Oral fluoride measurements for estimation of the anti-caries efficacy of fluoride treatments.

The aims of this work were (a) to assess the oral bioavailability of fluoride delivered from dentifrices and (b) to test for a possible link between the results and clinical data obtained with the same dentifrices. Oral fluoride concentrations were measured in samples of saliva and plaque taken from seven subjects, after use of dentifrices which contained 0, 1000, 1500, and 2500 micrograms F/g as sodium monofluorophosphate. Salivary fluoride in samples obtained within the first few hours after a single dentifrice application, or up to 20 h after four weeks' daily use, increased with increasing F content of the dentifrice. For example, the mean zero-time intercepts of the second phase of salivary fluoride clearance curves for the above dentifrices were 0.46, 1.48, 1.88, and 3.03 mumol F/L, respectively. Plaque fluoride measured after four weeks' daily use of the dentifrices exhibited similar dose-response behavior. Linear regression analysis showed these trends to be statistically significant for both saliva (p less than 0.001) and plaque (p less than 0.025). Mean saliva and plaque fluoride concentrations were inversely associated with mean three-year caries increments for the three fluoride-containing dentifrices obtained in a recent clinical trial: DMFS scores 6.80, 6.33, and 5.71, respectively (Stephen et al., 1988). This suggests that oral fluoride measurements are a valuable in vivo method for the evaluation of the potential anti-caries efficacy of fluoride-containing dental products.

Oral fluoride retention after use of fluoride dentifrices.

Fluoride is the only extensively clinically proven means of reducing dental caries. Despite a large body of epidemiological data on the effectiveness of fluoride, delivered in the form of dentifrices, mouthrinses, drinking water, etc., the precise mode of action of fluoride is not completely understood. The purpose of this paper is to report an investigation of the link between oral fluoride levels and applied fluoride dose from dentifrices. Human salivary fluoride clearance studies and equilibrium baseline studies of fluoride in saliva and plaque have been carried out with dentifrices which contained 1,000, 1,500 and 2,500 micrograms fluoride per gram as sodium monofluorophosphate. After a single brushing with a fluoride dentifrice, salivary fluoride decreased in two distinct phases: an initial rapid phase which lasted for 40-80 min, depending on the individual, and a second slow phase lasting for several hours. The latter phase is believed to be due to fluoride released from an oral fluoride reservoir. During regular repeated use of the test dentifrices, the equilibrium baseline fluoride concentration, attained in both saliva and plaque between one application and the next, increased significantly compared with placebo values. Such elevated baseline fluoride concentrations also increased with increasing Na2FPO3 content of the dentifrices. The present work supports the concept that labile fluoride, stored in an oral fluoride reservoir at the time of treatment application, may maintain a prolonged protective effect against dental caries.

Fluoride in plaque following use of dentifrices containing sodium monofluorophosphate.

Previous work showed that plaque fluoride increased with increasing NaF content of mouthwashes following daily use. The main aim of this study was to test whether a similar relationship was detectable after regular use of dentifrices containing amounts of sodium monofluorophosphate equivalent to 1000, 1500, and 2500 micrograms F/g. Plaque was collected from three groups, each consisting of approximately 80 children, who had each used one of the dentrifrices for one year. Plaque fluoride increased significantly with increasing Na2FPO3 content of the dentifrices. For the 1000-micrograms-F/g group, plaque fluoride also increased significantly with increasing frequency of dentifrice use, but did not correlate with amount of dentifrice applied per brushing. The inverse correlation observed between mean plaque fluoride concentrations and mean three-year caries increments suggests that oral fluoride measurements may prove valuable in estimating the likely anti-caries efficacy of fluoride-containing dental products.

Fluoride in saliva and plaque following use of fluoride-containing mouthwashes.

The sensitivity of methodology for measuring the concentration of fluorine species in saliva and in plaque has been tested. Human subjects mouth-rinsed daily with aqueous solutions of NaF and Na2FPO3. Samples of unstimulated whole saliva and of plaque were collected twice weekly at least 18 hr after treatment application. Oral fluoride concentrations rose from placebo values for approximately two weeks before attaining equilibrium and returned to baseline when daily mouthrinsing was stopped. Mean elevated oral fluoride concentrations increased significantly with increasing applied NaF concentration in the range 0-1000 ppm F (0-0.053 mol/L). There appeared to be a linear relationship between saliva and plaque fluoride. The ability of fluoride treatments to sustain elevated oral fluoride levels between daily applications may be of major importance in caries control.