dental caries in children and adolescents. Cochrane Database Syst Rev 2015; 2015:CD002280. [PMID: 26075879 PMCID: PMC7138249 DOI: 10.1002/14651858.cd002280.pub2] [Citation(s) in RCA: 63] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
BACKGROUND Topically applied fluoride gels have been widely used as a caries-preventive intervention in dental surgeries and school-based programmes for over three decades. This updates the Cochrane review of fluoride gels for preventing dental caries in children and adolescents that was first published in 2002. OBJECTIVES The primary objective is to determine the effectiveness and safety of fluoride gels in preventing dental caries in the child and adolescent population.The secondary objectives are to examine whether the effect of fluoride gels is influenced by the following: initial level of caries severity; background exposure to fluoride in water (or salt), toothpastes, or reported fluoride sources other than the study option(s); mode of use (self applied under supervision or operator-applied), and whether there is a differential effect between the tray and toothbrush methods of application; frequency of use (times per year) or fluoride concentration (ppm F). SEARCH METHODS We searched the Cochrane Oral Health Group Trials Register (to 5 November 2014), the Cochrane Central Register of Controlled Trials (CENTRAL) (Cochrane Library 2014, Issue 11), MEDLINE via OVID (1946 to 5 November 2014), EMBASE via OVID (1980 to 5 November 2014), CINAHL via EBSCO (1980 to 5 November 2014), LILACS and BBO via the BIREME Virtual Health Library (1980 to 5 November 2014), ProQuest Dissertations and Theses (1861 to 5 November 2014) and Web of Science Conference Proceedings (1945 to 5 November 2014). We undertook a search for ongoing trials on ClinicalTrials.gov and the WHO International Clinical Trials Registry Platform on 5 November 2014. We placed no restrictions on language or date of publication in the search of the electronic databases. We also searched reference lists of articles and contacted selected authors and manufacturers. SELECTION CRITERIA Randomised or quasi-randomised controlled trials where blind outcome assessment was stated or indicated, comparing topically applied fluoride gel with placebo or no treatment in children up to 16 years. The frequency of application had to be at least once a year, and study duration at least one year. The main outcome was caries increment measured by the change in decayed, missing and filled tooth surfaces in both permanent and primary teeth (D(M)FS and d(e/m)fs). DATA COLLECTION AND ANALYSIS At least two review authors independently performed study selection, data extraction and 'Risk of bias' assessment. We contacted study authors for additional information where required. The primary measure of effect was the prevented fraction (PF), that is, the difference in mean caries increments between the treatment and control groups expressed as a percentage of the mean increment in the control group. We performed random-effects meta-analyses where we could pool data. We examined potential sources of heterogeneity in random-effects metaregression analyses. We collected adverse effects information from the included trials. MAIN RESULTS We included 28 trials (3 of which are new trials since the original review), involving 9140 children and adolescents. Most of these trials recruited participants from schools. Most of the studies (20) were at high risk of bias, with 8 at unclear risk of bias.Twenty-five trials (8479 participants) contributed data for meta-analysis on permanent tooth surfaces: the D(M)FS pooled prevented fraction (PF) estimate was 28% (95% confidence intervals (CI) 19% to 36%; P < 0.0001; with substantial heterogeneity (P < 0.0001; I(2) = 82%); moderate quality evidence). Subgroup and metaregression analyses suggested no significant association between estimates of D(M)FS prevented fractions and the prespecified trial characteristics. However, the effect of fluoride gel varied according to the type of control group used, with D(M)FS PF on average being 17% (95% CI 3% to 31%; P = 0.018) higher in non-placebo-controlled trials (the reduction in caries was 38% (95% CI 24% to 52%; P < 0.0001, 2808 participants) for the 10 trials with no treatment as control group, and 21% (95% CI 15% to 28%; P < 0.0001, 5671 participants) for the 15 placebo-controlled trials. A funnel plot of the 25 trials in the D(M)FS PF meta-analysis indicated a relationship between prevented fraction and study precision, with an apparent lack of small studies with statistically significant large effects.The d(e/m)fs pooled prevented fraction estimate for the three trials (1254 participants) that contributed data for the meta-analysis on primary teeth surfaces was 20% (95% CI 1% to 38%; P = 0.04; with no heterogeneity (P = 0.54; I(2) = 0%); low quality evidence).There was limited reporting of adverse events. Only two trials reported information on acute toxicity signs and symptoms during the application of the gel (risk difference 0.01, 95% CI -0.01 to 0.02; P = 0.36; with no heterogeneity (P = 36; I(2) = 0%); 490 participants; very low quality evidence). None of the trials reported information on tooth staining, mucosal irritation or allergic reaction. AUTHORS' CONCLUSIONS The conclusions of this updated review remain the same as those when it was first published. There is moderate quality evidence of a large caries-inhibiting effect of fluoride gel in the permanent dentition. Information concerning the caries-preventive effect of fluoride gel on the primary dentition, which also shows a large effect, is based on low quality evidence from only three placebo-controlled trials. There is little information on adverse effects or on acceptability of treatment. Future trials should include assessment of potential adverse effects.
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Affiliation(s)
- Valeria C C Marinho
- Clinical and Diagnostic Oral Sciences, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, Turner Street, Whitechapel, London, UK, E1 2AD
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Mejàre IA, Klingberg G, Mowafi FK, Stecksén-Blicks C, Twetman SHA, Tranæus SH. A systematic map of systematic reviews in pediatric dentistry--what do we really know? PLoS One 2015; 10:e0117537. [PMID: 25706629 PMCID: PMC4338212 DOI: 10.1371/journal.pone.0117537] [Citation(s) in RCA: 62] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2014] [Accepted: 12/26/2014] [Indexed: 01/08/2023] Open
Abstract
OBJECTIVES To identify, appraise and summarize existing knowledge and knowledge gaps in practice-relevant questions in pediatric dentistry. METHODS A systematic mapping of systematic reviews was undertaken for domains considered important in daily clinical practice. The literature search covered questions in the following domains: behavior management problems/dental anxiety; caries risk assessment and caries detection including radiographic technologies; prevention and non-operative treatment of caries in primary and young permanent teeth; operative treatment of caries in primary and young permanent teeth; prevention and treatment of periodontal disease; management of tooth developmental and mineralization disturbances; prevention and treatment of oral conditions in children with chronic diseases/developmental disturbances/obesity; diagnosis, prevention and treatment of dental erosion and tooth wear; treatment of traumatic injuries in primary and young permanent teeth and cost-effectiveness of these interventions. Abstracts and full text reviews were assessed independently by two reviewers and any differences were solved by consensus. AMSTAR was used to assess the risk of bias of each included systematic review. Reviews judged as having a low or moderate risk of bias were used to formulate existing knowledge and knowledge gaps. RESULTS Out of 81 systematic reviews meeting the inclusion criteria, 38 were judged to have a low or moderate risk of bias. Half of them concerned caries prevention. The quality of evidence was high for a caries-preventive effect of daily use of fluoride toothpaste and moderate for fissure sealing with resin-based materials. For the rest the quality of evidence for the effects of interventions was low or very low. CONCLUSION There is an urgent need for primary clinical research of good quality in most clinically-relevant domains in pediatric dentistry.
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Affiliation(s)
| | - Gunilla Klingberg
- Department of Pediatric Dentistry, Faculty of Odontology, Malmö University, Malmö, Sweden
| | - Frida K. Mowafi
- Swedish Council on Health Technology Assessment, Stockholm, Sweden
| | - Christina Stecksén-Blicks
- Department of Odontology, Section for Pediatric Dentistry, Faculty of Medicine, Umeå University, Umeå, Sweden
| | - Svante H. A. Twetman
- Department of Odontology, Section for Cariology, Endodontics, Pediatric Dentistry and Clinical Genetics, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Sofia H. Tranæus
- Swedish Council on Health Technology Assessment, Stockholm, Sweden
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Association of caries increment in preschool children with nutritional and preventive variables. Clin Oral Investig 2015; 19:1913-9. [PMID: 25672515 DOI: 10.1007/s00784-015-1419-2] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2014] [Accepted: 01/29/2015] [Indexed: 10/24/2022]
Abstract
OBJECTIVES The aim of the present study was to evaluate the influence of various risk factors on dental caries increment in deciduous teeth of preschool children over 2.5 years. MATERIALS AND METHODS A longitudinal study was carried out in kindergartens in two German counties in Northern Hesse. At baseline examination in 2006-2007, the mean age of the children was 3.5 years. Caries experience was recorded according to WHO standards. Information about feeding practices during early childhood and preventive measures were collected by a structured questionnaire for each child. RESULTS Three hundred ninety-five (69.8%) of the 566 children showed no caries increment. A caries increase of 1 to 10 dmf-teeth was exhibited by 171 children (30.2%). The mean dmf-t increment amounted to 0.75. The bivariate analysis revealed that the consumption of sugary food and beverages had a negative impact on oral health. Early start of toothbrushing, use of fluoridated children's toothpaste, and frequent toothbrushing exerted a positive influence on dental health. Stepwise backward logistic regression analysis confirmed that a high social status has a significant positive impact on dental health (p = 0.028), whereas the consumption of sugary food and beverages was significantly associated with a higher dental caries increment (p = 0.004). CONCLUSION Obviously, it is not possible to limit the caries increment in children of low socioeconomic status as successfully as in children of high socioeconomic status. CLINICAL RELEVANCE There must be a stronger focus on families of low socioeconomic status when preventive measures are performed on groups or individuals.
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Inhibitory effects of children's toothpastes on Streptococcus mutans, Streptococcus sanguinis and Lactobacillus acidophilus. Eur Arch Paediatr Dent 2014; 16:219-26. [PMID: 25403148 DOI: 10.1007/s40368-014-0159-3] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2014] [Accepted: 10/16/2014] [Indexed: 10/24/2022]
Abstract
AIM As suppression of Streptococcus mutans in young children may prevent or delay colonisation of the oral cavity, toothbrushing with dentifrices containing anti-S. mutans activity may aid in preventing caries. The aims of this study were to compare the effects of children's dentifrices on the growth of S. mutans and non-mutans bacteria (Streptococcus sanguinis and Lactobacillus acidophilus). MATERIALS AND METHODS The agar diffusion assay at neutral pH was used to examine the antibacterial activity of commercial dentifrices and their major constituents. RESULTS Dentifrices containing 1,450 ppm fluoride produced greater growth inhibition of both S. mutans and S. sanguinis than those with <500 ppm. No inhibition was seen for pure solutions of sodium fluoride or sodium monofluorophosphate at fluoride concentrations up to 100,000 ppm. Stannous fluoride exerted antibacterial effects at concentrations above 10,000 ppm. Significant growth inhibition of both S. mutans and S. sanguinis was seen with sodium lauryl sulphate at 2,500 ppm and with triclosan at 100 ppm. No inhibitory effects were seen for xylitol, sorbitol, sodium pyrophosphate or polyethylene glycol at concentrations up to 80,000 ppm. CONCLUSION Sodium lauryl sulphate is the major bacterial inhibitory compound in children's dentifrices.
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dos Santos APP, Nadanovsky P, de Oliveira BH. A systematic review and meta-analysis of the effects of fluoride toothpastes on the prevention of dental caries in the primary dentition of preschool children. Evid Based Dent. 2014; 1: 5. Evid Based Dent 2014; 15:67. [PMID: 25343385 DOI: 10.1038/sj.ebd.6401035] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
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Chi DL. Caregivers who refuse preventive care for their children: the relationship between immunization and topical fluoride refusal. Am J Public Health 2014; 104:1327-33. [PMID: 24832428 PMCID: PMC4056200 DOI: 10.2105/ajph.2014.301927] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/08/2014] [Indexed: 11/04/2022]
Abstract
OBJECTIVES The aim of this study was to examine caregivers' refusal of preventive medical and dental care for children. METHODS Prevalence rates of topical fluoride refusal based on dental records and caregiver self-reports were estimated for children treated in 3 dental clinics in Washington State. A 60-item survey was administered to 1024 caregivers to evaluate the association between immunization and topical fluoride refusal. Modified Poisson regression models were used to estimate prevalence rate ratios (PRRs). RESULTS The prevalence of topical fluoride refusal was 4.9% according to dental records and 12.7% according to caregiver self-reports. The rate of immunization refusal was 27.4%. In the regression models, immunization refusal was significantly associated with topical fluoride refusal (dental record PRR = 1.61; 95% confidence interval [CI] = 1.32, 1.96; P < .001; caregiver self-report PRR = 6.20; 95% CI = 3.21, 11.98; P < .001). Caregivers younger than 35 years were significantly more likely than older caregivers to refuse both immunizations and topical fluoride (P < .05). CONCLUSIONS Caregiver refusal of immunizations is associated with topical fluoride refusal. Future research should identify the behavioral and social factors related to caregiver refusal of preventive care with the goal of developing multidisciplinary strategies to help caregivers make optimal preventive care decisions for children.
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Affiliation(s)
- Donald L Chi
- Donald L. Chi is with the Department of Oral Health Sciences, School of Dentistry, University of Washington, Seattle
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Pediatricians' oral health recommendations for 0- to 3-year-old children: results of a survey in Thuringia, Germany. BMC Oral Health 2014; 14:44. [PMID: 24885353 PMCID: PMC4021417 DOI: 10.1186/1472-6831-14-44] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2013] [Accepted: 04/23/2014] [Indexed: 11/10/2022] Open
Abstract
Background German societies of pediatricians and dentists disagree about oral health-related preventive recommendations (use of fluoride supplements, fluoride-containing toothpaste) for children aged 0–3 years. After failure to reach a consensus, there is no study that has evaluated the guidelines that pediatricians use in daily practice. Methods A standardized questionnaire was sent to all 167 practicing pediatricians in the state of Thuringia, Germany, to assess the current oral health-related preventive recommendations. Data were analyzed using descriptive statistics. Results The response rate was 52.0%. More than 9.0% of the pediatricians advise parents with regard to diet, use of baby bottles, oral hygiene and dental visits. The majority of pediatricians recommend to start tooth-brushing after the 1st birthday and recommend the use of toothpaste and a 1st dental visit after the 2nd birthday (78.0%). Additionally, 23.3% (n = 20) of pediatricians prescribe solely vitamin D, and 20.9% (n = 18) prescribe vitamin D combined with fluoride. Fluoride supplements are given as required by 37.2% (n = 32) of pediatricians, primarily between the 1st and 6th birthdays. The guidelines of the Pediatric Society were used by 1.2% of the pediatricians, the guidelines of the dentists were used by 5.8%, and a mix of both was used by 93.0%. The simultaneous use of fluoride supplements and fluoride toothpaste in the first three years was recommended by 45.9% of the pediatricians. Conclusions Pediatricians’ oral health recommendations are based on a mix of the guidelines from the German societies of pediatricians and dentists and led to no use or possible overdose of fluoride. Against the background of early childhood caries and dental fluorosis, there is a need for uniform guidelines.
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Smaïl-Faugeron V, Fron-Chabouis H, Courson F. Methodological quality and implications for practice of systematic Cochrane reviews in pediatric oral health: a critical assessment. BMC Oral Health 2014; 14:35. [PMID: 24716532 PMCID: PMC4108002 DOI: 10.1186/1472-6831-14-35] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2013] [Accepted: 03/31/2014] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND To ensure evidence-based decision-making in pediatric oral health, Cochrane systematic reviews that address topics pertinent to this field are necessary. We aimed to identify all systematic reviews of paediatric dentistry and oral health by the Cochrane Oral Health Group (COHG), summarize their characteristics and assess their methodological quality. Our second objective was to assess implications for practice in the review conclusions and provide an overview of clinical implications about the usefulness of paediatric oral health interventions in practice. METHODS We conducted a methodological survey including all paediatric dentistry reviews from the COHG. We extracted data on characteristics of included reviews, then assessed the methodological quality using a validated 11-item quality assessment tool (AMSTAR). Finally, we coded each review to indicate whether its authors concluded that an intervention should be implemented in practice, was not supported or was refuted by the evidence, or should be used only in research (inconclusive evidence). RESULTS We selected 37 reviews; most concerned the prevention of caries. The methodological quality was high, except for the assessment of reporting bias. In 7 reviews (19%), the research showed that benefits outweighed harms; in 1, the experimental intervention was found ineffective; and in 29 (78%), evidence was insufficient to assess benefits and harms. In the 7 reviews, topical fluoride treatments (with toothpaste, gel or varnish) were found effective for permanent and deciduous teeth in children and adolescents, and sealants for occlusal tooth surfaces of permanent molars. CONCLUSIONS Cochrane reviews of paediatric dentistry were of high quality. They provided strong evidence that topical fluoride treatments and sealants are effective for children and adolescents and thus should be implemented in practice. However, a substantial number of reviews yielded inconclusive evidence.
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Affiliation(s)
- Violaine Smaïl-Faugeron
- Institut National de la Santé et de la Recherche Médicale, UMR S 872, Equipe 22, Centre de Recherche des Cordeliers, Paris, France
- Assistance Publique-Hôpitaux de Paris, Hôpital Bretonneau, Service d’Odontologie, Paris, France
- Université Paris Descartes - Sorbonne Paris Cité, Faculté de Chirurgie Dentaire, Unité de Recherches Biomatériaux Innovants et Interface EA4462, 1 rue Maurice Arnoux, 92120 Montrouge, France
| | - Hélène Fron-Chabouis
- Université Paris Descartes - Sorbonne Paris Cité, Faculté de Chirurgie Dentaire, Unité de Recherches Biomatériaux Innovants et Interface EA4462, 1 rue Maurice Arnoux, 92120 Montrouge, France
- Assistance Publique-Hôpitaux de Paris, Hôpital Charles Foix, Service d’Odontologie, Ivry-sur-Seine, France
| | - Frédéric Courson
- Assistance Publique-Hôpitaux de Paris, Hôpital Bretonneau, Service d’Odontologie, Paris, France
- Université Paris Descartes - Sorbonne Paris Cité, Faculté de Chirurgie Dentaire, Unité de Recherches Biomatériaux Innovants et Interface EA4462, 1 rue Maurice Arnoux, 92120 Montrouge, France
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Estimated fluoride doses from toothpastes should be based on total soluble fluoride. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2013; 10:5726-36. [PMID: 24189183 PMCID: PMC3863868 DOI: 10.3390/ijerph10115726] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/08/2013] [Revised: 10/23/2013] [Accepted: 10/24/2013] [Indexed: 11/25/2022]
Abstract
The fluoride dose ingested by young children may be overestimated if based on levels of total fluoride (TF) rather than levels of bioavailable fluoride (total soluble fluoride—TSF) in toothpaste. The aim of the present study was to compare doses of fluoride intake based on TF and TSF. Fluoride intake in 158 Brazilian children aged three and four years was determined after tooth brushing with their usual toothpaste (either family toothpaste (n = 80) or children’s toothpaste (n = 78)). The estimated dose (mg F/day/Kg of body weight) of TF or TSF ingested was calculated from the chemical analysis of the toothpastes. Although the ingested dose of TF from the family toothpastes was higher than that from the children’s toothpastes (0.074 ± 0.007 and 0.039 ± 0.003 mg F/day/Kg, respectively; p < 0.05), no difference between types of toothpaste was found regarding the ingested dose based on TSF (0.039 ± 0.005 and 0.039 ± 0.005 mg F/day/Kg, respectively; p > 0.05). The fluoride dose ingested by children from toothpastes may be overestimated if based on the TF of the product. This finding suggests that the ingested dose should be calculated based on TSF. Dose of TSF ingested by children is similar whether family or children’s toothpaste is used.
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Wong HM, McGrath C, King NM. Diffuse opacities in 12-year-old Hong Kong children - four cross-sectional surveys. Community Dent Oral Epidemiol 2013; 42:61-9. [DOI: 10.1111/cdoe.12064] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2012] [Accepted: 06/29/2013] [Indexed: 11/28/2022]
Affiliation(s)
- Hai Ming Wong
- Paediatric Dentistry & Orthodontics; Faculty of Dentistry; The University of Hong Kong; Pokfulam Hong Kong
| | - Colman McGrath
- Periodontology & Public Health; Faculty of Dentistry; The University of Hong Kong; Pokfulam Hong Kong
| | - Nigel M. King
- Paediatric Dentistry; School of Dentistry; Faculty of Medicine; Dentistry and Health Sciences; The University of Western Australia; Perth WA Australia
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de Almeida Baldini Cardoso C, Mangueira DFB, Olympio KPK, Magalhães AC, Rios D, Honório HM, Vilhena FV, Sampaio FC, Buzalaf MAR. The effect of pH and fluoride concentration of liquid dentifrices on caries progression. Clin Oral Investig 2013; 18:761-7. [DOI: 10.1007/s00784-013-1031-2] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2012] [Accepted: 07/01/2013] [Indexed: 10/26/2022]
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Modesto A, Klein O, Tenuta LMA, Gerlach RF, Vieira AR. Summary of the IADR Cariology Research, Craniofacial Biology, and Mineralized Tissue Groups Symposium, Iguaçu Falls, Brazil, June 2012: Gene-environment Interactions and Epigenetics in Oral Diseases: Enamel Formation and its Clinical Impact on Tooth Defects, Caries, and Erosion. DENTISTRY 3000 2013; 1:http://dentistry3000.pitt.edu/ojs/index.php/dentistry3000/article/view/16/17. [PMID: 25392764 PMCID: PMC4225817 DOI: 10.5195/d3000.2013.16] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Characteristics of enamel may influence or modulate individual susceptibility to caries and erosion. These characteristics are defined during development, which is under strict genetic control, but can easily be modified in many ways by environmental factors. In the symposium, translational aspects of embryology, biochemistry, and genetics of amelogenesis were presented. The symposium provided unique insight into how basic sciences integrate with clinically relevant problems. The need for improved understanding of risks at the individual level, taking into consideration both environmental exposures and genetic background, was presented. The symposium was divided into four stepwise and interconnected topics as follows: 1) The Many Faces of Enamel Development; 2) Enamel Pathogenesis: Biochemistry Lessons; 3) Environmental Factors on Enamel Formation; and, 4) Genetic Variation in Enamel Formation Genes.
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Affiliation(s)
- Adriana Modesto
- University of Pittsburgh, School of Dental Medicine, Pittsburgh, PA, USA
| | - Ophir Klein
- University of California, School of Dentistry, San Francisco, CA, USA
| | - Livia M A Tenuta
- University of Campinas, Piracicaba Dental School, Piracicaba, SP, Brazil
| | | | - Alexandre R Vieira
- University of Pittsburgh, School of Dental Medicine, Pittsburgh, PA, USA
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Parnell C, Gugnani N, Sherriff A, James P, Beirne PV. Non-fluoride topical remineralising agents containing calcium and/or phosphate for controlling dental caries. Hippokratia 2012. [DOI: 10.1002/14651858.cd009732] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Affiliation(s)
- Carmel Parnell
- Cork University Dental School; Oral Health Services Research Centre; Wilton Cork Ireland
- HSE Dublin North East; Meath Dental Services Ireland
| | - Neeraj Gugnani
- DAV (C) Dental College; Department of Pediatric Dentistry; Model Town YamunaNagar 135001 Haryana India
| | - Andrea Sherriff
- University of Glasgow Dental School; Department of Dental Public Health; 378 Sauchiehall Street Glasgow UK G2 3JZ
- University of Glasgow; College of Medicine, Veterinary and Life Sciences; Glasgow UK
| | - Patrice James
- Cork University Dental School; Oral Health Services Research Centre; Wilton Cork Ireland
| | - Paul V Beirne
- University College Cork; Department of Epidemiology and Public Health; Brookfield Health Sciences Complex College Road Cork Ireland
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