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The aim of the present investigation was to evaluate the effect of sugar-free chewing gums containing fluoride (F) and urea in an intra-oral experimental caries model. Placebo chewing gums (without any active ingredient) and no gum served as controls. Fifteen subjects participated in a cross-over, single-blind study. Demineralised enamel and dentine blocks were embedded in circular plastic discs and bonded to the buccal surfaces of the lower canines and first premolars. The discs were removed and analysed using transversal microradiography after each of the six 4-week periods during which the subjects used either test or placebo products or no product. The results revealed that frequent use of sugar-free chewing gum is sufficient to inhibit further demineralisation of previously demineralised enamel and dentine specimens in the oral cavity. Comparing F, urea and placebo gums, the data showed that there was little or no difference between the products, except for an inhibitory effect on the chewing side of the dentition after using F chewing gums. Copyright (C) 2002 S. KargerAG, Basel.

This investigation was done to determine the bioavailability of fluoride (F) after toothbrushing associated with different water rinsing procedures. Eight adult subjects participated in four experiments, conducted with a randomised, crossover design: (A) 2 min brushing with an F dentifrice, followed by three quick (3 x 2 s) rinses, each with 10 ml of water; (B) brushing as in A followed by one long-lasting (1 min) rinse with 5 ml of water combined with the toothpaste-saliva mixture; (C) brushing as in A followed by expectoration but without any water rinse afterwards; and (D) ingestion of the toothpaste as a slurry with 100 ml of de-ionized water. Blood samples were collected before and frequently for 6 h after each experiment and analyzed for F content. The area under the plasma F concentration vs. time curves (AUC) was calculated and the degree of F absorption estimated. AUC values obtained in experiment D were assumed to represent 100% F bioavailability. The plasma values recorded during experiment A were not significantly greater than the baseline values, indicating almost no F absorption when 3 quick water rinses were performed after toothbrushing. The degrees of F absorption after one long-lasting water rinse (B) were 7.6 +/- 4.2% and with no water rinse after toothbrushing (C) 23.8 +/- 13.5%, respectively. The results showed that the degree of F absorption after toothbrushing using an F toothpaste is strongly related to the mode of water rinsing.

The study consisted of eight experiments, divided into three series, aimed at investigating the effect on the salivary fluoride (F) concentration of three post-brushing regimes: (1) rinsing once or twice with water, (2) rinsing either with a slurry of the toothpaste foam and water or with an 0.05% NaF solution, or a single NaF mouthrinse with no prior brushing, and (3) chewing and drinking ('eating') for 2 min. Brushing was done with 1.5 g of an 0.32% NaF dentifrice. The concentration of F in whole saliva was determined in 15 subjects at various time points up to 45 min after completing each experimental procedure. Results showed that the initial (0 min post-brushing) F concentration in saliva decreased about 1-2 times after a single, and 4-5 times after a double post-brushing water-rinse, as compared with no rinsing at all (p < 0.001). Brushing followed by a mouthrinse with an 0.05% NaF solution elevated the F concentration more than brushing alone (p < 0.001). Rinsing with the slurry of toothpaste foam and water gave only a somewhat (but not significantly) lower concentration of F in saliva than just rinsing with the 0.05% NaF solution. Eating immediately after brushing reduced the salivary F level about 12-15 times (p < 0.001) compared with brushing alone.(ABSTRACT TRUNCATED AT 250 WORDS)

The aim of the present investigation was to study the brushing and toothpaste technique employed by caries-active and caries-inactive patients in a toothbrushing population. The study consisted of 47 patients at a public dental clinic in the County of Bohuslan, Sweden; 23 with low (group L) and 24 with high caries activity (group H). They were asked to brush their teeth with a fluoride dentifrice at the clinic using an identical technique to that which they employed at home. Various factors, such as brushing time, amount of dentifrice, water consumption and mouthrinsing habits after brushing, were carefully registered. Saliva samples for fluoride analyses were collected up to 45 min after brushing. The members of group L used less rinsing water (0.7 +/- 0.6 dl; mean +/- SD) than those of group H (1.9 +/- 1.0 dl, p < 0.001). Comparing the mouthrinsings with water after the brushing, a significantly higher frequency was observed in group H (3.6 +/- 1.9 rinsings) than in group L (1.5 +/- 0.7 rinsings; p < 0.001). There were no differences between the two groups regarding the amount of dentifrice used and the total brushing time. When the salivary fluoride concentration was plotted vs. time and the area under the curve (AUC) calculated, a significantly higher mean value was found in group L than in group H (p < 0.01). Calculation of the correlation coefficient (r) between the AUC value and the amount of water used gave r = 0.53 (p < 0.001) and between the AUC and the frequency of mouthrinsing r = 0.46 (p < 0.01).(ABSTRACT TRUNCATED AT 250 WORDS)

The aim of the present investigation was to map the presence of prophylactic measures in organized Swedish dental health care systems, focusing on personnel working with children and adolescents. The study was conducted by sending a questionnaire to all public dental clinics in Sweden (830 clinics in all). The results showed that collectively – performed prophylactic measures were given at 66% of the child health centers/ child day care centers and at 63% of the pre-schools. 51% of all clinics replied that they performed some kind of fluoride administration collectively (mainly fluoride varnish application or fluoride mouthrinses). 34% of all clinics used fluoride varnishes at the ages from 6 to 12 years, and collectively-performed fluoride mouthrinsing in schools at these ages was carried out by 16% of the clinics. 26% of all the clinics answered that they aimed at increasing the time spent on prophylactic measures compared to only 2% that were planning to decrease this time. The remaining 12% aimed at maintaining the time spent at the present. Prophylactic measures were performed individually by 49% of the clinics, whereas 50% of the clinics preferred a combination of individually and collectively performed measures. It can be concluded that the preventive measures against dental caries in Swedish public dental care is mainly focused on individually performed prophylaxis.

The aim of the present investigation was to study two post-brushing water rinsing procedures: (1) on fluoride (F) accumulation in approximal dental plaque, and (2) on F clearance in the interdental area. Twenty subjects participated first in the accumulation study, including three experimental periods (A, B and C), each lasting for 7 days. During period A, they brushed with a 0.32% NaF dentifrice for 2 min, followed by a 1-min active mouth rinse with the toothpaste foam combined with 5 ml of water. During period B, the 2-min brushing was followed by three quick water rinses with 15 ml each. During period C, toothbrushing, which was carried out without any toothpaste, was followed by a 2-min active mouthrinse with 10 ml of a 0.05% NaF solution. All three procedures were performed in the morning (after breakfast) and in the evening (just before bedtime). The results showed that the accumulation of F in pooled approximal plaque after 7 days reached on average 2.7 times higher values after procedure A than B (p0.001). Procedure C also resulted in more F in plaque than B (p0.001). The same 20 subjects participated in the clearance study on a separate occasion. When measuring the F concentration in the interdental area at 3 h after the application, procedure A resulted in a significantly higher F concentration than both toothbrushing B and mouth rinse C; the AUC was 2.2 times larger for A than for B (p0.001). Thus, both the accumulation of F in approximal plaque and the clearance of F in the interdental area are related to the mode of water rinsing after toothbrushing.

A 3-year, double-blind caries trial was conducted to evaluate the caries-reducing effect of a modified technique to use toothpaste. At the outset, 369 children, 4 years of age, were randomly assigned to four groups. At the end of the study, when the children were 7 years old, 281 (76%) had completed the trial. Two of the groups (test groups, n = 131) were given the following instructions regarding 'toothpaste technique': (1) to spread the paste evenly on the teeth prior to brushing, (2) not to expectorate more than necessary during brushing, (3) to filter the remaining dentifrice foam in the dentition, together with a sip of water, by active cheek movements for 1 min before expectorating, and (4) not to carry out any further water rinsings afterwards, and not to eat or drink for 2 h after brushing. The children in the other two groups (control groups, n = 150) were not given any instruction how to use the dentifrice and how to rinse after the brushing, but were, as the children in the test groups, encouraged to use the test dentifrice and to brush their teeth twice daily. Two commercial fluoride dentifrices (A and B) were compared: one of the test groups and one of the control groups used each product. Approximal carious lesions were scored on bite-wing radiographs at baseline and at the end of the study on the distal surface of the first and on the mesial surface of the second primary molars. No difference in caries increment was found between toothpastes A and B. The children in the two test groups developed a mean of 1.14 new dfs during the 3 years compared to 1.55 in the two control groups (p0.05). Thus, the results indicate that the modified toothpaste technique reduced approximal caries in preschool children by an average of 26%.

The aim of the investigations was to evaluate the cariostatic effects of a modified toothpaste technique using fluoride (F) toothpaste. The modification consisted of an active mouthrinse with the toothpaste slurry and a sip of water for one minute after brushing. Toothpaste technique and salivary F concentration after toothbrushing were recorded in a caries active and a caries inactive group. The level of F in whole saliva, the concentration of F in plasma, the effect on demineralised enamel and dentine samples, and the accumulation of F in interdental plaque when using the modified toothpaste technique were studied. In a 3-year clinical trial, 4-year old children were trained in the toothpaste technique. The results showed that in the caries active group, the water rinsing was more thorough and more water was used compared to a caries inactive group. Rinsing with water and eating immediately after toothbrushing decreased the F level in whole saliva. Mouthrinsing with either a NaF solution or a slurry of toothpaste foam and water increased the F concentration in saliva compared to when a single or double water rinse was performed. The degree of F absorption in plasma, the accumulation of F in approximal plaque and the interdental clearance after toothbrushing were strongly related to the mode of water rinsing. The degree of demineralisation of enamel and dentine at approximal sites was also related to the mode of water rinsing. The clinical study showed that the cariostatic effect of the modified toothpaste technique resulted in 26% less approximal caries in the test group. It is concluded that a toothpaste technique where a slurry rinse was carried out after brushing increased the efficacy of F toothpaste.

The aim of the present investigation was to compare the clearance pattern in saliva and the salivary stimulating effect of a new fluoride (F) chewing gum (Fluorette) with three other F products used in Scandinavia for many years for caries prevention. Concentration of F was determined in whole saliva in three groups of subjects: 1) children, 10-12 yr of age (n = 20), 2) adults (n = 20), and 3) dry mouth patients (n = 15), after a single intake of the two tablets, Dentan and Fludent, and the two chewing gums, Fluomin and Fluorette, all containing 0.25 mg F as NaF. Sucking was allowed until the tablets had been completely dissolved in the mouth. The chewing gums were used for 15 min. Saliva samples were collected from subjects expectorating 0.3-0.5 ml at nine different time intervals up to 45 min after the intake. There were some significant differences in the maximum F concentration, the area under the salivary fluoride concentration curve (AUC) when plotted against time, and the salivary stimulating effect among the four products, but as a whole they were small and probably of minor clinical importance. Among the various groups, the dry mouth patients showed the highest salivary F concentration. Thus, the main conclusion from this study is that the F tablets and chewing gums studied, including the new product Fluorette, had approximately the same clearance pattern in saliva and the same salivary stimulating effect. However, there were great variations among the different subjects.