Effect of fluoridated toothpicks and dental flosses on enamel and dentine and on plaque composition in situ

The aim was to evaluate the effect of two toothpicks and two dental flosses on demineralized enamel and dentine and on plaque composition, using an in situ model with simulated approximal spaces within dentures. Fifteen subjects with full dentures were recruited and 14 completed the study. It consisted of two crossover periods, the first comparing a birch toothpick with AmF and a birch toothpick with NaF, and the second comparing a dental floss with AmF + NaF and a dental floss without F. Between these four periods, there was a control period without any approximal cleaning. In small, rectangular sample holders, one enamel and one dentine specimen were embedded, forming a triangular, approximal-like space. Two sample holders were mounted in the premolar-molar region of the upper or lower dentures. The subjects used the toothpicks or dental flosses 3 times/day for 4 weeks. The results showed that all toothpicks and dental flosses inhibited further demineralization compared to the control period ( p <0.001). The dental flosses were somewhat more effective in this respect than the toothpicks, especially in dentine. There were relatively small numerical differences between AmF and NaF toothpicks, but in favour of NaF regarding mineral gain ( p <0.05). The fluoridated floss gave somewhat less lesion depth in dentine than the non-fluoridated floss ( p <0.01). Toothpicks and flosses resulted in lower counts of microorganisms in plaque compared to the control period ( p <0.001); the AmF toothpick gave a more pronounced reduction than the NaF toothpick ( p <0.001). Copyright (C) 2005 S. Karger AG, Basel

Comparison of interproximal delivery and flow characteristics by dentifrice dilution and application of prepared toothpaste delivery technique

In home care, the toothpaste technique, which can enhance the caries-preventive effect without changing the amount of dentifrice and fluoride ion concentration, is of great significance. This study aimed to construct a model and experimental system that reproduces the interdental part and to clarify the relationship between the change in dentifrice viscosity due to dilution and washout in the high-risk approximal area of caries. Additionally, the effectiveness of the toothpaste technique and appropriate devices for delivering dentifrice to the interdental area at a low dilution were investigated. Diluted toothpaste samples were prepared (: ×1.00, ×1.25, ×1.50, ×1.75, ×2.00, ×3.00, and ×4.00). An acrylic interproximal model was created for this experiment. The flow characteristics and viscosity by dentifrice dilution were measured. In the case of low dilution of 57% (1.75×) or more, it was shown that the dentifrice in the high-risk area may be washed out early because of the decrease in viscosity, and the caries-preventive effect may be reduced. It was also suggested that to keep the dentifrice in the interdental area for 120 s at the end of brushing, a dilution must be devised to a concentration of at least 50% (2.00×). The prepared toothpaste delivery (PTD) method of delivering dentifrice to the interdental area while maintaining it at a low dilution is an effective toothpaste technique in terms of dentifrice dilution and viscosity. The use of finger brushes in the PTD method could increase the efficiency of dentifrice delivery

Acidogenic Potential of “Sugar-Free” Cough Drops

A patient presented with extensive marginal ditching around restorations recently placed during whole-mouth rehabilitation. The patient was not xerostomic and was otherwise normal except for the self-reported excessive use of “sugar-free” cough drops sweetened with sorbitol and Isomalt® (an equimolar mix of glucosyl-mannitol and glucosylsorbitol). This prompted an in vitro investigation to determine whether Streptococcus sobrinus 6715, a cariogenic streptococcus, could grow and produce acid in growth medium containing an aqueous extract of such “sugar-free” cough drops. The results indicate that S. sobrinus 6715 uses Isomalt® and sorbitol extensively, producing terminal culture pH as low as 4.2 when grown on medium with cough drop extract containing these sugars. This pH is sufficient to demineralize dental enamel. Patients should be cautioned against the chronic overuse of “sugar-free” cough drops and other “sugar-free” confections sweetened with a mixture of Isomalt® and sorbitol