Use of professionally administered topical fluorides in Asia

Professionally applied topical fluoride varnish, gel, and solution have been shown to be effective in preventing and in arresting dental caries. Their use in different countries in Asia varies greatly and may not correlate with the dental caries situation of the populations in the countries. In the higher-income countries, use of fluoride varnish and gel is common among dental professionals. In contrast, the use of professionally administered topical fluorides is not common in the lower-income countries. Fluoride varnish, being easy to apply and safe, has been the preferred agent for the prevention of early childhood caries, which is prevalent in many developing countries in Asia. The relatively high cost of professionally administered fluoride agents and the shortage of a dental workforce, especially in lower income countries, have hampered the widespread adoption of these effective caries prevention methods in the private and public dental services. Government health policies should be pursued to lower the cost of treatment, either through incentives for local production and/or elimination of taxes and tariffs on imported fluoride products.published_or_final_versio

In silico modelling of hyposalivation and biofilm dysbiosis in root caries

Root caries progression is aggravated by hyposalivation, which can accelerate the conversion of a dental biofilm from having a symbiotic microbial relationship with the host (predominance of nonaciduric species) to a dysbiotic one (dominated by aciduric species). Using a mathematical model previously employed to investigate factors associated with biofilm dysbiosis, we systematically explored the deleterious effect of hyposalivation on the composition of the biofilm and the risk of root dentin demineralization. By varying the clearance half-times of sugar (i.e., readily fermented dietary carbohydrates), we simulated hyposalivation and investigated its effect on 1) the time that the biofilm pH spends below the minimum for dentin or enamel demineralization and 2) the conversion of the biofilm from a symbiotic to dysbiotic composition. The effect of increasing sugar clearance half-times on the time that the biofilm pH is below the threshold for demineralization was more pronounced for dentin than for enamel (e.g., increasing the clearance half-time from 2 to 6 min doubled the time that the biofilm pH was below the threshold for dentin demineralization). The effect on biofilm composition assessed at 50 d showed that the conversion from a symbiotic to a dysbiotic biofilm happened around a frequency of 6 sugar intakes per day when the clearance half-time was 2 min but only 3 sugar intakes per day when the clearance half-time was 6 min. Taken together, the results confirm the profound effect that prolonged sugar clearance has on the dynamics of dental biofilm composition and the subsequent risk of root caries. This in silico model should be applied to study how interventions that alter salivary clearance rates or modify biofilm pH can affect clinical conditions such as root caries

Effect of sucrose on the selection of mutans streptococci and lactobacilli in dental biofilm formed in situ

Microorganisms are selected in dental biofilm by the acidic environment created by sugar fermentation, but the effect of extracellular polysaccharide (EPS) on the counts of cariogenic bacteria is not clear. Dental biofilm was formed in situ for 13 days under exposure 8 times a day to distilled-deionized water, glucose + fructose or sucrose solutions. Mutans streptococci (MS) counts were not different among the groups, but lactobacilli (LB) were significantly higher in glucose + fructose and sucrose groups, without significant difference between them, irrespective of the higher insoluble EPS concentration in the sucrose biofilm matrix. The data suggest that exposure to sugar is more relevant for the predominance of LB in dental biofilm than for MS and that insoluble EPS does not change the counts of these microorganisms in the biofilm. Copyright (c) 2006 S. Karger AG, Basel40654654