Effect of fluoride toothpastes on enamel demineralization

BACKGROUND: It was the aim of this study to investigate the effect of four different toothpastes with differing fluoride compounds on enamel remineralization. METHODS: A 3 × 3 mm window on the enamel surface of 90 human premolars was demineralized in a hydroxyethylcellulose solution at pH 4.8. The teeth were divided into 6 groups and the lower half of the window was covered with varnish serving as control. The teeth were immersed in a toothpaste slurry containing: placebo tooth paste (group 1); remineralization solution (group 2); Elmex Anticaries (group 3); Elmex Sensitive (group 4); Blend-a-med Complete (group 5) and Colgate GRF (group 6). Ten teeth of each group were used for the determination of the F(- )content in the superficial enamel layer and acid solubility of enamel expressed in soluble phosphorus. Of 6 teeth of each group serial sections were cut and investigated with polarization light microscopy (PLM) and quantitative energy dispersive X-ray analysis (EDX). RESULTS: The PLM results showed an increased remineralization of the lesion body in the Elmex Anticaries, Elmex Sensitive and Colgate GRF group but not in the Blend-a-med group. A statistically significant higher Ca content was found in the Elmex Anticaries group. The fluoride content in the superficial enamel layer was significantly increased in both Elmex groups and the Blend-a-med group. Phosphorus solubility was significantly decreased in both Elmex groups and the Blend-a-med group. CONCLUSION: It can be concluded that amine fluoride compounds in toothpastes result in a clearly marked remineralization of caries like enamel lesions followed by sodium fluoride and sodium monofluorophosphate formulations

Dentifrices, mouthwashes, and remineralization/caries arrestment strategies

While our knowledge of the dental caries process and its prevention has greatly advanced over the past fifty years, it is fair to state that the management of this disease at the level of the individual patient remains largely empirical. Recommendations for fluoride use by patients at different levels of caries risk are mainly based on the adage that more is better. There is a general understanding that the fluoride compound, concentration, frequency of use, duration of exposure, and method of delivery can influence fluoride efficacy. Two important factors are (1) the initial interaction of relatively high concentrations of fluoride with the tooth surface and plaque during application and (2) the retention of fluoride in oral fluids after application

Adjunctive Use of a Subgingival Controlled‐Release Chlorhexidine Chip Reduces Probing Depth and Improves Attachment Level Compared With Scaling and Root Planing Alone

The present studies evaluated the efficacy of a controlled‐release biodegradable Chlorhexidine (CHX) (2.5 mg) chip when used as an adjunct to scaling and root planing on reducing probing depth (PD) and improving clinical attachment level (CAL) in adult periodontitis. Two double‐blind, randomized, placebo‐controlled multicenter clinical trials (5 centers each) were conducted; pooled data are reported from all 10 centers (447 patients). At baseline, following 1 hour of scaling and root planing (SRP) in patients free of supragingival calculus, the chip was placed in target sites with PD 5 to 8 mm which bled on probing. Chip placement was repeated at 3 and/or 6 months if PD remained ≥ 5 mm. Study sites in active chip subjects received either CHX chip plus SRP or SRP alone (to maintain study blind). Sites in placebo chip subjects received either placebo chip plus SRP or SRP alone. Examinations were performed at baseline; 7 days; 6 weeks; and 3, 6, and 9 months. At 9 months significant reductions from baseline favoring the Chlorhexidine chip compared with both control treatments were observed with respect to PD (Chlorhexidine chip plus SRP, 0.95 ± 0.05 mm; SRP alone, 0.65 ± 0.05 mm, P \u3c 0.001; placebo chip plus SRP, 0.69 ± 0.05 mm, P \u3c 0.001) and CAL (Chlorhexidine chip plus SRP, 0.75 ± 0.06 mm; SRP alone, 0.58 ± 0.06 mm, P \u3c 0.05; placebo chip plus SRP, 0.55 ± 0.06 mm, P \u3c 0.05). The proportion of patients who evidenced a PD reduction from baseline of 2 mm or more at 9 months was significantly greater in the Chlorhexidine chip group (19%) compared with SRP controls (8%) (P \u3c 0.05). Adverse effects were minor and transient toothache, including pain, tenderness, aching, throbbing, soreness, discomfort, or sensitivity was the only adverse effect that was higher in the Chlorhexidine group as compared to placebo (P= 0.042). These data demonstrate that the adjunctive use of the Chlorhexidine chip results in a significant reduction of PD when compared with both SRP alone or the adjunctive use of a placebo chip. These multi‐center randomized control trials suggest that the Chlorhexidine chip is a safe and effective adjunctive chemotherapy for the treatment of adult periodontitis

Effects of Initial Abstinence and Programmed Lapses on The Relative Reinforcing Effects of Cigarette Smoking

Fifty-eight smokers received abstinence-contingent monetary payments for 1 (n  =  15) or 14 (n  =  43) days. Those who received contingent payments for 14 days also received 0, 1, or 8 experimenter-delivered cigarette puffs on 5 evenings. The relative reinforcing effects of smoking were assessed in a 3-hr session on the final study day, when participants made 20 choices between smoking or money. The reinforcement contingencies exerted robust control over smoking, and programmed smoking lapses produced few discernible effects. These results further illustrate the robust control that reinforcement contingencies can exert over cigarette smoking and suggest that any effects of lapses on the relative reinforcing effects of smoking are modest under conditions involving abstinence-contingent reinforcement contingencies