EFFECT OF HIGH-FLUORIDE TOOTHPASTE AND MOUTH RINSE ON THE PREVENTION OF DEMINERALIZED LESIONS DURING ORTHODONTIC TREATMENT
DOI:
https://doi.org/10.33279/jkcd.v14i03.698Keywords:
High-fluoride toothpaste, white spot lesion, demineralization, orthodonticsAbstract
Objectives: To evaluate the impact of using high-fl uoride toothpaste and mouth rinse in preventing demineralized lesions (DLs) during orthodontic therapy.
Materials and Methods: This randomized controlled trial included 250 patients of both gender
and were divided into three groups (A=FMR, B=HFT and C=FT). The FMR group, which received a 0.2% sodium fl uoride (NaF) mouth rinse in addition to 1450 ppm fl uoride (F) toothpaste; the HFT group, which used a 5000 ppm F toothpaste; and the Control (CTR) group, which utilized 1450 ppm F toothpaste. Non-probability purposive sampling was used for the recruitment of patients. A blinded healthcare professional evaluated digital images obtained before and after treatment to determine the percentage of individuals with at least one new demineralized lesion. SPSS version 25 was used for analysis.
Results: A total of 250 patients with a mean age of 16.82±2.21 years participated, comprising 95 males (38.0%) and 155 females (62.0%). Group A (n=83) had a mean age of 17.01±2.17 years, Group B (n=84) 16.46±2.19 years, and Group C (n=83) 17.00±2.26 years. Health status varied,
with Group A having 73.5% with no disease, Group B 83.3%, and Group C 90.4%. the study presents unadjusted relative risks for increases in demineralized lesions (≥1, ≥2, ≥3) in all teeth
and the aesthetic zone, comparing High-Fluoride Toothpaste (HFT) vs. Control (CTR), Fluoride Mouth Rinse (FMR) vs. CTR, and FMR vs. HFT. Pretreatment, white spot lesions (WSL) were
distributed across groups, with Group A and B showing diff erent prevalence rates. Post-treatment, Group A had 30.1% with 0 lesions, Group B 33.3%, and Group C 20.5%. Statistically significant differences were observed for increases in ≥1 WSL post-treatment (p=0.01), but not for ≥2 WSL (p=0.50) or ≥3 WSL (p=0.11).
Conclusion: It has been shown that using high fl uoride toothpaste and mouthwash can help prevent dental caries on canines, lateral incisors, and central incisors when undergoing orthodontic treatment. A mouthwash and toothpaste with high fl uoride content may be advised to prevent DL in the aesthetic zone.
References
Richter AE, Arruda AO, Peters MC, Sohn W. Incidence of caries lesions among patients treated with comprehensive orthodontics. American Journal of Orthodontics and Dentofacial Orthopedics. 2011;139(5):657-64.
Erbe C, Hartmann L, Schmidtmann I, Ohlendorf D, Wehrbein H. A New Method for Quantifying Labial White Spot Lesions. 2020.
Maret D, Marchal-Sixou C, Vergnes J-N, Hamel O, Georgelin-Gurgel M, Van Der Sluis L, et al. Effect of fixed orthodontic appliances on salivary microbial parameters at 6 months: a controlled observational study. Journal of Applied Oral Science. 2014;22:38-43.
Marda A, Elhamzaoui S, El Mansari A, Souly K, Farissi F, Zouhdi M, et al. Evaluation of changes in cariogenic bacteria in a young Moroccan population with fixed orthodontic appliances. International Journal of Dentistry. 2018;2018.
Sifakakis I, Papaioannou W, Papadimitriou A, Kloukos D, Papageorgiou SN, Eliades T. Salivary levels of cariogenic bacterial species during orthodontic treatment with thermoplastic aligners or fixed appliances: a prospective cohort study. Progress in orthodontics. 2018;19(1):1-9.
Lucchese A, Bondemark L, Marcolina M, Manuelli M. Changes in oral microbiota due to orthodontic appliances: a systematic review. Journal of oral microbiology. 2018;10(1):1476645.
Enerbäck H, Lövgren ML, Strömberg N, Westerlund A. Effect of high-fluoride toothpaste and mouth rinse on the prevention of demineralized lesions during orthodontic treatment: a randomized controlled trial. European Journal of Orthodontics. 2023;45(5):477-84.
Aoun A, Darwiche F, Al Hayek S, Doumit J. The fluoride debate: the pros and cons of fluoridation. Preventive nutrition and food science. 2018;23(3):171.
Enerbäck H, Lingström P, Möller M, Nylen C, Bresin CÖ, Ros IÖ, et al. Effect of a mouth rinse and a high-fluoride toothpaste on caries incidence in orthodontic patients: A randomized controlled trial. American Journal of Orthodontics and Dentofacial Orthopedics. 2022;162(1):6-15. e3.
Sonesson M, Twetman S, Bondemark L. Effectiveness of high-fluoride toothpaste on enamel demineralization during orthodontic treatment—A multicenter randomized controlled trial. European journal of orthodontics. 2014;36(6):678-82.
Geiger AM, Gorelick L, Gwinnett AJ, Benson BJ. Reducing white spot lesions in orthodontic populations with fluoride rinsing. American Journal of Orthodontics and Dentofacial Orthopedics. 1992;101(5):403-7.
van der Kaaij NC, van der Veen MH, van der Kaaij MA, ten Cate JM. A prospective, randomized placebo‐controlled clinical trial on the effects of a fluoride rinse on white spot lesion development and bleeding in orthodontic patients. European journal of oral sciences. 2015;123(3):186-93.
Derks A, Katsaros C, Frencken JE, Van’t Hof M, Kuijpers-Jagtman A. Caries-inhibiting effect of preventive measures during orthodontic treatment with fixed appliances: a systematic review. Caries research. 2004;38(5):413-20.
Stecksén-Blicks C, Renfors G, Oscarson N, Bergstrand F, Twetman S. Caries-preventive effectiveness of a fluoride varnish: a randomized controlled trial in adolescents with fixed orthodontic appliances. Caries research. 2007;41(6):455-9.
Chapman JA, Roberts WE, Eckert GJ, Kula KS, González-Cabezas C. Risk factors for incidence and severity of white spot lesions during treatment with fixed orthodontic appliances. American Journal of Orthodontics and Dentofacial Orthopedics. 2010;138(2):188-94.
Sonesson M, Brechter A, Abdulraheem S, Lindman R, Twetman S. Fluoride varnish for the prevention of white spot lesions during orthodontic treatment with fixed appliances: a randomized controlled trial. European Journal of Orthodontics. 2020;42(3):326-30.
Shungin D, Olsson AI, Persson M. Orthodontic treatment-related white spot lesions: a 14-year prospective quantitative follow-up, including bonding material assessment. American Journal of Orthodontics and Dentofacial Orthopedics. 2010;138(2):136. e1-. e8.
Featherstone JD. Prevention and reversal of dental caries: role of low level fluoride. Community dentistry and oral epidemiology. 1999;27(1):31-40.
Enaia M, Bock N, Ruf S. White-spot lesions during multibracket appliance treatment: a challenge for clinical excellence. American Journal of Orthodontics and Dentofacial Orthopedics. 2011;140(1):e17-e24.
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