Occupational leukoderma due to phenolic compounds in the ceramics industry?
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Adult↗
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Contact dermatitis among decorators and enamellers in hand-made ceramic decorations.
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Allergens↗
The efficacy of a fluoride varnish in reducing enamel demineralization adjacent to orthodontic brackets: an in vitro study.
OBJECTIVES: To test the hypothesis that fluoride varnish is effective in reducing demineralization (white spot) lesions adjacent to bonded orthodontic brackets. DESIGN: Two similar samples of extracted bovine incisors, with bonded orthodontic brackets, were separated into an experimental group (fluoride varnish was applied) and control group (no fluoride varnish) to examine the preventive effects of fluoride varnish. SETTING AND SAMPLE POPULATION: The dental clinic of the State University of Maringá--UEM (Maringá, Paraná, Brazil). Thirty-eight extracted bovine incisors with bonded orthodontic brackets. EXPERIMENTAL VARIABLE: Fluoride varnish was applied topically to half of the sample of extracted bovine teeth. No varnish was applied to the other half. OUTCOME MEASURE: The depths of enamel demineralization (white spot) lesions were measured from polarized light microscopy images using image analysis software. RESULTS: The teeth in both the experimental and control groups had been exposed to a cariogenic environment twice a day for 35 days. Those teeth that had been treated with two applications of fluoride varnish (one at the outset and another 15 days later) demonstrated about 38% less mean lesion depth than teeth where no varnish had been applied. CONCLUSION: Orthodontists may wish to consider the application of fluoride varnish during fixed orthodontic therapy to help reduce the development of enamel white spot lesions.
Animals↗
Effects of fluoride varnish on color of esthetic restorative material.
PURPOSE: This study determined the color stability of a compomer, hybrid ionomer, and composite after staining with three fluoride varnishes. MATERIALS AND METHODS: Five disks (10 mm in diameter, 2 mm thick) of each material were prepared in a mold and incubated at 100% relative humidity at 37 degrees C for 24 hours. Duraphat, Duraflor, FluorProtector, and water (control) were applied to the disks, which were subsequently brushed with a soft toothbrush and dentifrice. Color was measured at baseline, after staining, and after brushing using CIE L*a*b* (source C) against white background on a reflection spectrophotometer, and color change (delta E*) was calculated. Means (n = 5) and standard deviations were calculated and compared using a repeated-measures analysis of variance (ANOVA). Tukey-Kramer intervals (p = .05) were calculated to compare means. RESULTS: Varnishes Duraflor and Duraphat caused perceptible color changes (delta E* > 3.3) in compomer, hybrid ionomer, and composite after application; however, FluorProtector did not affect the color of the materials. After brushing, none of the materials exhibited perceptible values of delta E*, except the composite with Duraflor (delta E* = 5.4).
Analysis of Variance↗
Change in caries prevalence after implementation of a fluoride varnish program.
OBJECTIVE: In 1996 the caries prevalence of schoolchildren living in Neukölln, a district of Berlin, Germany, was higher than the mean of total Berlin. Hence, a special preventive program including the application of fluoride varnish was initiated. All 49 primary schools of the district joined the project. The aim of the present study was to evaluate in a cross-sectional study whether the preventive program resulted in a reduced caries prevalence. METHODS: The complete program included oral health education as well as the application of a highly concentrated fluoride varnish (Duraphat). All children whose parents' consent was given could receive fluoride varnish twice a year. All children were examined once a year by four calibrated dentists. The baseline examination was conducted in 1995-96, the final examination in 1999-2000 (1995-96: n = 7,748; 1996-97: n =15,673; 1997-98: n = 19,362; 1998-99: n = 19,822; 1999-2000: n = 17,984). RESULTS: A total of 80,589 dental records were used for data analysis. A decline of DMFT-values was observed in all age groups and school years. The major improvement was found in school year 1999-2000, when the program had been established for four years. CONCLUSION: The described program may be an effective public health measure for 6- to 12-year-old children with high caries prevalence.
Age Factors↗
A comparison of the costs and patient acceptability of professionally applied topical fluoride foam and varnish.
OBJECTIVES: In Canada and the United States, professionally applied topical fluorides (PATF) are usually applied as a gel or foam. However, fluoride varnish has also been found to be effective for caries prevention and may be a preferred method because less time is required and fluoride exposure can be better controlled. The goal of this study was to compare the costs and patient acceptability of two methods of PATF (foam and varnish). METHODS: The study population was a convenience sample of high-risk children from the York Region and the city of Hamilton, Ontario, Canada, who had been identified as requiring fluoride therapy (n = 256). Children received from dental hygienists either fluoride foam applied in trays or fluoride varnish painted on tooth surfaces. An observer recorded the time to perform each procedure, adverse outcomes, and the satisfaction of children with treatment. RESULTS: The varnish technique took significantly less time compared to foam (5.81 vs 7.86 minutes; P < .0001). Significant differences between procedure times were found in all age groups, but the largest difference was for children aged 3-6 years (5.22 vs 8.61 minutes; P < .0001). Signs of gagging were observed in a lower proportion of participants who received varnish (3.8% vs 15.1%; P < .01), and this difference was largest for children aged 3-6 years (2.6% vs 29.7%; P < .01). The cost per varnish application, for children aged 3-6 years, was substantially less after labor costs were considered (dollar 3.43 vs dollar 4.43, CDN). CONCLUSIONS: Varnish applications were found to take less time and resulted in fewer signs of discomfort. These results support the use of fluoride varnish in caries prevention programs, especially for younger children.
Adolescent↗
Clinical and microbiological effects of chlorhexidine and arginine sustained-release varnishes in the mentally retarded.
Local applications of sustained-released varnishes of chlorhexidine and arginine were used in a controlled pilot study of 34 mentally retarded patients, ages 18-45, assigned to one of these groups: chlorhexidine (C), arginine (A), or placebo (P). A professional scaling followed by four weeks of professional brushing to reach a Plaque Index (PII) and Gingival Index (GI) of 1.0 at baseline preceded eight weeks of daily varnish application to the buccal and labial surfaces of all teeth. Clinical parameters (PII and GI) and bacterial samples from selected teeth were collected at predetermined intervals. Four and eight weeks following the baseline, the PII was significantly different among the groups, with the lowest score in the chlorhexidine group. No significant differences among the three groups were noted for the GI. The chlorhexidine and arginine groups showed significant reductions (p < 0.05 and p < 0.01, respectively) in the number of S. mutans. The arginine group showed a nonsignificant increase in the number of S. sanguis. These results suggest that the topical antimicrobial agents may have some relevance to plaque control among patients with mental retardation.
Administration, Topical↗
Fluoride varnish for caries prevention: comparisons with other preventive agents and recommendations for a community-based protocol.
This paper reviews fluoride varnish (FV) literature to develop a community-based protocol for people with special needs or those who are caries susceptible. Safety, personnel and cost issues are discussed and existing NIH, CDC and WHO recommendations are presented. FV studies are assessed with respect to type of FV to use and frequency of application. FV is compared with studies using other caries preventive agents: 0.2% NaF mouthrinse, acidulated phosphate fluoride (APF) gel, dental sealants, water fluoridation and chlorhexidine. Because there are few FV studies among special need populations, conclusions are based on available literature and public health principles. If personnel are available, FV use is preferred to APF gel and may be preferable to 0.2% NaF mouthrinse. FV is more effective in optimally fluoridated communities. If many occlusal surfaces are at risk, sealants should be applied. Additional combinations and frequencies of preventive agents should be tested, especially for people with special needs and high caries risk adults.
Adult↗
Base-varnish interactions around amalgam restorations: spectrophotometric and microscopic assessment of leakage.
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Calcium Hydroxide↗
Comparison of the efficacy of three different chlorhexidine preparations in decreasing the levels of mutans streptococci in saliva and interdental plaque.
The aim of the present study was to evaluate and compare the effects of three different chlorhexidine (CHX)-containing preparations on mutans streptococci (MS) levels in interdental plaque and whole saliva. Ninety-three healthy school-children (8-10 years old) with high scores of salivary MS were selected by a screening procedure and randomised into three equally sized groups. MS were enumerated at all mesial interdental sites of the first permanent molars with aid of a modified chairside technique. The patients were then treated three times within 2 weeks with either a 1% CHX/thymol-containing varnish (group A) or a 1% CHX gel (group B), or they were subjected to daily supervised toothbrushing with a 0.4% CHX dentifrice for 1 month (group C). Follow-up samples of saliva and plaque from the interdental sites were collected 1 and 3 months after termination of treatment. A statistically significant reduction of MS levels in saliva and interdental plaque was found in all groups after 1 month. The CHX-containing dentifrice (group C) was the most effective method in reducing MS levels in saliva, and a significantly stronger (p < 0.05) suppression was found after 1 and 3 months when compared with the gel and the varnish forms. The gel (group B) tended to be slightly more effective than the varnish (group A). In the interdental plaque, the reduction of MS was less marked than in the saliva, and the three groups exhibited MS reductions of similar magnitude (20%) and duration, persisting up to 3 months. However, a high proportion (approximately 50%) of all interdental sites were relatively unaffected by the treatments. In conclusion, our results suggest that the interdental MS colonisation was difficult to combat, irrespective of CHX preparation and method, while the salivary levels were more easily affected. Daily tooth-brushing with a CHX-containing dentifrice was more effective in reducing MS in saliva compared with the gel or varnish applications.
Analysis of Variance↗
Effect of four dental varnishes on the colonization of cariogenic bacteria on exposed sound root surfaces.
The aim of this study was to evaluate the effect of four different dental varnishes on the colonization of mutans streptococci, total streptococci and lactobacilli on exposed sound root surfaces. Sixty-five individuals were randomly allotted to one of four groups for treatment with Cervitec((R) ) varnish containing 1% chlorhexidine and 1% thymol, a thymol varnish or one of two different fluoride varnishes, Fluor Protector and Duraphat. The varnish was applied to three buccal root surfaces in each patient at baseline and after 1 week. Dental plaque from the root surfaces was collected and analysed on four different occasions: at baseline, after 1 week, 1 month and 6 months. The Cervitec varnish caused a statistically significant reduction in the number of mutans streptococci over time. The reduction was significant at 1 week and 1 month relative to baseline. The numbers of total streptococci and lactobacilli were not significantly affected by treatment with Cervitec. No statistically significant difference over time was found for mutans streptococci, lactobacilli or total streptococci after treatment with the fluoride varnishes or the thymol varnish.
Analysis of Variance↗
Effects of dental treatment and single application of a 40% chlorhexidine varnish on mutans Streptococci in young children under intravenous anaesthesia.
Clinical studies suggest that application of a highly concentrated chlorhexidine varnish results in a decrease in the number of mutans streptococci and thereby a decrease in the caries risks. The aim of this study was to determine the effect of dental treatment on the levels of mutans streptococci (MS) and lactobacilli (LB) and the additional effect of a single application of 40% chlorhexidine varnish (EC40) on the level of MS. Twenty-three children under the age of 5 years scheduled for full dental treatment were selected. Of these 23 children (mean dmf-s 27.1, SD 19.3), 11 children had nursing bottle caries. The mean sugar exposure was 6.4. Subjects were randomly distributed into two groups of approximately equal size. One group received an EC40 application after dental treatment, while the other group received only full dental treatment, both with intravenous anaesthesia with propofol as a single drug. An unstimulated saliva sample and a plaque sample were taken prior to dental treatment. The saliva and plaque sampling of the subjects was repeated after 6 weeks. MS and LB were isolated and counted. The number of children harbouring more than 10(6) MS in a pooled plaque sample decreased significantly from 8 to 2 children 6 weeks after dental treatment. No additional effect of EC40 was found. The number of salivary MS did not change significantly between the groups or before and after treatment. The figures for LB remained at a high level of more than 10(4)/ml saliva before (21 children) and 6 weeks after treatment (17 children). The results of this study indicate that dental treatment results in a significant suppression of plaque MS, while a single application of EC40 showed no significant additional suppression after 6 weeks.
Anesthesia, Dental↗
A randomised controlled trial of the caries-preventive efficacy of a chlorhexidine-containing varnish in high-caries-risk adolescents.
A professionally applied two-stage chlorhexidine varnish, Chlorzoin((R)), was developed to achieve sustained release and minimise the problems of staining and bad taste associated with chlorhexidine mouthrinses. The primary aim of this randomised controlled clinical trial was to assess the efficacy of Chlorzoin in reducing the caries increment in high-caries-risk adolescents. Secondary aims included investigating the effect of compliance upon caries increment, the effect of Chlorzoin upon salivary mutans streptococci levels and assessing the benefit of individual dental health advice by dental auxiliaries in a community setting. 1,240 children, initially aged 11-13 years, assessed to be at high caries risk were recruited into the trial. The trial design involved four arms: an observational group, a control group, an active (Chlorzoin) varnish group and a placebo varnish group. All subjects were examined annually by a calibrated examiner who was blind to the group allocation. Three-year caries increments were calculated using clinical, clinical and fibre-optic transillumination, and clinical and bitewing data sets. The results indicated that the use of Chlorzoin had an initial effect on mutans streptococci levels but that no long-term reduction in caries increment or mutans streptococci infection could be detected. One reason for this lack of efficacy may have been the regimen of reduced frequency of varnish applications after the initial period. Children who followed the protocol and, therefore, were seen regularly by dental auxiliaries had a lower caries increment than those who did not. This finding was independent of varnish allocation. In summary, under this regimen, Chlorzoin has been found to be effective in decreasing salivary mutans streptococci but ineffective as a caries-preventive agent in high-risk Scottish children when applied pragmatically in a community setting.
Adolescent↗
Fluoride - is it capable of fighting old and new dental diseases? An overview of existing fluoride compounds and their clinical applications.
Since researchers first became aware of the anticaries action of fluoride, they have been investigating the effect of this preventive agent in inhibiting or arresting caries development. Many forms of systemic or topical fluoride have been studied and tested for clinical application. Water, salt, milk fluoridation and the use of fluoride supplements were introduced for systemic fluoridation mainly using sodium fluoride. Solutions, gels, toothpastes and rinses of sodium fluoride, stannous fluoride, amine fluorides, acidulated phosphate fluoride and monofluorophosphate were used for topical fluoridation. More recently nonaqueous fluoride varnishes in an alcoholic solution of natural resins and difluorosilane agents in a polyurethane matrix were introduced. Although all of these fluoridation methods have a caries-preventive action, these benefits and the ease of application is variable. As fluoride is a key component of oral health promotion a coordinated approach on a community and individual basis seems to be needed to maximize the cost-benefit ratio of prevention.
Animals↗
Caries-preventive effects of fluoride products when used in conjunction with fluoride dentifrice.
Toothbrushing with fluoride dentifrice has become an important public health measure in preventing caries and gingivitis. Since the fluoride concentration in dentifrices does not provide absolute protection for everyone and is limited by legal regulations, the question about the efficacy of additional use of topical fluoride products arises. In children aged 9-15 years, the biannual application of Duraphat varnish in school-based programmes provides a caries inhibition of 38%. A caries inhibition of up to 40% can also be achieved by gels containing 1.25% fluoride, if applied 30 times per year. In subjects with a risk of root caries, the daily use of a 250-500 ppm fluoride solution seems to be advisable.
Adolescent↗
The future of preventive programs in countries with different systems for dental care.
From 1990 onward the decline of caries has leveled off in economically developed countries and the effectiveness of preventive programs seems to have diminished. The aim of this paper is to consider the future of caries prevention in the light of the studies conducted during the past decade. A shift from population-based prevention to a high-risk strategy has been promoted in countries where caries is strongly polarized. In Finland, however, an intensive preventive program targeted to high-risk individuals had little effect on caries increment, which suggests that the utility of a high-risk strategy is questionable. The relative effects of population-based methods have also decreased during the last decades. Although discontinuation of water fluoridation had no effect on caries in Kuopio, Finland, water fluoridation is still effective in countries with a lower level of basic prevention and a less homogenous social structure. From the standpoint of cost-effectiveness, the use of professionally applied fluoride gels has been questioned in children with a low caries rate, and the same is probably true for fluoride varnishes. In countries with a high caries rate, a low level of basic prevention, and an unorganized dental care system any preventive program seems to be effective. The importance of fluoride toothpastes as a cost-effective and feasible method of fluoride delivery is indisputable and will be so in all countries irrespective of the caries level and dental care systems. Population-based dental health education continues to be important, also in the countries where the caries rate has so far been low.
Adolescent↗
Lack of effect of chlorhexidine varnish on Streptococcus mutans transmission and caries in mothers and children.
In a randomized clinical trial, we evaluated the effect of a 10% chlorhexidine varnish (Chlorzoin) on the mother-child transmission of Streptococcus mutans and on subsequent caries experience. Chlorhexidine (n = 38) or a placebo varnish (n = 37) was applied to the dentitions of 75 mothers at a time when their first babies were about 6 months old (approximate time of first tooth emergence). Three more applications at weekly intervals and subsequent applications at 6-month intervals followed the initial application. The mother-child pairs were followed up until the child's fourth birthday. Maternal salivary S. mutans levels in the treatment group remained significantly lower (p < 0.05) compared to the control group up to 12 months after the initial application. However, this intervention did not significantly alter the S. mutans colonization in children or the caries increment in either the mother or the child.
Adolescent↗
Effect of single and repeated application of chlorhexidine varnish on mutans streptococci in plaque from fissures of premolar and molar teeth.
The aim of this study was to determine the effects of one and two applications of 40% chlorhexidine varnish on the numbers of mutants streptococci in human dental fissure plaques from molar and premolar teeth. Twenty-nine subjects (aged 20-30 years) participated in the study and were randomly assigned to one of three groups. In each subject two fissures with high levels of mutants streptococci were selected. The fissures in group 1 (control group) were treated with placebo varnish containing no chlorhexidine. Fissures in group 2 received a single application of 40% chlorhexidine varnish, whereas fissures in group 3 received an additional chlorhexidine varnish application 1 week after the first application. Fissure plaque samples were taken prior to the first application of chlorhexidine varnish and subsequently 1, 2, and 4 months thereafter. Compared with the fissures in the control group, the suppression of mutans streptococci was significant in plaques from group 2 for up to 2 months and in plaques from group 3 for up to 4 months after application. Mutans streptococci were suppressed more strongly in premolar than in molar teeth and more strongly and for a longer period of time in fissures of premolar teeth treated twice than in fissures of premolars treated once.
Adolescent↗