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Dhanapriyanka M, Kosgallana S, Kanthi RDFC, Jayasekara P, Dao TMA, Ha DH, Do L. Professionally applied fluorides for preventing and arresting dental caries in low- and middle-income countries: Systematic review. J Public Health Dent 2024; 84:213-227. [PMID: 38623701 DOI: 10.1111/jphd.12617] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2023] [Revised: 03/24/2024] [Accepted: 04/03/2024] [Indexed: 04/17/2024]
Abstract
OBJECTIVES This systematic review aimed to review the safety and effectiveness of professionally applied fluorides for preventing and arresting dental caries in low- and middle-income countries (LMICs). METHODS Randomized controlled trials conducted in LMICs, in which professionally applied fluorides were compared with placebo/no treatment/health education only or usual care with a minimum one-year follow-up period, were included. Any topically applied fluoride agents such as sodium fluoride (NaF), acidulated phosphate fluoride, silver diamine fluoride (SDF), and nano silver fluoride (NSF) were included. Five databases (PubMed, Embase, Scopus, Web of Science, and Cochrane Library) were searched in May 2022. Meta-analysis was conducted using a random effect model. RESULTS This review included 33 studies for qualitative synthesis, encompassing 16,375 children aged between 1.5 and 14 years. Nevertheless, the meta-analysis focused on only 17 studies, involving 4067 children. Fourteen papers assessed potential adverse events, none of which was reported as major adverse events. SDF and NSF were identified as effective in arresting caries on primary teeth (p < 0.05) compared with a placebo or no treatment. Fluoride varnish and gel were identified as effective in reducing new caries development on primary teeth (p < 0.05) but not on permanent teeth (p > 0.05). The certainty of the generated evidence obtained is low. CONCLUSION The review provides valuable insights into the use of professionally applied fluorides in LMICs and contributes to recommendations for their use. However, the limited rigorous evidence suggests the need for further research to strengthen these findings and draw more robust conclusions.
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Affiliation(s)
- Manori Dhanapriyanka
- Ministry of Health, Colombo 10, Sri Lanka
- School of Dentistry, Faculty of Health and Behavioural Sciences, University of Queensland, Herston, Queensland, Australia
| | - Shamini Kosgallana
- Ministry of Health, Colombo 10, Sri Lanka
- School of Dentistry, Faculty of Health and Behavioural Sciences, University of Queensland, Herston, Queensland, Australia
| | | | | | - Thi Minh An Dao
- School of Dentistry, Faculty of Health and Behavioural Sciences, University of Queensland, Herston, Queensland, Australia
| | - Diep Hong Ha
- School of Dentistry, Faculty of Health and Behavioural Sciences, University of Queensland, Herston, Queensland, Australia
| | - Loc Do
- School of Dentistry, Faculty of Health and Behavioural Sciences, University of Queensland, Herston, Queensland, Australia
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Wang B, Wu Y, Li Q, Wu X, Kang X, Zhang L, Lyu M, Wang S. The Screening and Identification of a Dextranase-Secreting Marine Actinmycete Saccharomonospora sp. K1 and Study of Its Enzymatic Characteristics. Mar Drugs 2024; 22:69. [PMID: 38393040 PMCID: PMC10890608 DOI: 10.3390/md22020069] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2024] [Revised: 01/24/2024] [Accepted: 01/26/2024] [Indexed: 02/25/2024] Open
Abstract
In this study, an actinomycete was isolated from sea mud. The strain K1 was identified as Saccharomonospora sp. by 16S rDNA. The optimal enzyme production temperature, initial pH, time, and concentration of the inducer of this actinomycete strain K1 were 37 °C, pH 8.5, 72 h, and 2% dextran T20 of medium, respectively. Dextranase from strain K1 exhibited maximum activity at 8.5 pH and 50 °C. The molecular weight of the enzyme was <10 kDa. The metal ions Sr2+ and K+ enhanced its activity, whereas Fe3+ and Co2+ had an opposite effect. In addition, high-performance liquid chromatography showed that dextran was mainly hydrolyzed to isomaltoheptose and isomaltopentaose. Also, it could effectively remove biofilms of Streptococcus mutans. Furthermore, it could be used to prepare porous sweet potato starch. This is the first time a dextranase-producing actinomycete strain was screened from marine samples.
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Affiliation(s)
- Boyan Wang
- Jiangsu Key Laboratory of Marine Bioresources and Environment/Jiangsu Key Laboratory of Marine Biotechnology, Jiangsu Ocean University, Lianyungang 222005, China; (B.W.); (Y.W.); (Q.L.); (X.W.); (L.Z.); (M.L.)
| | - Yizhuo Wu
- Jiangsu Key Laboratory of Marine Bioresources and Environment/Jiangsu Key Laboratory of Marine Biotechnology, Jiangsu Ocean University, Lianyungang 222005, China; (B.W.); (Y.W.); (Q.L.); (X.W.); (L.Z.); (M.L.)
- Co-Innovation Center of Jiangsu Marine Bio-Industry Technology, Jiangsu Ocean University, Lianyungang 222005, China
| | - Qiang Li
- Jiangsu Key Laboratory of Marine Bioresources and Environment/Jiangsu Key Laboratory of Marine Biotechnology, Jiangsu Ocean University, Lianyungang 222005, China; (B.W.); (Y.W.); (Q.L.); (X.W.); (L.Z.); (M.L.)
- Co-Innovation Center of Jiangsu Marine Bio-Industry Technology, Jiangsu Ocean University, Lianyungang 222005, China
| | - Xudong Wu
- Jiangsu Key Laboratory of Marine Bioresources and Environment/Jiangsu Key Laboratory of Marine Biotechnology, Jiangsu Ocean University, Lianyungang 222005, China; (B.W.); (Y.W.); (Q.L.); (X.W.); (L.Z.); (M.L.)
- Co-Innovation Center of Jiangsu Marine Bio-Industry Technology, Jiangsu Ocean University, Lianyungang 222005, China
| | - Xinxin Kang
- Jiangsu Key Laboratory of Marine Bioresources and Environment/Jiangsu Key Laboratory of Marine Biotechnology, Jiangsu Ocean University, Lianyungang 222005, China; (B.W.); (Y.W.); (Q.L.); (X.W.); (L.Z.); (M.L.)
- Co-Innovation Center of Jiangsu Marine Bio-Industry Technology, Jiangsu Ocean University, Lianyungang 222005, China
| | - Lei Zhang
- Jiangsu Key Laboratory of Marine Bioresources and Environment/Jiangsu Key Laboratory of Marine Biotechnology, Jiangsu Ocean University, Lianyungang 222005, China; (B.W.); (Y.W.); (Q.L.); (X.W.); (L.Z.); (M.L.)
- Co-Innovation Center of Jiangsu Marine Bio-Industry Technology, Jiangsu Ocean University, Lianyungang 222005, China
| | - Mingsheng Lyu
- Jiangsu Key Laboratory of Marine Bioresources and Environment/Jiangsu Key Laboratory of Marine Biotechnology, Jiangsu Ocean University, Lianyungang 222005, China; (B.W.); (Y.W.); (Q.L.); (X.W.); (L.Z.); (M.L.)
- Co-Innovation Center of Jiangsu Marine Bio-Industry Technology, Jiangsu Ocean University, Lianyungang 222005, China
| | - Shujun Wang
- Jiangsu Key Laboratory of Marine Bioresources and Environment/Jiangsu Key Laboratory of Marine Biotechnology, Jiangsu Ocean University, Lianyungang 222005, China; (B.W.); (Y.W.); (Q.L.); (X.W.); (L.Z.); (M.L.)
- Co-Innovation Center of Jiangsu Marine Bio-Industry Technology, Jiangsu Ocean University, Lianyungang 222005, China
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Jain A, Deshpande AN, Shah YS, Jaiswal V, Tailor B. Effectiveness of Silver Diamine Fluoride and Sodium Fluoride Varnish in Preventing New Carious Lesion in Preschoolers: A Randomized Clinical Trial. Int J Clin Pediatr Dent 2023; 16:1-8. [PMID: 37020768 PMCID: PMC10067996 DOI: 10.5005/jp-journals-10005-2488] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/07/2023] Open
Abstract
Introduction Dental caries is a site-specific, multifactorial chronic disease affected globally. The prevalence of dental caries is strongly associated with social and economic disadvantage, and also the susceptibility of children to dental caries. Dental caries prevention can be achieved with topical fluoride agents. Topical fluoride promotes the remineralization of early carious lesions and reduces the demineralization of healthy enamel. Aim The aim of this randomized clinical trial was to compare the effectiveness of silver diamine fluoride (SDF) and sodium fluoride varnish (FV) in preventing new carious lesions in preschoolers. Materials and methods This randomized clinical trial was conducted on 285 children aged 3-6 years. Children were randomly allocated into three groups namely, group I-deionized distilled water (DIW), group II-sodium FV, and group III-SDF. The biannual application was performed at an interval of 6 months. New carious lesions were recorded using defs and International Caries Detection and Assessment System (ICDAS II) under LED magnifying loupes. Descriptive and inferential statistics were applied and tabulated using Statistical Package for the Social Sciences (SPSS) 23.0 software. Result There was a significant difference seen in the mean values of group III (SDF) when compared with group II (FV) and also between group III (SDF) and group I (DIW) when defs index was used. The mean score of ICDAS II after 12 months in group I (DIW) was -1.171, group II (FV) was -0.690, and group III (SDF) was -0.374. Conclusion silver diamine fluoride (SDF) was found to be most effective in preventing dental caries and also it appears to be the most cost-saving fluoride therapy. How to cite this article Jain A, Deshpande AN, Shah YS, et al. Effectiveness of Silver Diamine Fluoride and Sodium Fluoride Varnish in Preventing New Carious Lesion in Preschoolers: A Randomized Clinical Trial. Int J Clin Pediatr Dent 2023;16(1):1-8.
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Affiliation(s)
- Aishwarya Jain
- Department of Pediatric and Preventive Dentistry, K. M. Shah Dental College and Hospital, Sumandeep Vidyapeeth (Deemed to be University), Vadodara, Gujarat, India
| | - Anshula N Deshpande
- Department of Pediatric and Preventive Dentistry, K. M. Shah Dental College and Hospital, Sumandeep Vidyapeeth (Deemed to be University), Vadodara, Gujarat, India
| | - Yash S Shah
- Department of Pediatric and Preventive Dentistry, K. M. Shah Dental College and Hospital, Sumandeep Vidyapeeth (Deemed to be University), Vadodara, Gujarat, India
| | - Vidhi Jaiswal
- Department of Pediatric and Preventive Dentistry, K. M. Shah Dental College and Hospital, Sumandeep Vidyapeeth (Deemed to be University), Vadodara, Gujarat, India
| | - Brijesh Tailor
- Department of Pediatric and Preventive Dentistry, K. M. Shah Dental College and Hospital, Sumandeep Vidyapeeth (Deemed to be University), Vadodara, Gujarat, India
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Wang Z, Rong W, Xu T. Effect of Fluoride Varnish in Preventing Dental Caries of First Permanent Molars: A 24-Month Cluster Randomized Controlled Trial. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:16656. [PMID: 36554536 PMCID: PMC9779547 DOI: 10.3390/ijerph192416656] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/16/2022] [Revised: 12/02/2022] [Accepted: 12/09/2022] [Indexed: 06/17/2023]
Abstract
BACKGROUND Caries is a prevalent health problem. This study evaluated the effect of fluoride varnish in preventing dental caries of first permanent molars. METHODS The study was designed as a stratified cluster randomized controlled trial, with classes as the unit of randomization. Classes stratified by district were followed for 24 months. All eligible children of the selected classes were included for the trial. The children in the test group were biannually applied fluoride varnish. The outcomes were measured at an individual level. RESULTS In total, 107 classes (51 in the test group, 56 in the control group) were recruited for the trial. Of the 5397 participants, 5005 children (2385 in the test group, 2620 in the control group) completed the study. At the 24-month follow-up, the mean decayed and filled surface increment of the first permanent molars of the children in the test group was significantly lower than that of the children in the control group (0.38 versus 0.61). The caries incidence of the first permanent molars in the test group was 17.0%, while that of the control group was 23.7%, with a PF of 28.3%. CONCLUSIONS Semi-annual application of fluoride varnish is effective in reducing the caries increments of first permanent molars.
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Affiliation(s)
- Zhaoyou Wang
- Department of Stomotology, Peking University Third Hospital, Beijing 100191, China
| | - Wensheng Rong
- Department of Preventive Dentistry, Peking University School and Hospital of Stomatology, Beijing 100081, China
| | - Tao Xu
- Department of Preventive Dentistry, Peking University School and Hospital of Stomatology, Beijing 100081, China
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Larpbunphol N, Chanamuangkon T, Thamrongananskul N. The fluoride release, abrasion resistance, and cytotoxicity to hGFs of a novel cyanoacrylate-based fluoride varnish compared with conventional fluoride varnish. Dent Mater J 2022; 41:757-766. [PMID: 35793940 DOI: 10.4012/dmj.2022-005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
The important factors contributing to the effectiveness of fluoride varnish are the amount of fluoride ion release and the retention time of the varnish on the tooth surface. Commercial fluoride varnishes are susceptible to mechanical removal; therefore, patients are informed to avoid eating or performing oral hygiene for at least 12-24 h, which results in patient inconvenience. However, cyanoacrylate-based fluoride varnish would not have these disadvantages. This study compared the daily fluoride ion release, abrasion resistance to brushing, and toxicity to human gingival fibroblasts (hGFs) between a newly-developed cyanoacrylate-based fluoride varnish and conventional fluoride varnish (Duraphat varnish). The results demonstrated that the cyanoacrylate varnish had a significantly higher fluoride release for 9 days after application, higher abrasion resistance to brushing, and slightly less toxicity to hGFs compared with Duraphat varnish. This novel cyanoacrylate varnish could be an alternative fluoride varnish for preventing dental caries.
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Bezerra SJC, Viana ÍEL, Aoki IV, Duarte S, Hara AT, Scaramucci T. In-vitro evaluation of the anti-cariogenic effect of a hybrid coating associated with encapsulated sodium fluoride and stannous chloride in nanoclays on enamel. J Appl Oral Sci 2022; 30:e20210643. [PMID: 35507984 PMCID: PMC9064272 DOI: 10.1590/1678-7757-2021-0643] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2021] [Revised: 02/21/2022] [Accepted: 03/02/2022] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVE The aim of this study is to test, in vitro, the anti-cariogenic effect of experimental hybrid coatings, with nano clays of halloysite or bentonite, loaded with sodium fluoride or with a combination of sodium fluoride and stannous chloride, respectively. METHODOLOGY The varnish Fluor Protector (1,000 ppm of F-) was used as positive control and no treatment was the negative control. Enamel specimens (5 mm × 5 mm) were obtained from bovine teeth. The specimens (n=10) had their surfaces divided into two halves (5 mm × 2.5 mm each), in which one half received one of the treatments (Hybrid; Hybrid + NaF; Hybrid + NaF + SnCl2; Hybrid + NaF Loaded; Hybrid + NaF + SnCl2 Loaded). The specimens were submitted to a cariogenic challenge using a biofilm model (S. mutans UA159, for 5 days). Enamel surfaces both under and adjacent to the treated area were analyzed for mineral loss and lesion depth, by transverse microradiography. The pH of the medium was measured twice a day, and the fluoride release was analyzed. Additional specimens were submitted to confocal analysis. RESULTS Data were statistically analyzed by two-way ANOVA followed by Tukey test (α=0.05). None of hybrid groups were able to reduce the lesion depth; the Hybrid + NaF group, however, was able to reduce mineral loss differing from the negative control (p=0.008). The groups showed no significant difference in the pH measurement and fluoride release. Confocal analysis confirmed that for all groups the biofilm growth was similar. CONCLUSION None of the hybrid groups reduced lesion depth, but the Hybrid + NaF group was able to promote protection against mineral loss.
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Affiliation(s)
- Sávio José Cardoso Bezerra
- Universidade de São Paulo, Faculdade de Odontologia, Departamento de Dentística, São Paulo, Brasil
- Indiana University School of Dentistry, Operative Dentistry and Dental Public Health, Department of Cariology, Indianapolis, United States
| | - Ítallo Emídio Lira Viana
- Universidade de São Paulo, Faculdade de Odontologia, Departamento de Dentística, São Paulo, Brasil
| | - Idalina Vieira Aoki
- Universidade de São Paulo, Escola Politécnica, Departamento de Engenharia Química, São Paulo, Brasil
| | - Simone Duarte
- Indiana University School of Dentistry, Operative Dentistry and Dental Public Health, Department of Cariology, Indianapolis, United States
| | - Anderson Takeo Hara
- Indiana University School of Dentistry, Operative Dentistry and Dental Public Health, Department of Cariology, Indianapolis, United States
| | - Taís Scaramucci
- Universidade de São Paulo, Faculdade de Odontologia, Departamento de Dentística, São Paulo, Brasil
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Review of Professionally Applied Fluorides for Preventing Dental Caries in Children and Adolescents. APPLIED SCIENCES-BASEL 2022. [DOI: 10.3390/app12031054] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
This review aims to evaluate the effectiveness of professional topical fluoride application on the prevention of dental caries in primary and permanent dentition. A web search was conducted for English papers published from 2000 to 2020, using various digital resources (Pubmed, Google Scholar, Cochrane Library, and ResearchGate). The keywords were “professionally applied fluoride”, “fluoride gel”, “fluoride varnish”, “fluoride foam”, “fluoride mouthrinses”, and “non-cavitated caries lesions”. Inclusion criteria: (a) participants: children and adolescents, treated in a dental care setting; (b) intervention: professionally applied fluorides (gel, varnish, foam, mouthrinse); (c) comparator: no professional treatment or other preventive treatments; (d) outcomes: clinical effectiveness (e.g., caries reduction, tooth remineralization); (e) study design: randomized controlled trials, systematic reviews, meta-analyses; (f) publication period: 1 January 2000–31 December 2021. Clinical studies about home-use fluoride products, discussion papers, in-vitro studies, case reports, non-English articles, and studies with unclear methodology were excluded. Topical fluoride applications are indicated for patients with active smooth surface caries and for patients in high caries risk groups. Both APF gel and fluoride varnish are effective and can be recommended for caries prevention in primary and permanent teeth. For children under the age of 6, only 2.26% fluoride varnish is recommended.
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Sharma SV, Kelder S, Yamal JM, Chuang RJ, Byrd-Williams C, Bona G, Bajaj N, Brito F, Neumann AS. Development and Feasibility Testing of CATCH Healthy Smiles, an Oral Health Promotion Intervention for Prevention of Dental Caries Among Elementary School Children. THE JOURNAL OF SCHOOL HEALTH 2022; 92:20-30. [PMID: 34788893 DOI: 10.1111/josh.13100] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/20/2020] [Revised: 02/09/2021] [Accepted: 03/22/2021] [Indexed: 06/13/2023]
Abstract
BACKGROUND We present results of the development and feasibility testing of CATCH Healthy Smiles, a school-based oral health program, among children in grades K-2 in Houston, Texas. METHODS Study design was cross-sectional (N = 2 schools; N = 125 parent-child dyads; 31 kindergarteners, 42 first graders, and 52 second graders). CATCH Healthy Smiles program was implemented by trained school teachers in the 2016-2017 school year. Trained dentists conducted dental assessments to measure dental caries increment score (d3mfs). Parent-reported 24-hour dietary recalls and surveys assessed child and parent behavioral, environmental, and psychosocial factors. Logistic regression analysis assessed factors associated with caries experience adjusting for covariates. RESULTS Of the 113 children with complete dental assessments, 54% children in grade K, 62% in first grade, and 73% in second grade had caries experience. Children with caries experience had a higher body weight (AdjOR = 1.13, 95% confidence interval [CI]: 1.02-1.29), were less likely to be girls (AdjOR = 0.22, 95% CI: 0.05-0.82), had greater odds of difficulty drinking hot or cold beverages because of dental problems (AdjOR = 13.13, 95% CI: 1.09-275.14), greater frequency of consuming sugar-sweetened beverages (AdjOR = 11.53, 95% CI: 2.10-87.19), greater odds of receiving government assistance (AdjOR = 14.62, 95% CI: 2.74-119.81), and lower odds of seeing a dental provider (AdjOR = 0.11, 95% CI: 0.02-0.45). Process evaluation showed that 100% of the CATCH Healthy Smiles lessons and activities were taught in the two schools with a high degree of program fidelity and acceptability across the schools, children, and parents. CONCLUSIONS These data will be used to conduct a subsequent fully powered cluster randomized controlled trial.
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Affiliation(s)
- Shreela V Sharma
- Department of Epidemiology, Human Genetics & Environmental Sciences, Michael & Susan Dell Center for Healthy Living, University of Texas Health Science Center at Houston School of Public Health, 1200 Pressler, RAS E643, Houston, TX, 77030, USA
| | - Steven Kelder
- Department of Epidemiology, Human Genetics, and Environmental Sciences, Michael & Susan Dell Center for Healthy Living, University of Texas Health Science Center, School of Public Health, Austin Regional Campus, 1616 Guadalupe St., Suite 6300, Austin, TX, 78701, USA
| | - Jose-Miguel Yamal
- Department of Biostatistics and Data Science, University of Texas Health Science Center at Houston School of Public Health, 1200 Pressler, RAS W817, Houston, TX, 77030, USA
| | - Ru-Jye Chuang
- Department of Epidemiology, Human Genetics & Environmental Sciences, Michael & Susan Dell Center for Healthy Living, University of Texas Health Science Center at Houston School of Public Health, 1200 Pressler Street, RAS E615, Houston, TX, 77030, USA
| | - Courtney Byrd-Williams
- Department of Health Promotion and Behavior Sciences, Director, Maternal and Child Health Training Program, Michael & Susan Dell Center for Healthy Living, University of Texas Health Science Center, School of Public Health, Austin Regional Campus, 1616 Guadalupe, Austin, TX, 78701, USA
| | - Gisela Bona
- Pediatric Dentistry, Pre-doctoral Clinical Director Pediatric Dentistry, Department of Pediatric Dentistry, 7500 Cambridge St, Suite 5403, Houston, TX, 77054, USA
| | - Nimit Bajaj
- Henry M. Goldman School of Dental Medicine, Boston University, 635 Albany St, Boston, MA, 02118, USA
| | - Frances Brito
- Department of Biostatistics and Data Science, University of Texas Health Science Center at Houston School of Public Health, 1200 Pressler Street, Houston, TX, 77030, USA
| | - Ana S Neumann
- Department of General Practice and Dental Public Health, Director of Dental Public Health, The University of Texas Health Science Center at Houston School of Dentistry, 7500 Cambridge St, Suite 5423, Houston, TX, 77054, USA
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Dall Agnol MA, Battiston C, Tenuta LMA, Cury JA. Fluoride formed on enamel by fluoride varnish or gel application: A randomized controlled clinical trial. Caries Res 2021; 56:73-80. [PMID: 34915485 DOI: 10.1159/000521454] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2021] [Accepted: 12/12/2021] [Indexed: 11/19/2022] Open
Abstract
Although fluoride varnish (FV) and acidulated phosphate fluoride gel (APF-gel) are considered clinically effective to reduce caries, in vitro studies have shown that FV reacts slowly with enamel because most NaF present in the formulation is not solubilized in the FV. Therefore, we conducted a clinical study to evaluate if the time that FV remains on dental surfaces could overcome its slower chemical reactivity when compared with APF-gel. Sixty-eight volunteers were randomly allocated into four groups: Negative control (Control, no treatment), APF -gel application (1.23% F applied for 4 min), and FV application (Duraphat®, 2.26 % F) for 4 h (FV-4h) or 24 h (FV-24h). To evaluate fluoride formed and retained on enamel, acid biopsies were made on the buccal surfaces of the maxillary central incisors before, at the end of the application of fluoride products (immediately after gel application, or after 4 or 24 h of varnish application) and after 7 and 28 days. Fluoride concentration in dental biofilm was also analyzed before and up to 28 days after initial application. The data were analyzed by 2-way ANOVA, considering treatment and time as factors. The APF-gel and FV-24h groups formed greater fluoride concentration on enamel than the FV-4h and the control group at the end of application (p=0.0001), with no difference from each other (p=0.99). The groups did not differ regarding fluoride in biofilm, fluid (p=0.73) and solids (0.40). In conclusion, fluoride varnish needs to remain in contact with the teeth for prolonged times (>4 h) to reach the same reactivity obtained by a 4-min application of APF-gel.
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Affiliation(s)
| | - Carla Battiston
- Health Sciences Area, Dental School, UNOCHAPECO, Chapecó, Brazil
| | - Livia Maria Andalo Tenuta
- School of Dentistry, University of Michigan, Ann Arbor, Michigan, USA
- Piracicaba Dental School, UNICAMP, Piracicaba, Brazil
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Souza BMD, Silva MDS, Braga AS, Santos DMSD, Carvalho TDS, Santos NMD, Rios D, Buzalaf MAR, Magalhães AC. Acceptability and effect of TiF4 on dental caries: a randomized controlled clinical trial. Braz Oral Res 2021; 35:e121. [PMID: 34878076 DOI: 10.1590/1807-3107bor-2021.vol35.0121] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2020] [Accepted: 03/18/2021] [Indexed: 11/22/2022] Open
Abstract
This randomized three-armed controlled clinical trial compared the effect of titanium tetrafluoride (TiF4) and sodium fluoride (NaF) varnishes on caries control in smooth surfaces of permanent dentition and children's acceptability. Sixty children (6-8 y/o) were randomly divided into TiF4 (2.45% F-), NaF (2.26% F-) or placebo (control) groups. Varnishes were applied on permanent teeth once a week for the first 4 weeks and after the 6th and 12th months of the study. The variables were as follows: International Caries Detection and Assessment System (ICDAS) scores, quantitative fluorescence changes, visual plaque index (VPI) and degree of acceptability. Two-way RM-ANOVA, ANOVA/Tukey and χ2 tests were performed (p < 0.05). No differences were found between the treatments with respect to ICDAS scores (p = 0.32). Only TiF4 reduced the mean fluorescence loss significantly at 18 months compared to the baseline (p = 0.003). TiF4 showed a lower percentage of new caries lesions by tooth surface than the placebo, while NaF did not induce such a change (p < 0.014). Regardless of the treatment, more than 95% of the participants reported being satisfied. For all groups, the VPI decreased significantly at 3 months compared to the baseline value (p < 0.001), with no differences between the treatments (p = 0.17). TiF4 had a similar ability to control caries lesions as NaF; however, only TiF4 differed from the placebo (p = 0.004). The acceptability of TiF4 varnish was similar to that of NaF varnish.
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Affiliation(s)
- Beatriz Martines de Souza
- Universidade de São Paulo - USP, Bauru School of Dentistry, Department of Biological Sciences, Bauru, SP, Brazil
| | - Mayara de Souza Silva
- Universidade de São Paulo - USP, Bauru School of Dentistry, Department of Biological Sciences, Bauru, SP, Brazil
| | - Aline Silva Braga
- Universidade de São Paulo - USP, Bauru School of Dentistry, Department of Biological Sciences, Bauru, SP, Brazil
| | | | - Thamyris de Souza Carvalho
- Universidade de São Paulo - USP, Bauru School of Dentistry, Department of Biological Sciences, Bauru, SP, Brazil
| | - Natália Mello Dos Santos
- Universidade de São Paulo - USP, Bauru School of Dentistry, Department of Pediatric Dentistry, Orthodontic and Public Health, Bauru, SP, Brazil
| | - Daniela Rios
- Universidade de São Paulo - USP, Bauru School of Dentistry, Department of Pediatric Dentistry, Orthodontic and Public Health, Bauru, SP, Brazil
| | | | - Ana Carolina Magalhães
- Universidade de São Paulo - USP, Bauru School of Dentistry, Department of Biological Sciences, Bauru, SP, Brazil
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Motivational interviewing for caries prevention in adolescents: a randomized controlled trial. Clin Oral Investig 2021; 26:585-594. [PMID: 34254214 DOI: 10.1007/s00784-021-04037-w] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2020] [Accepted: 06/14/2021] [Indexed: 10/20/2022]
Abstract
OBJECTIVE The objective of this study is to investigate the effectiveness of motivational interviewing (MI) in changing health behaviors (snack and toothbrushing) and preventing dental caries among adolescents. METHODS Five hundred and twelve adolescents with unfavorable caries-related behaviors ("snacking three times or more a day" and/or "toothbrushing less often than twice a day") were randomly assigned to three groups. Group I received prevailing health education (oral health talks and pamphlets). Participants in group II joined a one-on-one face-to-face MI session. In group III, a patient communication tool (Cariogram) was incorporated to facilitate the MI process. At baseline and 24 months post-intervention, a self-administered questionnaire gathered information of participants' sociodemographic characteristics and oral health self-efficacy and behaviors. Their oral hygiene and tooth status were assessed by a blinded examiner. RESULTS After 24 months, 460 (89.8%) participants were followed up. Compared with group I, (i) restriction of frequent snacking was more likely in group II [OR (95% CI): 3.91 (1.48-10.33)] and group III [OR (95% CI): 6.33 (2.46-16.27)], whereas group III tended to adopt the behavior of toothbrushing twice a day [OR (95% CI): 4.80 (1.79-12.85)]; (ii) no significant between-group difference in plaque score reduction was found (p > 0.05); and (iii) groups II and III developed fewer cavitated teeth (△DICDASII 3-6MFT) [β (95% CI): - 0.19 (- 0.37, - 0.01) and - 0.20 (- 0.38, - 0.02), respectively], whereas increment of total carious lesions (△DICDASII 1-6MFT) was lower in group III [β (95% CI): - 0.63 (- 1.24, - 0.02)]. CONCLUSION MI outperformed prevailing health education in improving oral health behaviors and preventing dental caries among adolescents. CLINICAL RELEVANCE Incorporating MI into dental care for caries-prone adolescents contributes to optimal health outcomes. TRIAL REGISTRATION HKUCTR-1852 ( http://www.hkuctr.com/ ) (Hong Kong, 2013).
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Baik A, Alamoudi N, El-Housseiny A, Altuwirqi A. Fluoride Varnishes for Preventing Occlusal Dental Caries: A Review. Dent J (Basel) 2021; 9:64. [PMID: 34204978 PMCID: PMC8229232 DOI: 10.3390/dj9060064] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2021] [Revised: 05/19/2021] [Accepted: 05/28/2021] [Indexed: 11/16/2022] Open
Abstract
Dental caries are most likely to occur on occlusal surfaces from the early eruptive stages of the tooth. In children, about 80% to 90% of dental caries are occlusal caries. Different preventive modalities are used to prevent occlusal caries. One of the methods used for occlusal caries prevention is fluoride varnish. A vast number of clinical trials have evaluated several types of sealant material and fluoride varnish to assess their ability to prevent occlusal caries in both primary and permanent dentition. The purpose of the current study was to provide an updated overview of the development, composition, mechanism of action, application, and safety of fluoride varnish, as well as its effect on occlusal caries prevention. This review of recently published studies on fluoride varnish and its effect on occlusal caries prevention shows that in children at moderate to high risk of caries, fluoride varnishes prevent occlusal caries. Both resin-based fissure sealants and fluoride varnish are effective for occlusal caries prevention for first-permanent molars. However, it was not possible to identify which one has the best effect. It is recommend that fluoride varnish is applied for children at high risk of caries two to four times per year.
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Affiliation(s)
- Alaa Baik
- Pediatric Dentistry Department, King Abdulaziz University Dental Hospital, Jeddah 21589, Saudi Arabia;
| | - Najlaa Alamoudi
- Pediatric Dentistry Department, Faculty of Dentistry, King Abdulaziz University, Jeddah 21589, Saudi Arabia;
| | - Azza El-Housseiny
- Pediatric Dentistry Department, Faculty of Dentistry, Alexandria University, Alexandria 21526, Egypt;
| | - Amani Altuwirqi
- Pediatric Dentistry Department, Faculty of Dentistry, King Abdulaziz University, Jeddah 21589, Saudi Arabia;
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Ricomini Filho AP, Chávez BA, Giacaman RA, Frazão P, Cury JA. Community interventions and strategies for caries control in Latin American and Caribbean countries. Braz Oral Res 2021; 35:e054. [PMID: 34076078 DOI: 10.1590/1807-3107bor-2021.vol35.0054] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2021] [Accepted: 03/11/2021] [Indexed: 01/12/2023] Open
Abstract
Dental caries remains highly prevalent in Latin American and Caribbean countries (LACC). However, this disease can be controlled through interventions that implement evidence-based strategies in an affordable manner and that target all population groups instead of the most affluent only. Therefore, the aim of this report was to summarize the main scientifically documented community interventions and strategies based on restriction of sugars consumption, use of fluoride, and the use of occlusal sealants for caries control in LACC. A critical literature review was carried out in a systematic manner that included defined search strategies, independent review of the identified publications, and compilation of results in this report. Three systematic searches were conducted using the PubMed, LILACS, and SciELO databases to identify studies related to community interventions and strategies for caries control in LACC. Of the 37 publications identified, twenty-six focused on fluoride use, eight on occlusal sealant use, and three on the restriction of sugar consumption. Documented community interventions for sugars restriction were scarce in the region and were based on food supplementation, sugar replacement, and education. Thus, local and/or national policies should prioritize investment in upstream, coherent, and integrated population-wide policies such as taxes on sugary drinks and stronger regulation of advertising and promotion of sugary foods and drinks mainly targeting children. The main fluoride-based strategies used drinking water, refined domestic salt, cow milk, toothpaste and, to a lesser extent, mouth-rinses, acidulated phosphate fluoride (APF) gels, and varnishes to deliver fluoride to the population. Evidence of fluoride use was seen in Argentina, Belize, Bolivia, Brazil, Chile, Colombia, Costa Rica, Cuba, Dominican Republic, Ecuador, El Salvador, Guatemala, Haiti, Honduras, Mexico, Nicaragua, Panama, Paraguay, Peru, Uruguay, and Venezuela. Studies reporting the use of occlusal sealants were mainly located in Brazil, Chile, Colombia, Costa Rica, Peru, Mexico, and Venezuela. Community interventions restricting sugar consumption should be implemented at the individual level and through public policies. The use of fluoride must be monitored at the local, regional, and national levels so as to achieve maximum anti-caries effect while also minimizing the risk of dental fluorosis. Moreover, fluoridated water and salt programs, used as a mutually exclusive community level strategy for caries control, should expand their benefits to reach non-covered areas of the LACC while also simultaneously providing adequate surveillance of the fluoride concentration delivered to the population. Regulating the concentration of soluble fluoride (for anti-caries effect) in dentifrice formulations is also necessary in order to provide the population with an effective strategy for disease control. Targeting culturally appropriate, economically sustainable caries control interventions to rural populations and native ethnic groups such as indigenous people, quilombolas (African-origin), and riverside Amazonian people remains a crucial challenge.
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Affiliation(s)
| | | | - Rodrigo Andrés Giacaman
- University of Talca - UTALCA, Faculty of Health Sciences, Department of Oral Rehabilitation, Cariology Unit, Talca, Chile
| | - Paulo Frazão
- Universidade de São Paulo - USP, Public Health School, São Paulo, SP, Brazil
| | - Jaime Aparecido Cury
- Universidade de Campinas - Unicamp, Piracicaba Dental School, Department of Biosciences, Piracicaba, SP, Brazil
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Zaror C, Muñoz-Millán P, Espinoza-Espinoza G, Vergara-González C, Martínez-Zapata MJ. Cost-effectiveness of adding fluoride varnish to a preventive protocol for early childhood caries in rural children with no access to fluoridated drinking water. J Dent 2020; 98:103374. [DOI: 10.1016/j.jdent.2020.103374] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2020] [Revised: 04/18/2020] [Accepted: 05/08/2020] [Indexed: 11/25/2022] Open
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Brandão CB, Corona SAM, Torres CP, Côrrea-Marques AA, Saraiva MCP, Borsatto MC. Efficacy of CO lasers in preventing dental caries in partially erupted first permanent molars: a randomized 18-month clinical trial. Lasers Med Sci 2020; 35:1185-1191. [PMID: 31970563 DOI: 10.1007/s10103-020-02967-7] [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: 04/03/2019] [Accepted: 01/13/2020] [Indexed: 12/19/2022]
Abstract
The aim of this controlled randomized double-blinded clinical trial was to evaluate the use of a CO2 laser with or without topical application of acidulated fluorides in the prevention of dental caries in partially erupted first permanent molars. We selected 61 healthy children at high risk of caries, all between 6 and 8 (7.1 ± 0.8) years of age and with 4 partially erupted first permanent molars. A CO2 laser device emitting at 10.6 μm was used (0.5 W, 0.05 mJ per pulse, 10 kHz). Each first molar in an individual was randomly assigned to one treatment: (L) CO2 laser (0.066 J/cm2); (FL) 1.23% acidulated fluoride gel and CO2 laser (0.066 J/cm2); (V) 5% fluoride varnish, or (S) sealant (control). Patients were followed-up at 3, 6, 12, and 18 months after treatment, through direct visual examination and by an operator blinded to the treatments (kappa ≥ 0.70). The International Caries Detection and Assessment System (ICDAS-II) index was used to assess the soundness of tooth structure or the presence of white spot lesions, cavitated enamel, and/or dentin lesions. The Yildiz Visual Index was used to evaluate sealant retention. Results were evaluated using Kaplan-Meier survival analysis, and the hazard ratio of the treatments was estimated using shared frailty models with a gamma distribution, which considered the patient as a cluster. There were no significant differences among treatments compared to sealants. After 18 months, the use of a CO2 laser with or without acidulated fluorides was shown to be effective in preventing caries on the occlusal surface of partially erupted permanent first molars in children at high risk for caries.
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Affiliation(s)
- Cristina Bueno Brandão
- Department of Pediatric Dentistry, Ribeirão Preto School of Dentistry, University of São Paulo, Ribeirão Preto, São Paulo, Brazil
| | - Silmara Aparecida Milori Corona
- Department of Restorative Dentistry, Ribeirão Preto School of Dentistry, University of São Paulo, Ribeirão Preto, São Paulo, Brazil
| | - Carolina Paes Torres
- Department of Pediatric Dentistry, Ribeirão Preto School of Dentistry, University of São Paulo, Ribeirão Preto, São Paulo, Brazil
| | - Alessandra Afonso Côrrea-Marques
- Department of Pediatric Dentistry, Ribeirão Preto School of Dentistry, University of São Paulo, Ribeirão Preto, São Paulo, Brazil
| | - Maria Conceição Pereira Saraiva
- Department of Pediatric Dentistry, Ribeirão Preto School of Dentistry, University of São Paulo, Ribeirão Preto, São Paulo, Brazil
| | - Maria Cristina Borsatto
- Department of Pediatric Dentistry, Ribeirão Preto School of Dentistry, University of São Paulo, Ribeirão Preto, São Paulo, Brazil.
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Chiba FY, Garbin CAS, Saliba TA, Garbin AJÍ, Moimaz SAS. Effect of Chlorhexidine and Fluoride Varnishes on Streptococcus mutans Count and Dental Plaque Index. JOURNAL OF HEALTH SCIENCES 2019. [DOI: 10.17921/2447-8938.2019v21n4p371-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
AbstractThe control of dental plaque by chemical means can be a valuable auxiliary resource for individuals who have difficulties in performing dental plaque control through regular oral hygiene procedures. The aim of this study was to evaluate the effect of chlorhexidine and fluorine varnishes on the levels of Streptococcus mutans (S. mutans) present in the dental biofilm and on the dental plaque index. The study was carried out in a sample comprised thirty-nine schoolchildren between 13 and 15 years of age, distributed into 2 groups. Group I received a single layer of varnish with chlorhexidine and thymol on the maxillary right first molar. Group II received the application of varnish with fluoride following the same methodology. S. mutans count and dental plaque index recording were performed 7 days before the application and 7, 15 and 30 days after the treatment. It was observed that chlorhexidine and fluoride varnishes significantly reduced the number of S. mutans in dental plaque for 30 days (p<0.05). There was no difference between the varnishes. With regard to the dental plaque index, there was no alteration in any of the experimental time periods for both groups. It was concluded that varnishes, mainly those that contain fluoride, can be an interesting alternative for the prevention of dental caries in collective oral health programs. Keywords: Chlorhexidine. Fluorides. Dental Plaque. ResumoO controle da placa dental por meios químicos pode ser um valioso recurso auxiliar para indivíduos que apresentam dificuldades em realizar o controle da placa dental por meio de procedimentos regulares de higiene bucal. O objetivo neste estudo foi avaliar o efeito dos vernizes de clorexidina e de flúor sobre os níveis de Streptococcus mutans (S. mutans) presentes no biofilme dental e sobre o índice de placa dental. O estudo foi realizado em uma amostra composta por 39 escolares, entre 13 e 15 anos de idade, distribuídos em 2 grupos. O grupo I recebeu uma única aplicação de verniz com clorexidina e timol no primeiro molar superior direito. O grupo II recebeu a aplicação de verniz com flúor seguindo a mesma metodologia. A contagem de S. mutans e o índice de placa dental foram registrados 7 dias antes da aplicação e 7, 15 e 30 dias após o tratamento. Observou-se que os vernizes de clorexidina e flúor reduziram significativamente o número de S. mutans na placa dental por 30 dias (p <0,05). Não houve diferença entre os vernizes. Com relação ao índice de placa dental, não houve alteração em nenhum dos períodos experimentais para ambos os grupos. Concluiu-se que os vernizes, principalmente aqueles que contêm flúor, podem ser uma alternativa interessante para a prevenção da cárie dentária em programas coletivos de saúde bucal. Palavras-chave: Clorexidina. Fluoretos. Placa Dentária.
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Wu S, Zhang T, Liu Q, Yu X, Zeng X. Effectiveness of fluoride varnish on caries in the first molars of primary schoolchildren: a 3-year longitudinal study in Guangxi Province, China. Int Dent J 2019; 70:108-115. [PMID: 31705529 DOI: 10.1111/idj.12528] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
Abstract
AIMS To evaluate the effectiveness of 5% sodium fluoride varnish on caries in first permanent molars and to assess the suitability of using this method to control caries among children in rural areas of Guangxi province, China. METHODS A total of nine schools with 32 classes were selected by simple random sampling. There were 999 students in the experimental group and 1,004 in the control group. The experimental group received oral health education and topical application of 5% sodium fluoride varnish, while the control group received oral health education only. Dental examinations were performed in November 2014 and November 2017, and the modified International Caries Detection and Assessment System (ICDAS-II) was used to record the caries status of the first permanent molars. The data were entered into SPSS 22 for statistical analysis. RESULTS A total of 1,748 students (853 in the experimental group and 895 in the control group) completed the study. After 3 years of intervention, the experimental group had a lower prevalence of caries, a lower caries increment, a lower decayed, missing and filled teeth (DMFT) index and a lower decayed, missing and filled surfaces (DMFS) index compared with the control group (respectively: 58.9% vs 65.5%, 34.8% vs 42.1%, 1.38 vs 1.59 and 2.06 vs 2.38). All the differences were statistically significant (P < 0.05). CONCLUSION In this study population, twice-yearly application of 5% sodium fluoride varnish and oral health education were more effective for preventing caries in first permanent molars than oral health education alone. The implementation of fluoride varnish application as a public health measure in schools in rural areas is recommended.
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Affiliation(s)
- Shanshan Wu
- Department of Dental Public Health, College of Stomatology, Guangxi Medical University, Nanning, China
| | - Tingting Zhang
- Department of Dental Public Health, College of Stomatology, Guangxi Medical University, Nanning, China
| | - Qiulin Liu
- Department of Dental Public Health, College of Stomatology, Guangxi Medical University, Nanning, China
| | - Xueting Yu
- Department of Dental Public Health, College of Stomatology, Guangxi Medical University, Nanning, China
| | - Xiaojuan Zeng
- Department of Dental Public Health, College of Stomatology, Guangxi Medical University, Nanning, China
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Lai X, Liu X, Liu X, Deng T, Feng Y, Tian X, Lyu M, Wang AS. The Marine Catenovulum agarivorans MNH15 and Dextranase: Removing Dental Plaque. Mar Drugs 2019; 17:md17100592. [PMID: 31635432 PMCID: PMC6835279 DOI: 10.3390/md17100592] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2019] [Revised: 10/15/2019] [Accepted: 10/16/2019] [Indexed: 12/03/2022] Open
Abstract
Dextranase, a hydrolase that specifically hydrolyzes α-1,6-glucosidic bonds, has been used in the pharmaceutical, food, and biotechnology industries. In this study, the strain of Catenovulum agarivorans MNH15 was screened from marine samples. When the temperature, initial pH, NaCl concentration, and inducer concentration were 30 °C, 8.0, 5 g/L, and 8 g/L, respectively, it yielded more dextranase. The molecular weight of the dextranase was approximately 110 kDa. The maximum enzyme activity was achieved at 40 °C and a pH of 8.0. The enzyme was stable at 30 °C and a pH of 5–9. The metal ion Sr2+ enhanced its activity, whereas NH4+, Co2+, Cu2+, and Li+ had the opposite effect. The dextranase effectively inhibited the formation of biofilm by Streptococcus mutans. Moreover, sodium fluoride, xylitol, and sodium benzoate, all used in dental care products, had no significant effect on dextranase activity. In addition, high-performance liquid chromatography (HPLC) showed that dextran was mainly hydrolyzed to glucose, maltose, and maltoheptaose. The results indicated that dextranase has high application potential in dental products such as toothpaste and mouthwash.
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Affiliation(s)
- Xiaohua Lai
- Jiangsu Key Laboratory of Marine Bioresources and Environment/Jiangsu Key Laboratory of Marine Biotechnology, Jiangsu Ocean University, Lianyungang 222005, China.
- Co-Innovation Center of Jiangsu Marine Bio-industry Technology, Jiangsu Ocean University, Lianyungang 222005, China.
| | - Xin Liu
- Jiangsu Key Laboratory of Marine Bioresources and Environment/Jiangsu Key Laboratory of Marine Biotechnology, Jiangsu Ocean University, Lianyungang 222005, China.
- Co-Innovation Center of Jiangsu Marine Bio-industry Technology, Jiangsu Ocean University, Lianyungang 222005, China.
| | - Xueqin Liu
- Jiangsu Key Laboratory of Marine Bioresources and Environment/Jiangsu Key Laboratory of Marine Biotechnology, Jiangsu Ocean University, Lianyungang 222005, China.
- Co-Innovation Center of Jiangsu Marine Bio-industry Technology, Jiangsu Ocean University, Lianyungang 222005, China.
| | - Tian Deng
- Jiangsu Key Laboratory of Marine Bioresources and Environment/Jiangsu Key Laboratory of Marine Biotechnology, Jiangsu Ocean University, Lianyungang 222005, China.
- Co-Innovation Center of Jiangsu Marine Bio-industry Technology, Jiangsu Ocean University, Lianyungang 222005, China.
| | - Yanli Feng
- Jiangsu Key Laboratory of Marine Bioresources and Environment/Jiangsu Key Laboratory of Marine Biotechnology, Jiangsu Ocean University, Lianyungang 222005, China.
- Co-Innovation Center of Jiangsu Marine Bio-industry Technology, Jiangsu Ocean University, Lianyungang 222005, China.
| | - Xiaopeng Tian
- Jiangsu Key Laboratory of Marine Bioresources and Environment/Jiangsu Key Laboratory of Marine Biotechnology, Jiangsu Ocean University, Lianyungang 222005, China.
- Co-Innovation Center of Jiangsu Marine Bio-industry Technology, Jiangsu Ocean University, Lianyungang 222005, China.
| | - Mingsheng Lyu
- Jiangsu Key Laboratory of Marine Bioresources and Environment/Jiangsu Key Laboratory of Marine Biotechnology, Jiangsu Ocean University, Lianyungang 222005, China.
- Co-Innovation Center of Jiangsu Marine Bio-industry Technology, Jiangsu Ocean University, Lianyungang 222005, China.
- Collaborative Innovation Center of Modern Biological Manufacturing, Anhui University, Hefei 230039, China.
| | - And Shujun Wang
- Jiangsu Key Laboratory of Marine Bioresources and Environment/Jiangsu Key Laboratory of Marine Biotechnology, Jiangsu Ocean University, Lianyungang 222005, China.
- Co-Innovation Center of Jiangsu Marine Bio-industry Technology, Jiangsu Ocean University, Lianyungang 222005, China.
- Collaborative Innovation Center of Modern Biological Manufacturing, Anhui University, Hefei 230039, China.
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Godoi FAD, Carlos NR, Bridi EC, Amaral FLBD, França FMG, Turssi CP, Kantovitz KR, Basting RT. Remineralizing effect of commercial fluoride varnishes on artificial enamel lesions. Braz Oral Res 2019; 33:e044. [PMID: 31141037 DOI: 10.1590/1807-3107bor-2019.vol33.0044] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2018] [Accepted: 04/26/2019] [Indexed: 11/22/2022] Open
Abstract
The aim of this study was to evaluate soluble and insoluble fluoride concentrations in commercial varnishes, and their remineralization effect on artificial caries enamel lesions using surface and cross-sectional microhardness evaluations. Forty bovine enamel blocks were separated into four groups (n=10): control (no treatment), Enamelast (Ultradent Products), Duraphat (Colgate-Palmolive) and Clinpro White Varnish (3M ESPE). Surface enamel microhardness evaluations were obtained, artificial enamel caries lesions were developed by dynamic pH-cycling, and the varnishes were then applied every 6 days, after which the enamel blocks were submitted to dynamic remineralization by pH cycles. After removal of the varnishes, the enamel surfaces were reassessed for microhardness. The blocks were sectioned longitudinally, and cross-sectional microhardness measurements were performed at different surface depths (up to 300 μm depth). Polarized light microscopy images (PLMI) were made to analyze subsurface caries lesions. The fluoride concentration in whole (soluble and insoluble fluoride) and centrifuged (soluble fluoride) varnishes was determined using an extraction method with acetone. The data were analyzed to evaluate the surface microhardness, making adjustments for generalized linear models. There was a significant decrease in enamel surface microhardness after performing all the treatments (p<0.0001). Enamelast and Duraphat showed significantly higher enamel microhardness values than the control and the Clinpro groups (p = 0.0002). Microhardness loss percentage was significantly lower for Enamelast (p = 0.071; One-way ANOVA). PLMI showed that subsurface caries lesions were not remineralized with the varnish treatments. No significant differences in the in-depth microhardness levels (p = 0.7536; ANOVA) were observed among the treatments. Enamelast presented higher soluble and insoluble fluoride concentrations than the other varnishes (p < 0.0001; Kruskal-Wallis and Dunn tests). Enamelast and Duraphat varnishes promoted enamel surface remineralization, but no varnish remineralized the subsurface lesion body. Although insoluble and soluble fluoride concentration values did not correspond to those declared by the manufacturer, Enamelast presented higher fluoride concentration than the others.
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ElSalhy M, Ali U, Lai H, Flores-Mir C, Amin M. Caries reporting in studies that used the International Caries Detection and Assessment System: A scoping review. Community Dent Oral Epidemiol 2018; 47:92-102. [PMID: 30334280 DOI: 10.1111/cdoe.12430] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2017] [Revised: 07/06/2018] [Accepted: 09/30/2018] [Indexed: 12/25/2022]
Abstract
OBJECTIVE To explore how caries was reported in studies that employed the International Caries Detection and Assessment System (ICDAS). METHODS A systematic database search up to August 2017 was carried out using PubMed, Ovid MEDLINE, Cochrane library and ISI Web of Science electronic databases. Only studies that used the ICDAS for dental caries examinations were included. Studies were excluded if the examination was done only for the validation or the calibration of the ICDAS and/or if the examination was not done for the whole dentition. Measures used to report caries were considered. RESULTS A total of 126 papers met the inclusion criteria. Forty-four different synthesis measures were used to report caries. Most of the studies used a combination of multiple measures to report patient's caries level. These reporting measures cluster into four main groups: the number of individual ICDAS scores (ie, total counts of every score); the number of decayed surfaces/teeth (ie, total counts of combined caries scores for surfaces or teeth); measures of caries experience (ie, total counts of combined caries scores, filled and/or missing surfaces or teeth); and measures of central tendency and dispersion. The number of decayed surfaces and individual ICDAS scores were the most commonly used measures. Three studies used mean ICDAS score (ie, total ICDAS scores divided by the number of teeth), two used mean ICDAS score of carious teeth (ie, total ICDAS scores divided by the number of carious teeth) and two used the maximum ICDAS score (ie, highest ICDAS score recorded). The total ICDAS score was used only once. Many studies synthesized from the ICDAS the number of decayed, missing and filled teeth/surfaces (dmft/DMFT, dmfs/DMFS) as a measure of caries experience. CONCLUSIONS There are variations among studies in the utilization of the system to summarize caries. Most studies presented caries data using the categorical characteristics of the ICDAS.
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Affiliation(s)
- Mohamed ElSalhy
- College of Dental Medicine, University of New England, Portland, ME, USA
| | - Ussama Ali
- Georgian College of Applied Arts and Technology, Barrie, Ontario, Canada
| | - Hollis Lai
- School of Dentistry, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alberta, Canada
| | - Carlos Flores-Mir
- School of Dentistry, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alberta, Canada
| | - Maryam Amin
- School of Dentistry, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alberta, Canada
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Purification and Characterization of a Biofilm-Degradable Dextranase from a Marine Bacterium. Mar Drugs 2018; 16:md16020051. [PMID: 29414837 PMCID: PMC5852479 DOI: 10.3390/md16020051] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2017] [Revised: 01/27/2018] [Accepted: 01/31/2018] [Indexed: 12/03/2022] Open
Abstract
This study evaluated the ability of a dextranase from a marine bacterium Catenovulum sp. (Cadex) to impede formation of Streptococcus mutans biofilms, a primary pathogen of dental caries, one of the most common human infectious diseases. Cadex was purified 29.6-fold and had a specific activity of 2309 U/mg protein and molecular weight of 75 kDa. Cadex showed maximum activity at pH 8.0 and 40 °C and was stable at temperatures under 30 °C and at pH ranging from 5.0 to 11.0. A metal ion and chemical dependency study showed that Mn2+ and Sr2+ exerted positive effects on Cadex, whereas Cu2+, Fe3+, Zn2+, Cd2+, Ni2+, and Co2+ functioned as inhibitors. Several teeth rinsing product reagents, including carboxybenzene, ethanol, sodium fluoride, and xylitol were found to have no effects on Cadex activity. A substrate specificity study showed that Cadex specifically cleaved the α-1,6 glycosidic bond. Thin layer chromatogram and high-performance liquid chromatography indicated that the main hydrolysis products were isomaltoogligosaccharides. Crystal violet staining and scanning electron microscopy showed that Cadex impeded the formation of S. mutans biofilm to some extent. In conclusion, Cadex from a marine bacterium was shown to be an alkaline and cold-adapted endo-type dextranase suitable for development of a novel marine agent for the treatment of dental caries.
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Murphy KL, Larsson LS. Interprofessional oral health initiative in a nondental, American Indian setting. J Am Assoc Nurse Pract 2017; 29:733-740. [PMID: 28922571 DOI: 10.1002/2327-6924.12517] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2017] [Revised: 08/01/2017] [Accepted: 08/08/2017] [Indexed: 11/11/2022]
Abstract
BACKGROUND AND PURPOSE Tooth decay is the most common chronic childhood disease and American Indian (AI) children are at increased risk. Pediatric primary care providers are in an opportune position to reduce tooth decay. The purpose of this study was to integrate and evaluate a pediatric oral health project in an AI, pediatric primary care setting. METHODS The intervention set included caregiver education, caries risk assessment, and a same-day dental home referral. All caregiver/child dyads age birth to 5 years presenting to the pediatric clinic were eligible (n = 47). CONCLUSIONS Most children (n = 35, 91.1%) were scored as high risk for caries development. Of those with first tooth eruption (n = 36), ten had healthy teeth (27.8%) and seven had seen a dentist in the past 3 months (19.4%). All others were referred to a dentist (n = 29) and 21 families (72.4%) completed the referral. IMPLICATIONS FOR PRACTICE In fewer than 5 min per appointment (x = 4.73 min), the primary care provider integrated oral health screening, education, and referral into the well-child visit. Oral health is part of total health, and thus should be incorporated into routine well-child visits.
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Affiliation(s)
- Kate L Murphy
- College of Nursing, Montana State University, Bozeman, Montana
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Wu L, Gao X, Lo ECM, Ho SMY, McGrath C, Wong MCM. Motivational Interviewing to Promote Oral Health in Adolescents. J Adolesc Health 2017; 61:378-384. [PMID: 28532895 DOI: 10.1016/j.jadohealth.2017.03.010] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/02/2016] [Revised: 03/11/2017] [Accepted: 03/15/2017] [Indexed: 10/19/2022]
Abstract
PURPOSE Motivational interviewing (MI) is a counseling strategy to help people change their behaviors. This single-blinded randomized controlled trial evaluated the effectiveness of MI in improving adolescents' oral health. METHODS Fifteen secondary schools were randomly assigned to three groups: (I) prevailing health education, (II) MI, and (III) MI coupled with interactive dental caries risk assessment (MI + RA). Adolescents (n = 512) with unfavorable oral health behaviors (infrequent toothbrushing and/or frequent snacking) were recruited; 161, 163, and 188 in groups I-III, respectively. Participants in the three groups received their respective interventions. At baseline and after 6 and 12 months, participants completed a questionnaire on their oral health self-efficacy and behaviors. Their oral hygiene (dental plaque score) and dental caries (number of decayed surfaces/teeth status) were recorded. RESULTS Compared with group I, subjects in groups II and III were more likely to reduce their snacking frequency (odds ratios [95% confidence intervals {CIs}]: 7.12 [1.80-28.16] and 11.17 [2.90-42.98], respectively) and increase their toothbrushing frequency (odds ratios [95% CIs]: 5.26 [2.28-12.16] and 11.45 [4.99-26.26], respectively) after 12 months. Taking group I as a reference, groups II and III had lower number of new carious teeth △D ICDAS II 1-6MFT (β [95% CI]: -.24 [-.44 to -.04] and -.31 [-.51 to -.11], respectively). CONCLUSIONS MI was more effective than prevailing health education strategy in eliciting positive changes in adolescents' oral health behaviors and preventing dental caries.
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Affiliation(s)
- Lingli Wu
- Dental Public Health, Faculty of Dentistry, The University of Hong Kong, Hong Kong SAR, China
| | - Xiaoli Gao
- Dental Public Health, Faculty of Dentistry, The University of Hong Kong, Hong Kong SAR, China.
| | - Edward C M Lo
- Dental Public Health, Faculty of Dentistry, The University of Hong Kong, Hong Kong SAR, China
| | - Samuel M Y Ho
- Department of Applied Social Sciences, City University of Hong Kong, Hong Kong SAR, China
| | - Colman McGrath
- Dental Public Health, Faculty of Dentistry, The University of Hong Kong, Hong Kong SAR, China
| | - May C M Wong
- Dental Public Health, Faculty of Dentistry, The University of Hong Kong, Hong Kong SAR, China
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Muñoz-Millán P, Zaror C, Espinoza-Espinoza G, Vergara-Gonzalez C, Muñoz S, Atala-Acevedo C, Martínez-Zapata MJ. Effectiveness of fluoride varnish in preventing early childhood caries in rural areas without access to fluoridated drinking water: A randomized control trial. Community Dent Oral Epidemiol 2017; 46:63-69. [PMID: 28850712 DOI: 10.1111/cdoe.12330] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2016] [Accepted: 07/27/2017] [Indexed: 11/28/2022]
Abstract
OBJECTIVES Early childhood caries (ECC) constitutes a serious public health issue, especially in communities without water fluoridation. We assessed the effectiveness of biannual fluoride varnish applications to prevent ECC in children from nonfluoridated rural areas. METHODS A triple-blind randomized control trial with two parallel arms was conducted with 275 two- to three-year-old children without cavitated carious lesions from 28 rural public preschools in Chile. The preschools were located in areas of low socioeconomic status without access to fluoridated water. An oral health education component was administered to children, parents and educators. A new toothbrush and toothpaste for each child was delivered to the parents at baseline and at four follow-up visits. The participants were randomly allocated to receive fluoride varnish or placebo applications every six months. Trained, calibrated dentists blind to the treatment arm performed visual dental assessments at 6, 12, 18 and 24 months. The primary endpoint was the development of cavitated carious lesions in children during the 24-month follow-up period using WHO criteria, and the secondary outcomes were an increase in caries measured as a change in the index of decayed, missing or filled teeth (dmft) since the beginning of the study and the development of adverse effects. An intention-to-treat (ITT) approach was used for the primary analysis. RESULTS We included 131 participants in the intervention group and 144 participants in the placebo group; of these children, 89 (67.9%) in the intervention group and 100 (69.4%) in the control group completed the protocol. The comparative ITT analysis of caries incidence after 24 months of follow-up showed a between-group prevention fraction of 18.9% (-2.9%-36.2%). Caries incidence was 45.0% for the experiment group and 55.6% for the control group (P = .081), with a mean dmft of 1.6 (SD = 2.4) and 2.1 (SD = 2.5), respectively. No adverse effects were reported. CONCLUSIONS In conclusion, biannual fluoride varnish application is not effective in preschool children from rural nonfluoridated communities at a high risk of caries.
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Affiliation(s)
- Patricia Muñoz-Millán
- Faculty of Dentistry, Universidad de La Frontera, Temuco, Chile.,Faculty of Dentistry, Center for Research in Epidemiology, Economics and Oral Public Health (CIEESPO), Universidad de La Frontera, Temuco, Chile
| | - Carlos Zaror
- Faculty of Dentistry, Universidad de La Frontera, Temuco, Chile.,Faculty of Dentistry, Center for Research in Epidemiology, Economics and Oral Public Health (CIEESPO), Universidad de La Frontera, Temuco, Chile
| | - Gerardo Espinoza-Espinoza
- Faculty of Dentistry, Center for Research in Epidemiology, Economics and Oral Public Health (CIEESPO), Universidad de La Frontera, Temuco, Chile.,Faculty of Medicine, Universidad de La Frontera, Temuco, Chile
| | | | - Sergio Muñoz
- Faculty of Medicine, Universidad de La Frontera, Temuco, Chile
| | - Claudia Atala-Acevedo
- Faculty of Dentistry, Universidad de La Frontera, Temuco, Chile.,Faculty of Dentistry, Center for Research in Epidemiology, Economics and Oral Public Health (CIEESPO), Universidad de La Frontera, Temuco, Chile
| | - Maria José Martínez-Zapata
- Iberoamerican Cochrane Centre, Biomedical Research Institute Sant Pau (IIB Sant Pau), CIBER Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain
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Comar L, Souza B, Martins J, Santos M, Buzalaf M, Magalhães A. Response of carious enamel to TiF 4 varnish treatment under diverse cariogenic activities in situ. J Dent 2017; 63:81-84. [DOI: 10.1016/j.jdent.2017.05.023] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2017] [Revised: 05/25/2017] [Accepted: 05/30/2017] [Indexed: 10/19/2022] Open
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Mishra P, Fareed N, Battur H, Khanagar S, Bhat MA, Palaniswamy J. Role of fluoride varnish in preventing early childhood caries: A systematic review. Dent Res J (Isfahan) 2017; 14:169-176. [PMID: 28702057 PMCID: PMC5504868 DOI: 10.4103/1735-3327.208766] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Background: Early childhood caries is a public health problem that continues to affect babies and preschool children worldwide. This untreated caries process results in progressive destruction of the crowns of the teeth, often accompanied by severe pain and suffering, affecting the quality of life. Fluoride varnish which is one of the most important materials to prevent ECC is easy to apply and well tolerated by children. This study aimed to evaluate the scientific evidence regardingthe role of fluoride varnish in preventing early childhood caries. Materials and Methods: Records were searched from various databases such as PubMed/Medline, Cochrane, and EMBASE. Articles published over the past 36 years (1979-2015) were identified using the key search terms. A total of 190 records were identified by title/abstracts/full text articles and were retrieved. Potentially relevant reports identified from the reference lists of relevant studies, review articles and chapters were hand-searched, which yielded an additional 10 articles. The main outcome of our investigation was prevention of early childhood caries following application of fluoride varnish and unavoidable fluoride exposure. Out of 190 articles originally identified, 30 records were considered potentially eligible and sought for further assessment. 17 articles met the inclusion criteria and these studies were assessed independently for methodology and performance. Results: Analysis of literature revealed that basically two concentrations of fluoride varnishes have been used: 1% and 5%, with a caries preventive fraction ranges of 6.4-30% and 5-63%, respectively. Conclusion: The results showed that fluoride varnishes have been used at concentrations of 1% and 5% in the prevention of ECC. The preventive fraction was influenced by the frequency of application, the duration of study and sample size. The evidence level of the studies was of moderate to limited value.
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Affiliation(s)
- Poulami Mishra
- Department of Public Health Dentistry, KVG Dental College and Hospital, Sullia, Karnataka, India
| | - Nusrath Fareed
- Department of Public Health Dentistry, KVG Dental College and Hospital, Sullia, Karnataka, India
| | - Hemant Battur
- Department of Public Health Dentistry, KVG Dental College and Hospital, Sullia, Karnataka, India
| | - Sanjeev Khanagar
- Department of Public Health Dentistry, KVG Dental College and Hospital, Sullia, Karnataka, India
| | - Manohar A Bhat
- Department of Public Health Dentistry, KVG Dental College and Hospital, Sullia, Karnataka, India
| | - Jagan Palaniswamy
- Department of Public Health Dentistry, KVG Dental College and Hospital, Sullia, Karnataka, India
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Dabiri D, Fontana M, Kapila Y, Eckert G, Sokal-Gutierrez K. Community-based assessment and intervention for early childhood caries in rural El Salvador. Int Dent J 2016; 66:221-8. [DOI: 10.1111/idj.12228] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
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Fernández CE, Tenuta LMA, Zárate P, Cury JA. Insoluble NaF in Duraphat® may prolong fluoride reactivity of varnish retained on dental surfaces. Braz Dent J 2016; 25:160-4. [PMID: 25140722 DOI: 10.1590/0103-6440201302405] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2014] [Accepted: 04/17/2014] [Indexed: 03/03/2024] Open
Abstract
There is no consensus about the clinical recommendation of the time that Duraphat® varnish should be maintained on enamel surfaces without suffering mechanical disturbance by the patient. Considering the importance of calcium fluoride (CaF2)-like reservoirs on the anticaries effect of professional fluoride application, an in vitro study was designed to test the reactivity of Duraphat® varnish with enamel forming these reservoirs as a function of time. Since most fluoride in Duraphat® varnish is insoluble to react and form products on enamel, the relative contribution of the varnish soluble and insoluble fluoride fractions to the reactivity was also evaluated. For this, whole-varnish, containing soluble and insoluble fluoride (total fluoride concentration of 23699 ± 384 µg F/g), or centrifuged varnish, containing only soluble fluoride (fluoride concentration of 258 ± 97 µg F/g), were applied in a standardized manner on enamel slabs (n=8/varnish group/time), which were immersed in continuously renewed artificial saliva for up to 36 h. CaF2-like reservoirs formed on enamel by varnish application were extracted using 1 M KOH and fluoride concentration was measured with ion specific electrode. The results were expressed as µg F/cm(2) of enamel area. Whole varnish formed significantly higher fluoride concentration on enamel than centrifuged varnish, reaching maximum concentration at 24 h (22.0 ± 4.5 µg F/cm(2)). Centrifuged varnish reached maximum concentration at 6 h (3.20 ± 0.81 µg F/cm(2)). In conclusion, a longer varnish retention time than the usually recommended could improve the anticaries effect of Duraphat® varnish, allowing that NaF particles, initially insoluble in the varnish matrix, prolong the reactivity with enamel.
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Affiliation(s)
| | | | - Paulo Zárate
- Piracicaba Dental School, University of Campinas, Piracicaba, SP, Brazil
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A school-based oral health intervention in East London: the Happy Teeth fluoride varnish programme. Br Dent J 2016; 215:E14. [PMID: 24157788 DOI: 10.1038/sj.bdj.2013.997] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/10/2013] [Indexed: 11/09/2022]
Abstract
BACKGROUND The Community Dental Services of Barts Health NHS Trust in City and Hackney and Tower Hamlets PCTs in East London have provided a school-based oral health intervention since 2009. OBJECTIVE The aim of this paper is to present the programme development, outcomes and evaluation. SUBJECTS AND METHODS The programme consists of fluoride varnish applications linked to school dental screenings for three to six-year-olds, combined with oral health promotion for parents/carers. An outreach linkworker works closely with schools to help identify and support vulnerable families into the programme. RESULTS In the first year of the programme 160 of the target children (42%) had one FV application and 81 children (21%) had two applications. In the second year 149 children (39%) had one FV application, and 113 (29%) had two applications. Amendments to the protocol increased programme participation in the third year, with 1,822 of the target children (61%) having one FV application and 1,586 (53%) having two applications. CONCLUSIONS The programme proved acceptable to the school staff, participating parents/carers and children. The Happy Teeth programme is proposed as a model for school-based fluoride varnish programmes.
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Perrini F, Lombardo L, Arreghini A, Medori S, Siciliani G. Caries prevention during orthodontic treatment: In-vivo assessment of high-fluoride varnish to prevent white spot lesions. Am J Orthod Dentofacial Orthop 2016; 149:238-43. [DOI: 10.1016/j.ajodo.2015.07.039] [Citation(s) in RCA: 45] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2015] [Revised: 07/01/2015] [Accepted: 07/01/2015] [Indexed: 11/27/2022]
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Irigoyen-Camacho ME, Luengas-Aguirre MI, Amador-Pedraza Y, Zepeda-Zepeda MA, Villanueva-Gutiérrez T, Sánchez-Pérez L. [Comparison of varnishes and fluoridated toothpaste for the prevention of dental caries in school children]. Rev Salud Publica (Bogota) 2015; 17:801-814. [PMID: 28453056 DOI: 10.15446/rsap.v17n5.48147] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2013] [Accepted: 03/18/2015] [Indexed: 11/09/2022] Open
Abstract
Objective To compare preventive effect on dental caries of two frequencies of fluoridated varnish (FV) applications and a group given brushing instructions and using fluoridated toothpaste. Materials and Methods Follow-up study of 203 children attending an elementary school in the municipality of Tláhuac, Mexico City. The children were followed for 22 months. The students were randomly assigned to one of the following groups: 1) brushing instructions with fluoridated toothpaste, 2) FV every six months, 3) three FV applications per week per year. The FV contained fluorosilane (1000 ppm F) and NaF dentifrice (1450 ppm F). The DMFT-caries index and the presence of white spots were recorded (ICDAS, International Caries Detection and Assessment System). Results At baseline, the mean age of the children was 9.3 (SD 0.76) years, white lesions 0.63 (SD 1.48) and DMFT =0.70 (SD 1.11). Averages of the initial and final DMFT scores in the three groups were 0.67 and 1.17 for the toothpaste group, 0.77 and 1.46 for FV twice a year group, and 0.67 y 1.03 for the three-applications-FV group. According to the results of the GEE (Generalized-Estimating Equations) model, there were no significant differences in the rate of white lesions or the increase of the DMFT index. The results for the DMFT were: for bi-annual applications of FV, RR=1.24 (p=0.178) and for the three consecutive applications of FV, RR=0.83, (p=0.298) in comparison with the brushing-instructions group using fluoridated toothpaste, among the three treatment groups, controlling for age, sex, and initial-caries index in primary teeth and brushing frequency. Conclusions Schoolchildren showed a low incidence of caries using any of the three preventive regimens applied.
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El-Damanhoury HM, Fakhruddin KS, Awad MA. Effectiveness of teaching International Caries Detection and Assessment System II and its e-learning program to freshman dental students on occlusal caries detection. Eur J Dent 2014; 8:493-497. [PMID: 25512730 PMCID: PMC4253105 DOI: 10.4103/1305-7456.143631] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
Objective: To assess the feasibility of teaching International Caries Detection and Assessment System (ICDAS) II and its e-learning program as tools for occlusal caries detection to freshmen dental students in comparison to dental graduates with 2 years of experience. Materials and Methods: Eighty-four freshmen and 32 dental graduates examined occlusal surfaces of molars/premolars (n = 72) after a lecture and a hands-on workshop. The same procedure was repeated after 1 month following the training with ICDAS II e-learning program. Validation of ICDAS II codes was done histologically. Intra- and inter-examiner reproducibility of ICDAS II severity scores were assessed before and after e-learning using (Fleiss's kappa). Results: The kappa values showed inter-examiner reproducibility ranged from 0.53 (ICDAS II code cut off ≥ 1) to 0.70 (ICDAS II code cut off ≥ 3) by undergraduates and 0.69 (ICDAS II code cut off ≥ 1) to 0.95 (ICDAS II code cut off ≥ 3) by graduates. The inter-examiner reproducibility ranged from 0.64 (ICDAS II code cut off ≥ 1) to 0.89 (ICDAS II code cut off ≥ 3). No statistically significant difference was found between both groups in intra-examiner agreements for assessing ICDAS II codes. A high statistically significant difference (P ≤ 0.01) in correct identification of codes 1, 2, and 4 from before to after e-learning were observed in both groups. The bias indices for the undergraduate group were higher than those of the graduate group. Conclusions: Early exposure of students to ICDAS II is a valuable method of teaching caries detection and its e-learning program significantly improves their caries diagnostic skills.
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Affiliation(s)
- Hatem M El-Damanhoury
- Department of General and Specialist Dental Practice, College of Dental Medicine, University of Sharjah, Sharjah, UAE.,Department of Operative Dentistry, Faculty of Dentistry, Suez Canal University, Ismalia, Egypt
| | - Kausar Sadia Fakhruddin
- Department of General and Specialist Dental Practice, College of Dental Medicine, University of Sharjah, Sharjah, UAE
| | - Manal A Awad
- Department of General and Specialist Dental Practice, College of Dental Medicine, University of Sharjah, Sharjah, UAE
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Steel K. How effective is the application of topical fluoride varnish in preventing dental caries in children? a literature review. Prim Dent J 2014; 3:74-76. [PMID: 25198645 DOI: 10.1308/205016814812736745] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
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Carey CM. Focus on fluorides: update on the use of fluoride for the prevention of dental caries. J Evid Based Dent Pract 2014; 14 Suppl:95-102. [PMID: 24929594 PMCID: PMC4058575 DOI: 10.1016/j.jebdp.2014.02.004] [Citation(s) in RCA: 77] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
UNLABELLED Improving the efficacy of fluoride therapies reduces dental caries and lowers fluoride exposure. BACKGROUND Fluoride is delivered to the teeth systemically or topically to aid in the prevention of dental caries. Systemic fluoride from ingested sources is in blood serum and can be deposited only in teeth that are forming in children. Topical fluoride is from sources such as community water, processed foods, beverages, toothpastes, mouthrinses, gels, foams, and varnishes. The United States Centers for Disease Control and Prevention (CDC) and the American Dental Association (ADA) have proposed changes in their long standing recommendations for the amount of fluoride in community drinking water in response to concerns about an increasing incidence of dental fluorosis in children. Current research is focused on the development of strategies to improve fluoride efficacy. The purpose of this update is to inform the reader about new research and policies related to the use of fluoride for the prevention of dental caries. METHODS Reviews of the current research and recent evidence based systematic reviews on the topics of fluoride are presented. Topics discussed include: updates on community water fluoridation research and policies; available fluoride in dentifrices; fluoride varnish compositions, use, and recommendations; and other fluoride containing dental products. This update provides insights into current research and discusses proposed policy changes for the use of fluoride for the prevention of dental caries. CONCLUSIONS The dental profession is adjusting their recommendations for fluoride use based on current observations of the halo effect and subsequent outcomes. The research community is focused on improving the efficacy of fluoride therapies thus reducing dental caries and lowering the amount of fluoride required for efficacy.
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Affiliation(s)
- Clifton M Carey
- University of Colorado, School of Dental Medicine, Aurora, CO 80045, USA.
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Bergström EK, Birkhed D, Granlund C, Moberg Sköld U. Approximal caries increment in adolescents in a low caries prevalence area in Sweden after a 3.5-year school-based fluoride varnish programme with Bifluorid 12 and Duraphat. Community Dent Oral Epidemiol 2014; 42:404-11. [DOI: 10.1111/cdoe.12108] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2013] [Accepted: 04/17/2014] [Indexed: 12/01/2022]
Affiliation(s)
- Eva-Karin Bergström
- Department of Cariology; Institute of Odontology; The Sahlgrenska Academy; University of Gothenburg; Gothenburg Sweden
- Department of Preventive and Community Dentistry; Public Dental Health Service; Västra Götaland Region; Gothenburg Sweden
| | - Dowen Birkhed
- Department of Cariology; Institute of Odontology; The Sahlgrenska Academy; University of Gothenburg; Gothenburg Sweden
| | - Christina Granlund
- Specialist Clinic of Oral and Maxillofacial Radiology; Public Dental Health Service; Västra Götaland Region; Gothenburg Sweden
| | - Ulla Moberg Sköld
- Department of Cariology; Institute of Odontology; The Sahlgrenska Academy; University of Gothenburg; Gothenburg Sweden
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Genderson MW, Sischo L, Markowitz K, Fine D, Broder HL. An overview of children's oral health-related quality of life assessment: from scale development to measuring outcomes. Caries Res 2013; 47 Suppl 1:13-21. [PMID: 24107604 DOI: 10.1159/000351693] [Citation(s) in RCA: 53] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2013] [Accepted: 04/25/2013] [Indexed: 11/19/2022] Open
Abstract
The objectives of this paper are to present an overview of children's oral health-related quality of life and include specific applications for using quality of life assessment in dental research. The process of developing pediatric oral health- related quality of life measures, in particular the Child Oral Health Impact Profile, is outlined. Examples of children's oral health-related quality of life measurement in caries research are also provided. Quality of life outcomes are presented and discussed in the context of caries research. Lastly, the relevance of measuring clinically meaningful difference in the context of measuring outcomes research is highlighted with recommendations for future research.
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Affiliation(s)
- M W Genderson
- Virginia Commonwealth University, Richmond, Va., USA
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Donovan TE, Anderson M, Becker W, Cagna DR, Carr GB, Albouy JP, Metz J, Eichmiller F, McKee JR. Annual Review of selected dental literature: Report of the Committee on Scientific Investigation of the American Academy of Restorative Dentistry. J Prosthet Dent 2013; 110:161-210. [DOI: 10.1016/s0022-3913(13)60358-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
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39
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Raucci-Neto W, de Castro-Raucci LMS, Lepri CP, Faraoni-Romano JJ, Gomes da Silva JM, Palma-Dibb RG. Nd:YAG laser in occlusal caries prevention of primary teeth: a randomized clinical trial. Lasers Med Sci 2013; 30:761-8. [PMID: 23955196 DOI: 10.1007/s10103-013-1417-z] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2013] [Accepted: 07/29/2013] [Indexed: 10/26/2022]
Abstract
Dental caries is still the most prevalent chronic disease affecting human populations. Among the preventive treatments performed, it has been reported that laser irradiation combined with topical fluoride can induce an even greater increase in enamel caries resistance. The aim of this study was to evaluate the Nd:YAG laser, with or without fluoride, in occlusal caries prevention of the primary dentition. A double-blind split-mouth study design was used. Fifty-two children with high caries risk (7.6 ± 1.4 years) were selected and received the following: G1--the first molar was a negative control, and the second received a resin sealant; G2--the first molar was a negative control, and the second received laser irradiation (50 mJ, 10 Hz, 0.5 W); G3--the first molar received only acidulate phosphate fluoride (APF), and the second received APF + laser; G4--fisrt molar received only fluoride varnish, and the second received fluoride varnish + laser. Patients were followed up to 12 months to evaluate the presence of white-spot lesions and/or caries cavities by three calibrated observers. Thirty-five patients completed the study. Significant differences were found between the treatment and control groups (p < 0.05). The laser-alone and resin sealant resulted in statistically lower caries formation than the negative control group (p < 0.05). Nd:YAG laser irradiation in primary teeth effectively prevented occlusal caries in pits and fissures when used alone with lower energy over a 1-year period.
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Affiliation(s)
- Walter Raucci-Neto
- Department of Restorative Dentistry, Ribeirão Preto Dental School, University of São Paulo, Avenida do Café, s/nº, Monte Alegre, CEP 14040-904, Ribeirão Preto, SP, Brazil,
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Marinho VCC, Worthington HV, Walsh T, Clarkson JE. Fluoride varnishes for preventing dental caries in children and adolescents. Cochrane Database Syst Rev 2013; 2013:CD002279. [PMID: 23846772 PMCID: PMC10758998 DOI: 10.1002/14651858.cd002279.pub2] [Citation(s) in RCA: 262] [Impact Index Per Article: 23.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
BACKGROUND Topically-applied fluoride varnishes have been used extensively as an operator-applied caries-preventive intervention for over three decades. This review updates the first Cochrane review of fluoride varnishes for preventing dental caries in children and adolescents, which was first published in 2002. OBJECTIVES To determine the effectiveness and safety of fluoride varnishes in preventing dental caries in children and adolescents, and to examine factors potentially modifying their effect. SEARCH METHODS We searched the Cochrane Oral Health Group's Trials Register (to 13 May 2013), the Cochrane Central Register of Controlled Trials (CENTRAL) (The Cochrane Library 2013, Issue 4), MEDLINE via OVID (1946 to 13 May 2013), EMBASE via OVID (1980 to 13 May 2013), CINAHL via EBSCO (1980 to 13 May 2013), LILACS and BBO via the BIREME Virtual Health Library (1980 to 13 May 2013), ProQuest Dissertations and Theses (1861 to 13 May 2013), and Web of Science Conference Proceedings (1945 to 13 May 2013). A search for ongoing trials was undertaken on ClinicalTrials.gov on 13 May 2013. There were no restrictions on language or date of publication in the search of the electronic databases. SELECTION CRITERIA Randomised or quasi-randomised controlled trials with blind outcome assessment used or indicated, comparing topically-applied fluoride varnish with placebo or no treatment in children up to 16 years during at least one year. The main outcome was caries increment measured by the change in decayed, missing and filled tooth surfaces in both permanent (D(M)FS) and primary (d(e/m)fs) teeth. DATA COLLECTION AND ANALYSIS At least two review authors assessed all search results, extracted data and undertook risk of bias independently. Study authors were contacted for additional information. The primary measure of effect was the prevented fraction, 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. The caries increments nearest to three years were used from each included study. Random-effects meta-analyses were performed where data could be pooled. Potential sources of heterogeneity were examined in random-effects meta-regression analyses. Adverse effects information was collected from the included trials. MAIN RESULTS Twenty-two trials with 12,455 participants randomised (9595 used in analyses) were included. For the 13 that contributed data for the permanent tooth surfaces meta-analysis, the pooled D(M)FS prevented fraction estimate comparing fluoride varnish with placebo or no treatment was 43% (95% confidence interval (CI) 30% to 57%; P < 0.0001). There was substantial heterogeneity, confirmed statistically (P < 0.0001; I(2) = 75%), however this body of evidence was assessed as of moderate quality. The pooled d(e/m)fs prevented fraction estimate was 37% (95% CI 24% to 51%; P < 0.0001) for the 10 trials that contributed data for the primary tooth surfaces meta-analysis, also with some heterogeneity (P = 0.009; I(2) = 59%). Once again this body of evidence was assessed as of moderate quality. No significant association between estimates of D(M)FS or d(e/m)fs prevented fractions and the pre-specified factors of baseline caries severity, background exposure to fluorides, application features such as prior prophylaxis, concentration of fluoride, frequency of application were found. There was also no significant association between estimates of D(M)FS or d(e/m)fs prevented fractions and the post hoc factors: whether a placebo or no treatment control was used, length of follow-up, or whether individual or cluster randomisation was used, in the meta-regression models. A funnel plot of the trials in the main meta-analyses indicated no clear relationship between prevented fraction and study precision. In both methods, power is limited when few trials are included. There was little information concerning possible adverse effects or acceptability of treatment. AUTHORS' CONCLUSIONS The conclusions of this updated review remain the same as those when it was first published. The review suggests a substantial caries-inhibiting effect of fluoride varnish in both permanent and primary teeth, however the quality of the evidence was assessed as moderate, as it included mainly high risk of bias studies, with considerable heterogeneity.
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Affiliation(s)
- Valeria CC Marinho
- Queen Mary University of LondonClinical and Diagnostic Oral Sciences, Barts and The London School of Medicine and DentistryTurner StreetWhitechapelLondonUKE1 2AD
| | - Helen V Worthington
- School of Dentistry, The University of ManchesterCochrane Oral Health GroupCoupland III Building, Oxford RoadManchesterUKM13 9PL
| | - Tanya Walsh
- School of Dentistry, The University of ManchesterCoupland III Building, Oxford RoadManchesterUKM13 9PL
| | - Jan E Clarkson
- University of DundeeDental Health Services Research UnitThe Mackenzie BuildingKirsty Semple WayDundeeScotlandUKDD2 4BF
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Sen B, Blackburn J, Morrisey MA, Kilgore ML, Becker DJ, Caldwell C, Menachemi N. Effectiveness of preventive dental visits in reducing nonpreventive dental visits and expenditures. Pediatrics 2013; 131:1107-13. [PMID: 23713098 DOI: 10.1542/peds.2012-2586] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND AND OBJECTIVE Although preventive dental visits are considered important for maintaining pediatric oral health, there is relatively little research showing that they reduce subsequent nonpreventive dental visits or costs. At least 1 study seemed to find that early preventive dental care is associated with more restorative and emergency visits. Previous studies are limited by their inability to account for unmeasurable factors that may lead children to "select" into using both more preventive and nonpreventive dental care. We used econometric techniques that minimize selection bias to assess the effectiveness of preventive dental care in reducing subsequent nonpreventive dental service utilization among children. METHODS Using data from Alabama's Children's Health Insurance Program (CHIP), 1998-2010., a cohort study of children's dental service utilization was conducted. Outcomes were 1-year lagged nonpreventive dental care and expenditures, and overall dental and medical expenditures. Children who were continuously enrolled for at least 3 years were included. Separate models were estimated for children aged <8 years (n = 14 972) and those aged ≥8 years (n = 21 833). RESULTS More preventive visits were associated with fewer subsequent nonpreventive dental visits and lower nonpreventive dental expenditures for both groups. However, more preventive visits did not reduce overall dental or medical (inclusive of dental) expenditures. CONCLUSIONS Preventive dental visits can reduce subsequent nonpreventive visits and expenditures for children continuously enrolled in CHIP. However, they may not reduce overall program costs. Effective empirical research in this area must continue to address unobserved confounders and selection issues.
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Affiliation(s)
- Bisakha Sen
- Department of Health Care Organization and Policy, University of Alabama, Birmingham, AL, USA
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