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Fluoride mouthrinses and fluoride varnishes.

The cariostatic efficacy of rinsing with a 0.05-0.2% neutral sodium fluoride solution has been clearly demonstrated, especially in supervised school-based programmes in moderate and high caries risk children. The cost-benefit effect, however, is questionable in populations with low caries prevalence, and fluoride rinsing programmes are gradually being replaced by more individual fluoride therapy comprising combinations of fluoride toothpastes, tablets, or varnishes. Fluoride varnishes were developed as individual alternatives to conventional topical fluoride application and are today gaining acceptance for clinical application. Two varnishes, Duraphat containing 5% wt NaF and Fluor Protector with 0.9% wt fluor silane, are available commercially. The clinical effects seem to depend mainly on application frequency, especially in high caries risk groups. The cost-benefit effect is high, but can be increased by delegating application to auxiliary personnel in conjunction with regular dental visits. Toxicologically both fluoride mouthrinses and fluoride varnishes are safe if used as directed.

Child↗

Effect of chlorhexidine-containing varnish (Cervitec) on microbial vitality and accumulation of supragingival dental plaque in humans.

The effect on local plaque formation of a varnish containing 1% chlorhexidine and 1% thymol (Cervitec) was evaluated. Ten volunteers with clinically healthy oral conditions were asked to refrain from any kind of oral hygiene measures for three periods of three days. Undisturbed plaque formation was recorded during the first experimental period. At the beginning of the second period, the varnish was applied to six vestibular enamel surfaces and removed after 1 h. The third experimental period was initiated 12 weeks after varnish application to assess a potential long-term effect. During each period of plaque formation, samples were collected from the vestibular surfaces after 24 h (from teeth 15/25), after 48 h (from teeth 14/24) and after 72 h (from teeth 13/23), respectively, and evaluated for total microscopic bacterial counts (BC) and colony forming units (CFU). Microbial vitality was assessed by the plating efficiency [PE = (CFU/BC) x 100] and directly by a vital fluorescence (VF) technique. VF of 48- and 72-hour plaque was significantly reduced after Cervitec application. An inhibitory effect by Cervitec could not be discerned 12 weeks after varnish treatment.

Adult↗

Effect of an antibacterial varnish on mutans streptococci in plaque from enamel adjacent to orthodontic appliances.

The effect of an antibacterial varnish (Cervitec) on the levels of mutans streptococci in plaque adjacent to bonded orthodontic brackets was evaluated in 18 children using a split-mouth technique with a placebo varnish control. The test varnish contained 1% chlorhexidine and 1% thymol as active ingredients. Both varnishes were applied on four occasions during a 3-month period, and plaque was subsequently collected between 1 week and 6 months after the onset of treatment. All teeth involved in the study were carefully examined and clinically assessed for enamel demineralization prior to onset of the fixed appliances and immediately after debonding. The results showed a more frequent growth of mutans streptococci in the dental plaque collected from placebo-treated quadrants as compared with the test quadrants on all sampling occasions. The proportion of mutans streptococci within the plaque microflora was significantly (p < 0.05-0.01) lower on the test sides than on the opposite sides at the 1-week and 1-month examinations. The incidence of incipient enamel lesions around the brackets and along the gingival margin was generally low, and no differences were found between the test and placebo varnish treated quandrants at the time of debonding. The results suggest that mutans streptococci in plaque from orthodontic patients can be suppressed effectively by topical applications of an antibacterial varnish.

Adolescent↗

Microleakage of three cement bases.

The purpose of this study was to evaluate the ability of a glass-ionomer cement-base material to prevent bacterial penetration along the dentin interface and to compare it with two conventional cement-base materials. A total of 107 Class 5 restorations was placed in Rhesus monkey teeth by means of three test materials [zinc oxide-eugenol (ZOE), copalite varnish + zinc phosphate cement base (V + ZP), and a glass-ionomer lining cement (GI)], with unetched and unbonded resin composite used alone as a control material and as a final restoration over the test base materials. Following disinfection, Class 5 cavities were prepared on the buccal surfaces of the teeth to the inner one-half of dentin. A sterile filter-paper disk was then placed on the axial wall and covered with a Teflon disk. Next, the cavities were based to the dento-enamel junction with one of the test base materials and finally restored with unetched and unbonded resin composite. After five and 16 weeks, the filter-paper disks were retrieved and cultivated for the presence and type of bacteria. The five-week results showed positive growth in two groups: the composite-only controls and the V + ZP group. The 16-week results showed growth in all of the test groups, but only one of nine teeth showed growth in the zinc oxide-eugenol group and one of 16 teeth in the glass-ionomer group. The results of this study indicate that under the conditions tested, a glass-ionomer base was capable of minimizing bacterial penetration along the material-tooth interface.

Animals↗

Effects of chlorhexidine-containing gel and varnish on abutment teeth in patients with overdentures.

Previous experiments have shown that daily use of 1% chlorhexidine gel strongly reduced caries development in the abutment teeth under overdentures. The present experiment was designed to determine whether intermittent application of chlorhexidine, either in a varnish or in a gel, might be used as an alternative preventive method, less demanding for the patient. To this end, 31 patients were distributed among four treatment groups, with the number of mutans streptococci in plaque and saliva used as a balancing criterion. The treatments consisted of a single application of 40% chlorhexidine varnish, daily application of 1% chlorhexidine gel for one week, or the corresponding placebo treatments with varnish or gel without chlorhexidine. Patients were re-called for bacteriological and clinical examination at various intervals during an eight-week period following treatment. Chlorhexidine varnish and chlorhexidine gel applications significantly suppressed mutans streptococci on the abutment teeth for four and eight weeks, respectively. In agreement with earlier findings, the numbers of Actinomyces viscosus/naeslundii in plaque were significantly increased after chlorhexidine varnish treatment. The chlorhexidine gel reduced plaque accumulation and gingival bleeding for one week but had no long-lasting effect. The results seem to justify a long-term clinical test of intermittent chlorhexidine applications as an alternative for daily use in patients with overdentures.

Analysis of Variance↗

Researching occupational mortality. The problem of comparison.

In a number of countries, studies on occupational mortality have proved to be a useful epidemiological tool for the surveillance of on-the-job health risks. In Scandinavia, studies of this type are facilitated by record linkages made possible by the personal identity number. Health selection of occupational groups makes the problem of comparison one of critical interest in analytical epidemiology of occupational mortality and morbidity. Three generally applied principles in choosing control groups are discussed. Uses of random samples of the whole population will most likely yield under- or overestimates of the true risk of the occupation. It is recommended that comparison groups be introduced from other occupations or from the same occupation if possible making the groups similar with respect to socio-economic factors and especially health selection.

Adult↗

Reduction of postoperative pain: a double-blind, randomized clinical trial.

The authors investigated the capability of two commonly used basing techniques to reduce postoperative sensitivity. The authors measured the time it took the subjects to respond to a standardized stimulus of cold water (cold response measure, or CRM) at baseline and one week after treatment. The authors found no significant reduction in the mean CRM for the group receiving Amalgambond Plus (Parkell), but they did find a significant decrease in the mean CRM for the group receiving Copalite (Harry J. Bosworth Co.) with or without Vitrebond (3M). The authors concluded that the subjects in the Amalgambond Plus group experienced no more sensitivity to cold at one week postoperative than they did at baseline, while the subjects in the Copalite/Vitrebond group did.

Adolescent↗

Assessing the effect of fluoride varnish on early enamel carious lesions in the primary dentition.

BACKGROUND: The aim of this study was to evaluate the effect of fluoride varnish on enamel caries progression in the primary dentition. METHODS: One hundred forty-two children in Head Start schools (3 to 5 years old) were randomized into the varnish and control groups. Children in the varnish group received fluoride varnish (Duraphat, Colgate-Palmolive Co.) at baseline and after four months, and children in the control group received no professional fluoride applications. Two calibrated examiners performed the examinations at baseline and at nine months. RESULTS: At nine months, the authors found that in the control group, 37.8 percent of active enamel lesions on occlusal, buccal and lingual surfaces became inactive, 3.6 percent progressed and 36.9 percent did not change. In the varnish group, 81.2 percent became inactive, 2.4 percent progressed and 8.2 percent did not change. The difference between the groups was statistically significant (P < .0001). The mean decayed surfaces, or ds, value in the varnish group was significantly lower after nine months than it was at baseline (P < .0001). When enamel lesions were included in the data analysis (along with dentinal lesions), the decayed with initial enamel lesions, missing and filled surfaces, or dEmfs, values; decayed with initial enamel lesions, missing and filled teeth, or dEmft, values; and decayed surfaces with initial enamel lesions, or dEs, values were significantly lower in the varnish group after nine months than they were at baseline (P < .0001). CONCLUSIONS: These results suggest that fluoride varnish applications may be an effective measure in reversing active pit-and-fissure enamel lesions in the primary dentition. CLINICAL IMPLICATIONS: Fluoride varnishes are safe, easy to apply and well-accepted by patients. This study shows that fluoride varnish may offer an efficient, nonsurgical alternative for the treatment of decay in children.

Child, Preschool↗

Prevalence survey of inhalant abuse.

Although there is a paucity of hard epidemiologic data on the prevalence of inhalant abuse, there is considerable anecdotal evidence that such abuse is continuing. Recently, we received repeated reports that one particularly public housing project in Atlanta had high rates of inhalant abuse, and to assess the prevalence of such abuse in children 4 to 20 years old, we conducted a random household survey in 400 of the project's 1,140 units. In an attempt to get complete and reliable data, wer chose and trained 10 residents as interviewers. Fifty youngsters were identified as ever having used inhalants, representing a sample prevalence of approximately 4%. The typical sniffer was a male, age 15, in the 9th grade or currently out of school. Some sniffers, though, continued to use inhalants into the 20s. Not unexpectedly, sniffers were found to use alcohol and other drugs at greater rates than other children. Although the parents of sniffers often said that they recognized drug-related problems in their children, the seldom sought help. Nevertheless, most residents felt that a drug-counseling program should be established in the project to provide alternative recreational activities.

Adolescent↗

Effect of resin coating as a means of preventing marginal leakage beneath full cast crowns.

The purpose of this study was to evaluate the effectiveness of resin coating as a means of preventing marginal leakage beneath full cast crowns which were emplaced using different cements. Standard full cast crown preparation was made on 64 extracted premolars. These samples were then divided into four groups, with half of each group coated with dentin coating material after preparation. Crowns were cemented onto the teeth using zinc cement, Fuji I, Vitremer, or C&B Metabond. The samples were thermal-cycled for 10,000 cycles. They were then immersed in erythrosine solution, sectioned, and observed under a microscope. Microleakage analyses were performed using a 0-4 point system. The data were statistically analyzed. There were significant differences between the coated specimens and the uncoated specimens using Fuji I and Vitremer. The results showed that a resin coating could decrease the amount of marginal leakage when applied with these two cements.

Bicuspid↗

Surface conditions and viscoelastic properties of the denture liner Permaflex.

This in vitro study evaluated the viscoelastic properties of Permaflex compared to other soft lining materials. The surface condition of this material was also investigated under both laboratory and simulated clinical conditions and with and without the application of a varnish. The tests provided practical instructions for the use of Permaflex, which showed good adaptive properties to stress and surface condition initially and after adjustment.

Chemical Phenomena↗

Neutron activation analysis of fluoride release after treatment with a fluoride varnish in vitro.

OBJECTIVE: To use neutron activation analysis to study a new type of cariostatic material, fluoride varnish, in terms of its anti-caries mechanism and its release in vitro. MATERIALS AND METHODS: Twenty enamel specimens were measured for baseline fluoride content using neutron activation analysis. The enamel specimens were then fluoridated with 1.5% sodium fluoride varnish for 24 hours, and their enamel fluoride content was measured again with neutron activation analysis. RESULTS: The baseline fluoride content in the enamel specimens was 161.7 micrograms/g; after fluoridation, the fluoride content in the enamel specimens increased to 277.8 micrograms/g, or about 1.7 times. CONCLUSION: It is evident that this sodium fluoride varnish can significantly increase enamel fluoride content. The neutron activation analysis is a good method for fluoride measurement in vitro.

Cariostatic Agents↗