Distribution and kinetics of fluoride ions in the free aqueous and residual phases of human dental plaque.

24-h plaque samples from 97 dental students were studied. One minute after rinsing with 20 mM NaF, pH 7.80, the mean plaque fluid fluoride activity was 4.9 ± 0.8 mM and exceeded the control values at 2 h but not 3 h after rinsing. The total fluoride content in plaque residue followed a similar time course. The sodium concentration of plaque fluid, and the large decrease in potassium concentration of plaque residue indicated a short-term injury to the cellular elements. The increased fluoride content of the plaque residue could not be ascribed to mineral deposition. It was concluded that the presence of plaque during a rinse was advantageous because it reduced the fluoride ion activity at the enamel surface, which reduced CaF₂ formation, and it increased fluoride levels of the enamel environment up to 3 h after rinsing with 20 mM NaF.     

Effect of a water rinse on 'labile' fluoride and other ions in plaque and saliva before and after conventional and experimental fluoride rinses

Labile reservoirs are important in maintaining ion concentrations in oral fluids, especially after a fluoride dentifrice application, where a persistent increase in fluid fluoride can mitigate or reverse caries progression. In this study, the effect of experimental and conventional fluoride rinses on the in vitro and in vivo water-induced release of fluoride, calcium, phosphate, acetate and hydrogen ions from oral reservoirs was examined. At the start of each experiment, 13 subjects rinsed either with a conventional 228-ppm fluoride NaF rinse, a 228-ppm fluoride controlled-release rinse (CR rinse) or received no rinse. Sixty minutes later upper and lower molar plaque samples and 1-min saliva samples were collected. The subjects then rinsed with deionized water for 1 min, and 7 min later, a second set of samples was collected (in vivo study). Plaque fluid and clarified saliva were then recovered from samples by centrifugation, and the remaining plaque mass was sequentially extracted with water and acid to measure the water-extracted and total whole-plaque fluoride (in vitro study). All the samples were analyzed using microtechniques for pH, free calcium, phosphate, organic acids (plaque fluid) and fluoride (plaque fluid, centrifuged saliva and plaque extracts). Results showed that in vivo water rinsing decreased acetate and phosphate in plaque fluid, and fluoride in plaque fluid and saliva, but had no effect on plaque fluid pH. In vivo water rinsing, however, increased plaque fluid free calcium, apparently due to water-induced loss of calcium-binding ions. Water- or fluoride-rinse-induced changes in plaque fluid concentration were greater at the lower molar site, suggesting that rinse pooling may influence ion distribution. Before the water rinse, plaque fluid, saliva and whole-plaque total fluoride values were 1.7, 2 and 4 times higher after the CR rinse compared to the NaF rinse. Furthermore, the CR rinse deposited approximately 11 times more water-extracted fluoride compared to the NaF rinse, suggesting a 'more efficient' precipitation of 'labile' or 'loosely bound fluoride'. The results presented here, and in previous studies, suggest the possibility of formulating effective fluoride dentifrices with a lower fluoride content than is currently in use.     

Effect in vitro acidification on plaque fluid composition with and without a NaF or a controlled-release fluoride rinse

Plaque fluid ion concentration changes, especially fluoride, in response to the pH decrease associated with a cariogenic episode are important components of the caries process. A "controlled-release" (CR) fluoride rinse, based on the controlled release of fluoride in the presence of calcium, has been shown to form large fluoride reservoirs in resting plaque. In this study, the in vitro acid-induced release of fluoride, and other ions, was examined in 48-hour-fasted plaque fluid from subjects (n = 11) who received no rinse, or who used a 228-ppm CR or NaF fluoride rinse 1 hr before being sampled. After collection, the plaque was centrifuged to yield plaque fluid, acidified (0.1 microL of 0.5 mol/L HCl per milligram plaque), and then re-centrifuged before a second sample was obtained. Although previous studies indicated a higher plaque fluid fluoride after the new rinse relative to NaF, no statistically significant difference was observed here. Average fluoride release after acidification (average pH, 5.2) was statistically greater following the use of the CR rinse (153 micromol/L) compared with the NaF rinse (17 micromol/L). No fluoride release was seen in the no-rinse samples. The pH, free calcium, phosphate, acetate, propionate, and buffer capacity were not affected by the different amounts of fluoride deposited in the plaque. However, following acid addition, an increase in free calcium and phosphate was observed, which was also independent of the rinse. The large release of fluoride following acidification suggests that the new rinse may provide an improved cariostatic effect.     

Changes in lactate and other ions in plaque and saliva after a fluoride rinse and subsequent sucrose administration

The purpose of this study was to examine plaque and saliva composition after a fluoride rinse and subsequent sucrose application. Fifteen subjects accumulated plaque for 48 h, and then rinsed with a fluoride rinse based on 228 microg/g (ppm) Na2SiF6 and some received no rinse. After 60 min, upper and lower buccal molar plaque samples and 1-min saliva samples were collected. The subjects then rinsed with 10% g/g sucrose solution, and 7 and 15 min later, a second and a third set of samples were collected. Plaque fluid and clarified saliva were then recovered from these samples by centrifugation, and the remaining plaque acid extracted. The plaque fluid, centrifuged saliva, and plaque extract samples were then analyzed using micro techniques for pH, free calcium, phosphate, organic acids (plaque fluid and saliva only) and fluoride. Considering both the fluoride rinse and no-rinse groups, the most notable compositional changes in saliva 7 min after the sucrose rinse were pH -0.40 unit, free calcium 0.42 mM, lactate 5.2 mM, phosphate -1.3 mM, and fluoride 2.8 microM; while in plaque fluid, the corresponding changes were pH -1.59 unit, free calcium 1.5 mM, lactate 35 mM, phosphate -1.6 mM and fluoride -26 microM. After sucrose rinsing, undersaturation was found with respect to dicalcium phosphate dihydrate in saliva and plaque fluid and with respect to tooth enamel in some plaque fluid samples. Plaque fluid composition appeared to be strongly influenced by salivary clearance, diffusive loss of ions into the water phase of the rinse, and lower jaw pooling of the sucrose and fluoride components of the rinses. After the experimental rinse, the fluoride concentration in plaque fluid [86 +/- 22 mM (upper molar site), 162 +/- 150 mM (lower molar site)], saliva (26 +/- 18 mM), and whole plaque [99 +/- 97 microg/g (upper molar site), 197 +/- 412 microg/g (lower molar site)] was comparable to the values in previous studies using this rinse. These very high plaque fluid fluoride concentrations, compared with the 'no-rinse' samples, induced an approximately 0.3-unit increase in the plaque fluid pH 7 min after the sucrose rinse, a small decrease (approximately 20%) in lactate production and a modest increase in enamel saturation. Although these changes were all statistically significant, no correlation was found between the decrease in lactate concentration and plaque fluid fluoride, pH or whole plaque fluoride.     

Buffering effect of a prophylactic gel on dental plaque

The aim of this study was to evaluate the effect of a new prophylactic gel on plaque pH and plaque fluoride concentration. Twelve participants with normal (n=6, ≥0.7 ml/min) and low (n=6, <0.7 ml/min) stimulated whole salivary secretion rate were included. After 3 days of plaque accumulation, at random the participants were (1) treated with Profylin fluoride gel with buffering components (active gel), (2) treated with Profylin fluoride gel without buffering components (placebo gel), (3) asked to rinse with water, and (4) given no treatment. All test series were followed by rinsing with a nutrition solution; after which registration of plaque pH was performed during 60 min. There were two drop outs with low salivary secretion rate in the water session. The overall least pronounced pH fall was found after the use of the prophylactic gel. Significant differences between the prophylactic gel and the placebo gel were found for the participants with normal secretion rate. Fluoride plaque concentrations evaluated in 12 individuals after (1) application of the active gel, (2) rinsing with 0.2% NaF, and (3) rinsing with water showed significantly higher values after rinsing with the NaF solution. It can be concluded that application of the active gel, particularly in subjects with normal salivary secretion rate, in general, buffered plaque pH to higher levels. Factors like concentration of buffering agent and solubility of the gel need to be further evaluated to improve the effect.     

The effect of salivary clearance of sucrose and fluoride on human dental plaque acidogenicity

Ten subjects rinsed with a 20% (0.58 M) sucrose solution with or without 0.2% NaF (905 parts/10(6) F-) added in two separate experiments. Saliva and plaque were collected before rinsing and after 2, 5, 10 and 30 min. Sucrose and fluoride concentrations in saliva and acid anion and fluoride concentrations in plaque were analysed. There was a statistically significant and positive correlation between the concentration of sucrose in the saliva 2 min after the rinse and the subsequent concentrations of lactate in plaque at 10 and 30 min after the rinse with sucrose alone but not in the presence of fluoride. Salivary fluoride concentrations during 2-30 min after the sucrose rinse were significantly correlated with plaque fluoride concentrations during the same time. The addition of fluoride to the sucrose rinse significantly inhibited lactate production.     

Effect of an essential oil mouthrinse, with and without fluoride, on plaque metabolic acid production and pH after a sucrose challenge

This clinical study evaluated the effect of rinsing with an essential oil-containing antiseptic mouthrinse, with or without 100 mg/kg fluoride ion, on the plaque metabolic acid production and plaque pH response after a sucrose challenge. This observer-blind, randomized study used a three-way crossover design. Twenty-four subjects rinsed with 20 ml of one of the following rinses: (1) essential oil (EO) mouthrinse, (2) essential oil mouthrinse plus 100 mg/kg fluoride, or (3) negative control, for 30 s, twice daily for 16 days. On day 17, 1 h after the last mouthrinse, subjects rinsed with 20 ml of mass fraction 10% sucrose solution for 1 min. Seven minutes after the sucrose challenge, supragingival plaque was collected from molar and premolar teeth. Plaque pH and metabolic acid ions were analyzed using a micro pH electrode and capillary electrophoresis, respectively. The results showed that after EO mouthrinse dental plaque produced 36% less lactate, 36% less acetate and 44% less propionate than after the negative control rinse. The dental plaque also exhibited a pH 0.42 unit higher after EO rinse than after the negative control rinse. These results were not affected by the addition of 100 mg/kg fluoride to the EO mouthrinse. From these results we concluded that this EO antiseptic mouthrinse, with or without fluoride ion, is effective in reduction of plaque acidogenicity after a sucrose challenge.     

Effect of rinse with calcium enriched milk on plaque fluid

Previous research has shown that rinsing the mouth with milk significantly diminished the pH in dental plaque fluid; however, the degree of saturation with respect to the dental enamel (DS) was not significantly decreased because of an increase in the calcium ion concentration in plaque fluid. The aim of this study was to investigate the cariostatic effect of adding calcium to milk on the DS value of the plaque fluid after rinsing. Plaque samples were collected from 8 Japanese male dental students. Prior to plaque collection, all subjects refrained from practicing oral hygiene for 48 hr and fasted overnight. Supragingival plaque samples were collected from one side of the mouth of each subject, and then collected from the other side, following a 30-second rinse with 15 mL of calcium-enriched milk, which was prepared by adding calcium carbonate to ordinary milk, and a 10-minute waiting period. The samples were cleared by centrifugation, and the plaque fluid was analyzed for inorganic ions and pH, using an ion chromatograph and pH microelectrode, respectively. The calcium ion concentration of the milk was 6.4 mM, which was about 36% higher than that of ordinary milk. The pH decreased significantly (p<5%) from 6.4 to 6.1 following the rinse with calcium enriched milk, as tested by the paired t-test. The decrease in pH might have caused a reduction of the DS value; however, it was compensated for by a significant (p<0.5%) increase in the calcium ion concentration of plaque fluid.     

Salivary fluoride levels following application of fluoride varnish or fluoride rinse

OBJECTIVES: This study examined the concentration of fluoride in whole saliva over time following the application of a fluoride varnish or a single rinse with a fluoride solution. METHODS: A two-period, two-treatment randomized cross-over experimental trial with a 2-week washout period was used with 16 adult subjects. In the first period, eight subjects rinsed once with a 0.05% NaF solution and 8 subjects had 5.0% NaF varnish applied to facial and lingual surfaces of 20 teeth. Stimulated whole saliva was collected at baseline, 5 and 15 min, 1, 2, 4, 8, 12, 24, 32, 48, 56, 72, 80, 96, 104 h. After the washout period each subject was switched to the other treatment and saliva was collected at the same intervals. Salivary fluoride content was measured with the micro-diffusion method. RESULTS: The NaF levels peaked at 5 min after application for both varnish (mean +/- SE 24.5 +/- 5.0 ppm) and rinse (3.2 +/- 0.8 ppm). Mean NaF levels returned to baseline, on average, within 2 h for the rinse and within 24 h for the varnish. The maximum fluoride levels were significantly greater (P < 0.01) with the varnish than with the rinse and remained above baseline levels for a longer duration. CONCLUSIONS: Salivary fluoride levels with the rinse returned to baseline, on average, in 2 h while they remained elevated for, on average, 24 h with the varnish. Salivary fluoride levels from the varnish were found to be comparable with those in previous studies for 1.1% neutral NaF.     

Fluoride in plaque fluid, plaque, and saliva measured for 2 hours after a sodium fluoride monofluorophosphate rinse

Sodium monofluorophosphate (NaMFP) and sodium fluoride (NaF) are the two most common sources of fluoride used in currently marketed fluoride dentifrices. The purpose of this study was to investigate the effect of mouth rinses containing NaF or NaMFP on the concentrations of fluoride, or the MFP ion, in saliva, whole plaque, and plaque fluid. Twelve subjects abstained from tooth brushing for 48 h, fasted overnight, and then rinsed 1 min with 12 mmol/l (228 ppm [microg/g] F) NaF or NaMFP in the morning. Before the rinse and at 30, 60 and 120 min afterwards, upper and lower molar and premolar plaque samples and whole saliva samples were collected. Aliquots of plaque fluid and centrifuged saliva were obtained from these samples, and the whole plaque residue acid extracted. The F and MFP concentrations were then measured in these samples using ultramicro methods. For both rinses, a higher concentration of plaque fluid fluoride was found at lower molar sites while the reverse was true for the whole plaque fluoride. Furthermore, for both rinses, plaque fluid, whole plaque, but not salivary, fluoride concentrations were above baseline at 120 min. Following the NaMFP rinse, a substantial amount of unhydrolyzed MFP was found in plaque fluid and saliva. Although there was a very large range in these measurements, fluoride in plaque fluid (excluding fluoride in unhydrolyzed MFP) and whole plaque were significantly (p<0.05) greater after the NaF rinse at all time periods. In saliva, the NaF rinse produced a statistically significant greater salivary fluoride (excluding fluoride in unhydrolyzed MFP) only at 60 min. The lack of a clear correlation between these measurements and clinical studies suggest a novel mechanism may enhance the effectiveness of NaMFP dentifrices.     

Ca pre-rinse greatly increases plaque and plaque fluid F

Previous studies demonstrated that a Ca pre-treatment greatly increases salivary F from a subsequent NaF rinse. This study examines if these increases are found in plaque and plaque fluid F. Thirteen individuals accumulated plaque before rinsing with: (1) 12 mmol/L NaF (228 microg/g F), (2) 150 mmol/L Ca rinse, or (3) the Ca rinse followed by the F rinse. One hr later, plaque samples were collected, the plaque fluid was recovered, and the plaque residues were extracted 5 times with pH 6.8 or pH 4.8 buffers, and then by acid. The F in each extract after the Ca rinse/F rinse greatly exceeded the corresponding F from the NaF rinse. Consequently, the Ca rinse/F rinse increased the total plaque F and the plaque fluid F by 12x and 5x, compared with the NaF rinse alone. These and the previous salivary results suggest that a Ca pre-treatment may increase the cariostatic effects of topical F agents.     

Human dental plaque pH, and the organic acid and free amino acid profiles in plaque fluid, after sucrose rinsing

The relationship between these factors was studied in plaque and plaque fluid samples taken at intervals during the Stephan pH curve following a sucrose mouth rinse. Levels of lactate rose after the rinse, then fell during the pH recovery phase. Levels of acetate, propionate and phosphate fell after rinsing, then rose again. Amino acid concentrations also changed, with many showing a fall followed by a rise; others rising then falling; and some showing a more variable or complex pattern. In resting plaque fluid, only alanine, proline, glutamic acid, glycine and ammonia were present at concentrations above 1 mmol/l. Delta-aminovaleric acid was detected at levels below those that have been found in monkeys. Hydroxyproline and hydroxylysine were consistently detected, levels of arginine were generally low, and those of cystine consistently very low. The results may provide a basis for understanding the complex metabolic interrelations that occur in the course of the Stephan curve and which may reflect or produce the observed pH changes. They suggest that besides the amount of acid produced, the type of acid, buffering power and base production should be considered as determinants of plaque pH.     

Effects of mouthrinses with triclosan, zinc ions, copolymer, and sodium lauryl sulphate combined with fluoride on acid formation by dental plaque in vivo

Bacteriological tests demonstrated a slight synergistic effect of triclosan and sodium lauryl sulphate (SLS) on the growth of Streptococcus mutans NCTC 10449 and Streptococcus sanguis ATCC 10556 in vitro. A single mouthrinse with SLS (17.4 mM) or SLS plus triclosan (3.5 mM) significantly decreased the number of salivary mutans streptococci in a group of 12 subjects up to 90 min after rinsing. The effect on plaque pH of a mouthrinse with either 12.0 mM NaF, NaF plus 10.0 mM zinc acetate, NaF plus 17.4 mM SLS, or NaF plus SLS plus 3.5 mM triclosan with or without the addition of zinc ions or 0.65% w/v of a polyvinylmethyl ether/maleic acid copolymer was investigated. The plaque pH responses to a 10% w/v sucrose mouthrinse were measured in 2-day-old plaque with microtouch pH electrodes in six groups of 10 subjects 90 min after a single mouthrinse with test solution. There was no significant difference in plaque pH between the various mouthrinses. In conclusion, triclosan enhanced the growth-inhibitory activity of SLS against oral streptococci in vitro but not against salivary mutans streptococci in vivo. Neither triclosan incorporated into a mouthrinse containing SLS plus fluoride, nor the addition of zinc ions or copolymer affected acid formation by dental plaque in vivo.     

Effect of nonfluoridated milk and fluoridated milk on acidic dental plaque

PurposeRecovering the acidic plaque pH to its resting value as soon as possible after exposure to a sugary beverage might reduce the risk of dental caries. Milk contains nutrients that help to buffer acid. Adding fluoride to milk might enhance this effect. Accordingly, this study investigates the effect of milk and fluoridated milk on acidic dental plaque.MethodsThe study was a randomized crossover design. Ten subjects were asked to rinse for 2 min with the following solutions: (1) water, (2) 10% sucrose, (3) milk, (4) fluoridated milk, (5) 10% sucrose followed by water, (6) 10% sucrose followed by milk, or (7) 10% sucrose followed by fluoridated milk. The supra-gingival plaque was collected before rinsing and every 5 min after rinsing to measure the plaque pH.ResultsThe results showed that rinsing with 10% sucrose caused acidic dental plaque. After rinsing with 10% sucrose followed by milk, fluoridated milk, or water, the maximum plaque pH dropped and the area under the curve was significantly less than that after rinsing with 10% sucrose alone (p = 0.001). The maximum change in the plaque pH and the area under the curve in the group challenged with 10% sucrose followed by fluoridated milk were significantly lower than those in the group followed by nonfluoridated milk (p = 0.04).ConclusionRinsing with milk could raise the acidic plaque pH to the resting value faster than individual's natural capacity to do so. Adding fluoride to milk can enhance this effect.     

Influence of short-term sucrose exposure on plaque acidogenicity and cariogenic microflora in individuals with different levels of mutans streptococci

The aim was to study the short-term effect of a varying sucrose exposure on plaque acidogenicity and cariogenic microflora in two groups of subjects with different levels of mutans streptococci (MS). Eight subjects with low (<10(4)) and 8 with high (>10(6)) numbers of MS per millilitre saliva participated. Three 7-day test periods were conducted. During two of these, the subjects rinsed either 5 or 10 times daily with 10% sucrose; the third period without any mouth rinses served as control. The subjects refrained from oral hygiene during the last 3 days of each test period. On day 7, the following parameters were measured: plaque pH after a sucrose rinse, numbers of MS, Streptococcus sanguis and lactobacilli in saliva, percent MS in plaque and plaque index. The results revealed that plaque acidogenicity was more pronounced for the high-MS group compared to the low-MS group after all three test periods, i.e. lower resting pH, deeper pH falls and a lower final pH. For both groups, the greatest pH-lowering capacity of plaque was found after the period with 10 sucrose rinses/day. An increase in bacterial counts was noted for both groups during the test periods with the 5- and 10-time rinse regimen; this increase was larger for the high-MS group compared to the group with low MS counts. The highest plaque index was, irrespective of the test period, found for the high-MS group.     

Fluoride in plaque fluid and saliva after NaF or MFP rinses

A micro-analytic method, capable of measuring the fluoride concentration in 5 nl of plaque fluid, was used to follow changes in fluoride concentration in saliva and plaque fluid at 6 single tooth-sites in 6 subjects for 180 min after a 0.048 M fluoride rinse as a NaF or MFP (sodium monoftuorophosphate) solution. The maximum fluoride concentrations in saliva after NaF was 13 × higher than with MFP. About 5% of the total amount of fluoride following the 20 ml NaF rinse was retained in the oral cavity. The corresponding figure following MFP was < 1%. The saliva/plaque fluid fluoride ratios for upper molars and lower incisors were significantly higher than for the upper incisors and lower molars. There was a tendency for a decline in the ratios with respect to time for all sites. To characterize the plaque fluid fluoride intra-oral single-site distribution and clearance, fluoride concentration versus time (AUC) was calculated from 10 to 60 min after a rinse. The NaF AUC followed the order: upper incisor, lower molar, upper molar and lower incisors reflecting a different exposure and clearance pattern due to the different access of the plaque to saliva. The MFP AUC values varied more, but were all significantly lower than the NaF AUC values. Analysis of plaque fluid fluoride curves at various sites revealed an exponential decline in most cases. With NaF, the baseline plaque fluid fluoride levels were not reached within 3 h. It is concluded that NaF solutions result in a significantly higher intra-oral fluoride exposure than MFP solutions. The fluoride distribution and clearance of fluoride from different sites in the oral cavity are linked to salivary access to these sites. These site-specific differences may have clinical consequences with regard to the dynamics of fluoride in the de- and remineralization processes.     

Effects of mouthrinses containing essential oils and alcohol-free chlorhexidine on human plaque acidogenicity

The aim of this in vivo study was to evaluate the effect of two antimicrobial mouthrinses on dental plaque acidogenicity after a sucrose challenge. Twenty subjects, with a mean age of 59 years, participated in a double-blind intraindividual randomized study. Three mouthrinses were used in 16-day rinsing periods in addition to their regular mechanical oral hygiene: a solution with essential oils (EO), solution with alcohol-free chlorhexidine (CHX) and water (negative control). The three test periods were separated by 3-month washout periods. Changes in plaque acidogenicity were evaluated after a sucrose challenge at day 0 (baseline) and at day 17 of each mouthrinse period using the microtouch method. Both CHX and EO resulted at day 17 in statistically significant less attenuated pH falls compared to the water rinse. The CHX mouthrinse resulted in the least pronounced pH values compared with EO (ns) during the whole 30-min period. When calculated as area under the curve (AUC), significantly lower values (AUC_6.2 ) were found for CHX and EO at day 17 compared to day 0. A significant difference for AUC_6.2 between CHX and water was found at day 17. No statistically significant differences were found for any of the comparisons with AUC_5.7. The results from this study indicate that both the essential oils and the alcohol-free chlorhexidine reduced plaque acidogenicity after a sucrose challenge. Large interindividual variations were observed.     

Effects of mouth rinses with chlorhexidine and zinc ions combined with fluoride on the viability and glycolytic activity of dental plaque

Inhibition of plaque acidogenicity by a mouthrinse with chlorhexidine (CHX) or zinc ions has been ascribed to a prolonged bacteriostasis due to substantive properties of the agents. The present aim was to study the effects of mouthrinses with CHX and Zn ions combined with fluoride on the viability and glycolytic activity of dental plaque in order to assess the bacteriostatic versus possible bactericidal effects. Following 2 d of plaque accumulation, 4 groups of 10 students rinsed with either 12 mM NaF (F), 0.55 mM CHX diacetate + F (F-CHX), 10 mM Zn acetate+F (F-Zn), or with the three agents in combination (F-CHX-Zn). Plaque samples were collected before and 90 min after mouthrinsing. Thereafter, the in vivo plaque pH response to sucrose was monitored in each student using touch microelectrodes. F-CHX and F-CHX-Zn reduced the in vivo pH fall significantly as compared with F. whereas F-Zn exerted a non-significant inhibition. Pooled pre- and post-rinse plaque samples were used to measure the pH fall during fermentation of [¹⁴C]-glucose, and the glycolytic profiles were analyzed by HPLC. Bacterial viability was assessed by counting the colony-forming units (CPU). All mouthrinses except F reduced glucose consumption and acid formation and thus the pH fall. F-CHX reduced the CFU equal to the reduction of glucose consumption, indicating that inhibition of plaque acidogenicity was due to a bactericidal rather than a bacteriostatic effect. F and F-Zn did not reduce the CFU, thus F-Zn decreased glucose metabolism without affecting plaque viability. F-CHX-Zn reduced both the CFU and glucose metabolism of surviving plaque microorganisms.     

A theoretical analysis of the effects of plaque thickness and initial salivary sucrose concentration on diffusion of sucrose into dental plaque and its conversion to acid during salivary clearance

A mathematical model, written in FORTRAN, has been developed to simulate the interrelated processes of salivary sucrose clearance from the mouth, diffusion of sucrose into dental plaque, and conversion of sucrose to acid and glucan. Reaction of acid with enamel is not included in the model. A total of 28 parameters can be varied by the user, and the relative importance of the different factors affecting acid formation can be assessed. The output of the program gives sucrose and acid concentrations and pH at different depths within the plaque. The initial variables studied were plaque thickness, the salivary sucrose concentration, and the duration of exposure of the plaque to sucrose. Stephan curves typical of those recorded in vivo were generated by the model. With any particular salivary sucrose concentration, there was an optimum plaque thickness at which a minimum pH was achieved at the enamel surface, with very thin or thick plaque samples producing a smaller pH fall. With thick plaque, the minimum pH was often not achieved at the inner surface but at some intermediate depth, which may explain the location of early caries lesions in fissures. The extent of the pH fall at the inner surface and the duration of the pH-minimum region of the Stephan curve were directly related to the initial salivary sucrose concentration and to the duration of exposure to sucrose prior to normal salivary clearance. Simulation of a water rinse at as short a time as two min after the beginning of normal salivary sugar clearance showed that this procedure had only a very small effect on the shape of the Stephan curve.(ABSTRACT TRUNCATED AT 250 WORDS)     

Plaque formation and lactic acid production after the use of amine fluoride/stannous fluoride mouthrinse

The aim of this study was to determine the effects of 3 wk of daily rinsing with amine fluoride/stannous fluoride (AmF/SnF(2)) mouthrinse on plaque formation at buccal and interproximal sites, and on the acid production in plaque, in a randomized clinical trial with 30 participants. The amount of plaque was scored according to Turesky's modification of the Quigley and Hein index. Plaque samples were collected, before and after sucrose rinsing, from the buccal and interproximal surfaces of upper (pre)molars at two baseline visits and on days 2 and 7 after the discontinuation of 3 wk of daily rinsing. Metabolic acid ions were determined by capillary electrophoresis. The results at baseline showed higher lactic acid concentrations in resting interproximal plaque than in buccal plaque, and a higher acid production in response to sucrose challenge in buccal plaque than in interproximal plaque. After 3 wk of use of the AmF/SnF(2) mouthrinse, no significant differences in plaque scores were observed, and the alleged reduction in acidogenicity of dental plaque was not significant on the second day after the last mouthrinse. We conclude that 3 wk of use of AmF/SnF(2) rinse once daily does not result in a reduction of plaque formation or in a reduction of sucrose metabolism in buccal and interproximal plaque after discontinuing the rinse.