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Koh M, Kerr D, Hill CM, Chi DL. A Mixed-Methods Study on Topical Fluoride Beliefs and Refusal Behaviors for Caregivers of Children with Special Health Care Needs. Matern Child Health J 2024; 28:104-115. [PMID: 37966559 PMCID: PMC10876822 DOI: 10.1007/s10995-023-03806-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/23/2023] [Indexed: 11/16/2023]
Abstract
OBJECTIVE To understand topical fluoride-related beliefs and refusal behaviors for caregivers of children with special health care needs (CSHCN). METHODS This was an explanatory sequential mixed methods study. For the quantitative analyses, we surveyed 520 caregivers to (a) compare fluoride-related beliefs between caregivers of CSHCN and caregivers of healthy children and (b) evaluate the association between special health care need (SHCN) status and topical fluoride refusal. We used logistic regression models to generate unadjusted odds ratios, confounder-adjusted odds ratios (AOR), and 95% confidence intervals (CI). For the qualitative analyses, we interviewed 56 caregivers who refused or were hesitant about topical fluoride. Data were coded deductively and compared by SHCN status to an existing conceptual model of topical fluoride refusal. RESULTS In the quantitative analysis, 41.3% of caregivers refused or thought about refusing topical fluoride. There were no significant differences in fluoride beliefs by SHCN status (p-values > 0.05) nor was there a significant association between SHCN status and topical fluoride refusal (AOR: 0.65, 95% CI 0.37-1.14; p = 0.13). In the qualitative analysis, the relative importance of each domain of the conceptual model was similar between the caregiver groups. Two differences were that all caregivers of CSHCN thought fluoride was unnecessary and wanted to keep chemicals out of their child's body. CONCLUSIONS FOR PRACTICE While caregivers of CSHCN were not more likely to refuse topical fluoride than caregivers of healthy children, there may be important differences in the underlying reasons for refusing topical fluoride.
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Affiliation(s)
- Madelyn Koh
- Department of Oral Health Sciences, School of Dentistry, University of Washington, B530D, Box 357475, 1959 NE Pacific St., Seattle, WA, 98195, USA
| | - Darragh Kerr
- Department of Oral Health Sciences, School of Dentistry, University of Washington, B530D, Box 357475, 1959 NE Pacific St., Seattle, WA, 98195, USA
| | - Courtney M Hill
- Department of Oral Health Sciences, School of Dentistry, University of Washington, B530D, Box 357475, 1959 NE Pacific St., Seattle, WA, 98195, USA
| | - Donald L Chi
- Department of Oral Health Sciences, School of Dentistry, University of Washington, B530D, Box 357475, 1959 NE Pacific St., Seattle, WA, 98195, USA.
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Saini SJ, Carle AC, Forsyth AR, Chi DL. Association between caregiver opposition to topical fluoride and COVID-19 vaccines. Vaccine 2023; 41:1035-1041. [PMID: 36567141 PMCID: PMC9747692 DOI: 10.1016/j.vaccine.2022.12.018] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2022] [Revised: 12/07/2022] [Accepted: 12/08/2022] [Indexed: 12/15/2022]
Abstract
PURPOSE Caregivers who oppose topical fluoride in dental settings may be opposed to other preventive health treatments, including COVID-19 vaccines. The study objective was to examine the association between caregiver opposition to topical fluoride and COVID-19 vaccines. METHODS The study took place at the University of Washington in Seattle, WA. English-speaking caregivers of children aged < 18 years were eligible to participate. An 85-item REDCap survey was administered from February to September 2021. The predictor variable was topical fluoride opposition (no/yes). The outcome was COVID-19 vaccine opposition (no/yes). The models included the following covariates: child and caregiver age; caregiver race and ethnicity, education level, dental insurance type, parenting style, political ideology, and religiosity; and household income. Logistic regression models generated odds ratios (OR) and 95 % confidence intervals (α = 0.05). RESULTS Six-hundred-fifty-one caregivers participated, and 403 caregivers with complete data were included in the final regression model. Mean child age was 8.5 years (SD 4.2), mean caregiver age was 42.1 years (SD 9.1), 53.0 % of caregivers were female, 57.3 % self-reported as white, and 65.5 % were insured by Medicaid. There was a significant positive association between topical fluoride and COVID-19 vaccine opposition (OR = 3.13; 95 % CI: 1.87, 5.25; p < 0.001). Other factors associated with COVID-19 vaccine opposition included conservative political views (OR = 2.77; 95 % CI: 1.26, 6.08; p < 0.011) and lower education (OR = 3.47; 95 % CI: 1.44, 8.38; p < 0.006). CONCLUSIONS Caregivers opposed to topical fluoride in dental settings were significantly more likely to oppose COVID-19 vaccines for their child. Future research should identify ways to address both topical fluoride and vaccine opposition to prevent diseases in children.
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Affiliation(s)
- Sapna J Saini
- Department of Pediatric Dentistry, University of Washington School of Dentistry, 6222 NE 74th St #8158, Seattle, WA 98115, USA.
| | - Adam C Carle
- James M. Anderson Center for Health Systems Excellence, Cincinnati Children's Hospital Medical Center, 3333 Burnet Ave., MLC 7014, Cincinnati, OH 45229-3039, USA; Department of Pediatrics, University of Cincinnati College of Medicine, 3230 Eden Ave, Cincinnati, OH 45267, USA; Department of Psychology, University of Cincinnati College of Arts and Sciences, 1 Edwards Center, Cincinnati, OH 45221, USA.
| | - Anna R Forsyth
- Department of Pediatric Dentistry, University of Washington School of Dentistry, 6222 NE 74th St #8158, Seattle, WA 98115, USA.
| | - Donald L Chi
- Department of Pediatric Dentistry, University of Washington School of Dentistry, 6222 NE 74th St #8158, Seattle, WA 98115, USA; Department of Oral Health Sciences, University of Washington, 1959 NE Pacific Street, Box 357475, Seattle, WA 98195, USA; Department of Health Systems and Population Health, University of Washington, 1959 NE Pacific St., Box 357660, Seattle, WA, 98195, USA.
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Sharma V, Mohapatra A, Bagchi A. Ternion Cusp: An Unusual Variant of Talon's Cusp: A Case Report. Int J Clin Pediatr Dent 2022; 15:784-788. [PMID: 36866150 PMCID: PMC9973072 DOI: 10.5005/jp-journals-10005-2476] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/17/2023] Open
Abstract
Background Teeth are hard mineralized anatomical components of the dentofacial skeleton that are developed during the gestation period by odontogenesis. This dental development comprises five stages viz. initiation, proliferation, histodifferentiation, morphodifferentiation, and apposition. Excitation to the dental organ during morphodifferentiation is responsible for the formation of a talon cusp, which manifests as a cusp-like structure of hard tissue projecting from the cingulum to a varying measurable length toward the incisal edge of maxillary and mandibular anterior teeth. Various literature has reported that it comprises enamel, dentine, and an inconsistent amount of pulp tissue. Old literature suggests its occurrence in primary and permanent teeth and mostly on the palatal aspect of teeth as one cusp; therefore, known as a talon cusp (eagle's talon). Case description An exceptional case of three cusped structures projecting from the palatal side of a maxillary central incisor is thus reported. The rare occurrence of an atypical talon cusp with three well-defined mamelon-like cusps on the palatal surface of the permanent maxillary central incisor is coined as ternion cusp, meaning "three" by authors. Its occurrence is repercussed as attrition of the teeth in the opposite arch. Selective or retruded contact position (RCP) was done, followed by topical fluoride application was rendered. Conclusion Managing and treating these exceptional cusps depends upon their size, present complications, and patient compliance. How to cite this article Sharma V, Mohapatra A, Bagchi A. Ternion Cusp: An Unusual Variant of Talon's Cusp: A Case Report. Int J Clin Pediatr Dent 2022;15(6):784-788.
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Affiliation(s)
- Varsha Sharma
- Department of Pedodontics and Preventive Dentistry, Kalinga Institute of Dental Sciences, Kalinga Institute of Industrial Technology (KIIT) (Deemed to be University), Bhubaneswar, Odisha, India
| | - Abinash Mohapatra
- Department of Pedodontics and Preventive Dentistry, Kalinga Institute of Dental Sciences, Kalinga Institute of Industrial Technology (KIIT) (Deemed to be University), Bhubaneswar, Odisha, India
| | - Anandamoy Bagchi
- Department of Pedodontics and Preventive Dentistry, Kalinga Institute of Dental Sciences, Kalinga Institute of Industrial Technology (KIIT) (Deemed to be University), Bhubaneswar, Odisha, India
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Yan IG, Zheng FM, Gao SS, Duangthip D, Lo ECM, Chu CH. Fluoride Delivered via a Topical Application of 38% SDF and 5% NaF. Int Dent J 2022; 72:773-778. [PMID: 35570014 DOI: 10.1016/j.identj.2022.03.004] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2022] [Revised: 03/05/2022] [Accepted: 03/08/2022] [Indexed: 11/28/2022] Open
Abstract
OBJECTIVES The objectives of this study were to compare the amount of fluoride delivered via a topical application of 38% silver diamine fluoride (SDF) solution and 5% sodium fluoride (NaF) varnish as well as to determine the amount of 38% SDF solution delivered using various micro-applicators. METHODS The weights of 38% SDF (Saforide) and 5% NaF (Duraphat) applied to the occlusal surface of an extracted human upper first premolar with a regular-size (2.50-mm tip diameter) micro-applicator were measured using an electronic-analytical balance. Afterwards, the weight of 38% SDF applied to a premolar using the micro-applicators of 5 common brands (Premium Plus, 3M, Dentsply, Elevate Oral Care, and SDI) were studied. The tip diameter of each micro-applicator was measured under a microscope. The weights of the delivered fluoride and silver were also calculated. RESULTS The mean weights of the fluoride delivered via the SDF solution and NaF varnish were 0.25 ± 0.07 mg and 0.49 ± 0.08 mg, respectively (P < .001). In addition, the tip diameters of the micro-applicators ranged from 1.89 ± 0.03 mm to 2.76 ± 0.02 mm. The mean weights of the fluoride delivered per application of 38% SDF using different applicators ranged from 0.13 ± 0.06 mg to 0.30 ± 0.09 mg, whereas the mean weights of the silver ranged from 0.76 ± 0.32 mg to 1.68 ± 0.50 mg. The weights of the delivered 38% SDF solution varied with the brand and with the tip diameters of the dental micro-applicators (P < .001). CONCLUSIONS The fluoride of the 38% SDF solution delivered topically was significantly less than that of 5% NaF varnish. Moreover, the amount of SDF solution delivered depends on the brand and size of the micro-applicators.
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Affiliation(s)
- Iliana Gehui Yan
- Faculty of Dentistry, The University of Hong Kong, Hong Kong SAR, China
| | | | - Sherry Shiqian Gao
- Department of Stomatology, School of Medicine, Xiamen University, Xiamen, China
| | | | | | - Chun Hung Chu
- Faculty of Dentistry, The University of Hong Kong, Hong Kong SAR, China.
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Sleibi A, Tappuni AR, Baysan A. Reversal of Root Caries with Casein Phosphopeptide-Amorphous Calcium Phosphate and Fluoride Varnish in Xerostomia. Caries Res 2021; 55:475-484. [PMID: 34352792 DOI: 10.1159/000516176] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2020] [Accepted: 03/28/2021] [Indexed: 11/19/2022] Open
Abstract
Different formulas of topical fluoride have been used to manage root carious lesions. This clinical trial aimed to investigate the efficacy of a dental varnish containing casein phosphopeptide-amorphous calcium phosphate (CPP-ACP) and fluoride compared with fluoride alone in reversing/arresting root caries in xerostomic patients over 1 year. A total of 80 patients (age range 45-92 years) with primary root caries (n = 184 root carious lesions) and unstimulated salivary flow rate of <0.2 mL/min were randomly allocated to receive either dental varnish containing CPP-ACP and 5% fluoride (group 1: MI varnish; GC, Japan) (n = 41, 83 lesions), or dental varnish with 5% fluoride alone (group 2: NUPRO White; Dentsply, USA) (n = 39, 101 lesions). Clinical assessments with Severity Index (SI) for root caries, DIAGNOdent measurements, and varnish application were carried out at baseline, 3, 6, and 12 months. Standard oral hygiene instructions with 1,450 ppm fluoride toothpastes were provided for both groups. After 3 months, 63.9% (n = 46) of root caries in group 1 became hard (SI: 0) compared with 39.3% (n = 35) in group 2 (p < 0.01). After 6 and 12 months, the differences in SI were insignificant (group 1, n = 60, 83.3%) (group 2, n = 66, 74.2%) (p = 0.36), and (group 1, n = 60, 89.6%) (group 2, n = 67, 81.7%, n = 1 soft, 1.2%) (p = 0.29), respectively. In both groups, noncavitated leathery lesions were more likely to become hard when compared to the cavitated root caries. A significant decrease in plaque index, surface roughness, lesion dimension, and DIAGNOdent readings with a significant increase in lesion distance from the gingival margin was reported in both groups (p < 0.05). This study has provided evidence that fluoride dental varnish either with or without calcium and phosphate has the potential to arrest/reverse root caries, especially noncavitated lesions for patients with xerostomia.
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Affiliation(s)
- Ahmed Sleibi
- Oral Bioengineering, Institute of Dentistry, Queen Mary University of London, London, United Kingdom,
| | - Anwar R Tappuni
- Centre for Oral Immunobiology and Regenerative Medicine, Institute of Dentistry, Queen Mary University of London, London, United Kingdom
| | - Aylin Baysan
- Oral Bioengineering, Institute of Dentistry, Queen Mary University of London, London, United Kingdom
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Anderson M, Dahllöf G, Warnqvist A, Grindefjord M. Development of dental caries and risk factors between 1 and 7 years of age in areas of high risk for dental caries in Stockholm, Sweden. Eur Arch Paediatr Dent 2021; 22:947-957. [PMID: 34106458 PMCID: PMC8526475 DOI: 10.1007/s40368-021-00642-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2021] [Accepted: 05/25/2021] [Indexed: 11/25/2022]
Abstract
Purpose To explore caries predictors at age 1 year and caries development at ages 5 and 7 years in two groups of children following different fluoride-based preventive programs. Methods We conducted a prospective cluster-randomized controlled intervention trial with two parallel arms comparing two prevention programs: one program included fluoride varnish applications every 6 months, the other did not; otherwise, the programs were the same. Participants were 1- and 3-year-old children enrolled at 23 dental clinics in high-risk areas in Stockholm, Sweden. The baseline examination included structured interviews. Caries data were extracted from dental records. The primary outcome measures were ICDAS 1–6 > 0 at baseline (age 1 year) and defs > 0 at ages 2, 3, 5, and 7 years. The secondary outcome measure at age 7 was DFS > 0. Results Continuous caries development occurred: defs > 0 in 23% at 5 years and in 42% at 7 years. We found no difference in caries development between children who had or had not received fluoride varnish as toddlers. At age 1-year, significant predictors for dental caries in later preschool years were immigrant background, family income, and sweets consumption. Fluoride toothpaste > once a day at 1 year had an OR < 1 for defs > 0 at 5- and 7 years. Conclusions For toddlers, fluoride varnish does not seem to be an adequate prevention tool. Brushing with fluoride toothpaste from 1 year of age could not arrest caries development. Immigrant background was the strongest predictor. A new toolbox as well as collaborative upstream actions for reducing free-sugar intake are needed.
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Affiliation(s)
- M Anderson
- Division of Orthodontics and Pediatric Dentistry, Department of Dental Medicine, Karolinska Institutet, Stockholm, Sweden.
- Department of Pediatric Dentistry, Folktandvården Eastmaninstitutet, Folktandvården Stockholms Län AB, Stockholm, Sweden.
- Center of Pediatric Oral Health, Stockholm, Sweden.
- Pedodonti, Folktandvården Eastmaninstitutet, Dalagatan 11, 10231, Stockholm, Sweden.
| | - G Dahllöf
- Division of Orthodontics and Pediatric Dentistry, Department of Dental Medicine, Karolinska Institutet, Stockholm, Sweden
- Center of Pediatric Oral Health, Stockholm, Sweden
- Center for Oral Health Services and Research, TkMidt, Trondheim, Norway
| | - A Warnqvist
- Division of Biostatistics, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - M Grindefjord
- Division of Orthodontics and Pediatric Dentistry, Department of Dental Medicine, Karolinska Institutet, Stockholm, Sweden
- Department of Pediatric Dentistry, Folktandvården Eastmaninstitutet, Folktandvården Stockholms Län AB, Stockholm, Sweden
- Center of Pediatric Oral Health, Stockholm, Sweden
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Cunha-Cruz J, Pires Dos Santos AP. Professionally and Self-Applied Fluorides are Effective in Preventing Dental Root Caries. J Evid Based Dent Pract 2021; 21:101523. [PMID: 34051954 DOI: 10.1016/j.jebdp.2020.101523] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
ARTICLE TITLE AND BIBLIOGRAPHIC INFORMATION Topical Fluoride to Prevent Root Caries: Systematic Review with Network Meta-analysis. Zhang J, Sardana D, Li KY, Leung KCM, Lo ECM. J Dent Res. 2020; 99(5):506-13. SOURCE OF FUNDING Other funding. The study was funded by the Tam Wah-Ching endowed professorship of the University of Hong Kong. TYPE OF STUDY/DESIGN Systematic review with meta-analysis.
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Hayes C, Douglass CW, Kim FM, Burgard SL, Couper D. A case-control study of topical and supplemental fluoride use and osteosarcoma risk. J Am Dent Assoc 2021; 152:344-353.e10. [PMID: 33745682 PMCID: PMC9773635 DOI: 10.1016/j.adaj.2021.01.010] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2020] [Revised: 11/17/2020] [Accepted: 01/18/2021] [Indexed: 12/24/2022]
Abstract
BACKGROUND A relationship between fluoride and osteosarcoma has been hypothesized but not validated. To the authors' knowledge, there are no published studies examining topical fluoride or dietary fluoride supplements and osteosarcoma risk. The purpose of this study was to examine the association between ever or never use of topical and dietary fluoride supplements and osteosarcoma. METHODS The authors performed a secondary data analysis on data from 2 separate but linked studies. Patients for Phase 1 and Phase 2 were selected from US hospitals using a hospital-based matched case-control study design. Case patients were those who had received diagnoses of osteosarcoma, and control patients were those who had received diagnoses of other bone tumors or nonneoplastic conditions. In Phase 1, case patients (N = 209) and control patients (N = 440) were those seeking treatment at orthopedic departments from 1989 through 1993. In Phase 2, incident case patients (N = 108) and control patients (N = 296) were identified and treated by physicians from 1994 through 2000. This analysis included all patients who met eligibility criteria and on whom the authors had complete data on exposure, outcome, and covariates. The authors used conditional logistic regression to estimate odds ratios and 95% confidence intervals (CIs) for the association of topical fluoride use and supplemental fluoride use with osteosarcoma. RESULTS The adjusted odds ratios were 0.94 (95% CI, 0.60 to 1.46) and 0.78 (95% CI, 0.46 to 1.33) for topical fluoride and supplemental fluoride, respectively. CONCLUSIONS Neither topical nor dietary fluoride supplements are associated with an increased risk of developing osteosarcoma. PRACTICAL IMPLICATIONS Supplemental and topical fluorides used in the dental office and in over-the-counter products are not related to an increased risk of developing osteosarcoma.
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Affiliation(s)
- Catherine Hayes
- Division of Commonwealth Medicine, Office of Clinical Affairs, University of Massachusetts Medical School, Worcester, MA; Department of Health Policy and Health Services Research, Henry M. Goldman School of Dental Medicine, Boston University, Boston, MA; Department of Oral Health Policy and Epidemiology, Harvard School of Dental Medicine, Boston, MA
| | - Chester W. Douglass
- Department of Oral Health Policy and Epidemiology, Harvard School of Dental Medicine, Boston, MA
| | | | - Sheila L. Burgard
- Department of Biostatistics, University of North Carolina at Chapel Hill, Chapel Hill, NC
| | - David Couper
- Department of Biostatistics, University of North Carolina at Chapel Hill, NC
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Timms L, Hume C, Wilson V, McClean L, Marshman Z, Zaitoun H. A service evaluation of an intervention to increase application of topical fluoride varnish in general dental practice in South Yorkshire. Eur Arch Paediatr Dent 2021; 22:93-7. [PMID: 32418054 DOI: 10.1007/s40368-020-00539-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2019] [Accepted: 05/03/2020] [Indexed: 12/16/2022]
Abstract
PURPOSE Dental caries is still common in children in the UK despite many available preventative interventions. Application of topical fluoride varnish can reduce caries experience. National and international guidance recommends at least twice-yearly application of topical fluoride varnish, however guidance is not always followed. This project aimed to first identify the proportion of patients receiving fluoride varnish by their primary care dental practitioner prior to their referral to a secondary care service and subsequently increase this rate by introducing an intervention. METHODS The intervention required the referring practitioner to document the date of which topical fluoride was applied prior to referral. Referrals without this information were rejected. Data were collected pre and post this change in policy to ascertain fluoride application rates. Parents and children were questioned about the frequency of application, and referral forms were reviewed for practitioner-reported application. RESULTS Topical fluoride application rates improved by 19% points for patient-reported application, and 31% points for practitioner-reported application. The biggest increase in application rate was in the cohort of patients receiving 6-monthly fluoride application. CONCLUSION This study demonstrated that a simple intervention, mandating that primary care dental practitioners record the most recent application of topical fluoride before referring a patient to secondary care, can improve the rates of topical fluoride varnish application in the UK.
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Hayashi M, Momoi Y, Fujitani M, Fukushima M, Imazato S, Kitasako Y, Kubo S, Nakashima S, Nikaido T, Shimizu A, Sugai K, Takahashi R, Unemori M, Yamaki C. Evidence-based consensus for treating incipient enamel caries in adults by non-invasive methods: recommendations by GRADE guideline. Jpn Dent Sci Rev 2020; 56:155-63. [PMID: 33294058 DOI: 10.1016/j.jdsr.2020.09.005] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2020] [Revised: 09/28/2020] [Accepted: 09/30/2020] [Indexed: 11/22/2022] Open
Abstract
Remineralization treatment, which offers the advantage of being non-invasive, is increasingly being used as a minimal intervention treatment in managing incipient enamel caries. The aim of this review was to develop EBM guideline for optimized strategies for non-invasive treatment of incipient enamel caries. Japanese Society of Conservative Dentistry (JSCD) guideline committee formulated a Guideline for treating incipient enamel caries using the GRADE system, which is the global, mainstream standard for guideline development. The committee selected the most frequent clinical questions (CQs) in treating incipient enamel caries and identified clinically important outcomes in evaluating the efficacy of treatments. Using extensive electronic and manual searches, relevant randomized controlled trials and controlled clinical trials were identified. Based on evidence profiles produced by the committee, the panel discussed the effects, benefits and disadvantages of the selected treatments, as well as their cost effectiveness and feasibility, in order to achieve a consensus in treating incipient enamel caries non-invasively. A recommendation was made for each clinical question after voting by the panel members. Based on the evidence profile and panel discussions for each CQ, the experts strongly recommended application of topical fluoride to inhibit cavitation of incipient enamel caries, and to diminish white spot lesions.
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Yang SY, Jeong IJ, Kim KM, Kwon JS. Time-dependent effects after enamel fluoride application on an acid etching system in orthodontic bracket bonding. Clin Oral Investig 2021; 25:497-505. [PMID: 32556578 DOI: 10.1007/s00784-020-03409-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2020] [Accepted: 06/10/2020] [Indexed: 10/24/2022]
Abstract
OBJECTIVES This study investigated the effectiveness of acid etching and bond strength in an orthodontic bonding system in accordance with various time periods after 1.23% acidulated phosphate fluoride (APF) gel applications. MATERIALS AND METHODS APF gel was applied on the enamel surface of bovine teeth, which were assigned to group F0. The tooth specimens were then immersed in distilled water for 1 (F1), 7 (F7), 14 (F14), 21 (F21) and 28 (F28) days. A group without fluoride pretreatment was a control group. All groups were etched with 35% phosphoric acid and evaluated using a surface hardness tester and scanning electron microscope (SEM). A shear bond strength (SBS) test was performed using a universal testing machine, and the bond failure modes were also examined. RESULTS After the 1.23% APF gel treatment, the hardness of the acid-etched enamel surface decreased as the immersion period increased. SEM images of the test groups showed etched patterns similar to control group as the immersion period increased. The SBS increased with increasing immersion period, whereas group F21 was not significantly different from the control group. Relatively high adhesive remnant index scores were identified as the ageing period increased. CONCLUSIONS The present study indicated that in order to obtain suitable bond strength, it is recommended to use an acid etching-based bonding system for the fixation of orthodontic appliances on the enamel surface 21 days after the use of APF gel. CLINICAL RELEVANCE Fluoride pre-treatment interferes with the acid etching effects on enamel, causing a reduction in the bond strength with orthodontic brackets.
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Cerón-Zamora E, Navarrete-Hernández JDJ, Lara-Carrillo E, Robles-Bermeo NL, Lucas-Rincón SE, Hernández-Martínez CT, López-Pontigo L, Villalobos-Rodelo JJ, Medina-Solís CE. Factors associated with the use of Dental Health Services by Mexican Schoolchildren to receive Professionally Applied Topical Fluoride. P R Health Sci J 2020; 39:203-209. [PMID: 32663919] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
OBJECTIVE To identify the prevalence of and factors associated with the use of dental health services to receive professionally applied topical fluoride (DHSU-PATF) in the 12 months prior to the study among Mexican schoolchildren aged 6 to 12 years. METHODS A cross-sectional study was performed in 1,404 schoolchildren selected randomly from 15 public schools in the city of Pachuca, Mexico. Questionnaires were distributed to determine the demographic, socioeconomic, and behavioral variables. The dependent variable was the DHSU-PATF in the year before the study, which was dichotomized as 0 (no DHSU-PATF) or 1 (yes, DHSU-PATF). We calculated odds ratios (OR) and 95% confidence intervals. The analysis was performed in Stata 11.0. RESULTS The prevalence of DHSU-PATF was 5.1%, but lower among younger children (OR = 0.86) and greater among children with health insurance (private insurance, OR = 3.64; insurance provided by the government owned oil company, the Army, or the Navy, OR = 5.03). The level of knowledge about oral health among guardians/ parents was also a factor (medium, OR = 2.37; high, OR = 4.05). Additionally, among the children whose parents/guardians perceived them (the children) as having good or very good oral health, the OR was 3.33; among children whose parents brushed their teeth with greater relative frequency, the OR was 8.74. Finally, DHSU-PATF was greater among children with relatively higher socioeconomic status (2nd quartile, OR = 3.29; 3rd quartile, OR = 5.99; 4th quartile, OR = 4.64). CONCLUSION The receipt of PATF was low in this sample of Mexican schoolchildren and is associated with socioeconomic and behavioral factors. This gives us a guideline to create or improve topical fluoride application strategies in the public and private Mexican health systems.
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Affiliation(s)
- Eduardo Cerón-Zamora
- Academic Area of Dentistry of Health Sciences Institute at Autonomous University of Hidalgo State, Pachuca, Mexico; Advanced Studies and Research Center in Dentistry "Dr. Keisaburo Miyata" of Faculty of Dentistry at Autonomous University of the State of Mexico, Toluca, México
| | | | - Edith Lara-Carrillo
- Advanced Studies and Research Center in Dentistry "Dr. Keisaburo Miyata" of Faculty of Dentistry at Autonomous University of the State of Mexico, Toluca, México
| | - Norma Leticia Robles-Bermeo
- Advanced Studies and Research Center in Dentistry "Dr. Keisaburo Miyata" of Faculty of Dentistry at Autonomous University of the State of Mexico, Toluca, México
| | - Salvador Eduardo Lucas-Rincón
- Academic Area of Dentistry of Health Sciences Institute at Autonomous University of Hidalgo State, Pachuca, Mexico; Clinic of Dental Specialties of the General Hospital of Pachuca, campus Arista of the Ministry of Health of Hidalgo, Pachuca, México
| | | | - Lydia López-Pontigo
- Academic Area of Dentistry of Health Sciences Institute at Autonomous University of Hidalgo State, Pachuca, Mexico
| | - Juan José Villalobos-Rodelo
- Faculty of Dentistry at Autonomous University of Sinaloa, Culiacan, México; ISSSTE Sinaloa, Culiacan, Mexico
| | - Carlo Eduardo Medina-Solís
- Academic Area of Dentistry of Health Sciences Institute at Autonomous University of Hidalgo State, Pachuca, Mexico; Advanced Studies and Research Center in Dentistry "Dr. Keisaburo Miyata" of Faculty of Dentistry at Autonomous University of the State of Mexico, Toluca, México
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Abdelwahed AG, Temirek MM, Hassan FM. Antierosive Effect of Topical Fluorides: A Systematic Review and Meta-Analysis of In Situ Studies. Open Access Maced J Med Sci 2019; 7:1523-1530. [PMID: 31198467 PMCID: PMC6542392 DOI: 10.3889/oamjms.2019.291] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2019] [Revised: 04/22/2019] [Accepted: 04/23/2019] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND: The effectiveness of the application of topical fluorides in prevention of erosive tooth wear has been an issue of controversy in the literature. The objective of this systematic review was to assess in situ studies investigating the effects of using topical fluorides on prevention of erosive tooth wear MATERIAL AND METHODS: Two electronic databases PubMed/MEDLINE and Cochrane Central Register of Controlled Trials were searched. Eligibility criteria included in situ-controlled studies that assessed the effect of the erosive process without additional tooth brushing. The search involved English-written articles only. A total of 684 potentially relevant titles and abstracts were found after removal of duplicates, of which 22 full-text articles were selected. Seventeen studies were included in the qualitative synthesis of which 6 studies included in the meta-analysis. The following data were obtained for each study: authors, year of publication, country, study design, periods of study, duration, blinding, interventions (type/concentration/form), tooth substrate, location of the intraoral appliance, number of samples attached to each appliance, type of acidic media used for erosive challenge, duration of erosive challenge, subjects (number/age/sex), reported side effects -if any-, measuring device, amounts of tissue loss. RESULTS: The risk of bias of the included studies was assessed using the Cochrane Collaboration tool for assessing the risk of bias. A meta-analysis of the present study was performed using Comprehensive Meta-Analysis version 2.2.048 software. CONCLUSION: The use of oral hygiene products containing AmF/NaF/SnCl2 or NaF may be effective in the prevention of erosive tooth wear.
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Affiliation(s)
- Ahmed Gamal Abdelwahed
- Conservative Dentistry Department, Faculty of Dentistry, October 6 University, Cairo, Egypt
| | - Marwa Mohamed Temirek
- Conservative Dentistry Department; Faculty of Dentistry, Fayoum University, Faiyum, Egypt
| | - Fayez Mohamed Hassan
- Conservative Dentistry Department, Faculty of Dentistry, Cairo University, Cairo, Egypt
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Carpiano RM, Chi DL. Parents' attitudes towards topical fluoride and vaccines for children: Are these distinct or overlapping phenomena? Prev Med Rep 2018; 10:123-128. [PMID: 29755930 PMCID: PMC5945909 DOI: 10.1016/j.pmedr.2018.02.014] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2017] [Revised: 02/12/2018] [Accepted: 02/26/2018] [Indexed: 11/27/2022] Open
Abstract
Despite attention paid to parental refusal of child vaccines, the phenomenon of topical fluoride refusal is poorly understood. We examine the extent to which parent attitudes and Internet use regarding topical fluoride treatment and vaccines may overlap and, in turn, uniquely or distinctly correlate with fluoride and vaccine refusal for the child. In 2017, we analyzed data collected from 2011 to 12 for 361 children from three Washington state dental clinics. The instrument included analogous measures of topical fluoride and vaccine safety concerns, perceived severity of preventable cavities/disease, and Internet use for fluoride/vaccine information; and measures of non-fluoridated toothpaste use, attitudes towards dental x-rays and amalgam and composite fillings. We assessed dental chart-based topical fluoride refusal occurring in 2009 or 2010 and parent-reported vaccine refusal. All analogous fluoride and vaccine items were substantively correlated. However, in a series of adjusted models, none of these items were significantly associated with fluoride refusal. Multiple fluoride and vaccine items were associated with vaccine refusal in unadjusted models; but only vaccine safety concerns, perceived severity of a preventable cavity, and Internet use for vaccine information remained significant in adjusted models. Although there is concordance between the two refusal behaviors as well as analogous attitudes and Internet use, these findings challenge the idea that fluoride refusal should be addressed with interventions focusing on vaccine refusal. Further research is required on the factors underlying refusal of preventive dental care. Studies find that parental refusal of child topical fluoride and vaccines correlate. We tested overlap of factors possibly underlying refusal of both treatments. Analogous fluoride and vaccine attitudes and Internet use items correlated. None of these items were significantly associated with fluoride refusal. Few vaccine- and fluoride-related items were associated with vaccine refusal.
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Affiliation(s)
- Richard M Carpiano
- School of Public Policy, University of California, Riverside, Riverside, CA, USA.,Department of Sociology, University of California, Riverside, USA.,Center for Healthy Communities, University of California, Riverside, USA.,Department of Sociology, University of British Columbia, Vancouver, BC, Canada
| | - Donald L Chi
- Department of Oral Health Sciences, School of Dentistry, University of Washington, Seattle, WA, USA
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Anderson M, Dahllöf G, Soares FC, Grindefjord M. Impact of biannual treatment with fluoride varnish on tooth-surface-level caries progression in children aged 1-3 years. J Dent 2017; 65:83-88. [PMID: 28739318 DOI: 10.1016/j.jdent.2017.07.009] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2017] [Revised: 07/04/2017] [Accepted: 07/18/2017] [Indexed: 10/19/2022] Open
Abstract
OBJECTIVE This study describes caries progression at tooth-surface level in children from 1 to 3 years of age and the impact of biannual treatment with fluoride varnish. METHODS Children who participated in a cluster-randomized controlled trial and had shown signs of dental caries were included in this study (n=801). International Caries Detection and Assessment System (ICDAS) was used to classify dental caries. The present study compared children receiving a standard yearly intervention to children receiving the same standard preventive intervention supplemented with an application of fluoride varnish every half year. RESULTS The maxillary incisors were the first teeth to develop cavitation (ICDAS 3-6) and also mostly affected. Further analyses focusing on maxillary incisors buccal surfaces showed that sound surfaces had least progression and that progression to extensive decay was more common in teeth that had exhibited moderate decay. A summarizing progression index (PI) was calculated for the buccal surfaces of the maxillary incisors. Between 1 and 2 years of age PI was 26% and between 2 and 3 years of age PI was 21%. The progression on buccal incisors and on occlusal first primary molars did not differ between intervention groups (p≤0,05). CONCLUSION No impact on caries progression for biannual treatment with fluoride varnish was found. CLINICAL SIGNIFICANCE Using fluoride varnish as a complement to standard intervention in toddlers did not add in the prevention of dental caries or its progression. The education of parents in the use fluoride toothpaste as they start brushing the teeth of their children is essential.
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Affiliation(s)
- Maria Anderson
- Department of Dental Medicine (DENTMED), OF, Division 6, Pedodontics, Box 4064, 141 04, Huddinge, Sweden; Pediatric Dentistry, Public Dental Service, Eastman Institute, Dalagatan 11, SE-11324, Stockholm, Sweden.
| | - Göran Dahllöf
- Department of Dental Medicine (DENTMED), OF, Division 6, Pedodontics, Box 4064, 141 04, Huddinge, Sweden; Center for Pediatric Oral Health Research, Pediatric Dentistry, Public Dental Service, Eastman Institute, Dalagatan 11, SE-11324, Stockholm, Sweden.
| | - Fernanda Cunha Soares
- Department of Dental Medicine (DENTMED), OF, Division 6, Pedodontics, Box 4064, 141 04, Huddinge, Sweden.
| | - Margaret Grindefjord
- Department of Dental Medicine (DENTMED), OF, Division 6, Pedodontics, Box 4064, 141 04, Huddinge, Sweden; Pediatric Dentistry, Public Dental Service, Eastman Institute, Dalagatan 11, SE-11324, Stockholm, Sweden; Center for Pediatric Oral Health Research, Pediatric Dentistry, Public Dental Service, Eastman Institute, Dalagatan 11, SE-11324, Stockholm, Sweden.
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Chi DL. Parent Refusal of Topical Fluoride for Their Children: Clinical Strategies and Future Research Priorities to Improve Evidence-Based Pediatric Dental Practice. Dent Clin North Am 2017; 61:607-617. [PMID: 28577640 DOI: 10.1016/j.cden.2017.03.002] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
A growing number of parents are refusing topical fluoride for their children during preventive dental and medical visits. This nascent clinical and public health problem warrants attention from dental professionals and the scientific community. Clinical and community-based strategies are available to improve fluoride-related communications with parents and the public. In terms of future research priorities, there is a need to develop screening tools to identify parents who are likely to refuse topical fluoride and diagnostic instruments to uncover the reasons for topical fluoride refusal. This knowledge will lead to evidence-based strategies that can be widely disseminated into clinical practice.
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Affiliation(s)
- Donald L Chi
- Department of Oral Health Sciences, School of Dentistry, University of Washington, Box 357475, B509 Health Sciences Building, Seattle, WA 98195-7475, USA.
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Patil RU, Sahu A, Kambalimath HV, Panchakshari BK, Jain M. Knowledge, Attitude and Practice among Dental Practitioners Pertaining to Preventive Measures in Paediatric Patients. J Clin Diagn Res 2016; 10:ZC71-ZC75. [PMID: 28209009 DOI: 10.7860/jcdr/2016/22300.9122] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2016] [Accepted: 09/17/2016] [Indexed: 11/24/2022]
Abstract
INTRODUCTION Prevention at primary level is of great value in Paediatric Dentistry. Since use of preventive measures can prevent future complications, dental professionals share an important responsibility toward early screening, prompt referral and treatment and this knowledge must transfer into the practice of dentistry. AIM To evaluate Knowledge, Attitude and Practice (KAP) among dental practitioners in Bhopal city (central part of India) pertaining to sealants, topical fluorides usage and orthodontic consideration in paediatric patients. MATERIALS AND METHODS A descriptive cross-sectional survey was conducted using a 20-item self-administered, closed ended, structured questionnaire. A total of 200 available private dental practitioners of Bhopal city made up the sampling frame of study. RESULTS Out of 200 practicing dentists, 147 participated with response rate of 73.5% in which 69.4% were males and 30.6% were females. A total of 83% dentists were less than 35 years of age, while 17% were equal to or more than 35 years of age. Qualification distribution revealed 67.3% dental graduate and 32.6% dental specialist. A highly significant difference in knowledge in relation to age was observed. The mean±SD were found for Knowledge as 8.46±1.82, Attitude as 2.65±0.780, and Practice as 1.66±1.57. Statistically significant correlations were found between attitude and practice (r=0.58, p<0.001). CONCLUSION Dentists in Bhopal city have vast knowledge towards preventive dentistry. The attitude is highly commendable but underutilized in practice, which needs to be improved.
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Affiliation(s)
- Raju Umaji Patil
- Professor and Head, Department of Paedodontics, STES Sinhgad Dental College and Hospital , Vadgoan, Pune, Maharashtra, India
| | - Amitkumar Sahu
- Postgraduate Student, Department of Paedodontics, Rishiraj College of Dental Sciences , Bhopal, Madhya Pradesh, India
| | - Halaswamy V Kambalimath
- Professor and Head, Department of Paedodontics, Rishiraj College of Dental Sciences , Bhopal, Madhya Pradesh, India
| | | | - Manish Jain
- Assistant Professor, Department of Public Health Dentistry, Peoples Dental Academy , Bhopal, Madhya Pradesh, India
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Bayrak S, Tunc ES, Aksoy A, Ertas E, Guvenc D, Ozer S. Fluoride release and recharge from different materials used as fissure sealants. Eur J Dent 2010; 4:245-50. [PMID: 20613911] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
OBJECTIVES Fluoride release/recharge properties of fissure sealants are important for their long-term inhibition of caries. This study was conducted to examine the relationship between fluoride release and recharge of pit-and-fissure sealants. METHODS Specimens were prepared from 5 different sealant materials: Fissurit F, a conventional resin; Fuji VII, a glass-ionomer cement (GIC); Fuji II LC, a resin-modified GIC; Ionosit, a polyacid-modified composite resin (PMRC); and Aelite Flo, a flowable composite resin. Specimens stored in a polyethylene test tube containing 5.0 ml ultrapure water. On day 21, specimens were exposed to 1.23% APF gel. Fluoride release was measured using a fluoride-specific ion electrode at 1-7, 14, 21, 22, 28, 35 and 42 days. RESULTS The glass-ionomer based sealants Fuji VII and Fuji II LC had significantly higher fluoride release than the other materials at all times tested (P<.05). Fluoride release of all materials tested increased following exposure to APF gel (P<.05). CONCLUSIONS Within the limitations of this short-term study, glass ionomer-based sealants were shown to have higher initial fluoride release as well as higher fluoride recharge capacity than other sealants.
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