The Effectiveness of a Calcium Sodium Phosphosilicate Desensitizer in Reducing Cervical Dentin Hypersensitivity

BackgroundNovaMin (NovaMin Technology, Alachua, Fla.) was introduced into the dental market as a desensitizer in December 2004. However, to the authors' knowledge, no researchers yet have evaluated the effectiveness of 100 percent NovaMin powder with NovaMin-containing toothpaste in reducing dentin hypersensitivity compared with the effectiveness of NovaMin-containing toothpaste only and a desensitizing toothpaste containing potassium nitrate as a control.MethodsThe authors divided 60 participants randomly into three groups: NovaMin powder with NovaMin-containing toothpaste (group 1), a placebo powder with NovaMin-containing toothpaste (group 2) and a placebo powder with the control toothpaste (group 3). The authors used tactile and cold stimuli and a visual analog scale to evaluate participants' pain at baseline, immediately after powder application and at one week, two weeks and four weeks after powder application. They analyzed data by using Friedman and Wilcoxon signed-rank tests for within-group comparison. They used Kruskal-Wallis and Mann-Whitney U tests for between-group comparison. They considered P < .05 to be statistically significant.ResultsGroups 1 and 2 showed significant hypersensitivity reduction over baseline at all time points. Group 3 showed significant hypersensitivity reduction at one week onward. Group 1 showed significant improvement compared with groups 2 and 3, except for response to tactile stimulus at four weeks with group 2. Between groups 2 and 3, there were significant differences at two and four weeks.Conclusions and Clinical ImplicationsThe use of NovaMin powder and NovaMin-containing toothpaste for hypersensitivity reduction is more effective than the use of a desensitizing toothpaste containing potassium nitrate and fluoride.     

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目的评价氟化泡沫与氟保护漆治疗龈下刮治及根面平整术后敏感的效果。方法选取2009年9月至2011年3月北京大学口腔医院门诊部牙周科行龈下刮治及根面平整术后1周有1颗以上的切牙中等程度敏感的患者209例（患牙503颗）,根据患者的年龄、性别、牙齿数目分层,随机分为对照组（采用生理盐水涂檫根面）、氟保护漆组（采用氟保护漆脱敏治疗）、氟化泡沫组（采用氟化泡沫脱敏治疗）。用视觉模拟评分（VAS）法对牙齿敏感程度进行评估,分别于脱敏前以及脱敏后即刻、1周、1个月记录VAS值,并记录各组临床操作时间。结果脱敏前各组VAS值相近,差异无统计学意义（P〉0．05）;脱敏后各时间点对照组与其余两组差异有统计学意义（P〈0．05）;氟保护漆组在脱敏后1周和1个月时VAS值均低于氟化泡沫组,但差异无统计学意义（P〉0．05）。氟保护漆组每颗牙的平均{临床操作时间与其余两组差异有统计学意义（P〈0．05）。结论氟化泡沫和氟保护漆均可减轻龈下刮治和根面平整术后敏感的程度,氟化泡沫操作更简单,更适合临床推广使用。     

4种防龋方法在固定矫治中预防牙釉质脱矿的研究

目的:比较4种防龋方法在正畸固定矫治中预防牙釉质脱矿的效果.方法:采用固定矫治器矫治的200名患者随机分为4组(n=50),分别用普通牙膏、含氟牙膏、氟保护漆和护牙素对牙釉质进行处理,定期随访,比较矫治完成后4组患者的牙釉质脱矿情况.结果:按牙齿数计算含氟牙膏、普通牙膏、氟保护漆和护牙素4组牙釉质的脱矿率分别为16.3％、21.9％、9.3％和8.5％ (x2=99.7,P=0.000001)氟保护漆和护牙素组脱矿率低于其他2组,该2组脱矿率之间的差异无统计学意义(x2=0.39,P=0.529851).结论:应用含氟制剂可以有效预防固定矫治中牙釉质脱矿的发生,护牙素和氟保护漆的效果更明显.     

Caries reductions related to the use of fluorides: a retrospective cohort study

AIM: To test whether topical fluoride regimes provided additional caries protection to the first molar teeth of children exposed to fluoridated toothpaste and optimally fluoridated water supplies. PARTICIPANTS AND METHODS: This two-year retrospective cohort study included 660, 8-year-old-children. A cluster sampling technique was used to select three groups of 220 children. Group 1 was selected from schools using fluoride mouthrinses (Programme 1). Group 2 was selected from schools applying fluoride gel (APF 1.23%) in addition to the weekly fluoride mouthrinse (Programme 2). Oral health education and oral hygiene instruction were provided to both groups. The control group was selected from schools in the same area that had not adopted any oral health preventive programme. All children were exposed to optimally fluoridated water and fluoridated toothpaste for the last two years or more. Participants were examined for DMFS scores of their first molars using WHO criteria by one examiner (MLRS). RESULTS: The percentage caries free children in Control, Programme 1 and Programme 2 were 55%, 65% and 65.5%, respectively. The differences between Programme 1 and 2 in relation to the Control Group were statistically significant (P < 0.05). There was no difference between Programme 1 and 2 (P = 0.92). CONCLUSIONS: Weekly fluoride rinsing combined whether or not with fluoride gel applications once every three months, provided additional caries-preventive benefits to children with high levels of caries and exposed to optimally fluoridated drinking water and toothpaste. There was no difference in caries levels between children having fluoride rinses and those having fluoride rinses and fluoride gel.     

氟化亚锡牙膏对牙本质敏感症脱敏作用的Meta分析

目的 对有关含氟化亚锡牙膏治疗牙本质敏感症的随机对照试验（RCT）进行Meta分析,评价其治疗牙本质敏感症的疗效。方法依照Cochrane系统评价员手册（5.1.0版本）指导进行分析,包含检索策略、纳入排除标准、数据提取及质量评价。通过计算机检索CNKI、CBM、PubMed、Embase数据库和Cochrane Library,查找有关含氟化亚锡牙膏治疗牙本质敏感症的RCT,检索时间截至2015年1月。由2位研究者独立根据纳入与排除标准进行文献筛选、资料提取和质量评价后,采用RevMan 5.3软件进行Meta分析。结果共纳入6个RCT,包括494例患者（试验组247例,对照组247例）。氟化亚锡脱敏牙膏治疗牙本质敏感的Meta分析结果显示,触压探诊敏感测试（SMD=1.41,95%可信区间为0.74~2.09）及冷空气喷吹测试（SMD=-1.16,95%可信区间为-1.84~-0.48）的差异均有统计学意义（P<0.000 01）,氟化亚锡脱敏牙膏治疗牙本质敏感症的效果较好。结论现有证据表明,氟化亚锡脱敏牙膏治疗牙本质敏感症的效果较好;但纳入研究的语种、地区及质量有一定局限性,且样本量较小,仍需更多高质量、大样本的RCT以进一步验证。     

The effect of oral topical fluorides on the surface of commercially pure titanium.

This study investigated the risk of corrosion of titanium abutments by the accidental or unauthorized use of preventive fluorides in the mouth. Polished test pieces of commercially pure ASTM grade 1 titanium were immersed in topically used fluorides (toothpaste, gel, and varnish). They were brushed in vitro with toothpaste and gel, corresponding to the time and effect of brushing with toothpaste twice a day for 6 years and with gel once a week for 12 years. Results indicate that an aminofluoride toothpaste with low ionizable fluoride content (0.125%) used in brushing natural teeth does not cause deterioration of the titanium abutments in the same mouth if the titanium is grade 1 purity. Carefully controlled use of fluoride gel (F 1.25%) and varnish (F 2.25%) is likewise not dangerous. The mechanical abrasion caused by toothbrush bristles appears to be the main deteriorating factor for the titanium surface.     

Effect of fluoride containing dentifrice, mouthrinsing, and varnish on approximal dental caries in a 3-year clinical trial

The purpose of this study was to evaluate the separate effect of fluoride dentifrice, fluoride mouthrinsing and fluoride varnish on approximal dental caries. All 252 13-14-yr-old children at an elementary school were selected at random and divided among four groups for a 3-yr longitudinal study. Group 1 received a fluoride dentifrice for home care and a fluoride mouthrinse once a week. Group 2 received a fluoride dentifrice for home care and a placebo mouthrinse once a week. Group 3 received a fluoride dentifrice for home care and a fluoride varnish once every 3 months. Group 4 received a placebo dentifrice for home care and a fluoride rinse once a week. Fluoride rinsing did not give any additional effect compared with placebo-rinsing when a fluoride dentifrice was used for home care. Fluoride varnish gave a significant caries reduction compared with fluoride rinsing.     

Evaluation of Pacific Islands Early Childhood Caries Prevention Project: Republic of the Marshall Islands

Objectives: This communication reports an outcomes evaluation of the Pacific Islands Early Childhood Caries Prevention Project. Methods: The evaluation includes children in three conditions: a) topical fluoride varnish three times per school year; b) varnish plus twice-per-day toothbrushing; and c) intervention 2 plus three-times-per-day xylitol containing gummy bear snacks at school and home visits to encourage parental involvement. For this evaluation, groups 2 and 3 have been combined. Results: One year after project implementation, mean decayed, extracted, or filled primary teeth was 10.3 [standard deviation (SD)  =  4.3] teeth for group 1, and 8.2 (SD  =  4.0) teeth for the combination of groups 2 and 3 ( P <  0.05). Twenty-four percent of group 1 had cavitated lesions in any permanent molar versus 12.8 percent in groups 2 and 3 combined ( P >  0.05). Conclusion: Evaluation confirms the outcome of a program including both in-school twice-daily toothbrushing with fluoridated toothpaste and frequent applications of fluoride varnish.     

The Efficiency of Semiannual Silane Fluoride Varnish Applications: a Two-year Clinical Study in Preschool Children

Objective : The aim of this two-year community demonstration trial was to study the caries inhibitory effects of semiannual applications of a fluoride varnish in preschool children. Methods : Twenty-four public dental health clinics in the county of Halland, Sweden, with 5,137 preschool children, 4 and 5 years of age, were matched and equally allocated to a fluoride varnish group ( n =2,535) and a reference group ( n =2,602). The children in the fluoride varnish group were treated every six months with topical applications of a silane fluoride varnish, Fluor Protector (0.1% F), while no fluoride varnish was used in the reference group. Both groups received a basic preventive program at annual checkups consisting of dietary counseling and instructions to parents to brush their children's teeth at least once daily with fluoridated dentifrice. Caries data were collected by clinical examinations at baseline and after one and two years. Results : Caries prevalence at baseline did not differ significantly between the groups. After two years, the mean caries incidence was low and no statistical difference was found in the total number of carious and filled surfaces (dfs) between the two groups. However, the incidence of approximal lesions (dfsa) was significantly lower ( P <.05) in the fluoride varnish group than the reference group. Children in the fluoride varnish group with dfs scores of 1–4 and ≥5 at the start of the study exhibited a statistically significant ( P <.05) reduction in approximal caries incidence of 19 percent and 25 percent, respectively, when compared with the reference group. Conclusion : Preschool children 4 and 5 years of age with clinical caries who receive semiannual applications of a silane fluoride varnish containing 0.1 percent F experience a reduced incidence of approximal caries over two years.     

Fluoride varnishes and caries development in primary tooth enamel: an in vitro study

This in vitro study evaluated the effect of fluoride varnishes on caries development in primary tooth enamel using polarized light microscopic techniques. A total of forty extracted or exfoliated primary teeth with intact, caries-free smooth surfaces underwent a fluoride-free prophylaxis and soft tissue were assigned to one of the following groups: 1) duraphat (5 percent sodium fluoride, vanish, Colgate, n=10); 2) Duraflor (5 percent sodium fluoride, Pharmascience, n = 10); 3 Cavity Shield (5 percent sodium fluoride varnish, Omni, n=10); and 4) Control (n=10). An acid-resistant coating was applied to the specimens leaving an exposed window of sound enamel (5mm x 1mm). The fluoride varnishes were applied to the primary teeth according to the manufacturer's recommendation. Following thermocycling (500 cycles, 5-50 degrees C) of the fluoride varnish-treated and control teeth, a fluoride-free pumice toothbrushing was performed to remove visible and macroscopically (dissecting microscope at 16x) detectable fluoride varnish. An acid resistant coating was reapplied where necessary, leaving the fluoride varnish treated sound enamel window exposed. Following in vitro caries formation (2.2mM Ca, 2.2mM PO4 50mM acetic acid, 0.5ppm fluoride, pH 3.90), longitudinal sections (5 per specimen) were obtained and evaluated by polarized light microscopy for mean lesion depth. Comparisons were made among treatment and control groups.     

Clinical evaluation of low-level laser therapy and fluoride varnish for treating cervical dentinal hypersensitivity

The aim of this study was to evaluate in vivo the use of low-level galium-aluminium-arsenide (GaAlAs) (BDP 600) laser and sodium fluoride varnish (Duraphat) in the treatment of cervical dentine hypersensitivity. Twelve patients, with at least two sensitive teeth were selected. A total of 60 teeth were included in the trial. Prior to desensitizing treatment, dentine hypersensitivity was assessed by a thermal stimulus and patients' response to the examination was considered to be a control. The GaAlAs laser (15 mW, 4 J/cm2) was irradiated on contact mode and fluoride varnish was applied at cervical region. The efficiency of the treatments was assessed at three examination periods: immediately after first application, 15 and 30 days after the first application. The degree of sensitivity was determined following predefined criteria. Data were submitted to analysis and no statistically significant difference was observed between fluoride varnish and laser. Considering the treatments separately, there was no significant difference for the fluoride varnish at the three examination periods, and for laser therapy, significant difference (P < 0.05) was found solely between the values obtained before the treatment and 30 days after the first application. It may be concluded that both treatments may be effective in decreasing cervical dentinal hypersensitivity. Moreover, the low-level GaAlAs laser showed improved results for treating teeth with higher degree of sensitivity.     

Topical iodine and fluoride varnish combined is more effective than fluoride varnish alone for protecting erupting first permanent molars: a retrospective cohort study

Objective: This communication examines the combined effect of topical polyvinylpyrollidone (PVP)‐iodine plus fluoride varnish in the prevention of tooth decay in erupting first permanent molars in an ongoing public health program. Methods: The evaluation employed a retrospective cohort design with two groups of children 60‐83 months. Cohort 1 (2004‐05) received three times per school year topical fluoride varnish, and Cohort 2 (2008‐09) received topical application of 10 percent PVP‐iodine followed at each visit with topical fluoride varnish. The children were examined clinically at the beginning and end of the school year. Results: The proportion of children with caries‐free first permanent molars in Cohort 2 (PVP‐iodine plus fluoride varnish) was 0.883 and was greater than that in Cohort 1 (varnish), which was 0.785 (Chi‐square = 1.000E1, df 1, P < 0.002). Conclusions: This evaluation of an ongoing dental public health program adds evidence that topical antiseptics applied at the same time as fluoride varnish are more effective than varnish alone. Randomized trials are needed.     

Caries-preventive effectiveness of fluoride varnish as adjunct to oral health promotion and supervised tooth brushing in preschool children: A double-blind randomized controlled trial

Objectives

To evaluate the effect of biannual fluoride varnish applications in preschool children as an adjunct to school-based oral health promotion and supervised tooth brushing with 1000 ppm fluoride toothpaste.

Methods

424 preschool children, 2–5 year of age, from 10 different pre schools in Athens were invited to this double-blind randomized controlled trial and 328 children completed the 2-year programme. All children received oral health education with hygiene instructions twice yearly and attended supervised tooth brushing once daily. The test group was treated with fluoride varnish (0.9% diflurosilane) biannually while the control group had placebo applications. The primary endpoints were caries prevalence and increment; secondary outcomes were gingival health, mutans streptococci growth and salivary buffer capacity.

Results

The groups were balanced at baseline and no significant differences in caries prevalence or increment were displayed between the groups after 1 and 2 years, respectively. There was a reduced number of new pre-cavitated enamel lesions during the second year of the study (p = 0.05) but the decrease was not statistically significant. The secondary endpoints were unaffected by the varnish treatments.

Conclusions

Under the present conditions, biannual fluoride varnish applications in preschool children did not show significant caries-preventive benefits when provided as an adjunct to school-based supervised tooth brushing with 1000 ppm fluoride toothpaste.

Clinical significance

In community based, caries prevention programmes, for high caries risk preschool children, a fluoride varnish may add little to caries prevention, when 1000 ppm fluoride toothpaste is used daily.     

Comparison of efficacy of three commercially available dentifrices on dentinal hypersensitivity: a randomized clinical trial

Background: Dentinal hypersensitivity has been defined as a short, sharp pain arising from exposed dentine as a result of various stimuli such as heat, cold, chemical, or osmotic, that cannot be ascribed to any other pathology. This study was conducted to assess the efficacy of three commercially available toothpastes in the reduction of dentinal hypersensitivity. Methods: A total of 149 subjects (72 males and 77 females; aged 20 to 60 years) were entered into the study and randomly divided into four groups: Group 1 – toothpaste containing 5% potassium nitrate; Group 2 – toothpaste containing 5% calcium sodium phosphosilicate with fused silica; Group 3 – toothpaste containing 3.85% amine fluoride; and Group 4 – a placebo toothpaste. After sensitivity scores for controlled air stimulus and cold water at baseline were recorded, subjects were given toothpastes and sensitivity scores were measured again at 2 weeks and 6 weeks. Results: All groups showed a reduction in sensitivity scores at 2 weeks and 6 weeks. The calcium sodium phosphosilicate group was found to be significantly better compared to the other groups at the end of 6 weeks. Conclusions: The calcium sodium phosphosilicate group showed a better reduction in the symptoms of dentinal hypersensitivity.     

Remineralization of primary root caries lesions using an amine fluoride rinse and dentifrice twice a day

PURPOSE: To assess the clinical effect of daily use of a toothpaste and mouthrinse, both containing amine fluoride, on primary root caries lesions (PRCL) in an adult caries risk population. METHODS: A clinical trial based on male and female subjects, 55-81 years of age, randomly assigned into two equal groups (Groups A and B). Fifty subjects allocated to Group A used a fluoride toothpaste twice a day, (Elmex sensitive toothpaste, 1400 ppm F) plus a mouthrinse twice a day with 10 ml of a fluoride solution (Elmex sensitive rinse containing 250 ppm F). The fluoride used was amine fluoride and potassium fluoride (AmF/KF, 1:1). Subjects in Group B used the same fluoride toothpaste plus a placebo mouth rinse solution without fluoride. At baseline, a total of 420 PRCL were clinically recorded as either soft (score 3) or leathery (score 2). Parallel and blind recordings measuring electric resistance of the selected PRCL were performed at baseline and after 3, 6, 9 and 12 months using an electrical caries monitor (ECM). Prevalence of tooth sensitivity and subject's satisfaction was also measured in the two groups. RESULTS: The clinical results showed statistically significant higher numbers of reversals of soft (score 3) and leathery (score 2) PRCL in Group A compared to Group B. After 12 months, the number of soft PRCL (score 3) decreased in Group A from 74% at baseline to 11% compared with 73% to 46% in Group B. After 12 months, 67% of the PRCL became hard (score 1) in Group A compared to only 7% in Group B (P < 0.001). Statistically significant higher (P < 0.001) ECM mean (sd) log10 resistance values were recorded for the subjects in Group A, 2.67 (2.56) kOhm compared to 2.12 (1.88) kOhm in Group B. Tooth sensitivity was substantially reduced after 12 months, by 56% in Group A compared to 20% in Group B.     

A longitudinal study of the effectiveness of self applied 10 per cent stannous fluoride paste for secondary school children.

1. Stannous fluoride toothpaste was used twice yearly for three years in supervised brush-ins by puplis at two Melbourne schools--one coeducational and one boys. 2. Of the original 492 pupils who formed the Test and Control Groups, 347 were available for the final examination. Of these, only the Test Group (167) had participated in four brush-ins. 3. The Test Group consisted of 119 boys and 48 girls, and the Control Group 129 boys and 51 girls. 4. The reduction in caries increment was 16 per cent for DMFS and 19 per cent for DMFT. A reduction of 34 per cent DMFS and 30 per cent DMFT was recorded for the girls. 5. The results for boys in the co-educational State school showed no reduction in caries increment. 6. Time taken for the brush-ins was not more than 20 minutes.     

Short-term assessment of the Nd:YAG laser with and without sodium fluoride varnish in the treatment of dentin hypersensitivity--a clinical and scanning electron microscopy study

BACKGROUND: The aim of the present study was to evaluate clinically and under scanning electron microscopy (SEM) the efficacy of Nd:YAG laser irradiation alone and in combination with 5% sodium fluoride varnish in the management of dentin hypersensitivity. Methods: The study was conducted on 40 patients divided into four groups who had at least one tooth of Grade III mobility with clinically elicitable dentin hypersensitivity. Following the pretreatment assessment of hypersensitivity using the visual analog scale (VAS) and cold air blast test, the selected tooth in all the groups received 1% citric acid treatment for 1 minute. Group 1 patients received no further treatment; group 2, 3, and 4 patients received additional treatment with 5% sodium fluoride varnish, Nd:YAG laser for 2 minutes, and a combination of 5% sodium fluoride varnish and Nd:YAG laser, respectively. Two hours following treatment, hypersensitivity was again assessed, and the teeth were extracted, sectioned, and scanned using scanning electron microscopy (SEM). RESULTS: The mean VAS score in group 1 showed a 27% increase from baseline, but groups 2, 3, and 4 showed a decrease of 33%, 44%, and 62%, respectively. The mean cold air blast score showed a 22% increase in group 1, but values decreased by 43%, 50%, and 83% in groups 2, 3, and 4, respectively. The number of patent tubules also progressively decreased from group 1 through group 4. CONCLUSIONS: The combination of Nd:YAG laser and 5% sodium fluoride varnish seems to show an impressive efficacy, when compared to either treatment alone, in treating dentin hypersensitivity. The SEM findings seem to relate to the clinical findings in that reduction in number/patency of tubules was associated with improvement in treatment efficacy.     

Effect on caries of different fluoride prophylactic programs in preschool children. A two year clinical study

376 three-year old children were divided into four experimental groups and exposed to different combinations of preventive programs for a period of two years. All the groups were given the same basic prophylactic information. Additionally Group I received fluoride tablets (FLUDENT) for daily sucking twice a day plus a placebo dentifrice free of fluoride. Group II was given a fluoride dentifrice containing 0.025% F, (ACTA). Group III was given a placebo dentifrice plus fluoride varnish (Duraphat) twice a year. Group IV a fluoride dentifrice containing 0.025% F (ACTA) plus fluoride varnish (Duraphat) twice a year. No statistically significant difference in caries increment during the two experimental years was found between the groups. A tendency to lower caries increment was found in Group IV, i.e. in the children using the low fluoride dentifrice and treated twice a year with fluoride varnish.     

A study in vitro of the combined effects of soft drinks and tooth brushing with fluoride toothpaste on the wear of dentine

The aim of this study was to measure loss of dentine produced by soft drinks alone and combined with tooth brushing with and without toothpastes. Groups of flat human dentine specimens were exposed for 10 min and then 30 min to orange juice (OJ), carbonated cola (CC) or modified blackcurrant (MB) drinks alone or after the exposures brushed with a fluoride toothpaste for 10 s. Further groups were exposed to OJ as before but brushed with water or non-fluoride toothpaste or placed in slurries of fluoride paste. Five cycles of each regimen were carried out. Tissue loss was determined by profilometry. Water immersion/brushing and brushing controls were included. OJ and CC produced similar erosion and significantly more than MB. Compared with drinks alone, dentine loss was reduced by fluoride toothpaste brushing but increased by water and non-fluoride toothpaste brushing. Fluoride toothpaste slurry had no significant effect on soft drink erosion. Very little abrasion with brushing alone was recorded over the time frame of these experiments. It is concluded that fluoride toothpaste could provide protection, albeit small, against erosion. The data again support the concept of brushing before meals.