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Horowitz AM, Maybury C, Clough SR, Wang MQ, Kleinman DV. Dental Hygiene Students' Knowledge, Understanding and Intended Use of Caries Preventive Regimens and Community Water Fluoridation. J Dent Hyg 2024; 98:68-77. [PMID: 38346898] [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] [Received: 10/20/2023] [Accepted: 12/29/2023] [Indexed: 02/15/2024]
Abstract
Purpose The purpose of this study was to determine dental hygiene students' perspectives regarding their knowledge and understanding about caries prevention strategies and their intention to use these regimens in clinical practice. Dental hygienists' knowledge and understanding of caries prevention is critical because they are the primary providers of these regimens and the relevant education.Methods This 2019 national cross-sectional online survey was designed by the University of Maryland (UMD), structured by the ADA staff for online administration, distributed and collected by the American Dental Hygienists' Association (ADHA) to 9533 email addresses, and de-identified response data were analyzed by UMD. The survey included questions on three caries preventive regimens: fluoride varnish, dental sealants, and silver diamine fluoride (SDF), and items on community water fluoridation (CWF), respondent's demographics and intent to use the regimens. Statistical analyses included descriptive statistics and analysis of variance. Significance was set at p<0.05.Results Of the 235 surveys returned (response rate 2.5%) the majority were female, White and born in the United States. Over half were in associate degree programs; nearly a third were in baccalaureate programs. Respondents reported greater knowledge/understanding and intention to use fluoride varnish and dental sealants than SDF. Less than half (44.7%) reported knowledge/understanding of SDF and only 22.6% had a high level of confidence regarding applying it. Additionally, only 31.1% indicated they were extremely likely to use SDF upon graduation.Conclusions To reduce the prevalence of caries, dental hygiene graduates must be well-versed with the latest science-based preventive procedures, including non-invasive caries prevention and control therapies. The results of this survey, albeit non representative of the general population of dental hygiene students, suggest a need for a more extensive review of the caries preventive regimen content, especially for silver diamine fluoride, of dental hygiene curricular programs.
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Affiliation(s)
- Alice M Horowitz
- School of Public Health, University of Maryland, College Park, MD, USA
| | - Catherine Maybury
- School of Public Health, University of Maryland, College Park, MD, USA
| | - Sharon R Clough
- Council on Advocacy for Access and Prevention, American Dental Association, Chicago, IL, USA
| | - Min Qi Wang
- School of Public Health, University of Maryland, College Park, MD, USA
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Tayhan A, Çetinkaya A. Development and psychometric analysis: Fluoride varnish parent attitude, belief scale. Public Health Nurs 2024; 41:1-9. [PMID: 37655433 DOI: 10.1111/phn.13251] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2023] [Revised: 08/11/2023] [Accepted: 08/16/2023] [Indexed: 09/02/2023]
Abstract
OBJECTIVE To develop a scale to determine parents' attitudes and beliefs regarding fluoride varnish. DESIGN AND METHODS This study had a cross-sectional design and was conducted between 2019 and 2021. A total of 810 parents were included in the study sample. Exploratory factor analysis (EFA), confirmatory factor analysis (CFA), discriminant validity, and convergent validity methods were used to estimate the scale validity. For reliability, the Cronbach alpha coefficient, item-total correlation coefficients, and test-retest method were used. RESULTS As a result of psychometric analysis, the scale was found to have a three-factor structure. The factor loads of the items were between 0.838 and 0.715. The three-factor construct showed a good fit in confirmatory factor analysis (X2 (41): 110.06, p <.001; RMSEA: 0.065; RMSR, 0.02; GFI, 0.95; and NFI, 0.94). Cronbach's α coefficient on the scale was 0.85. The item-total correlation of the scale was found to be between 0.355 and 0.626. The test-retest intra-class correlation coefficient of the scale was 0.72. CONCLUSIONS This study suggests that the developed scale is a reliable tool to evaluate the attitudes and beliefs of parents toward fluoride varnish. It is thought that the scale will make a contribution to public health.
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Affiliation(s)
- Ali Tayhan
- Department of Public Health Nursing, Faculty of Health Sciences, Manisa Celal Bayar University, Manisa, Turkey
| | - Aynur Çetinkaya
- Department of Public Health Nursing, Faculty of Health Sciences, Manisa Celal Bayar University, Manisa, Turkey
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Obeid RF, Ammar MM, Younis SH. Dentinomimetics and cementomimetics of Moringa oleifera leaves extract. Sci Rep 2023; 13:19243. [PMID: 37935743 PMCID: PMC10630475 DOI: 10.1038/s41598-023-46656-1] [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] [Received: 06/07/2023] [Accepted: 11/03/2023] [Indexed: 11/09/2023] Open
Abstract
To evaluate the biomimetic remineralization capabilities of Moringa oleifera leaves (MOL) extract on coronal dentin and acellular cementum, two different concentrations (50 and 200 mg/ml) of MOL extract loaded in plain varnish (M1 and M2 groups respectively) were compared to fluoride varnish (FL group) and native surface (C group). Eighty sound premolar teeth were collected. Forty teeth (10 teeth in each group) were used for coronal dentin testing while the other forty (10 teeth in each group) were used for acellular cementum testing. Teeth in M1, M2, and FL groups were etched for 30 s and then received the specific varnish treatment. All samples were immersed in artificial saliva for 14 days and then collected, dried, and examined by scanning electron microscopy and energy dispersive X-ray spectroscopy (EDX). Histologically, FL group showed mineral deposition as discrete vesicular granules of various sizes on the surface of both coronal dentin and acellular cementum. Mineral deposition only occurred on some DTs openings while opened tubules remained. The surface of the acellular cementum revealed regular grooves, micro-fissures, and cracks. In the M1 and M2 groups, mineral deposition appeared as a homogenous continuous layer on coronal dentin and acellular cementum. Only a few DTs and cementum fissures were not filled completely. In L.S. sections of the coronal one-third, the DTs appeared almost sealed with varying lengths of mineral deposition. EDX results statistical analysis showed that the M2 group had the highest phosphate ions (P-) and calcium ions (Ca+2) at%. MOL has an extraordinary effect on the remineralization of coronal dentin and acellular cementum. It would have a promising ability to control dentinal hypersensitivity and formation of biomimetic cementum tissue.
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Affiliation(s)
- Raneem F Obeid
- Faculty of Oral and Dental Medicine, Future University in Egypt, Cairo, 11835, Egypt.
| | - Mohamed M Ammar
- Faculty of Oral and Dental Medicine, Future University in Egypt, Cairo, 11835, Egypt
| | - Sara H Younis
- Faculty of Oral and Dental Medicine, Future University in Egypt, Cairo, 11835, Egypt
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Goff SL, Gilson CF, DeCou E, Dick AW, Geissler KH, Dalal M, Kranz AM. Barriers and Facilitators to Optimal Fluoride Varnish Application. Acad Pediatr 2023:S1876-2859(23)00371-6. [PMID: 37802248 PMCID: PMC10995105 DOI: 10.1016/j.acap.2023.09.018] [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] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/26/2023] [Revised: 09/21/2023] [Accepted: 09/30/2023] [Indexed: 10/08/2023]
Abstract
OBJECTIVE National guidelines recommend that all children under age six receive fluoride varnish (FV) in medical settings. However, application rates remain low. This study aimed to update understanding of barriers and facilitators to guideline concordant FV application. METHODS We conducted virtual semi-structured interviews with a purposive sample (eg, FV application rates, geographic location, practice size and type) of pediatric primary care clinicians and medical assistants in Massachusetts between February 1 and June 30, 2022. The Consolidated Framework for Implementation Research (CFIR) served as the study's theoretical framework and data were analyzed using a modified grounded theory approach. RESULTS Of the 31 participants, 90% identified as White and 81% as female. Major themes, which linked to four CFIR domains, included: variation in perceived adequacy of reimbursement; differences in FV application across practice types; variation in processes, protocols, and priorities; external accountability for quality of care; and potential levers for change. Important subthemes included challenges for small practices; role of quality measures in delivering guideline-concordant preventive oral health care; and desire for preventive care coordination with dentists. CONCLUSIONS This study suggests that potential barriers and facilitators to guideline concordant FV application exist at multiple levels that may warrant further study. Examples include testing the effectiveness of quality measures for FV application and testing strategies for implementing consistent processes and protocols for improving FV application rates.
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Affiliation(s)
- Sarah L Goff
- University of Massachusetts Amherst School of Public Health and Health Sciences (SL Goff, CF Gilson, and E DeCou), Health Promotion and Policy, Amherst, Mass.
| | - Charlotte F Gilson
- University of Massachusetts Amherst School of Public Health and Health Sciences (SL Goff, CF Gilson, and E DeCou), Health Promotion and Policy, Amherst, Mass
| | - Erin DeCou
- University of Massachusetts Amherst School of Public Health and Health Sciences (SL Goff, CF Gilson, and E DeCou), Health Promotion and Policy, Amherst, Mass
| | | | - Kimberley H Geissler
- UMass Chan Medical School-Baystate (KH Geissler), Department of Healthcare Delivery and Population Sciences, Springfield, Mass
| | - Michelle Dalal
- Boston Office, Reliant Medical Group (M Dalal), Milford, Mass
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Marusiak MJ, Paulden M, Ohinmaa A. Professional oral health care prevents mouth-lung infection in long-term care homes: a systematic review. Can J Dent Hyg 2023; 57:180-190. [PMID: 38020079 PMCID: PMC10662425] [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] [Received: 02/16/2022] [Revised: 03/30/2022] [Accepted: 06/26/2023] [Indexed: 12/01/2023]
Abstract
Background Nursing home-acquired pneumonia (NHAP) is the leading cause of mortality among residents in long-term care (LTC) homes. Aspiration pneumonia (AP) is one cause of NHAP. Professional oral health care (POHC) and daily mouth care can be effective in decreasing AP risk. Aim To identify, appraise, synthesize, analyze, and interpret results on the effectiveness of onsite POHC interventions/programs delivered to LTC home residents in reducing oral disease and NHAP. To summarize the findings and provide recommendations for clinical work and future research. Methods The PICO question addressed was, "In LTC home residents with oral health needs (P), is onsite POHC (I), compared to usual care (C), clinically effective in reducing dental disease and pneumonia/AP (O)?" Databases searched were PubMed, EMBASE (Ovid), CINAHL (Ebsco), Cochrane Library (Wiley), Web of Science, and the databases of the Centre for Reviews and Dissemination. Included were randomized controlled trials (RCTs), non-RCTs, and cross-sectional studies. PRISMA guidelines were followed and GRADE was used to assess the quality of studies. Results Thirteen clinical effectiveness studies were included: 10 RCTs, 1 non-RCT, and 2 cross-sectional studies. Discussion Better oral health and respiratory infection outcomes were found in the experimental groups who received an onsite POHC intervention compared to the control groups. Conclusion There is moderate-to-strong evidence that onsite POHC in LTC homes, provided mostly by dental hygienists, is effective in preventing bacterial mouth infection, pneumonia, and AP.
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Affiliation(s)
- Michelle J Marusiak
- Alumna, School of Public Health, University of Alberta, Edmonton, AB, Canada. This literature review was written in partial fulfillment of the requirements for the Master of Science (Health Policy Research Specialization) program at the University of Alberta.
| | - Michael Paulden
- School of Public Health, University of Alberta, Edmonton, AB, Canada
| | - Arto Ohinmaa
- School of Public Health, University of Alberta, Edmonton, AB, Canada
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Sahin D, Deger C, Oglakci B, Demirkol M, Kucukyildirim BO, Gursel M, Eliguzeloglu Dalkilic E. The Effects of a Novel Nanohydroxyapatite Gel and Er: YAG Laser Treatment on Dentin Hypersensitivity. Materials (Basel) 2023; 16:6522. [PMID: 37834658 PMCID: PMC10573567 DOI: 10.3390/ma16196522] [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] [Subscribe] [Scholar Register] [Received: 08/12/2023] [Revised: 09/01/2023] [Accepted: 09/29/2023] [Indexed: 10/15/2023]
Abstract
PURPOSE This study evaluates the effects of a novel nanohydroxyapatite gel and Er: YAG laser on the surface roughness, surface morphology, and elemental content after dentin hypersensitivity treatments. METHODS Dentin discs (2 × 3 × 3 mm3) were prepared from 75 human molars. Out of 75 human molars, 50 were used to evaluate surface roughness and randomly divided into five groups: Group ID (intact dentin), Group DD (demineralized dentin), Group BF (fluoride varnish/Bifluorid 10), Group Lsr (Er: YAG laser-50 mJ, 0.50 W, 10 Hz), and Group NHA (nanohydroxyapatite-containing gel). Dentin hypersensitivity was stimulated by 35% phosphoric acid for 1 min (except Group ID). The surface roughness (Ra, μm) was measured via contact profilometry (n = 10). Out of the 75 sound human molars, 25 were used to evaluate the surface morphology and elemental content using scanning electron microscopy and energy-dispersive X-ray spectroscopy (n = 5). The data were statistically analyzed using Welsch ANOVA, Games-Howell, Kruskal-Wallis, and Dunn tests (p < 0.05). RESULTS Group Lsr showed significantly lower surface roughness than Group NHA and Group BF (p < 0.05). The SEM analysis indicated that most of the dentinal tubules were obliterated for Group NHA. Precipitant plugs with partially occluded dentinal tubules were observed for Group BF, while partially or completely occluded tubules with a melting appearance were detected for Group Lsr. The EDS analysis revealed that Group NHA and Group Lsr presented similar calcium and phosphorus amounts to Group ID. All dentin hypersensitivity treatment methods could provide promising results in terms of tubular occlusion efficiency. However, laser treatment resulted in smoother surfaces, which could help prevent dental plaque accumulation.
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Affiliation(s)
- Demet Sahin
- Department of Periodontology, Faculty of Dentistry, Bezmialem Vakif University, 34093 Istanbul, Turkey;
| | - Ceren Deger
- Department of Restorative Dentistry, Faculty of Dentistry, Bezmialem Vakif University, 34093 Istanbul, Turkey or (C.D.); or (B.O.); or (E.E.D.)
| | - Burcu Oglakci
- Department of Restorative Dentistry, Faculty of Dentistry, Bezmialem Vakif University, 34093 Istanbul, Turkey or (C.D.); or (B.O.); or (E.E.D.)
| | - Metehan Demirkol
- Department of Mechanical Engineering, Yildiz Technical University, 34349 Istanbul, Turkey; (M.D.); or (B.O.K.)
| | - Bedri Onur Kucukyildirim
- Department of Mechanical Engineering, Yildiz Technical University, 34349 Istanbul, Turkey; (M.D.); or (B.O.K.)
| | - Mehtikar Gursel
- Department of Periodontology, Faculty of Dentistry, Bezmialem Vakif University, 34093 Istanbul, Turkey;
| | - Evrim Eliguzeloglu Dalkilic
- Department of Restorative Dentistry, Faculty of Dentistry, Bezmialem Vakif University, 34093 Istanbul, Turkey or (C.D.); or (B.O.); or (E.E.D.)
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Seshadri VRA, Varghese NS, Gurunathan D. Evaluation of the Cytocompatibility of Fluoride Varnish and Its Effect on Human Gingival Fibroblasts (hGFs): An In Vitro Study. Cureus 2023; 15:e41735. [PMID: 37575824 PMCID: PMC10415168 DOI: 10.7759/cureus.41735] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2023] [Accepted: 07/11/2023] [Indexed: 08/15/2023] Open
Abstract
Introduction Untreated dental decay poses a significant oral health challenge, leading to pain, tooth loss, and infections. Fluoride varnishes are in prolonged contact with the tooth surface and this prevents dental decay. However, limited research has been conducted regarding the cytotoxicity and cytocompatibility of varnishes on oral cells. Recent studies have shed light on the cytotoxic effect of these varnishes on human fibroblast cells. Material and Methods The fibroblasts were isolated and cultured in 0.00001, 0.0001, 0.001, 0.01, 0.1, and 1 % fluoride concentration The cells were incubated for 72 hours at a temperature of 37°C and cell viability after the application of varnish was assessed using 3-(4,5-dimethylthiazol-2-yl)-2,5 diphenyl tetrazolium bromide (MTT) assay. Results This study observed that fluoride varnish had a concentration dependant cytotoxic effect on human gingival fibroblasts (hGFs). As the concentration of fluoride increased, the cell viability decreased. At 1% concentration, there was maximum cell cytotoxicity. At the lowest concentration (0.00001), more than 78% of the cells were found to be viable. Conclusion Further research is necessary to develop safer and more biocompatible fluoride varnish formulations to ensure their efficacy in preventing dental caries without causing harm to oral tissues.
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Affiliation(s)
- V Ranjith Akshay Seshadri
- Pediatric and Preventive Dentistry, Saveetha Dental College, Saveetha Institute of Medical and Technical Sciences, Chennai, IND
| | - Nikitha S Varghese
- Pediatric and Preventive Dentistry, Saveetha Dental College, Saveetha Institute of Medical and Technical Sciences, Chennai, IND
| | - Deepa Gurunathan
- Pediatric and Preventive Dentistry, Saveetha Dental College, Saveetha Institute of Medical and Technical Sciences, Chennai, IND
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Domantaitė M, Trakinienė G. Influence of the use of remineralizing agents on the tensile bond strength of orthodontic brackets. Sci Rep 2023; 13:507. [PMID: 36627322 PMCID: PMC9832128 DOI: 10.1038/s41598-023-27390-0] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2022] [Accepted: 01/02/2023] [Indexed: 01/11/2023] Open
Abstract
This study aimed to evaluate the influence of the use of remineralizing agents on the tensile bond strength. The study sample consisted of 80 recently extracted molars, which were randomly divided into four experimental groups (n = 20): groups FG1 and FG30, in which fluoride varnish was used, and groups RG1 and RG30, in which Recaldent tooth mousse was used. The mesiobuccal surfaces served as experimental, and distobuccal as control (n = 80). Brackets were bonded to both surfaces and were submitted to a tension test at different time intervals (T1 and T30). Tensile bond strength (TBS) and the amount of adhesive remnant (ARI) were assessed. A statistically significantly lower mean of TBS compared to the control group was found only in the FG1 group (p < 0.001), and no significant difference was found between the other groups. The FG1 group showed significantly higher ARI scores (p < 0.001) compared to the control group. No significant difference was found between the other groups. In conclusion, bonding brackets one day after applying fluoride varnish significantly reduced the TBS, but after 30 days it was set back to an optimal value. The use of Recaldent before orthodontic treatment had no adverse effect.
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Affiliation(s)
- Milda Domantaitė
- Department of Orthodontics, Lithuanian University of Health Sciences, Medical Academy, Lukšos -Daumanto 6, Kaunas, Lithuania
| | - Giedrė Trakinienė
- Department of Orthodontics, Lithuanian University of Health Sciences, Medical Academy, Lukšos -Daumanto 6, Kaunas, Lithuania.
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Treeratweerapong Y, Nakornchai S, Jirarattanasopha V. Effectiveness of applying proximal enamel caries with fluoride-releasing sealant and fluoride varnish on caries progression in permanent teeth: A 12-month split-mouth randomized clinical trial. Int J Paediatr Dent 2023; 33:30-39. [PMID: 35579583 DOI: 10.1111/ipd.13011] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/04/2021] [Revised: 05/07/2022] [Accepted: 05/15/2022] [Indexed: 12/16/2022]
Abstract
BACKGROUND Few studies report on managing initial proximal caries with sealants, and no reports focus on fluoride-releasing sealants. AIM To compare the effectiveness between applications of a fluoride-releasing sealant and fluoride varnish on proximal enamel caries to control caries progression in permanent teeth. DESIGN This was a split-mouth randomized controlled trial in forty-four 11- to 16-year-old children with radiographic caries in at least one contralateral pair of teeth with proximal enamel caries. The lesions were evaluated using DIAGNOdent and were also assessed visually after tooth separation. The lesions in each subject were randomly sealed with a fluoride-releasing sealant (Helioseal® F) or applied with fluoride varnish (Duraphat®). The fluoride varnish-treated lesion was reapplied at 3 and 6 months. Clinical examination, bitewing radiograph evaluation, and DIAGNOdent assessment were performed at 6 and 12 months. The caries progression outcome variables were regression, no change, and progression. The data were analyzed with the McNemar-Bowker test. RESULTS Radiographic examination and DIAGNOdent assessment demonstrated no significant differences in the percentages of regression, no change, or progression at the 12-month follow-up (p > .05). CONCLUSION Applications of a fluoride-releasing sealant and of fluoride varnish three times resulted in a nonsignificant difference in caries progression of initial proximal caries at the 12-month follow-up.
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Affiliation(s)
| | - Siriruk Nakornchai
- Department of Pediatric Dentistry, Faculty of Dentistry, Mahidol University, Bangkok, Thailand
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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. Int J Environ Res 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] [What about the content of this article? (0)] [Affiliation(s)] [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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Phonghanyudh A, Duangthip D, Mabangkhru S, Jirarattanasopha V. Is Silver Diamine Fluoride Effective in Arresting Enamel Caries? A Randomized Clinical Trial. Int J Environ Res Public Health 2022; 19:ijerph19158992. [PMID: 35897363 PMCID: PMC9331268 DOI: 10.3390/ijerph19158992] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/17/2022] [Revised: 07/19/2022] [Accepted: 07/21/2022] [Indexed: 02/04/2023]
Abstract
Background: There is limited information on the effectiveness of 38% silver diamine fluoride (SDF) in managing enamel caries. Objective: This study aimed to compare effectiveness of 38% SDF and 5% Sodium fluoride (NaF) varnish in arresting enamel caries in young children when applied semiannually over 18 months. Methods: A randomized controlled trial was conducted on children aged 1−3 years who had at least one active carious surface. They were allocated into two groups: Group 1 (38% SDF) and Group 2 (5% NaF varnish). Visual-tactile examination was used to assess extent of carious lesions. Enamel caries that did not progress to dentin were classified as having caries arrest. Intention-to-treat analysis was performed. Results: At baseline, 290 children with 1974 tooth surfaces with enamel caries were recruited. Caries arrest rates at the tooth surface level in Group 1 and Group 2 were 59.1% and 58.8%, respectively (p = 0.873), at 18 months. The multilevel logistic regression analysis revealed that tooth position, tooth surface, extent of enamel caries at baseline, caries experience, and brushing with fluoride toothpaste influenced caries arrest (p < 0.05). Conclusion: The semiannual application of 38% SDF and 5% NaF varnish had comparable effectiveness in arresting enamel caries in primary teeth.
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Affiliation(s)
- Araya Phonghanyudh
- School of Dentistry, King Mongkut’s Institute of Technology Ladkrabang, Bangkok 10520, Thailand;
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Vitiello F, Tosco V, Monterubbianesi R, Orilisi G, Gatto ML, Sparabombe S, Memé L, Mengucci P, Putignano A, Orsini G. Remineralization Efficacy of Four Remineralizing Agents on Artificial Enamel Lesions: SEM-EDS Investigation. Materials (Basel) 2022; 15:ma15134398. [PMID: 35806523 PMCID: PMC9267358 DOI: 10.3390/ma15134398] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/23/2022] [Revised: 06/13/2022] [Accepted: 06/20/2022] [Indexed: 12/23/2022]
Abstract
Dental remineralization represents the process of depositing calcium and phosphate ions into crystal voids in demineralized enamel, producing net mineral gain and preventing early enamel lesions progression. The aim of the present study was to qualitatively and quantitatively compare the remineralizing effectiveness of four commercially available agents on enamel artificial lesions using Scanning Electron Microscopy (SEM) combined with Energy Dispersive Spectroscopy (EDS) techniques. Thirty-six extracted third molars were collected and randomly assigned to six groups (n = 6), five of which were suspended in demineralizing solution for 72 h to create enamel artificial lesions, and one serving as control: G1, treated with a mousse of casein phosphopeptide and amorphous calcium−phosphate (CPP-ACP); G2, treated with a gel containing nano-hydroxyapatite; G3, treated with a 5% SF varnish; G4, treated with a toothpaste containing ACP functionalized with fluoride and carbonate-coated with citrate; G5, not-treated artificial enamel lesions; G6, not demineralized and not treated sound enamel. G1−G4 were subjected to pH cycling over a period of seven days. Analyses of the specimens’ enamel surfaces morphology were performed by SEM and EDS. Data were statistically analyzed for multiple group comparison by one-way ANOVA/Tukey’s test (p < 0.05). The results show that the Ca/P ratio of the G5 (2.00 ± 0.07) was statistically different (p < 0.05) from G1 (1.73 ± 0.05), G2 (1.76 ± 0.01), G3 (1.88 ± 0.06) and G6 (1.74 ± 0.04), while there were no differences (p > 0.05) between G1, G2 and G6 and between G4 (2.01 ± 0.06) and G5. We concluded that G1 and G2 showed better surface remineralization than G3 and G4, after 7 days of treatment.
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Affiliation(s)
- Flavia Vitiello
- Department of Clinical Sciences and Stomatology (DISCO), Polytechnic University of Marche, 60126 Ancona, Italy; (F.V.); (V.T.); (R.M.); (G.O.); (S.S.); (L.M.); (A.P.)
| | - Vincenzo Tosco
- Department of Clinical Sciences and Stomatology (DISCO), Polytechnic University of Marche, 60126 Ancona, Italy; (F.V.); (V.T.); (R.M.); (G.O.); (S.S.); (L.M.); (A.P.)
| | - Riccardo Monterubbianesi
- Department of Clinical Sciences and Stomatology (DISCO), Polytechnic University of Marche, 60126 Ancona, Italy; (F.V.); (V.T.); (R.M.); (G.O.); (S.S.); (L.M.); (A.P.)
| | - Giulia Orilisi
- Department of Clinical Sciences and Stomatology (DISCO), Polytechnic University of Marche, 60126 Ancona, Italy; (F.V.); (V.T.); (R.M.); (G.O.); (S.S.); (L.M.); (A.P.)
| | - Maria Laura Gatto
- Department of Materials, Environmental Sciences and Urban Planning (SIMAU) & UdR INSTM, Polytechnic University of Marche, 60131 Ancona, Italy; (M.L.G.); (P.M.)
| | - Scilla Sparabombe
- Department of Clinical Sciences and Stomatology (DISCO), Polytechnic University of Marche, 60126 Ancona, Italy; (F.V.); (V.T.); (R.M.); (G.O.); (S.S.); (L.M.); (A.P.)
| | - Lucia Memé
- Department of Clinical Sciences and Stomatology (DISCO), Polytechnic University of Marche, 60126 Ancona, Italy; (F.V.); (V.T.); (R.M.); (G.O.); (S.S.); (L.M.); (A.P.)
| | - Paolo Mengucci
- Department of Materials, Environmental Sciences and Urban Planning (SIMAU) & UdR INSTM, Polytechnic University of Marche, 60131 Ancona, Italy; (M.L.G.); (P.M.)
| | - Angelo Putignano
- Department of Clinical Sciences and Stomatology (DISCO), Polytechnic University of Marche, 60126 Ancona, Italy; (F.V.); (V.T.); (R.M.); (G.O.); (S.S.); (L.M.); (A.P.)
| | - Giovanna Orsini
- Department of Clinical Sciences and Stomatology (DISCO), Polytechnic University of Marche, 60126 Ancona, Italy; (F.V.); (V.T.); (R.M.); (G.O.); (S.S.); (L.M.); (A.P.)
- Correspondence:
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Gudkina J, Amaechi BT, Abrams SH, Brinkmane A, Petrosina E. The Effect of MI Varnish™ on Caries Increment and Dietary Habits among 6- and 12-Year-Old Children in Riga, Latvia: A 3-Year Randomized Controlled Trial. Dent J (Basel) 2022; 10:dj10060096. [PMID: 35735638 PMCID: PMC9221846 DOI: 10.3390/dj10060096] [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] [Received: 04/13/2022] [Revised: 05/05/2022] [Accepted: 05/20/2022] [Indexed: 12/04/2022] Open
Abstract
Aims: This randomized controlled trial investigated the effect of MI Varnish™ (5% NaF/CPP-ACP) on caries increment in 6- and 12-year-old children in Riga, Latvia within 36 months. Methods: Forty-eight 6-year-old children (Group 1) and forty-seven 12-year-old children (Group 3) received quarterly varnish application, while forty-eight 6-year-old children (Group 2) and thirty-seven 12-year-old children (Group 4) did not have varnish applied. All children/parents received the same preventive advice. All children were visually examined using ICDAS-II criteria. Questionnaires on dietary habits were completed by the children/parents at baseline and after 36 months. DMFS and dfs were calculated from ICDAS data. The statistical analysis was performed (α = 0.05) using a Chi-squared test, paired t-test (Welch test) and the Pearson correlation coefficient. The trial registration number is ISRCTN10584414. Results: In Group 1 versus Group 2, the DMFS(SD) (Baseline/36 months) values were 5.02(5.85)/13.21(6.67) (p < 0.001) versus 2.65(4.54)/10.81(6.14) (p < 0.001), respectively; the dfs(SD) (Baseline/36 months) values were 36.75(12.96)/24.04(12.9) (p < 0.001) versus 33.67(12.74)/23.88(11.91) (p < 0.001), respectively. In Group 3 versus Group 4, the DMFS(SD) (Baseline/36 months) values were 48.62(23.18)/70.96(23.28) (p < 0.001) versus 34.73(17.99)/54.95(16.09) (p < 0.001), respectively; the dfs(SD) (Baseline/36 months) values were 1.7(4.4)/0 (p < 0.05) versus 2(6.39)/0 (p = 0.06), respectively. The prevalence of caries (dfs + DMFS) decreased by 4.52 (p < 0.001) and 1.63 (p < 0.001) in Groups 1 and 2, respectively, but increased by 20.64 (p < 0.001) and 18.22 (p < 0.001) in Groups 3 and 4, respectively. An analysis of the questionnaires indicated the habitual, frequent consumption of a sugary diet by all the children. A significant correlation (r = 0.321; p < 0.05) was observed between caries increment and the frequency of daily intake of sugary snacks, soft drinks and tea with sugar at baseline only in Group 1. Conclusions: A quarterly application of MI varnish (CPP-ACP/fluoride) reduced caries increment in 6- and 12-year-old children in Riga, Latvia.
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Affiliation(s)
- Jekaterina Gudkina
- Conservative Dentistry and Oral Health Department, Riga Stradins University, LV-1007 Riga, Latvia;
- Correspondence:
| | - Bennett T. Amaechi
- Department of Comprehensive Dentistry, University of Texas Health Science Center, San Antonio, TX 78229, USA;
| | - Stephen H. Abrams
- Quantum Dental Technologies and Cliffcrest Dental Office, 2995 Kingston Road Scarborough, Scarborough, ON M1M 1P1, Canada;
| | - Anda Brinkmane
- Conservative Dentistry and Oral Health Department, Riga Stradins University, LV-1007 Riga, Latvia;
| | - Eva Petrosina
- Statistical Laboratory, Riga Stradins University, LV-1007 Riga, Latvia;
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Amend S, Hartmann T, Heinzel-Gutenbrunner M, Frankenberger R, Krämer N, Winter J. Caries Experience and Increment in Children Attending Kindergartens with an Early Childhood Caries Preventive Program Compared to Basic Prophylaxis Measures-A Retrospective Cohort Study. J Clin Med 2022; 11. [PMID: 35628990 DOI: 10.3390/jcm11102864] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2022] [Revised: 05/11/2022] [Accepted: 05/17/2022] [Indexed: 02/04/2023] Open
Abstract
Dental caries constitutes a public health challenge. As preventive strategies are desirable, this retrospective cohort study aimed to assess the caries experience and increment in children attending kindergartens with an early childhood caries (ECC) preventive program (intervention group, IG) compared to basic prophylaxis measures (control group, CG) located in areas of different socioeconomic status (SES) within Marburg (Germany). The long-term caries experience (2009−2019) of these 3−5-year-old kindergarten children was evaluated. For the caries increment, dental records of 2019 were screened for the availability of a minimum of two dental examinations at least 8 months apart. Caries was scored according to the WHO criteria (dmf−t). The data were split by observation period (300−550 and >550 days). Overall, 135 children (Ø 3.7 years) attended IG, and 132 children (Ø 3.6 years) attended CG. After 300−550 days, no significant differences were found between both groups regarding mean caries increment and experience (p > 0.05). After >550 days, IG with low SES exhibited a high caries experience. Fluoride varnish applications could not reduce the caries increment compared to CG in the short-term but slightly decreased the long-term caries experience. Comprehensive ECC prevention measures actively involving parents are needed to overcome the caries burden.
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Rodriguez GA, Cabello RA, Borroni CP, Palacio RA. Cost-effectiveness of probiotics and fluoride varnish in caries prevention in preschool children. J Public Health Dent 2022; 82:280-288. [PMID: 35567374 DOI: 10.1111/jphd.12526] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2020] [Revised: 01/11/2022] [Accepted: 04/15/2022] [Indexed: 11/29/2022]
Abstract
OBJECTIVES The purpose of this study was to evaluate the cost-effectiveness of two preventive interventions aimed at increasing the proportion of caries-free preschool children of low socioeconomic status using a decision analytic model. METHODS Two scenarios were tested, one with a school milk program (SMP) and one without (non-SMP). Fluoride varnish (FV) and a probiotic (PB) were compared to a do-nothing alternative among children in public nurseries/schools over a 4-year period. FV was applied biannually and a PB (Lactobacillus rhamnosus) added to milk powder prepared daily. A Markov decision tree model was utilized. Several sources of data were used to populate the model. Probabilistic and deterministic sensitivity analyses were performed, and a public provider perspective was used. RESULTS In the SMP scenario, PB was more effective and less costly than FV and, compared with do-nothing, increased the proportion of caries-free children by 14.5%, with a cost of USD 12.5 per child (June 2018). PB presented an incremental cost-effectiveness ratio (ICER) or cost per extra caries-free child of USD 86.2. In the non-SMP scenario, both interventions were cost-effective. FV (compared with do-nothing) increased the percentage of caries-free children by 8.3% with an ICER of USD 338.3 and PB (compared with FV) increased the effect by 6.2% with an ICER of USD 1400.2. CONCLUSIONS The findings showed that PB was most effective and less costly than FV in the SMP scenario only. This type of analysis and its results provide essential information for decision-makers to improve the oral health of preschool children.
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Affiliation(s)
| | | | - Catalina P Borroni
- School of Dentistry, Pontificia Universidad Catolica de Chile, Santiago, Chile
| | - Raul A Palacio
- School of Dentistry, Pontificia Universidad Catolica de Chile, Santiago, Chile
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Tomaževič T, Drevenšek M, Kosem R. Evaluation of fluoride varnish treatment of postorthodontic white spot lesions by visual inspection and laser fluorescence-A randomized controlled study. Clin Exp Dent Res 2022; 8:931-938. [PMID: 35510617 PMCID: PMC9382033 DOI: 10.1002/cre2.579] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [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] [Received: 11/30/2021] [Revised: 03/31/2022] [Accepted: 04/03/2022] [Indexed: 11/06/2022] Open
Abstract
OBJECTIVES White spot lesions (WSLs), as a side effect of orthodontic therapy, can be treated with fluoride varnish, with the difference in efficiency reported. MATERIAL AND METHODS Patients with buccal WSLs were consecutively included in a randomized controlled double-blind study. At first inspection and at three follow-ups over 6 months, 0.1% fluoride varnish and placebo (water) were applied in the test group (N = 21) and control group (N = 21), respectively. The maximum laser fluorescence value (LFV) of WSLs was recorded using DIAGNOdent. Between the groups, differences in the mean numbers of WSLs and the mean LFV of WSLs per patient at different time points were analyzed with mixed-design analysis of variance. Orthodontic therapy duration (OTD) was included in the model as a covariate. RESULTS A decrease in the mean WSLs number and LFV was observed; however, there were no significant differences between study groups at any time point. OTD was in interaction only with LFV. Analysis showed a different pattern of mean LFV changes for patients with OTD of >48 months compared to patients with OTD of ≤24. CONCLUSION The changes in numbers of WSLs and LFV over the study period indicated regression of WSLs, but an additional effect of FV was not confirmed.
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Affiliation(s)
- Tanja Tomaževič
- Department of Paediatric and Preventive Dentistry, University Medical Centre Ljubljana, Ljubljana, Slovenia
| | - Martina Drevenšek
- Department of Orthodontics, Faculty of Medicine, University of Ljubljana, University Medical Centre Ljubljana, Ljubljana, Slovenia
| | - Rok Kosem
- Department of Paediatric and Preventive Dentistry, University Medical Centre Ljubljana, Ljubljana, Slovenia
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Uchil SR, Suprabha BS, Shenoy R, Rao A. Clinical effectiveness of resin-modified glass ionomer-based fluoride varnish for preventing occlusal caries lesions in partially erupted permanent molars: A randomised active-controlled trial. Int J Paediatr Dent 2022; 32:314-323. [PMID: 34379856 DOI: 10.1111/ipd.12887] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/14/2020] [Revised: 07/22/2021] [Accepted: 07/28/2021] [Indexed: 11/29/2022]
Abstract
BACKGROUND Deep pits and fissures in partially erupted permanent molars are vulnerable to dental caries. AIM To assess the clinical effectiveness of resin-modified glass ionomer-based fluoride varnish (RMGI-F varnish: Clinpro XT™ varnish) in preventing occlusal caries lesions in partially erupted permanent first molars. DESIGN In this randomised active-controlled superiority trial with a single-blind parallel design, 74 children with 182 partially erupted first permanent molars were allocated into two groups: Group 1: RMGI-F varnish; and Group 2: GI sealant (active control), with an application of 0.1% sodium fluoride varnish for all other teeth. The primary outcome was ICDAS score ≥1 at 12 months of follow-up. Data were analysed using adjusted Chi-square test and GEE regression for binary outcomes. RESULTS Group 1 (15.7%) and Group 2 (13.8%) did not differ significantly in ICDAS ≥1 scores at 12 months of follow-up (adjusted χ2 = 0.373, p = .541). There was no significant difference in retention between Group 1 (48.3%) and Group 2 (20.7%) at 12 months of follow-up (adjusted χ2 = 0.1, p = .752). Mean application time per tooth (16 ± 5.9 vs 20.2 ± 5.4 min) was significantly different (t = 5.26, p = .014). CONCLUSIONS RMGI-F varnish was not superior to GI sealant in preventing occlusal caries lesions in partially erupted molars.
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Affiliation(s)
- Savil Ramachandra Uchil
- Department of Pediatric and Preventive Dentistry, Manipal College of Dental Sciences, Mangalore, Manipal Academy of Higher Education, Manipal, India
| | - Baranya Shrikrishna Suprabha
- Department of Pediatric and Preventive Dentistry, Manipal College of Dental Sciences, Mangalore, Manipal Academy of Higher Education, Manipal, India
| | - Ramya Shenoy
- Department of Public Health Dentistry, Manipal College of Dental Sciences, Mangalore, Manipal Academy of Higher Education, Manipal, India
| | - Arathi Rao
- Department of Pediatric and Preventive Dentistry, Manipal College of Dental Sciences, Mangalore, Manipal Academy of Higher Education, Manipal, India
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Davidson T, Bergström EK, Husberg M, Moberg Sköld U. Long-Term Cost-Effectiveness through the Dental-Health FRAMM Guideline for Caries Prevention. Int J Environ Res Public Health 2022; 19:ijerph19041954. [PMID: 35206144 PMCID: PMC8871848 DOI: 10.3390/ijerph19041954] [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] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/05/2022] [Revised: 02/04/2022] [Accepted: 02/06/2022] [Indexed: 02/04/2023]
Abstract
A guideline called FRAMM, which is an acronym in Swedish for the most important parts of this guideline, namely “fluoride”, “advice”, “arena”, “motivation” and “diet”, was implemented in 2008 in the Västra Götaland Region in Sweden. This guideline included fluoride varnish applications performed at school twice a year at six-monthly intervals for all 12- to 15-year-olds, together with lessons on oral health. The aim of this analysis was to estimate the long-term cost-effectiveness, using prognostic calculations, of the FRAMM Guideline for 12- to 15-year-olds, compared with routine care, until the participants were 23 years old. A cost-effectiveness analysis was performed from a health care perspective, based on four years of verified data and seven years of prognosis. Data from FRAMM were combined with cost data from price lists in Sweden. The cost-effectiveness was analyzed by relating the difference in costs to the difference in the number of approximal surfaces with fillings and/or dentin lesions (DFSa). The analysis shows that FRAMM was considered dominant compared to the controls in all alternative scenarios, hence costs were prognosed to be lowered and outcomes were prognosed to be improved. A dental health program like the FRAMM Guideline with fluoride varnish during the caries risk period from 12 to 15 years is predicted to be cost-effective in the longer perspective. To further study the actual long-term caries increment after a preventive dental health program would be of great interest to verify these results.
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Affiliation(s)
- Thomas Davidson
- Department of Health, Medicine and Caring Sciences, Linköping University, SE-581 83 Linköping, Sweden;
- Correspondence:
| | - Eva-Karin Bergström
- Department of Cariology, Institute of Odontology, Sahlgrenska Academy, University of Gothenburg, SE-405 30 Gothenburg, Sweden; (E.-K.B.); (U.M.S.)
| | - Magnus Husberg
- Department of Health, Medicine and Caring Sciences, Linköping University, SE-581 83 Linköping, Sweden;
| | - Ulla Moberg Sköld
- Department of Cariology, Institute of Odontology, Sahlgrenska Academy, University of Gothenburg, SE-405 30 Gothenburg, Sweden; (E.-K.B.); (U.M.S.)
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Qeli E, Toti Ç, Odorici A, Blasi E, Tragaj E, Tepedino M, Masedu F, Kaçani G, Hysi D, Meto A, Fiorillo L, Meto A. Effectiveness of Two Different Fluoride-Based Agents in the Treatment of Dentin Hypersensitivity: A Prospective Clinical Trial. Materials (Basel) 2022; 15:1266. [PMID: 35161211 DOI: 10.3390/ma15031266] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/20/2022] [Revised: 02/01/2022] [Accepted: 02/04/2022] [Indexed: 11/17/2022]
Abstract
Hyperesthesia is related to increased sensitivity of dental tissues to mechanical, chemical and thermal stimuli. The aim of this prospective clinical trial was to compare the effectiveness of a calcium-fluoride-forming agent (Tiefenfluorid®, Humanchemie GmbH, Alfeld, Germany) with that of a fluoride varnish (EnamelastTM, Ultradent Inc., Cologne, Germany) in the treatment of dental hyperesthesia in adult patients. In total, 176 individuals (106 females and 70 males, aged 18-59 years old) diagnosed with dental hyperesthesia (DH) were enrolled. The main clinical symptoms were hyperesthesia from coldness and sweetness during chewing; the types of clinical lesions were also determined and recorded. The patients were selected randomly and divided into two groups: (i) the first group of 96 patients was treated with Tiefenfluorid® applied in three appointments at 7-day intervals; (ii) the second group of 80 patients was treated with EnamelastTM, applied seven times at 7-day intervals. All the patients were recalled 7 days, 14 days, 1 month, 3 months, and 6 months from the last application. At the baseline and during every follow-up visit, the DH was measured with a pulp tester. A random intercept/random slope model was used to evaluate the effect of the treatment, at various times with respect to the initial diagnosis. Within the limits of the present study, Tiefenfluorid® was more effective than EnamelastTM against DH in that it provided long-lasting results, with a significant improvement still detected at the latest 6-month follow-up.
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Vasireddy D, Sathiyakumar T, Mondal S, Sur S. Socioeconomic Factors Associated With the Risk and Prevalence of Dental Caries and Dental Treatment Trends in Children: A Cross-Sectional Analysis of National Survey of Children's Health (NSCH) Data, 2016-2019. Cureus 2021; 13:e19184. [PMID: 34873524 PMCID: PMC8635037 DOI: 10.7759/cureus.19184] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/01/2021] [Indexed: 11/05/2022] Open
Abstract
Introduction In the United States of America, early childhood caries (ECC) is the most common chronic childhood disease of early onset, with dental caries being the most prevalent chronic disease among children aged 6-19 years. Children without an established medical home, from low-income households, and who are uninsured have historically shown to be prone to dental caries and attribute to higher health care costs. Early recognition of these risk factors by a pediatrician helps prevent the development of medical and psychosocial complications in the child. Methods The cross-sectional data of the prevalence of dental caries and dental treatment trends in children and three socioeconomic risk factors, namely establishment of a medical home, household income, and child's health insurance, were accessed from the National Survey of Children's Health (NSCH) for the years 2016-2019. The association of the risk factors with the prevalence of dental caries and with the prevalence of dental treatment were analyzed using two-sample proportion tests and chi-square (χ2) tests for dichotomous categorical variables and non-dichotomous categorical variables, respectively. Standardized residuals were calculated and analyzed as well. Furthermore, the odds ratios were calculated and utilized to quantify the influence of each category on the highly associated category with having teeth decay and not receiving dental treatment under each socioeconomic risk factor. Results The results of this study revealed that the three socioeconomic factors considered have statistically significant associations with tooth decay and dental treatment. The prevalence and associative risk of tooth decay and untreated caries were the highest in the children without a medical home. Additionally, the odds of having tooth decay was >50% higher for the children from the lowest household income category (0-99% federal poverty level [FPL]) compared to those from the high household income categories (200-399% FPL and >400% FPL). Public insurance coverage was associated with the highest prevalence of dental caries and not receiving fluoride treatment. Furthermore, the likelihood of not availing dental treatment is nearly two times or more higher for the uninsured children than children having public insurance, or private insurance, or a combination of both. Conclusion Our study findings reveal that children belonging to certain socioeconomic risk categories are at a higher risk of developing dental caries and not receiving dental treatment. As a consequence, the study implies that increased support and expansion of public health insurance will benefit oral health care for the children. Pediatricians play an integral part in developing a medical home for the child by providing preventative dental care and establishing continued care through dental referrals.
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Effenberger S, Greenwall L, Cebula M, Myburgh N, Simpson K, Smit D, Wicht MJ, Schwendicke F. Cost-effectiveness and efficacy of fluoride varnish for caries prevention in South African children: A cluster-randomized controlled community trial. Community Dent Oral Epidemiol 2021; 50:453-460. [PMID: 34676577 DOI: 10.1111/cdoe.12702] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2021] [Revised: 09/28/2021] [Accepted: 10/04/2021] [Indexed: 11/28/2022]
Abstract
OBJECTIVES This cluster-randomized controlled community trial aimed to assess the efficacy and costs of fluoride varnish (FV) application for caries prevention in a high-risk population in South Africa. METHODS 513 children aged 4-8 years from two schools in a township in South Africa were randomly allocated by class to the FV or Control (CO) groups. In addition to supervised toothbrushing with fluoridated toothpaste in both groups, FV was applied in 3-month intervals by trained local non-professional assistants. Intraoral examinations were conducted at baseline, 12, 21 and 24 months. Primary outcome was the increment of teeth with cavitated lesions (i.e. newly developed or progressed, formerly non-cavitated lesions), requiring restoration or extraction over the study period. Additionally, treatment and re-treatment costs were analyzed. RESULTS 513 children (d1-4 mft 5.9 ± 4.3 (mean ± SD)) were randomly allocated to FV (n = 287) or CO (n = 226). 10.2% FV and CO teeth received or required a restoration; 3.9% FV and 4.1% CO teeth were extracted, without significant differences between groups. While FV generated high initial costs, follow-up costs were comparable in both groups, resulting in FV being significantly more expensive than CO (1667 ± 1055 ZAR vs. 950 ± 943 ZAR, p < .001). CONCLUSIONS Regular FV application, in addition to daily supervised toothbrushing, had no significant caries-preventive effect and was not cost-effective in a primary school setting within a peri-urban, high-risk community in South Africa. Alternative interventions on community or public health level should be considered to reduce the caries burden in high-risk communities.
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Affiliation(s)
| | | | - Marcus Cebula
- DMG Dental-Material Gesellschaft mbH, Hamburg, Germany
| | - Neil Myburgh
- Department of Community Oral Health, University of the Western Cape, Bellville, South Africa
| | - Karen Simpson
- Department of Community Oral Health, University of the Western Cape, Bellville, South Africa
| | - Dirk Smit
- Department of Community Oral Health, University of the Western Cape, Bellville, South Africa
| | - Michael J Wicht
- Department of Operative Dentistry and Periodontology, University Hospital of Cologne, Cologne, Germany
| | - Falk Schwendicke
- Department of Oral Diagnostics, Digital Health and Health Services Research, Charité - Universitätsmedizin Berlin, Berlin, Germany
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Sathiyakumar T, Vasireddy D, Mondal S. Impact of Sociodemographic Factors on Dental Caries in Children and Availing Fluoride Treatment: A Study Based on National Survey of Children's Health (NSCH) Data 2016-2019. Cureus 2021; 13:e18395. [PMID: 34729273 PMCID: PMC8555922 DOI: 10.7759/cureus.18395] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/30/2021] [Indexed: 11/09/2022] Open
Abstract
Introduction Dental caries is a global health issue. It is a largely preventable, multifactorial non-communicable disease. Given the gravity of the situation, in 2014 United States Preventive Services Task Force recommended that the primary care physician apply fluoride varnish from the eruption of the first tooth till the child attains five years of age. Using 2016-2019 National Survey of Children's Health (NSCH) cross-sectional representative data, the aim of this study was to determine if the child's age, gender, and race are predictors of the child having decayed teeth or cavities in the past 12 months and if they had availed preventative dental services from the dentist in the past 12 months in the US and if so, did they receive fluoride treatment. Methods The prevalence of dental caries and dental treatment among children under each category of sociodemographic risk factors were estimated using 2016-2019 NSCH's cross-sectional representative data on two survey questions. Then, the statistical significance of the association of the categorical risk factors with the prevalence of dental caries and the association of the categorical risk factors with the prevalence of fluoride dental treatment were tested using two-sample proportion tests and chi-square tests. Further, chi-square residual analysis was employed to better understand the nature of the association and to reveal the degree of contribution to the test statistic from each categorical combination of risk factors. Results Prevalence and associative risk of tooth decay in children was the highest in the 6-11 years age group across all three years under study. The 6-11 years age group had the highest prevalence and association of receiving fluoride treatment across all three years. In our study, the prevalence of dental caries in children by race varied according to the year. In 2016-2017 and 2018-2019, it was the Hispanic population with the highest prevalence of tooth decay. In 2017-2018 the highest prevalence was seen in the Non-Hispanic Black (NHB) population. Across all three years, the Hispanic population had the highest associative risk of tooth decay. The Non-Hispanic White (NHW) population had the highest prevalence and association with receiving fluoride treatment across all three years. Male children were found to have the higher prevalence and associative risk of decayed teeth across all three survey years. Conclusion Dental caries is a worldwide health burden. However, it can be prevented by different precautionary measures. The results of our study revealed that certain sociodemographic factors such as age, gender, and race of the child make certain groups of the child population more at risk for the development of dental caries; most notable findings were that the male children were significantly associated to have decayed teeth and not availing dental fluoride treatment for which limited information is available in the literature. Additionally, the age groups 1-5 and 6-11 were significantly associated with the prevalence of not receiving dental treatment and the prevalence of dental caries, respectively. More active participation of pediatricians in getting trained for the application of fluoride varnish and helping getting their patients established with dental services per recommendations will help streamline preventative dental care.
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Skinner J, Dimitropoulos Y, Sohn W, Holden A, Rambaldini B, Spallek H, Ummer-Christian R, Marshall S, Raymond K, AO TC, Gwynne K. Child Fluoride Varnish Programs Implementation: A Consensus Workshop and Actions to Increase Scale-Up in Australia. Healthcare (Basel) 2021; 9:healthcare9081029. [PMID: 34442166 PMCID: PMC8392282 DOI: 10.3390/healthcare9081029] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2021] [Revised: 07/20/2021] [Accepted: 07/22/2021] [Indexed: 11/16/2022] Open
Abstract
This paper presents the findings of the National Fluoride Varnish Workshop in 2018 along with subsequent actions to scale-up the use of fluoride varnish nationally in Australia. The use of fluoride varnish programs to prevent dental caries in high-risk child populations is an evidence-based population health approach used internationally. Such programs have not been implemented at scale nationally in Australia. A National Fluoride Varnish Consensus Workshop was held in Sydney in November 2018 with an aim of sharing the current work in this area being undertaken by various Australian jurisdictions and seeking consensus on key actions to improve the scale-up nationally. Forty-four people attended the Workshop with oral health representatives from all Australian state and territory health departments, as well as the Australian Dental Association (ADA) at both NSW branch and Federal levels. There was strong support for further scale-up of fluoride varnish programs nationally and to see the wider use of having non-dental professionals apply the varnish. This case study identifies key actions required to ensure scale-up of systematic fluoride varnish programs as part of a strategic population oral health approach to preventing dental caries among high-risk children who may not routinely access dental care.
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Affiliation(s)
- John Skinner
- Poche Centre for Indigenous Health, The University of Sydney, Room 224 Edward Ford Building, Sydney 2006, Australia; (Y.D.); (B.R.); (T.C.A.); (K.G.)
- Correspondence: ; Tel.: +61-4889-27557
| | - Yvonne Dimitropoulos
- Poche Centre for Indigenous Health, The University of Sydney, Room 224 Edward Ford Building, Sydney 2006, Australia; (Y.D.); (B.R.); (T.C.A.); (K.G.)
| | - Woosung Sohn
- The University of Sydney School of Dentistry, 2 Chalmers St, Surry Hills 2010, Australia; (W.S.); (A.H.); (H.S.)
| | - Alexander Holden
- The University of Sydney School of Dentistry, 2 Chalmers St, Surry Hills 2010, Australia; (W.S.); (A.H.); (H.S.)
| | - Boe Rambaldini
- Poche Centre for Indigenous Health, The University of Sydney, Room 224 Edward Ford Building, Sydney 2006, Australia; (Y.D.); (B.R.); (T.C.A.); (K.G.)
| | - Heiko Spallek
- The University of Sydney School of Dentistry, 2 Chalmers St, Surry Hills 2010, Australia; (W.S.); (A.H.); (H.S.)
| | - Rahila Ummer-Christian
- Fluoride Varnish Initiative, Loddon Mallee Aboriginal Reference Group, Bendigo 3550, Australia;
| | - Stuart Marshall
- Statewide Dental Services, SA Dental, Level 5 Roma Mitchell House, 136 North Tce, Adelaide 5000, Australia;
| | - Kate Raymond
- Department of Health, Northern Territory Government, Level 7 Manunda Place, 38 Cavenagh Street, Darwin 0800, Australia;
| | - Tom Calma AO
- Poche Centre for Indigenous Health, The University of Sydney, Room 224 Edward Ford Building, Sydney 2006, Australia; (Y.D.); (B.R.); (T.C.A.); (K.G.)
| | - Kylie Gwynne
- Poche Centre for Indigenous Health, The University of Sydney, Room 224 Edward Ford Building, Sydney 2006, Australia; (Y.D.); (B.R.); (T.C.A.); (K.G.)
- Faculty of Medicine, Health and Human Sciences, Macquarie University, Sydney 2113, Australia
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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: 5] [Impact Index Per Article: 1.7] [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: 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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Mazur M, Jedliński M, Ndokaj A, Ardan R, Janiszewska-Olszowska J, Nardi GM, Ottolenghi L, Guerra F. Long-Term Effectiveness of Treating Dentin Hypersensitivity with Bifluorid 10 and Futurabond U: A Split-Mouth Randomized Double-Blind Clinical Trial. J Clin Med 2021; 10:jcm10102085. [PMID: 34066300 PMCID: PMC8152040 DOI: 10.3390/jcm10102085] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2021] [Revised: 05/06/2021] [Accepted: 05/10/2021] [Indexed: 11/16/2022] Open
Abstract
Background: The definition of dental hypersensitivity is “pain derived from exposed dentin in response to chemical, thermal tactile or osmotic stimuli which cannot be explained as arising from any other dental defect or disease”. One of the treatments proposed is tubular occlusion. The aim of this in vivo split-mouth randomized clinical trial was to evaluate the clinical efficacy of a in-office application of a fluoride varnish (Bifluorid 10) and a bonding resin (Futurabond U) in adults with dentin hypersensitivity. Material and methods: A total of 180 teeth were treated with Bifluorid 10 and 160 with Futurabond U. Outcome measurements were taken one or two weeks before treatment, at baseline at the application days, at 1 week and at 1–6 months after first treatment. Results: Both treatments reduced pain intensity. Bifluorid 10 and Futurabond U have similar efficacy in reducing SCHIFF-measured pain reduction, while Bifluorid 10 is significantly more efficient for VAS-measured pain reduction, mainly due to long-term pain reduction. Patient age has a significant negative influence on pain reduction, while the influence of patient gender and BEWE of the tooth is insignificant. Conclusions: Bifluorid 10 and Futurabond U are effective in the treatment of dental hypersensitivity. The RCT was registered at the US National Institutes of Health (ClinicalTrials.gov) #NCT04813848.
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Affiliation(s)
- Marta Mazur
- Department of Dental and Maxillofacial Sciences, Sapienza University of Rome, 00161 Rome, Italy; (M.J.); (A.N.); (G.M.N.); (L.O.); (F.G.)
- Correspondence:
| | - Maciej Jedliński
- Department of Dental and Maxillofacial Sciences, Sapienza University of Rome, 00161 Rome, Italy; (M.J.); (A.N.); (G.M.N.); (L.O.); (F.G.)
- Department of Interdisciplinary Dentistry, Pomeranian Medical University in Szczecin, 70-111 Szczecin, Poland;
| | - Artnora Ndokaj
- Department of Dental and Maxillofacial Sciences, Sapienza University of Rome, 00161 Rome, Italy; (M.J.); (A.N.); (G.M.N.); (L.O.); (F.G.)
| | - Roman Ardan
- Chair of Econometrics, Department of Economic Sciences, Koszalin University of Technology, 75-343 Koszalin, Poland;
| | | | - Gianna Maria Nardi
- Department of Dental and Maxillofacial Sciences, Sapienza University of Rome, 00161 Rome, Italy; (M.J.); (A.N.); (G.M.N.); (L.O.); (F.G.)
| | - Livia Ottolenghi
- Department of Dental and Maxillofacial Sciences, Sapienza University of Rome, 00161 Rome, Italy; (M.J.); (A.N.); (G.M.N.); (L.O.); (F.G.)
| | - Fabrizio Guerra
- Department of Dental and Maxillofacial Sciences, Sapienza University of Rome, 00161 Rome, Italy; (M.J.); (A.N.); (G.M.N.); (L.O.); (F.G.)
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Göstemeyer G, Woike H, Paris S, Schwendicke F, Schlafer S. Root Caries Preventive Effect of Varnishes Containing Fluoride or Fluoride + Chlorhexidine/Cetylpyridinium Chloride In Vitro. Microorganisms 2021; 9:microorganisms9040737. [PMID: 33916105 PMCID: PMC8065905 DOI: 10.3390/microorganisms9040737] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [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: 01/15/2021] [Revised: 03/08/2021] [Accepted: 03/31/2021] [Indexed: 11/23/2022] Open
Abstract
Caries preventive varnishes containing only fluoride might differ from those containing a combination of fluoride and antimicrobial components in terms of mineralization properties and their impact on the cariogenic biofilm. We compared a fluoride and a fluoride + chlorhexidine (CHX)/cetylpyridinium chloride (CPC) varnish on root caries formation in vitro. One hundred bovine root dentin samples were allocated to five groups (n = 20/group): (1) 7700 ppm fluoride varnish (Fluorprotector S (F)), (2) experimental placebo varnish for F (F-P), (3) 1400 ppm fluoride + 0.3% CHX/0.5% CPC varnish (Cervitec F (CF)), (4) experimental placebo varnish for CF (CF-P), (5) untreated control. Cariogenic challenge was provided using a multi-station, continuous-culture 3-species (Streptococcus mutans (SM), Lactobacillus rhamnosus (LR), Actinomyces naeslundii (AN)) biofilm model for 10 days. Mineral loss (ΔZ) was evaluated using transversal microradiography and bacterial counts in the biofilm assessed as colony-forming units. Fluorescence in situ hybridization (FISH) and confocal microscopy were performed to assess the three-dimensional biofilm architecture. Mean ± SD (vol% × μm) ΔZ was significantly lower for F (9133 ± 758) and CF (9835 ± 1677) compared to control (11362 ± 919) (p < 0.05), without significant differences between F and CF. SM counts were significantly lower and LR counts significantly higher in F- and CF-biofilms compared to control. AN counts were significantly higher in the F-biofilms than in all other groups. According to FISH, SM and LR invaded dentinal tubules only in the control-group. In the CF-group, the basal biofilm layer did not contain SM and AN. Both F and CF varnishes had similar caries-preventive effects and a considerable impact on biofilm structure and composition.
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Affiliation(s)
- Gerd Göstemeyer
- Department of Operative and Preventive Dentistry, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Aßmannshauser Straße 4-6, 14197 Berlin, Germany; (H.W.); (S.P.)
- Correspondence: ; Tel.: +49-30-450-562-328
| | - Helen Woike
- Department of Operative and Preventive Dentistry, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Aßmannshauser Straße 4-6, 14197 Berlin, Germany; (H.W.); (S.P.)
| | - Sebastian Paris
- Department of Operative and Preventive Dentistry, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Aßmannshauser Straße 4-6, 14197 Berlin, Germany; (H.W.); (S.P.)
| | - Falk Schwendicke
- Department of Oral Diagnostics, Digital Health and Health Services Research, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Aßmannshauser Straße 4-6, 14197 Berlin, Germany;
| | - Sebastian Schlafer
- Section for Oral Ecology and Caries Control, Department of Dentistry and Oral Health, Aarhus University, Vennelyst Boulevard 9, 8000 Aarhus C, Denmark;
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Ortiz-Ruiz AJ, Martínez-Marco JF, Pérez-Silva A, Serna-Muñoz C, Cabello I, Banerjee A. Influence of Fluoride Varnish Application on Enamel Adhesion of a Universal Adhesive. J Adhes Dent 2021; 23:47-56. [PMID: 33512115 DOI: 10.3290/j.jad.b916831] [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] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
PURPOSE To study the effect of the varnish type, application time and surface polishing on the shear bond strength (SBS) of a universal adhesive in healthy and demineralized bovine enamel. MATERIALS AND METHODS 432 bovine primary central incisors were assigned to 18 groups according to enamel mineralization [healthy and demineralized], topical varnish [Clinpro White Varnish (CWV; 3M Oral Care) and Profluorid (PFV, Voco)], remineralization time [24 h or 21 days] and polishing or not of the enamel surface. Adhesion was tested using Futurabond M (Voco)+ and GrandioSO (Voco). Sheer bond strength (SBS) was measured and the fracture mode studied. The statistical analysis was performed using two-way ANOVA, Tukey's test, and Pearson's chi-squared test. RESULTS In healthy bovine enamel, CWV reduced SBS at 24 h and 21 days; polishing significantly improved SBS. PFV increased SBS in healthy enamel at 21 days and demineralized enamel at 24 h and 21 days; polishing had no effect on SBS. The application time and polishing of the enamel surface affected the behavior of varnishes with respect to SBS. There was a correlation between the type of fracture and the degree of mineralization as well as the timepoint of varnish application. CONCLUSIONS Remineralization of demineralized enamel with fluoride varnishes permits the recovery of the bond strength obtained in healthy enamel. Of the two varnishes studied, PFV had the highest SBS and more uniform behavior, regardless of the application timepoint, degree of mineralization, and surface treatment of the enamel..
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Cai J, Burrow MF, Manton DJ, Hardiman R, Palamara JEA. Remineralising effects of fluoride varnishes containing calcium phosphate on artificial root caries lesions with adjunctive application of proanthocyanidin. Dent Mater 2020; 37:143-157. [PMID: 33267974 DOI: 10.1016/j.dental.2020.10.021] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2020] [Revised: 08/13/2020] [Accepted: 10/24/2020] [Indexed: 11/18/2022]
Abstract
OBJECTIVES To evaluate the remineralising effects of fluoride (F) varnishes containing bioavailable calcium-phosphate compound (Ca-P) based remineralisation systems and 5000 ppm F toothpaste (FTP) on root caries lesions (RCLs) and the potential effects of proanthocyanidin (PA) for the treatments of RCLs when used as an adjunct to F regimens. METHODS Demineralised root dentine and a pH-cycling model were used to mimic RCLs and the oral environment. Remineralising effects of MI VarnishTM (MIV) containing casein phosphopeptide-amorphous calcium phosphate (CPP-ACP) and Clinpro™ White Varnish (CPWV) containing tri-calcium phosphate (TCP) along with FTP and PA were evaluated regarding the birefringence, elemental composition, mechanical properties and mineral density of remineralised dentine with DuraphatTM as a comparison. RESULTS MIV, CPWV and DuraphatTM promoted the incorporation of F into RCLs and increased mineral density but did not change microhardness of root dentine significantly. Surface microhardness increased significantly when MIV or CPWV was used with 5000 ppm FTP. Application of PA with F regimens significantly increased subsurface mineral density. When PA was applied with MIV or CPWV along with FTP, the highest ion uptake and relative mineral gain (%ΔZ) was achieved, and significant increase of microhardness was up to 30 μm depth. Generally, MIV was associated with a higher mineral content gain than CPWV. SIGNIFICANCE Treatment of carious root surfaces remains challenging due to the complex pathological processes and difficulty in restoring the highly organised structure of root dentine. Treatment strategies targeting both remineralisation and preservation of the dentinal organic matrix have the potential to improve the fluoride-mediated remineralisation approaches.
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Affiliation(s)
- Jing Cai
- Melbourne Dental School, The University of Melbourne, 720 Swanston Street, Carlton, VIC 3053, Australia
| | - Michael F Burrow
- Melbourne Dental School, The University of Melbourne, 720 Swanston Street, Carlton, VIC 3053, Australia; Faculty of Dentistry, the University of Hong Kong, Prince Philip Dental Hospital, Sai Ying Pun, Hong Kong SAR, China
| | - David J Manton
- Melbourne Dental School, The University of Melbourne, 720 Swanston Street, Carlton, VIC 3053, Australia; Centrum voor Tandheelkunde en Mondzorgkunde, UMCG, University of Groningen, The Netherlands
| | - Rita Hardiman
- Melbourne Dental School, The University of Melbourne, 720 Swanston Street, Carlton, VIC 3053, Australia
| | - Joseph E A Palamara
- Melbourne Dental School, The University of Melbourne, 720 Swanston Street, Carlton, VIC 3053, Australia.
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Ghosh A, Mazumder D. Comparative evaluation of treatment of noncarious cervical hypersensitivity by a fluoride varnish, a dentin bonding agent, and Er, Cr:YSGG laser: An in vivo study. J Conserv Dent 2020; 22:516-521. [PMID: 33088057 PMCID: PMC7542079 DOI: 10.4103/jcd.jcd_215_20] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [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: 05/13/2020] [Revised: 06/28/2020] [Accepted: 07/03/2020] [Indexed: 12/04/2022] Open
Abstract
Context: Dentin hypersensitivity is one of the most common dental problems encountered regularly. This commonly appearing condition is quite difficult to treat satisfactorily, and so, a large number of techniques and therapeutic alternatives constantly are being proposed to relieve it. However, till date, the search for an ideal agent is on. Various laser systems have been discussed as a new treatment option for dentin hypersensitivity. Researchers are claiming good prognosis with lasers. Treatment with soft tissue lasers is being practiced for some time and is well documented. However, the use of Er, Cr:YSGG laser for desensitization purpose is new, and the available data on clinical outcome are limited. Aims: The purpose of this study was to test and compare the efficacy of a fluoride varnish, a dentin bonding agent, and Er, Cr: YSGG laser in treating noncarious cervical hypersensitivity, in vivo. Settings and Design: Fifty patients aged between 25 and 55 years complaining of dentinal hypersensitivity who reported to the Department of Conservative Dentistry and Endodontics, Dr. R. Ahmed Dental College and Hospital, Kolkata, participated in this study. Subjects and Methods: Sensitive teeth in each patient were randomly divided into three treatment groups: Group 1 treated with fluoride varnish Group 2 treated with dentin bonding agent Group 3 treated with Er, Cr: YSGG laser.
Hypersensitivity assessment was done pretreatment, immediately posttreatment, and 1 day, 1, 2, 3, and 4 weeks postoperatively. Statistical Analysis Used: The data obtained were tabulated and subjected to statistical analysis using the paired and unpaired t-test. Results: In all the treatment groups, there was significant decrease in mean hypersensitivity scores from pretreatment values after 4 weeks. The posttreatment hypersensitivity scores of Group 3 were minimum for all three test stimuli followed by Group 2 and Group 1, respectively. Conclusions: All the three treatment agents, namely fluoride varnish, dentin bonding agent, and Er, Cr:YSGG laser, were effective in treating dentin hypersensitivity. Least recurrence in hypersensitivity occurred in the laser-treated group. Even where recurrences did occur, hypersensitivity did not return to pretreatment value and occurred more in those cases exhibiting high pretreatment sensitivity.
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Affiliation(s)
- Amrita Ghosh
- Department of Conservative Dentistry and Endodontics, Dr. R. Ahmed Dental College and Hospital, Kolkata, West Bengal, India
| | - Dibyendu Mazumder
- Department of Conservative Dentistry and Endodontics, Dr. R. Ahmed Dental College and Hospital, Kolkata, West Bengal, India
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Nelson S, Albert JM, Milgrom P. Comparative Effectiveness of Two Nonsurgical Treatments to Reduce Oral Health Disparities From Untreated Tooth Decay in Older Adults: Protocol for a Cluster Randomized Trial. JMIR Res Protoc 2020; 9:e17840. [PMID: 32897236 PMCID: PMC7509639 DOI: 10.2196/17840] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2020] [Revised: 07/14/2020] [Accepted: 07/19/2020] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND The majority of dental caries lesions in older adults are at the gumline, at the edges of failed fillings and crowns, and in the surfaces of roots after gum recession. These lesions are difficult to restore with conventional surgical treatments using a dental drill and restorations often fail. Clinical guidelines are general and apply treatments that were designed for younger individuals in the dental care of older adults. OBJECTIVE This study will compare the effectiveness of 2 evidence-based nonsurgical strategies to manage dental caries lesions in adults aged 62 or older: (1) biannual topical application of silver diamine fluoride versus (2) atraumatic restorative treatment + biannual fluoride varnish. METHODS A cluster randomized clinical trial is being conducted in 22 publicly subsidized and other low-income housing facilities/sites (Arm 1: 11 sites, 275 participants; Arm 2: 11 sites, 275 participants). At baseline, participants will be screened for caries lesions. Those with nonurgent lesions will be treated according to the treatment arm to which the housing site was randomly assigned. The primary outcomes are caries lesion arrest, tooth sensitivity, and tooth pain at 52 weeks after treatment. Analytic methods for the primary aim include a generalized estimating equation approach to determine noninferiority of silver diamine fluoride relative to atraumatic restorative treatment + fluoride varnish treatment. RESULTS The trial was funded in April 2019. Enrollment began in September 2019 and results are expected in June 2023. CONCLUSIONS This study will inform the standard of care for treating caries lesions in older adults. If effective, either of these interventions has broad applicability in clinical and community-based settings. TRIAL REGISTRATION ClinicalTrials.gov NCT03916926; https://clinicaltrials.gov/ct2/show/NCT03916926. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) DERR1-10.2196/17840.
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Affiliation(s)
- Suchitra Nelson
- Case Western Reserve University, Cleveland, OH, United States
| | | | - Peter Milgrom
- Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle, WA, United States
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Apriani A, Widyarman AS, Budiyanti EA, Roeslan BO. Caries Activity and Ph Level Changes after Fluoride Varnish and Casein Phosphopeptides-Amorphous Calcium Phosphate Application on Children's Saliva. Contemp Clin Dent 2020; 11:126-130. [PMID: 33110324 PMCID: PMC7583542 DOI: 10.4103/ccd.ccd_167_20] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [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: 02/27/2020] [Accepted: 05/23/2020] [Indexed: 12/31/2022] Open
Abstract
Background Caries is a disease affecting the hard tissue of the tooth wherein the demineralization process caused by Streptococcus mutans decreases saliva pH faster than the remineralization process can maintain it. Topical fluoridation, such as fluoride varnish and casein phosphopeptides-amorphous calcium phosphate (CPP-ACP) is the most common preventive therapy for the disease. Aims The aim of this study is to assess the difference between fluoride varnish and CPP-ACP in reducing saliva pH and caries activity. Materials and Methods This is an experimental study with a sample population of 60 children (aged 8-9 years old), divided into two groups of 30. Group 1 was treated with fluoride varnish, Group 2 with CPP-ACP. A t-test was used to measure the effects of the different treatments. Results The result showed that the average difference in saliva pH before and after application was -0.12933 in Group 1 and -0.14033 in Group 2 (P = 0.256). The average difference in caries activity before and after application was 3.189 log colony-forming units (CFUs)/mL in Group 1 and 2.237 log CFUs/mL in Group 2 (P = 0.275). Conclusion The most effective treatment for increasing saliva pH and reducing caries activity can be achieved by using the varnish for 1 month. However, there is no difference between fluoride varnish and CPP-ACP with regard to altering saliva pH and reducing caries activity statistically. Future study is needed to explore this result.
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Affiliation(s)
- Anie Apriani
- Post Graduate Student Faculty of Dentistry Trisakti University, Jakarta, Indonesia.,Department of Pediatric Dentistry, Maranatha Christian University, Bandung, Indonesia
| | - Armelia Sari Widyarman
- Department Head of Microbiology, Faculty of Dentistry, Trisakti University, Jakarta, Indonesia
| | - E Arlia Budiyanti
- Department of Pediatric Dentistry, Faculty of Dentistry, Trisakti University, Jakarta, Indonesia
| | - Boedi Oetomo Roeslan
- Department of Oral Biology, Faculty of Dentistry, Trisakti University, Jakarta, Indonesia
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Lian L, Lumsden C, Yoon R, Sirota D. Assessment of New York Primary Care Physicians' Knowledge, Attitudes, and Practices Related to Fluoride Varnish in an Urban Medical-Setting. J Clin Pediatr Dent 2020; 44:249-55. [PMID: 33167019 DOI: 10.17796/1053-4625-44.4.6] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
OBJECTIVE To determine changes in knowledge, attitudes, and practices of primary care physicians (PCPs) regarding fluoride varnish (FV). STUDY DESIGN Fifty-four PCPs at an urban medical center in New York completed a pre-intervention survey. A pediatric dental resident provided an hour-long educational lecture and a hands-on demonstration regarding FV application. Six months later, PCPs were sent a post-intervention survey via electronic mail. RESULTS Fifty-four PCPs participated in the pre-survey and FV training and 48% completed the post-survey. Prior to the FV training, 57% of PCPs knew that FV application by medical practitioners was reimbursable for children under 6-years-old and 2% of PCPs were applying FV. Post FV training, 62% of PCPs reported applying FV. Pre and post survey, barriers to FV application was not enough hands-on training (43% to 15% respectively) and not enough time (50% to 85% respectively). CONCLUSIONS Post FV training, PCPs' knowledge, attitudes and practices in regard to FV changed. Interprofessional education may be one approach to increasing FV application participation.
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Shen P, McKeever A, Walker GD, Yuan Y, Reynolds C, Fernando JR, Chen YY, MacRae CM, Schneider P, Reynolds EC. Remineralization and fluoride uptake of white spot lesions under dental varnishes. Aust Dent J 2020; 65:278-285. [PMID: 32678914 DOI: 10.1111/adj.12787] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/09/2020] [Indexed: 11/26/2022]
Abstract
INTRODUCTION The aim of this study was to evaluate white spot lesion (WSL) remineralization and fluoride uptake by the application of fluoride varnishes directly onto artificial WSLs in vitro. METHODS MI varnish containing casein phosphopeptide-amorphous calcium phosphate (CPP-ACP) and 2.26% fluoride and Duraphat varnish containing 2.26% fluoride (no added calcium) were compared with a placebo varnish (no added calcium or fluoride). Two WSLs were prepared in enamel slabs and varnish applied to cover one of the two lesions. Each slab was immersed in artificial saliva for 14 days at 37°C. Mineral content was determined using transverse microradiography and fluoride uptake using electron probe microanalysis. The data were statistically analysed using a linear mixed model. RESULTS Both MI and Duraphat varnishes significantly remineralized the covered and uncovered WSLs when compared with the placebo varnish (P < 0.001). The WSLs covered with varnish showed greater remineralization than those uncovered. MI varnish produced the highest level of remineralization and significantly greater fluoride uptake (0.44 ± 0.08 wt%) compared with Duraphat (0.24 ± 0.03 wt%) and the placebo varnish (0.06 ± 0.05 wt%). CONCLUSION Varnish containing fluoride and CPP-ACP was superior to varnish containing fluoride alone in promoting WSL remineralization and fluoride uptake.
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Affiliation(s)
- P Shen
- Oral Health Cooperative Research Centre, Melbourne Dental School, Bio21 Institute, The University of Melbourne, Melbourne, Victoria, Australia
| | - A McKeever
- Oral Health Cooperative Research Centre, Melbourne Dental School, Bio21 Institute, The University of Melbourne, Melbourne, Victoria, Australia
| | - G D Walker
- Oral Health Cooperative Research Centre, Melbourne Dental School, Bio21 Institute, The University of Melbourne, Melbourne, Victoria, Australia
| | - Y Yuan
- Oral Health Cooperative Research Centre, Melbourne Dental School, Bio21 Institute, The University of Melbourne, Melbourne, Victoria, Australia
| | - C Reynolds
- Oral Health Cooperative Research Centre, Melbourne Dental School, Bio21 Institute, The University of Melbourne, Melbourne, Victoria, Australia
| | - J R Fernando
- Oral Health Cooperative Research Centre, Melbourne Dental School, Bio21 Institute, The University of Melbourne, Melbourne, Victoria, Australia
| | - Y-Y Chen
- Oral Health Cooperative Research Centre, Melbourne Dental School, Bio21 Institute, The University of Melbourne, Melbourne, Victoria, Australia
| | - C M MacRae
- Microbeam Laboratory, CSIRO Mineral Resources, Clayton, Victoria, Australia
| | - P Schneider
- Oral Health Cooperative Research Centre, Melbourne Dental School, Bio21 Institute, The University of Melbourne, Melbourne, Victoria, Australia
| | - E C Reynolds
- Oral Health Cooperative Research Centre, Melbourne Dental School, Bio21 Institute, The University of Melbourne, Melbourne, Victoria, Australia
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Norrie O, Pharand L. Cost effectiveness of a fluoride varnish daycare program versus usual care in central Winnipeg, Canada. Can J Dent Hyg 2020; 54:68-74. [PMID: 33240366 PMCID: PMC7668277] [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] [Received: 07/23/2019] [Revised: 04/06/2020] [Accepted: 04/14/2020] [Indexed: 06/11/2023]
Abstract
Objective This project compares the cost effectiveness of a preventive fluoride varnish (FV) program with usual dental care (surgery under general anesthesia [GA]) for preschool children in 2 low-income communities in Winnipeg, Canada. Methods Program impact is described in terms of cost, cavities avoided, and reductions in surgery volume. Aggregate data for 873 children ages 1 to 6 years old enrolled in the Winnipeg Regional Health Authority Daycare Fluoride Varnish Program in January 2018 were analysed using a Markov model. Results The program was found to save approximately $822.98 per child over 5 years versus usual dental care. There were 4.38 cavities avoided per child and a savings of $187.71/cavity for the FV group. Participants' need for dental surgery under GA was reduced from 19.1% in the usual care group to 1.6% in the FV group (92% reduction) over 5 years. Sensitivity analyses using a Monte Carlo simulation showed that the program was cost effective over usual care 100% of the time. Finally, it was estimated that the program had saved $753,000 since its inception, or approximately $41.15 per FV application. Conclusion The FV intervention had better health outcomes, lower costs, and was less invasive than usual care involving dental surgery under GA for children enrolled in the program.
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Affiliation(s)
- Ola Norrie
- Research associate, Evaluation Platform, George and Fay Yee Centre for Health Care Innovation, University of Manitoba & Winnipeg Regional Health Authority, Winnipeg, MB, Canada
| | - Linda Pharand
- Senior dental hygienist, SMILEPlus Dental Program, Winnipeg Regional Health Authority, Winnipeg, MB, Canada
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Świetlicka I, Kuc D, Świetlicki M, Arczewska M, Muszyński S, Tomaszewska E, Prószyński A, Gołacki K, Błaszczak J, Cieślak K, Kamiński D, Mielnik-Błaszczak M. Near-Surface Studies of the Changes to the Structure and Mechanical Properties of Human Enamel under the Action of Fluoride Varnish Containing CPP-ACP Compound. Biomolecules 2020; 10:biom10050765. [PMID: 32422985 PMCID: PMC7277937 DOI: 10.3390/biom10050765] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2020] [Revised: 04/30/2020] [Accepted: 05/11/2020] [Indexed: 12/03/2022] Open
Abstract
Changes to the features of the enamel surface submitted to induced demineralisation and subsequent remineralisation were studied. The in vitro examination was conducted on polished slices of human molar teeth, divided in four groups: the untreated control (n = 20), challenged by a demineralisation with orthophosphoric acid (H3PO4) (n = 20), and challenged by a demineralisation following remineralisation with fluoride (F) varnish containing casein phosphopeptides (CPP) and amorphous calcium phosphate (ACP) compounds (n = 20). The specimens’ enamel surfaces were subjected to analysis of structure, molecular arrangement, mechanical features, chemical composition, and crystalline organization of apatite crystals. Specimens treated with acid showed a significant decrease in crystallinity, calcium, and phosphorus levels as well as mechanical parameters, with an increase in enamel surface roughness and degree of carbonates when compared to the control group. Treatment with fluoride CPP–ACP varnish provided great improvements in enamel arrangement, as the destroyed hydroxyapatite structure was largely rebuilt and the resulting enamel surface was characterised by greater regularity, higher molecular and structural organisation, and a smoother surface compared to the demineralised one. In conclusion, this in vitro study showed that fluoride CPP–ACP varnish, by improving enamel hardness and initiating the deposition of a new crystal layer, can be an effective remineralising agent for the treatment of damaged enamel.
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Affiliation(s)
- Izabela Świetlicka
- Department of Biophysics, Faculty of Environmental Biology, University of Life Sciences in Lublin, 20-950 Lublin, Poland;
- Correspondence: (I.Ś.); (M.A.)
| | - Damian Kuc
- Chair and Department of Paediatric Dentistry, Medical University of Lublin, 20-059 Lublin, Poland; (D.K.); (M.M.-B.)
| | - Michał Świetlicki
- Department of Applied Physics, Faculty of Mechanical Engineering, Lublin University of Technology, 20-618 Lublin, Poland; (M.Ś.); (A.P.)
| | - Marta Arczewska
- Department of Biophysics, Faculty of Environmental Biology, University of Life Sciences in Lublin, 20-950 Lublin, Poland;
- Correspondence: (I.Ś.); (M.A.)
| | - Siemowit Muszyński
- Department of Biophysics, Faculty of Environmental Biology, University of Life Sciences in Lublin, 20-950 Lublin, Poland;
| | - Ewa Tomaszewska
- Department of Animal Physiology, Faculty of Veterinary Medicine, University of Life Sciences in Lublin, 20-950 Lublin, Poland;
| | - Adam Prószyński
- Department of Applied Physics, Faculty of Mechanical Engineering, Lublin University of Technology, 20-618 Lublin, Poland; (M.Ś.); (A.P.)
| | - Krzysztof Gołacki
- Department of Mechanical Engineering and Automatics, Faculty of Production Engineering, University of Life Sciences in Lublin, 20-612 Lublin, Poland;
| | | | - Krystian Cieślak
- Institute of Renewable Energy Engineering, Faculty of Environmental Engineering, Lublin University of Technology, 20-618 Lublin, Poland;
| | - Daniel Kamiński
- Department of Crystallography, Faculty of Chemistry, Maria Curie-Sklodowska University, 20-031 Lublin, Poland;
| | - Maria Mielnik-Błaszczak
- Chair and Department of Paediatric Dentistry, Medical University of Lublin, 20-059 Lublin, Poland; (D.K.); (M.M.-B.)
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Johnson SC, French GM. A Quality Improvement Project to Optimize Fluoride Varnish Use in a Pediatric Outpatient Clinic with Multiple Resident Providers. Hawaii J Health Soc Welf 2020; 79:7-12. [PMID: 32490379 PMCID: PMC7260867] [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] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
The pediatric clinic at Kapi'olani Medical Center provides dental varnish to prevent decay. A chart review (conducted August 1-31, 2017) revealed that only 49.6% of eligible children received varnish. Among those who did not receive varnish, no explanation was provided in 83.9% of the charts. This quality improvement project was designed to increase delivery and documentation of dental varnish. The participants were 14-15 pediatric and psychiatry residents (11 present for all cycles). Cycle 1 interventions were a 5-minute resident educational session on the importance and process of fluoride varnish, and visual reminders on all order entry computers in the clinic. Cycle 2 intervention consisted of a prompt added to the clinic's default well child visit templates requiring notation of whether varnish was given and a reason if not. Data for cycle 2 was collected over 6 weeks as some residents chose to use their own templates, serving as an unplanned comparison group. Application of varnish increased to 77.7% (P < .001) after cycle 1, and was statistically unchanged for cycle 2 (74% (P = .24)). Documentation of reason for lack of varnish was missing in 80% (P = .59) after cycle 1 and 17 % (P < .001) after cycle 2 (with prompt). In the cycle 2 comparison group using their own templates, the varnish application rate was 71% (P < .001) with no explanation for lack of varnish 84% of the time (P = .95). Brief educational interventions may result in increased use of fluoride varnish in resident-based clinics. Task based prompts or stop measures in electronic medical record templates can improve documentation, which can inform efforts to improve varnish application.
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Affiliation(s)
| | - Gina Marie French
- University of Hawai'i Pediatrics, Kapi'olani Medical Center for Women and Children, Honolulu, HI (GMF)
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Akyildiz M, Sönmez IS. Comparison of Remineralising Potential of Nano Silver Fluoride, Silver Diamine Fluoride and Sodium Fluoride Varnish on Artificial Caries: An In Vitro Study. Oral Health Prev Dent 2019; 17:469-477. [PMID: 31268047 DOI: 10.3290/j.ohpd.a42739] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
PURPOSE To evaluate the remineralisation effect of an experimental nano silver fluoride (NSF) formulation using an in vitro remineralisation model, compared with silver diamine fluoride (SDF) and sodium fluoride varnish (NaF) in current clinical use. MATERIALS AND METHODS 45 sound human third molars were sectioned in buccolingual and mesiodistal direction and 180 enamel specimens were divided into four groups (NSF; SDF; NaF; Control). Early caries-like lesions were artificially created. Remineralisation agents were applied with a microbrush for 2 min in NSF and SDF group; NaF varnish were applied in a thin layer and then all specimens were stored in a moist environment at 37°C for 24 h. Each group was subjected to a pH cycling model for 7 days. The Vickers microhardness values (VHN) of specimens were compared before treatment, after demineralisation and after remineralisation. In addition, scanning electron microscope (SEM) images were investigated to compare morphological changes on the surfaces. Kruskal-Wallis and Mann-Whitney U tests were used for statistical analysis to compare the groups at p < 0.05. RESULTS All remineralisation agents were found to be statistically significant for the rehardening of the demineralised enamel specimens (p < 0.001). There was a statistically significant difference between the all groups after remineralisation (p < 0.001). The VHN values for postdemineralisation were determined as, respectively, NaF (229.96) > SDF (222.96) > NSF (191.36) > Control (175.80). SEM images have also supported the microhardness values. CONCLUSIONS NSF was not found to be effective as sodium fluoride varnish and SDF on artificial enamel caries lesions. Additional investigation is needed to recommend it as an alternative agent to routine fluoride treatments.
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Jain A, Suprabha BS, Shenoy R, Natarajan S, Rao A. Remineralising Effectiveness of Two Fluoride Varnishes Containing Additives: An In Vitro Study. Oral Health Prev Dent 2019; 17:385-393. [PMID: 31204393 DOI: 10.3290/j.ohpd.a42686] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
PURPOSE To assess the remineralising efficacy of fluoride varnish containing additives and conventional sodium fluoride varnish. MATERIALS AND METHODS 72 extracted upper central incisors specimens were randomly allocated to four groups after demineralisation: control; 5% sodium fluoride varnish (FV) (Fluoritop-SR); resin modified glass ionomer-based calcium phosphate containing fluoride varnish (CV) (Clinpro XT); fluoride varnish with xylitol coated calcium phosphate (cXp) (Embrace). Change in surface morphology, calcium phosphorous ratio and fluoride content of enamel were evaluated using scanning electron microscope and energy dispersive X-ray analysis (SEM-EDAX). Change in surface roughness was evaluated using profilometer analysis. All readings were taken at baseline, after demineralisation, at 2 weeks and 4 weeks of remineralisation. RESULTS At 4 weeks of remineralisation surface roughness values were ranked as follows: control > FV = cXp > CV. Calcium phosphorus ratios were in the order: CV > FV = cXp > control and fluoride content (for treatment groups): CV = cXp > FV. Scanning electron microscopy images showed mineral deposition on the surfaces of the treatment groups with different deposition pattern of minerals. CONCLUSION Fluoride varnishes with or without additives are effective in remineralisation of early enamel lesions. Glass ionomer-based fluoride varnish results in better remineralisation than xylitol coated calcium phosphate containing fluoride varnish and 5% sodium fluoride varnish.
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Aljamah AF, Hara AT, Levon JA, Eckert GJ, Lippert F. Effects of PVP-Iodine pH and Calcium Concentration on Fluoride Varnish Anti-Caries Efficacy In Vitro. Oral Health Prev Dent 2019; 17:257-262. [PMID: 31093615 DOI: 10.3290/j.ohpd.a42506] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
PURPOSE This laboratory study investigated the effects of PVP-iodine solutions with varying pH and calcium concentrations on enamel remineralization and fluoridation by subsequent treatment with fluoride varnish. MATERIALS AND METHODS Caries-like lesions were created in bovine enamel specimens (n = 15 per group) and characterized using Vickers surface microhardness (VHN). Specimens were treated with 10% PVP-iodine solutions varying in calcium concentration (0/10/100 mM) and pH (3.0/4.0/5.0), followed by 5% sodium fluoride varnish. A fluoride varnish-only control group was included. Specimens were then placed into artificial saliva for 16 h. The varnish was removed, hardness measured and enamel fluoride uptake (EFU) determined using the microbiopsy technique. Data were analyzed with one-way ANOVA. RESULTS Groups receiving PVP-iodine pre-treatments exhibited directionally greater rehardening (range: p = 0.0001 - 0.7008) and EFU (p = 0.0001-0.2670) than the control group. The presence of calcium in the pre-treatment enhanced rehardening. the groups '10mM Ca/pH 3.0' (∆VHN = 10.5 ± 6.3), '100mM Ca/pH 3.0' (∆VHN = 9.7 ± 4.1) and '10mM Ca/pH 5.0' (∆VHN = 8.7 ± 7.0) displayed the highest numerical gain vs the control (∆VHN=3.6±2.2). Different pH values had a minor effect on rehardening and EFU. The calcium effect was more pronounced for EFU than for rehardening with all three '100 mM Ca' groups exhibiting higher EFU (7.0 - 7.2 µg F/cm2) than all other groups (6.1 - 6.9 µg F/cm2). CONCLUSION PVP-iodine pre-treatments can be modified to enhance the rehardening and fluoridating effect of fluoride varnishes, thereby potentially improving their ability to prevent caries in vivo. Although numerical differences between groups were small, the addition of high concentrations of calcium paired with a low pH appears most favorable under the present conditions.
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Topsakal KG, Amuk NG. Effects of Different Remineralisation Agents and Adhesives Around Orthodontic Brackets: Is There a Relationship Between Remineralisation and Shear Bond Strength? Oral Health Prev Dent 2019; 17:567-577. [PMID: 31631193 DOI: 10.3290/j.ohpd.a43328] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
PURPOSE The aim of this in-vitro study was to evaluate the effects of different remineralisation agents and adhesives on the remineralisation of white spot lesions (WSL) using quantitative light-induced fluorescence (QLF) and the shear bond strength (SBS) of brackets. MATERIALS AND METHODS One hundred fifty premolars were bonded with Transbond XT and resin-modified glass-ionomer cement (RMGIC). WSL were created using a demineralization solution and an APF gel, Tooth Mousse (TM) and Duraphat were applied for remineralisation. WSL were evaluated using QLF and SBS of brackets and tested using an Instron testing machine. Paired-samples t-test, independent-samples t-test and one-way ANOVA were used for comparisons of the ∆F, area and SBS. Post-hoc tests were performed using Tukey's test. RESULTS In the Transbond group, all remineralisation agents provided remineralisation, with Duraphat producing greater improvement. In terms of lesion area, the positive control and APF gel group values were close to each other, and a statistically significant improvement was observed in the TM and Duraphat groups' areas. In the RMGIC group, with TM application, the ΔF value was statistically significantly higher; area differences between the APF and TM groups were not statistically significant. The Transbond group showed greater SBS than did RMGIC, and in the Transbond group, Duraphat had the highest SBS value. CONCLUSIONS In bonding with Transbond, the Duraphat group demonstrated greater improvement than other remineralisation agents. In the RMGIC group, the best remineralisation was obtained by TM. The Transbond XT and Duraphat combination provided the highest SBS values.
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Gözetici B, Öztürk-Bozkurt F, Toz-Akalın T. Comparative Evaluation of Resin Infiltration and Remineralisation of Noncavitated Smooth Surface Caries Lesions: 6-month Results. Oral Health Prev Dent 2019; 17:99-106. [PMID: 30874252 DOI: 10.3290/j.ohpd.a42203] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
PURPOSE To compare the therapeutic effects of the resin infiltration technique, self-assembling peptide (P11-4), and fluoride varnish application on white spot lesions (WSLs) on buccal surfaces based on LF pen measurements and LAA-ICDAS scores. MATERIALS AND METHODS The lesions of 113 patients from a total of 319 patients with at least four visible WSL on buccal surfaces were assessed by LAA-ICDAS and laser fluoresence (LF pen). To be included in the study, participants were required to have at least 4 buccal WLSs, each in different quadrants, with an LF pen score ≥ 8. Twenty-one patients were included in the study based on the laser fluoresence values. The lesions were randomly assigned into 4 groups (n = 21): IG (Icon), CRG (Curodont Repair), DG (Duraphat), and CG (control) groups. The treatment protocols were applied, but the control group received no treatment except regular brushing. Lesions were scored by LAA-ICDAS after 3 and 6 months and LF pen after 1 week, 3 and 6 months. RESULTS There was a statistically significant decrease in LF pen measurements of the control and the intervention groups after 6 months when compared to baseline. The greatest lesion regression was observed with IG (-23.25 ± 18.21), which differed statistically significantly from CRG (-8.15 ± 13.89), DG (-10.1 ± 10.31) and CG (-4.15 ± 9.72), followed by DG which differed statistically significantly from CG. Statistically significant differences were observed in the activity status of the lesions between baseline and 6 months, except for the control group. CONCLUSION In this study, the lesion regression rates shown by mean LF pen values in all groups after six months encourages the management of non-cavitated smooth surface caries lesions with non-operative treatment approaches. Regular brushing and professional tooth cleaning seem to be effective for the management of WSLs on buccal surfaces, and resin infiltration or fluoride varnish might enhance the improvement of these lesions in moderate- to high-caries-risk individuals.
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Latifi-Xhemajli B, Begzati A, Veronneau J, Kutllovci T, Rexhepi A. Effectiveness of fluoride varnish four times a year in preventing caries in the primary dentition: A 2 year randomized controlled trial. Community Dent Health 2019; 36:190-194. [PMID: 31436925 DOI: 10.1922/cdh_4453begzati05] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
OBJECTIVES To test the effectiveness of fluoride varnish in preventing caries in early childhood in children at high risk of caries. BASIC RESEARCH DESIGN Randomized controlled trial. PARTICIPANTS 504 participants, with mean age of 21 months at baseline randomly allocated into a test and a control group. 427 children remained in the study after two years. INTERVENTION Fluoride varnish applied four times a year, every three months. The intervention lasted for two years. MAIN OUTCOME MEASURES Dental status was recorded based on the International Caries Detection and Assessment System (ICADS). RESULTS Mean dmfs was similar in the control and test groups at baseline (1.0 and 1.2 respectively) but was significantly different (10.1 and 5.2, p ⟨ 0.001, ANOVA) at endpoint. The proportion caries free in the two groups was 40% and 69.4% after two years. CONCLUSIONS The application of fluoride varnish four times a year prevented the incidence and reduced the severity of caries in pre-school children. TRIAL REGISTRATION NUMBER DRKS00013980.
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Affiliation(s)
- B Latifi-Xhemajli
- Department of Pediatric and Preventive Dentistry, Faculty of Medicine, University of Pristina, Pristina, Kosovo
| | - A Begzati
- Department of Pediatric and Preventive Dentistry, Faculty of Medicine, University of Pristina, Pristina, Kosovo
| | - J Veronneau
- McGill University, Faculty of Dentistry, Montreal, Canada
| | - T Kutllovci
- Department of Pediatric and Preventive Dentistry, Faculty of Medicine, University of Pristina, Pristina, Kosovo
| | - A Rexhepi
- Department of Pediatric and Preventive Dentistry, Faculty of Medicine, University of Pristina, Pristina, Kosovo
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Abufarwa M, Noureldin A, Azimaie T, Campbell PM, Buschang PH. Preventive effects of carbon dioxide laser and casein phosphopeptide amorphous calcium phosphate fluoride varnish on enamel demineralization: A comparative, in vitro study. J Investig Clin Dent 2019; 10:e12400. [PMID: 30693660 DOI: 10.1111/jicd.12400] [Citation(s) in RCA: 2] [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] [Subscribe] [Scholar Register] [Received: 05/15/2018] [Accepted: 12/03/2018] [Indexed: 11/29/2022]
Abstract
AIM The aim of the present study was to compare the effects of carbon dioxide (CO2 ) laser and casein phosphopeptide amorphous calcium phosphate (CPP-ACP)fluoride varnish on enamel demineralization. METHODS Human teeth were randomly assigned to three groups. The enamel was treated with fluoride varnish, 10.6 μm CO2 laser, or no treatment (control), followed by 9 days of pH cycling. Baseline and final FluoreCam images were used to quantify the area, intensity, and impact of demineralization; cross-sectional microhardness was used to measure the mechanical properties of the enamel. RESULTS There were statistically-significant changes in the area, intensity and impact of demineralization in the control and laser groups (P < 0.05), but not in the fluoride group. The control group showed a significantly greater area and impact of enamel demineralization compared to the fluoride group. The area of demineralization in the laser group was significantly greater than that of the fluoride group. Enamel demineralization of the laser and control groups was comparable. The fluoride group showed statistically-significant harder enamel than the control at 20, 40, and 60 μm depths; the laser group enamel was significantly harder than the control at 20 and 40 μm depths. The fluoride group showed statistically-significant harder enamel than the laser group at 20 μm depth. CONCLUSIONS CPP-ACP fluoride varnish is more effective than CO2 in preventing enamel demineralization.
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Affiliation(s)
- Moufida Abufarwa
- Department of Biomedical Science, Texas A&M University College of Dentistry, Dallas, Texas
| | - Amal Noureldin
- Department of Public Health Sciences, Texas A&M University College of Dentistry, Dallas, Texas
| | - Taha Azimaie
- Rutgers School of Dental Medicine, Newark, New Jersey
| | - Phillip M Campbell
- Department of Orthodontics, Texas A&M University College of Dentistry, Dallas, Texas
| | - Peter H Buschang
- Department of Orthodontics, Texas A&M University College of Dentistry, Dallas, Texas
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Ben Khadra GM, Arrag EA, Alammori M, AlKadi MF. The effect of chlorhexidine-thymol and fluoride varnishes on the levels of Streptococcus mutans in saliva in children aged 6-8 years. Indian J Dent Res 2019; 30:67-72. [PMID: 30900660 DOI: 10.4103/ijdr.ijdr_208_17] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Background Streptococcus mutans is considered as the main pathogenic factor for initiation and progression of dental caries. Fluoride is one of the most effective agents used to control caries. Chlorhexidine (CHX) is the most antimicrobial agent against S. mutans and dental caries. Aims The study aimed to compare the effectiveness of antimicrobial activity of CHX-thymol (CHX/T) and fluoride varnishes on S. mutans levels in children's saliva aged from 6 to 8 years old. Materials and Methods The total number of children involved in this study is sixty, ages 6 and 8 years old. The participants were divided into three groups by block randomization: Group 1 CHX/T varnish, Group 2 fluoride varnish (f varnish, and Group 3 control group. Varnish was applied onto all tooth surfaces of the participants. At the baseline conditions, saliva samples were collected from the participants for bacterial examination test. This procedure was repeated in week 1, 4, and 12. Bacterial quantitative test was performed, and the number of S. mutans was estimated. Results The results revealed the significant efficacy of the two groups (fluoride and CHX/T varnishes) in reducing salivary S. mutans numbers when compared to the control group (P < 0.05). In terms of salivary colony-forming unit counts reduction of S. mutans, no significant difference was observed between the fluoride and CHX/T varnish groups (P > 0.05). Conclusion The outcomes showed that there was a significant reduction in S. mutans counts in children's saliva following the application of fluoride and CHX/T varnishes.
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Affiliation(s)
| | - Ettihad Abo Arrag
- Department of Pediatric Dentistry, Faculty of Dentistry, Damascus University, Damascus, Syria
| | - Mostafa Alammori
- Department of Microbiology, Faculty of Pharmacy, Damascus University, Damascus, Syria
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Lin YC, Chang CS, Ho PS, Lee CH, Chen JH, Huang HL. Immigrant⁻Native Differences in Sugar-Sweetened Beverage and Snack Consumption and Preventive Behaviors Associated with Severe Early Childhood Caries: A Large-Scale Survey in Taiwan. Int J Environ Res Public Health 2019; 16:ijerph16061047. [PMID: 30909520 PMCID: PMC6466279 DOI: 10.3390/ijerph16061047] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 01/13/2019] [Revised: 03/11/2019] [Accepted: 03/20/2019] [Indexed: 12/04/2022]
Abstract
This study assessed the differences between immigrants and natives in terms of combined effects of sugar-sweetened beverage (SSB) or snack consumption and preventive behaviors for severe early childhood caries (SECC) through a large-scale survey of 31,565 native and 1046 immigrant child–parent pairs in Taiwan. Children aged 3–5 years underwent dental examinations, and parents completed structured questionnaires. Immigrants had a significantly higher SECC prevalence than native children (32.3% vs. 19.4%). A combined effect of SECC was observed in native children who did not receive assistance when brushing teeth at night before sleep and those who consumed SSBs more than four times weekly (adjusted odds ratio (aOR) = 4.8). Moreover, native children who did not use dental floss and who consumed snacks more than four times weekly had an aOR of 4.1 for SECC. The combined effects of children with immigrant parents who did not receive assistance when brushing their teeth at night before sleep and those who consumed snacks more than four times weekly had an aOR of 8.2 for SECC. The results suggest the necessity of cross-cultural caries prevention programs for immigrants. Parents must limit children’s SSB and snack intake, and implement preventive measures to reduce SECC development.
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Affiliation(s)
- Ying-Chun Lin
- Department of Oral Hygiene, College of Dental Medicine, Kaohsiung Medical University, Kaohsiung 807, Taiwan.
| | - Chin-Shun Chang
- Taiwan Society of Oral Health, Keelung 201, Taiwan.
- School of Oral Hygiene, College of Oral Medicine, Taipei Medical University, Taipei 110, Taiwan.
| | - Pei-Shan Ho
- Department of Oral Hygiene, College of Dental Medicine, Kaohsiung Medical University, Kaohsiung 807, Taiwan.
- Division of Medical Statistics and Bioinformatics, Department of Medical Research, Kaohsiung Medical University Hospital, Kaohsiung 807, Taiwan.
| | - Chien-Hung Lee
- Division of Medical Statistics and Bioinformatics, Department of Medical Research, Kaohsiung Medical University Hospital, Kaohsiung 807, Taiwan.
- Department of Public Health and Research Center for Environmental Medicine, Kaohsiung Medical University, Kaohsiung 807, Taiwan.
| | - Jen-Hao Chen
- School of Dentistry, College of Dental Medicine, Kaohsiung Medical University, Kaohsiung 807, Taiwan.
- Department of Prosthodontics, Kaohsiung Medical University Hospital, Kaohsiung 807, Taiwan.
| | - Hsiao-Ling Huang
- Department of Oral Hygiene, College of Dental Medicine, Kaohsiung Medical University, Kaohsiung 807, Taiwan.
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Morgan-Trimmer S, Chadwick BL, Hutchings S, Scoble C, Lisles C, Drew CJ, Murphy S, Pickles T, Hood K, Chestnutt IG. The acceptability of fluoride varnish and fissure sealant treatments in children aged 6-9 delivered in a school setting. Community Dent Health 2019; 36:33-38. [PMID: 30667189 DOI: 10.1922/cdh_4263morgan-trimmer06] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
OBJECTIVE To assess the acceptability of fluoride varnish and fissure sealant treatments for children. To investigate the acceptability of delivering this treatment in a school setting for children, parents, clinicians and school staff. BASIC RESEARCH DESIGN Semi-structured interviews (with children, parents, clinicians and school staff) and a questionnaire (for school staff) as part of a two-arm, randomised clinical trial. PARTICIPANTS Children aged 6-9, their parents, clinical staff and school staff. INTERVENTIONS Fluoride varnish or fissure sealant was delivered to children from the ages of 6 to 9 years for 36 months, by a community dental service in a school setting. Fluoride varnish was re-applied every 6 months; fissure sealant was applied once to first permanent molars and re-applied as required. RESULTS Interviews with children a few days after treatment indicated little difference in preference; acceptability at this point was driven by factors such as finding it fun to visit 'the van' (i.e. mobile dental unit) and receiving a "sticker" rather than specific treatment received. Interviews with parents, clinicians and school staff indicated high acceptability of delivering this type of intervention in a school setting; this may have been partly due to the service being delivered by a well-established, child-oriented community dental service which delivered the clinical trial. CONCLUSIONS Preventive fluoride varnish and fissure sealant treatments in a school setting has high overall acceptability.
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Affiliation(s)
- S Morgan-Trimmer
- Institute of Health Research, College of Medicine and Health, University of Exeter, St Luke's Campus, Heavitree Road, Exeter, EX1 2LU
| | - B L Chadwick
- Applied Clinical Research and Public Health, Cardiff University School of Dentistry, Heath Park, Cardiff. CF14 4XY, UK
| | - S Hutchings
- Simbec-Orion Group Ltd, Simbec House, Merthyr Tydfil Industrial Park, Pentrebach, Merthyr Tydfil, Mid Glamorgan,CF48 4DR
| | - C Scoble
- South East Wales Trials Unit, Centre for Trials Research, Cardiff University, Neuadd Meirionnydd, Heath Park, Cardiff. CF14 4YS, UK
| | - C Lisles
- South East Wales Trials Unit, Centre for Trials Research, Cardiff University, Neuadd Meirionnydd, Heath Park, Cardiff. CF14 4YS, UK
| | - C J Drew
- South East Wales Trials Unit, Centre for Trials Research, Cardiff University, Neuadd Meirionnydd, Heath Park, Cardiff. CF14 4YS, UK
| | - S Murphy
- DECIPHer, School of Social Sciences, Cardiff University, 1 - 3 Museum Place, Cardiff. CF10 3BD
| | - T Pickles
- South East Wales Trials Unit, Centre for Trials Research, Cardiff University, Neuadd Meirionnydd, Heath Park, Cardiff. CF14 4YS, UK
| | - K Hood
- South East Wales Trials Unit, Centre for Trials Research, Cardiff University, Neuadd Meirionnydd, Heath Park, Cardiff. CF14 4YS, UK
| | - I G Chestnutt
- Applied Clinical Research and Public Health, Cardiff University School of Dentistry, Heath Park, Cardiff. CF14 4XY, UK
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Giray FE, Durhan MA, Haznedaroglu E, Durmus B, Kalyoncu IO, Tanboga I. Resin infiltration technique and fluoride varnish on white spot lesions in children: Preliminary findings of a randomized clinical trial. Niger J Clin Pract 2019; 21:1564-1569. [PMID: 30560818 DOI: 10.4103/njcp.njcp_209_18] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Aim To clinically assess the efficacy of resin infiltration versus fluoride varnish for arresting white spot lesions (WSLs) on permanent teeth in children. Subjects and Methods Among the children referred to the our University, Faculty of Dentistry, Department of Pediatric Dentistry, 23 aged between 8-14 with 81 anterior WSLs were included in the study. The participants were randomly assigned to either the resin infiltration group or the fluoride varnish group. WSLs were assessed using a laser fluorescence device (DIAGNOdent pen, Kavo, Germany) and were characterized at baseline, immediately following resin infiltration application and at a 6-month follow-up. For the statistical analyses, the IBM SPSS Statistics 22 (IBM SPSS, Turkey) program was used to assess the findings of the study. Results Participant retention was 100% at 6 months. There was no significant difference between the two groups when baseline DIAGNOdent (DD) values were compared (P > 0.05). The reduction in 6-month follow-up DD values were statistically significant in both groups relative to baseline values. The 6-month values of the resin infiltration group were statistically lower than those of the fluoride varnish group (P = 0.028, P < 0.05). Conclusions Resin infiltration and fluoride varnish are clinically feasible and efficacious methods for the treatment of anterior WSLs. The inhibition of caries progression by resin infiltration should now be considered an alternative to fluoride treatment.
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Affiliation(s)
- F Eren Giray
- Department of Pediatric Dentistry, School of Dentistry, Marmara University, Istanbul, Turkey
| | - M A Durhan
- Department of Pediatric Dentistry, School of Dentistry, Marmara University, Istanbul, Turkey
| | - E Haznedaroglu
- Department of Pediatric Dentistry, School of Dentistry, Marmara University, Istanbul, Turkey
| | - B Durmus
- Department of Pediatric Dentistry, School of Dentistry, Marmara University, Istanbul, Turkey
| | - I O Kalyoncu
- Department of Pediatric Dentistry, School of Dentistry, Marmara University, Istanbul, Turkey
| | - I Tanboga
- Department of Pediatric Dentistry, School of Dentistry, Marmara University, Istanbul, Turkey
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Mir M, Mojahedi SM, Tunér J, Shabani M, Darabi F, Rohban A. The effectiveness of home-use photobiomodulation toothbrush for treating dentin hypersensitivity: A pilot study. Laser Ther 2019; 28:193-198. [PMID: 32009733 DOI: 10.5978/islsm.28_19-or-16] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [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: 02/21/2019] [Accepted: 05/21/2019] [Indexed: 11/06/2022]
Abstract
Background and Aims Dentin hypersensitivity is a frequent oral condition among patients suffering from gingival recession. Recent studies have suggested that photobiomodulation has the potential to reduce inflammation and relieve pain. The present study aims to assess the effectiveness of a new design of photobiomodulation toothbrush with specific irradiation parameters as a homecare device in treating dentin hypersensitivity and to compare its therapeutic effect with that of fluoride varnish. Materials and Methods Thirty patients with gingival recession and dentin hypersensitivity were selected and randomly assigned to three groups of equal size: fluoride varnish, photobiomodulation, and the combination. Dentin pain and hypersensitivity were measured using visual analog scale (VAS) by two distinct tests: the contact test with a periodontal probe and the air blast test on the areas of gingival recession and denuded root; once at baseline and again one month after the initial application of treatments. Laser irradiation was carried out at the wavelength of 660 nm in CW with an output power of 40 mW for 30 seconds per spot (1.2 J per spot, 6 J/cm2 energy density, and 200 mW/cm2 power density), perpendicularly to denuded root surfaces in non-contact mode. Results A significant reduction in dentin pain and hypersensitivity was observed in all three groups. However, the reduction was significantly greater in the combination group. Conclusion At-home treatment of dentin hypersensitivity with photobiomodulation toothbrush is a convenient, safe, and effective method for the management of dentin hypersensitivity.
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Affiliation(s)
- Maziar Mir
- DDS, MSc. Alumnus, RWTH Hospital, Aachen, Germany.
| | - Seyed Masoud Mojahedi
- DDS, Ph.D. Department of Laser, School of Dentistry, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
| | - Jan Tunér
- DDS, PhotoBioModulation Consultant, Sollentuna, Sweden.
| | - Masoud Shabani
- DDS, MSc. Department of Community Dentistry, School of Dentistry, Ardabil University of Medical Sciences, Ardabil, Iran.
| | - Fatemeh Darabi
- Ph.D. Department of Public Health, Asadabad School of Medical Sciences, Asadabad, Iran.
| | - Alireza Rohban
- M.Sc. Department of Rehabilitation Management, School of Rehabilitation Sciences, Iran University of Medical Sciences, Tehran, Iran.
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Fontana M, Eckert GJ, Keels MA, Jackson R, Katz B, Levy BT, Levy SM. Fluoride Use in Health Care Settings: Association with Children's Caries Risk. Adv Dent Res 2018; 29:24-34. [PMID: 29355412 DOI: 10.1177/0022034517735297] [Citation(s) in RCA: 9] [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] [Indexed: 12/17/2022]
Abstract
Expanded partnership with the medical community is an important strategy for reducing dental caries disparities. The purpose of this study was to assess the relationship between fluoride (F) "in office" (drops/tablets and/or varnish), as prescribed or applied by a health care professional by age 1 y, and 1) caries development and 2) presence of other caries risk factors or mediators (e.g., socioeconomic status). Child-primary caregiver (PCG) pairs ( N = 1,325) were recruited in Indiana, Iowa, and North Carolina as part of a longitudinal cohort study to validate a caries risk tool for primary health care settings. PCGs completed a caries risk questionnaire, while children received caries examinations per the criteria of the International Caries Detection and Assessment System at ages 1, 2.5, and 4 y. Baseline responses regarding children's history of F in office were tested for association with other caries risk variables and caries experience at ages 2.5 and 4 y via generalized estimating equation models applied to logistic regression. The sample was 48% female, and many children (61%) were Medicaid enrolled. The prevalence of cavitated caries lesions increased from 7% at age 2.5 y to 25% by age 4 y. Children who received F in office were likely deemed at higher caries risk and indeed were significantly ( P < 0.01) more likely to develop cavitated caries lesions by ages 2.5 and 4 y, even after F application (odds ratios: 3.5 and 2.3, respectively). Factors significantly associated with receiving F included the following: child being Medicaid enrolled, not having an employed adult in the household, child and PCG often consuming sugary drinks and snacks, and PCG having recent caries experience. Increased F in office from a health care provider by age 1 y was associated with known caries risk factors. Most (69%) children had never been to the dentist, suggesting that risk factors could be alerting medical providers and/or parents, thereby affecting in-office F recommendations. Differences among states could also be related to state-specific F-varnish reimbursement policies (ClinicalTrials.gov NCT01707797).
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Affiliation(s)
- M Fontana
- 1 University of Michigan, Ann Arbor, MI, USA
| | - G J Eckert
- 2 Indiana University, Indianapolis, IN, USA
| | | | - R Jackson
- 2 Indiana University, Indianapolis, IN, USA
| | - B Katz
- 2 Indiana University, Indianapolis, IN, USA
| | - B T Levy
- 4 University of Iowa, Iowa City, IA, USA
| | - S M Levy
- 4 University of Iowa, Iowa City, IA, USA
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Ciftci ZZ, Hanimeli S, Karayilmaz H, Gungor OE. The efficacy of resin infiltrate on the treatment of white spot lesions and developmental opacities. Niger J Clin Pract 2018; 21:1444-1449. [PMID: 30417842 DOI: 10.4103/njcp.njcp_235_18] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Objectives The aim of this study was to evaluate the changes in opacities by applying resin infiltrate to developmental enamel opacities and applying resin infiltrate or fluoride varnish to white spot lesions (WSLs). Materials and Methods A total of 132 teeth with WSLs and developmental enamel opacities were included in the study. WSLs were treated with resin infiltrate (Group 1) and fluoride varnish (Group 2), and developmental enamel opacities were treated with only resin infiltrate (Group 3). Lesions were evaluated in accordance with International Caries Detection and Assessment System (ICDAS II) criteria and DIAGNOdent Pen scores before applying the material (T0), just after the application (T1), and after 1 month (T2) and 3 months (T3). Results A significant decrease in DIAGNOdent Pen scores was observed in all the groups and the most important decrease was seen in Group 2 (P < 0.05). A significant decrease in ICDAS II scores was observed in Groups 2 and 3 (T0-T1) and Group 1 (T1-T2) (P < 0.05). Conclusion DIAGNOdent pen scores decreased and the lesion was partially masked after resin infiltrate was applied to treat developmental enamel opacities; the resin infiltrate application, however, was more successful than fluoride varnish on WSLs. Treating WSLs with resin infiltrate was a good option due to shorter term esthetic recovery and high patient satisfaction.
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Affiliation(s)
- Z Z Ciftci
- Department of Pediatric Dentistry, Faculty of Dentistry, Akdeniz University, Antalya, Turkey
| | - S Hanimeli
- Department of Pediatric Dentistry, Faculty of Dentistry, Akdeniz University, Antalya, Turkey
| | - H Karayilmaz
- Department of Pediatric Dentistry, Faculty of Dentistry, Akdeniz University, Antalya, Turkey
| | - O E Gungor
- Department of Pediatric Dentistry, Faculty of Dentistry, Akdeniz University, Antalya, Turkey
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