Charles R Parkinson1, Anderson T Hara2, Marc Nehme3, Frank Lippert4, Domenick T Zero5. 1. GSK Consumer Healthcare, St George's Avenue, Weybridge, Surrey, KT13 0DE, UK. Electronic address: Charles.X.Parkinson@gsk.com. 2. Department of Cariology, Operative Dentistry and Dental Public Health, Oral Health Research Institute, Indiana University School of Dentistry, Indianapolis, IN, USA. Electronic address: ahara@iu.edu. 3. GSK Consumer Healthcare, St George's Avenue, Weybridge, Surrey, KT13 0DE, UK. Electronic address: drmnehme@gmail.com. 4. Department of Cariology, Operative Dentistry and Dental Public Health, Oral Health Research Institute, Indiana University School of Dentistry, Indianapolis, IN, USA. Electronic address: flippert@iu.edu. 5. Department of Cariology, Operative Dentistry and Dental Public Health, Oral Health Research Institute, Indiana University School of Dentistry, Indianapolis, IN, USA. Electronic address: dzero@iu.edu.
Abstract
OBJECTIVES:Fluoride mouthrinses provide advantages for fluoride delivery by maintaining elevated intra-oral fluoride concentrations following fluoride dentifrice use. This in situ caries study investigated potential anti-caries efficacy of a 220 ppm fluoride mouthrinse. METHODS: This was an analyst-blinded, four-treatment, randomised, crossover study using partially demineralised, gauze-wrapped, human enamel samples mounted in a mandibular partial denture. Participants brushed twice daily for 14 days with either a 1150 ppm fluoride or a fluoride-free placebo dentifrice and either rinsed once daily with the 220 ppm fluoride mouthrinse or not. Following each treatment period, percent surface microhardness recovery (%SMHR) and enamel fluoride uptake (EFU) were assessed. RESULTS:Fifty three participants completed the study. Compared with the placebo dentifrice/no rinse treatment, the fluoride-containing regimens demonstrated greater enamel remineralisation (%SMHR) and fluoridation (EFU): fluoride dentifrice/fluoride rinse (%SMHR difference: 21.55 [95% CI: 15.78,27.32]; EFU difference 8.35 [7.21,9.29]); fluoride dentifrice/no rinse: 19.48 [13.81,25.15]; 6.47 [5.35,7.60]; placebo dentifrice/fluoride rinse: 16.76 [11.06,22.45]; 5.87 [4.72,7.00] (all P < .0001). There were no significant differences in%SMHR between fluoride regimens. The fluoride dentifrice/fluoride rinse regimen was associated with higher EFU than the fluoride dentifrice/no rinse (1.88 [0.75,3.01], P = .0013) and placebo dentifrice/fluoride rinse regimens (2.48 [1.34,3.62], P < .0001). Treatments were generally well-tolerated. CONCLUSIONS: The in situ caries model demonstrated that the fluoride mouthrinse is effective in promoting enamel caries lesion remineralisation and fluoridation whether used following a fluoride or non-fluoride dentifrice. Additive (potential) anti-caries benefits of a fluoride rinse after a fluoride dentifrice were confined to enhancements in lesion fluoridation (EFU). CLINICAL SIGNIFICANCE: In conjunction with a fluoride dentifrice, fluoride mouthrinses enhance enamel fluoridation, which may be useful in caries prevention.
RCT Entities:
OBJECTIVES: Fluoride mouthrinses provide advantages for fluoride delivery by maintaining elevated intra-oral fluoride concentrations following fluoride dentifrice use. This in situ caries study investigated potential anti-caries efficacy of a 220 ppm fluoride mouthrinse. METHODS: This was an analyst-blinded, four-treatment, randomised, crossover study using partially demineralised, gauze-wrapped, human enamel samples mounted in a mandibular partial denture. Participants brushed twice daily for 14 days with either a 1150 ppm fluoride or a fluoride-free placebo dentifrice and either rinsed once daily with the 220 ppm fluoride mouthrinse or not. Following each treatment period, percent surface microhardness recovery (%SMHR) and enamel fluoride uptake (EFU) were assessed. RESULTS: Fifty three participants completed the study. Compared with the placebo dentifrice/no rinse treatment, the fluoride-containing regimens demonstrated greater enamel remineralisation (%SMHR) and fluoridation (EFU): fluoride dentifrice/fluoride rinse (%SMHR difference: 21.55 [95% CI: 15.78,27.32]; EFU difference 8.35 [7.21,9.29]); fluoride dentifrice/no rinse: 19.48 [13.81,25.15]; 6.47 [5.35,7.60]; placebo dentifrice/fluoride rinse: 16.76 [11.06,22.45]; 5.87 [4.72,7.00] (all P < .0001). There were no significant differences in%SMHR between fluoride regimens. The fluoride dentifrice/fluoride rinse regimen was associated with higher EFU than the fluoride dentifrice/no rinse (1.88 [0.75,3.01], P = .0013) and placebo dentifrice/fluoride rinse regimens (2.48 [1.34,3.62], P < .0001). Treatments were generally well-tolerated. CONCLUSIONS: The in situ caries model demonstrated that the fluoride mouthrinse is effective in promoting enamel caries lesion remineralisation and fluoridation whether used following a fluoride or non-fluoride dentifrice. Additive (potential) anti-caries benefits of a fluoride rinse after a fluoride dentifrice were confined to enhancements in lesion fluoridation (EFU). CLINICAL SIGNIFICANCE: In conjunction with a fluoride dentifrice, fluoride mouthrinses enhance enamel fluoridation, which may be useful in caries prevention.