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PubMedDate not supplied

The effect of a dentifrice containing soluble pyrophosphate and a copolymer on calculus deposit: a six-month clinical study.

A six-month, double blind, cross over clinical study was conducted to compare the effect of a commercially available anticalculus dentifrice and a placebo dentifrice on supragingival calculus deposits. Fifty adult subjects who entered the study were given an oral prophylaxis and were assigned to use either pyrophosphate/copolymer toothpaste or a placebo toothpaste for a period of three months. They were then scored for calculus deposits using the Volpe-Manhold method, received a second oral prophylaxis and used the alternate dentifrice for a second three month period of time. The subjects were again scored for calculus deposits and the study was completed. The results indicated that pyrophosphate/copolymer toothpaste reduced supragingival calculus formation by 37.07%, as compared to the placebo dentifrice. This reduction was significant at the 99% level of confidence.

Adult↗

PubMed1978

[The periodontally prophylactic effect of the dentifrice "Silka". 1. The effect of the dentifrice "Silka" on the periodontium compared to other dentifrices from the DDR production].

As compared to a toothpaste without periodontal-prophylactic adjuncts, the commercially available silka toothpaste exerted a statistically significant beneficial effect on the chronically inflamed gingivae. Thus, a periodontal-prophylactic efficiency may be attributed to the Silka toothpaste.

Benzyl Compounds↗

PubMed1986

Changing patterns of dental caries: a survey of 20 countries.

Data on oral health, sugar consumption, fluoride availability and other preventive programmes from twenty selected developed and developing countries were reviewed to identify the changes in oral health in children and causes associated with these changes during the past 20 years. Nine developed (industrialized) countries showed apparent substantial reduction (30-50 per cent) in the prevalence of dental caries in 5 and 12 year old children during the past decade. The countries are: Australia, Denmark, Finland, Netherlands, New Zealand, Norway, Sweden, United Kingdom and the USA. Caries in Thailand and Nigeria and other developing countries appear to have increased considerably. The most probable reasons for the decrease in dental caries in children in the developed countries were considered to be associated with: the widespread exposure to fluoridated water, fluoride supplements, especially the regular use of fluoridated toothpaste; the provision of preventive oral health services; the increased dental awareness through organised health education programmes; the ready availability of dental resources. The factor common to all countries with a substantial reduction in caries was fluoride, either as fluoridated water or toothpaste. Countries with decreased caries but no fluoridated water supplies all had experienced a rapid increase in the availability and the use of fluoridated toothpaste during the past 10 years. The contribution of improved dental health programmes, other than those involving fluoride, could not be adequately assessed. These changes, which appear to be continuing, have relevance also to similar countries which might just be entering the reduction phase, or for which that phase may already have begun, though it is as yet unnoticed and unreported. They also have relevance to developing countries in indicating how caries and perhaps periodontal disease have been controlled and prevented. It is inevitable that in developed countries with reducing dental caries there will be a decreased need for dental services and hence a change in the need for dental personnel. However, the lack of adequate data in most countries makes prediction of future changes in oral health and manpower needs a precarious procedure. The whole review indicates the urgent need for regular monitoring of oral health status in all countries and for better personnel planning and production.

Child↗

PubMed1985

Changing patterns of oral health and implications for oral health manpower: Part I. Report of a Working Group convened jointly by the Fédération Dentaire Internationale and the World Health Organisation.

Data on oral health, sugar consumption, fluoride availability and other preventive programmes from twenty selected developed and developing countries were reviewed to identify the changes in oral health in children and factors associated with these changes during the past 20 years. Nine developed (industrialized) countries showed apparent substantial reduction (30-50 per cent) in the prevalence of dental caries in 5- and 12-year-old children during the past decade. The countries are: Australia, Denmark, Finland, Netherlands, New Zealand, Norway, Sweden, United Kingdom and the USA. Caries in Thailand and Nigeria and other developing countries appears to have increased considerably. The most probable reasons for the decrease in dental caries in children in the developed countries were considered to be associated with: the widespread exposure to fluoridated water and/or fluoride supplements, especially the regular use of fluoride toothpaste; the provision of preventive oral health services; the increased 'dental awareness' through organized oral health education programmes; the ready availability of dental resources. The factor common to all countries with a substantial reduction in caries was fluoride, either as fluoridated water or toothpaste. Countries with decreased caries but no fluoridated water supplies had all experienced a rapid increase in the availability and the use of fluoride toothpaste during the past 10 years. The contribution of improved dental health programmes, other than those involving fluoride, could not be adequately assessed. These changes, which appear to be continuing, have relevance also to similar countries which might just be entering the reduction phase, or for which that phase may already have begun, though it is as yet unnoticed and unreported. They also have relevance to developing countries in indicating how caries and perhaps periodontal diseases have been controlled and prevented. It is inevitable that in developed countries with reducing dental caries there will be a decreased need for dental services and hence a change in the need for dental personnel. However, the lack of adequate data in most countries makes prediction of future changes in oral health and manpower needs a precarious procedure. The whole review indicates the urgent need for regular monitoring of oral health status in all countries and for better personnel planning and production in quantity and appropriate categories. Part II of this report will deal with a recommended process for achieving these urgent needs.

Adolescent↗

PubMed1993

In vivo studies with a dicalcium phosphate dihydrate/MFP system for caries prevention.

Recent basic studies have shown that increasing supersaturation with respect to dicalcium phosphate dihydrate (DCPD), above and beyond the amount present in saliva, enhanced the efficacy of fluoride in vitro. Since the combination of monofluorophosphate (MFP) with DCPD abrasive is unique for fluoride stability, dentifrices containing the combination were evaluated in a variety of in vivo tests. MFP with silicon dioxide (silica) abrasive at an equivalent fluoride concentration was used for comparison. The influence of slurries of DCPD or silicon dioxide on the intraoral plaque pH was measured following sucrose challenge in humans. The data indicated that DCPD slurries were more effective than silica in preventing plaque pH drop when compared to silica. A toothpaste containing MFP and DCPD was significantly more effective than an MFP/silica toothpaste. A toothpaste containing radiolabeled DCPD was applied topically in rats' teeth during a cariogenic challenge. The results showed that calcium45 was incorporated into the enamel with a concomitant reduction in enamel solubility. In a rat caries study using MFP/DCPD, matching placebo and MFP/silica, MFP/DCPD dentifrice showed a significantly greater reduction in smooth surface caries. Two dentifrices were also tested in an in situ human model for fluoride uptake in artificial root caries lesions where MFP/DCPD provided a significantly higher fluoride uptake than MFP/silica. A second in situ study in humans evaluated the same dentifrices. MFP/DCPD increased salivary plaque calcium and fluoride. These results of laboratory, animal and in situ studies taken together indicate that the MFP/DCPD combination is unique in providing extra supersaturation in saliva and plaque with concomitant enhanced anticaries efficacy.

Animals↗

PubMed1992

Localized formation of micronuclei in the oral mucosa and tobacco-specific nitrosamines in the saliva of "reverse" smokers, Khaini-tobacco chewers and gudakhu users.

"Reverse"-cigar smokers (who hold the burning end of cigars within the mouth), dippers (who place a mixture of Khaini-tobacco and slaked lime into the lower gingival groove) and users of tobacco-containing toothpaste (gudakhu) in Orissa, India, were examined for precancerous oral lesions, the frequency of micronucleated cells at 3 different intra-oral sites, and levels of tobacco-specific nitrosamines (TSNA) in the saliva. Among reverse-cigar smokers, a high incidence of leukokeratosis nicotina palati, an elevated frequency of micronucleated cells in the palate (2.5% as compared to 0.6% in non-smokers and non-chewers of tobacco) and tongue (2.1%) from which carcinomas preferentially develop, and up to 5890 ppb nitrosonornicotine and up to 1880 ppb N-nitrosoanatabine in the saliva were found. Among Khaini-tobacco chewers, the frequency of micronucleated cells was elevated to 2.1% in the gingival groove, and up to 1580 ng N-nitrosonornicotine, 690 ng N-nitrosoanatabine, 90 ng N-nitrosoanabasine, and 180 ng 4-(methyl-N-nitrosamino)-1-(3-pyridyl)-1-butanone) per ml of saliva were observed. The localized elevation of the frequency of micronuclei and cancer development is probably due to a synergistic effect of hyperthermia and tobacco-related carcinogens among reverse-cigar smokers, and to the close, prolonged contact between the mucosa and tobacco among Khaini-tobacco/slaked lime dippers. Neither pre-cancerous lesions nor an elevated frequency of micronuclei were seen in the oral mucosa of users of gudakhu, a tobacco-containing toothpaste, which may be due to the low amount of TSNA released from the gudakhu and the short exposure time, which is restricted to the period of tooth brushing.

Adult↗

PubMed1999

Viadent usage and oral leukoplakia: a spurious association.

Oral rinse and toothpaste products (Viadent) containing Sanguinaria extract have been shown through extensive clinical trials to be effective against plaque build-up and gingivitis. To establish safety, a comprehensive research program was conducted, including a series of clinical studies and a number of animal studies to evaluate acute, subchronic, and chronic toxicity, and the potential for irritation of mucosal tissues. In 1990 and 1993, an Expert Panel reported on reviews of these data and concluded that Viadent products are safe for their intended use. Despite the large database of information to support the safety of Viadent products, Damm et al. (1999) recently raised the possibility that their usage may be causally associated with development of oral leukoplakia. However, a critique of this recent report shows that it does not fulfil criteria for establishing causation. In particular, the study does not show that exposure to Viadent preceded the onset of leukoplakia, it does not demonstrate dose-response or biological plausibility, and it suffers from selection and information bias and from potential confounding. Furthermore, upon critical evaluation, the Damm et al. (1999) report on a case-series is inconsistent with the weight of available clinical evidence showing that Sanguinaria extract-containing oral health care products cause no cytotoxic or significant irritant effects in the oral mucosa in human studies of up to 6 months duration. The animal data similarly do not support a causal association between Viadent usage and oral leukoplakia in humans. These data demonstrate that Sanguinaria extract and whole Viadent formulations are without significant irritation potential and have no effects on the oral mucosa, even in studies with life-long dietary exposure to Sanguinaria extract. The mutagenicity and genotoxicity data do not indicate that Sanguinaria extract or its components are genotoxic in vivo. The results of 2 GLP-compliant rat oncogenicity studies provide no evidence of any carcinogenic effect of Sanguinaria extract. In conclusion, the available clinical and animal data provide no support for and in fact argue strongly against the hypothesis that the use of Viadent toothpaste and/or oral rinse products may be causally associated with the development of leukoplakia in humans.

Alkaloids↗

PubMed1992

Benefits and risks of fluoride supplementation: caries prevention versus dental fluorosis.

To assess the risks (dental fluorosis) and the benefits (caries prevention) of fluoride (F) tablets and F toothpaste, we surveyed 2003 schoolchildren aged 5-20 years old (mean = 10.82, SD = 3.40). Children were scored for dental caries by means of the decayed, missing, filled teeth index (DMFT index). Frequent use of F toothpaste (toothbrushing frequency) is poorly linked to caries (Spearman r = 0.05, P = 0.02) and dental fluorosis (r = 0.05, P = 0.03). Children who use F tablets regularly and appropriately exhibit mild fluorosis more often than non- or occasional users (odds ratio = 9.58), and have a mean DMFT index 50% lower than other children. We conclude that using F tablets is an effective means of preventing caries. When used appropriately in non fluoridated areas, using F tablets results in minor damage.

Adolescent↗

PubMed1986

Superficial fluoride levels and response to in-vitro caries-like lesion induction of enamel from Bristol (U.K.) and Birmingham (U.K.) human deciduous teeth.

Surface enamel fluoride levels were measured in deciduous canine teeth from Bristol, with non-fluoridated water supplies, and Birmingham, with fluoridated water supplies. Three populations studied were from Bristol (teeth shed before 1960), Bristol (after 1975) and Birmingham (after 1975). Up to 75 micron from the enamel surface, fluoride concentrations of post-1975 Bristol and Birmingham teeth were, respectively, X 1.3 and 3.4 greater than those of pre-1960 Bristol teeth. The increase in the Bristol teeth is presumably due mainly to the increased use of fluoride-containing toothpastes, that in Birmingham to fluoridated water plus the use of fluoride toothpastes. No difference in the rates of penetration into enamel of acid-gel induced, caries-like lesions were found between the two Bristol populations; Birmingham teeth showed a reduction of 10 per cent in penetration rate. It is suggested that raised fluoride levels in surface enamel do not reduce solubility sufficiently to account, by themselves, for the recent nationwide marked reduction in caries in children. Possibly, the raising of plaque fluoride levels is a more important factor, affecting demineralization, remineralization and bacterial activity.

Acid Etching, Dental↗

PubMed1994

Aetiological, predisposing and environmental factors in dentine hypersensitivity.

If the hydrodynamic theory of stimulus transmission across dentine is valid, sensitive dentine has tubules open at the surface and patent to the pulp. Direct and indirect evidence supports this supposition. Factors that result in dentine exposure remove the covering enamel or periodontal tissues (gingival recession). Epidemiological and clinical data for the distribution of exposed cervical dentine indicate that chronic trauma from physical and chemical factors is the most significant aetiological factor. Brushing with a toothpaste may not open dentinal tubules. It is more likely that toothpaste ingredients, when brushed on dentine, would create a smear layer. Exposure of tubules by erosion is probably the major initiator of sensitivity. An increase in our understanding of the aetiological factors involved in dentine hypersensitivity is essential if a sound approach to its management is to evolve. Such information could emanate from epidemiological studies, clinical investigations and laboratory experiments.

Beverages↗

PubMed2004

Quantitative analysis of the impact of the organic matrix on the fluoride effect on erosion progression in human dentine using longitudinal microradiography.

After an initial demineralisation, an intensive fluoridation is capable of inhibiting the erosive mineral loss in dentine completely, which might be related to the presence of the exposed organic dentine matrix. Aim of the present study was, therefore, to evaluate whether fluoride is also effective when the organic material is removed. The study was a cyclic de- and remineralisation model over 5 days in vitro. Samples from human coronal dentine were demineralised with citric acid (pH 2.3; 6 x 10 min per day) and intermittently stored in a remineralisation solution. Groups (n = 25 each) were defined as follows: Group 1: erosion only, no fluoridation; Group 2: erosion, alternately fluoridation with toothpaste (NaF; 0.15% F-; 3 x 5 min per day), mouthrinse (Olaflur/SnF2; 0.025 F-; 3 x 5 min per day) and gel (Olaflur/NaF; 1.25% F-; at Days 1 and 3 instead of one toothpaste application); Group 3: erosion and fluoridation as Group 2, organic material was continuously removed with collagenase (from Clostridium Histolyticum type VII, 100 U/ml) added to the remineralisation solution. Mineral content was monitored daily using longitudinal microradiogaphy. After fluoridation in the presence of collagenase, a linear increase in mineral loss (73.3 +/- 17.6 microm at Day 5) was observed, which significantly (P < or = 0.001) exceeded that of the control group (45.9 +/- 14.3 microm at Day 5). After fluoridation in the absence of collagenase, mineral loss ceased after the 2nd day (12.2 +/- 10.2 microm at Day 5) and was significantly lower compared to Groups 1 and 3 (P < or = 0.001). The results indicate that the dentine matrix is essential for the effectiveness of fluoride in dental erosion.

Cariostatic Agents↗

PubMed2006

Determination of glycerophosphate and other anions in dentifrices by ion chromatography.

Simple, reliable and sensitive analytical methods to determine the anions, such as fluoride, monofluorophaosphate, glycerophosphate related to anticaries are necessary for basic investigations of anticaries and quality control of dentifrices. A method for the simultaneous determination of organic acids, organic anions and inorganic anions in the sample of commercial toothpaste is proposed. Nine anions (fluoride, chloride, nitrite, nitrate, sulfate, phosphate, monofluorophaosphate, glycerophosphate and oxalic acid) were analyzed by means of ion chromatography using a gradient elution with KOH as mobile phase, IonPac AS18 as the separation column and suppressed conductivity detection. Optimized analytical conditions were further validated in terms of accuracy, precision and total uncertainty and the results showed the reliability of the IC method. The relative standard deviations (RSD) of the retention time and peak area of all species were less than 0.170 and 1.800%, respectively. The correlation coefficients for target analytes ranged from 0.9985 to 0.9996. The detection limit (signal to noise ratio of 3:1) of this method was at low ppb level (<15 ppb). The spiked recoveries for the anions were 96-103%. The method was applied to toothpaste without interferences.

Anions↗

PubMed2005

Effect of toothbrushing on titanium surface: an approach to understanding surface properties of brushed titanium.

OBJECTIVES: This in vitro study aimed to characterize the surface morphology and composition of tooth-brushed titanium casting and thereby to elucidate interactions between the metal and abrasive material in dentifrice. METHODS: Specimens were cast from CP Ti ingots and then mirror-finished. Two fluoride-free toothpastes containing crystalline CaHPO4.2H2O and amorphous SiO2 particles as abrasive were slurried with distilled water (15 g/30 mL). While toothbrushes were reciprocated at 120 strokes/min for 350,400 strokes, the specimens were brushed with the respective slurries under a load of 2.45 N. The brushed and non-brushed surfaces were characterized by means of SPM, EPMA, and XPS. SPM data were analyzed using one-way ANOVA, followed by post hoc Tukey test (p<0.01). RESULTS: Irrespective of toothpastes, toothbrushing had a significant influence on surface roughness. The CaHPO4.2H2O-containing paste produced much rougher surface than the SiO2-containing paste. Both the surfaces were chemically altered due to reactions with the respective abrasive materials. Abrading chips had dimensions of micron to submicron order. A number of chips were attached to abrasive particles. SIGNIFICANCE: The alterations of surface morphology and composition may affect biological responses of titanium in the oral environment. Dentifrice with lower abrasivity might be advisable for daily oral hygiene practice of patients with dental titanium devices.

Calcium Phosphates↗

PubMed2006

Variation in surface topography of different NiTi orthodontic archwires in various commercial fluoride-containing environments.

OBJECTIVES: The surface topography can affect the friction behavior between an orthodontic wire and brackets during clinical applications. The purpose of this study was to investigate the influence of a fluoride-containing environment on the surface topography variations of different nickel-titanium (NiTi) orthodontic archwires. METHODS: Four different NiTi commercial orthodontic archwires were immersed in fluoride mouthwashes and in artificial saliva with the addition of commercial fluoride toothpastes or prophylactic gels for a 28-day period. Atomic force microscopy (AFM) was used to measure the three-dimensional surface topography of NiTi archwires before and after the immersion tests. Two-way analysis of variance (ANOVA) was used to analyze the surface roughness variance (including DeltaR(a), DeltaR(ms), and DeltaR(z)) with the archwire manufacturer and immersion test environment as the factors. RESULTS: Both the archwire manufacturer and immersion environment had a significant influence on DeltaR(a), DeltaR(ms), and DeltaR(z) (manufacturer: P<0.05; environment: P<0.0001). Regardless of the archwire manufacturer, no statistically significant difference in DeltaR(a) (<70 nm), DeltaR(ms) (<90 nm), and DeltaR(z) (<450 nm) was observed on the tested NiTi archwires in lower fluoride-containing (<2500 ppm) environments, including the various fluoride mouthwashes and the artificial saliva added with fluoride toothpastes. In artificial saliva added with high fluoride prophylactic gel (around 17,000 ppm), a significant increase in DeltaR(a) (around 120-250 nm), DeltaR(ms) (around 140-320 nm), and DeltaR(z) (around 770-1410 nm), i.e. increasing the surface roughness, was observed on the tested NiTi archwires. SIGNIFICANCE: The variation in the surface topography of the NiTi orthodontic archwires in the commercial fluoride-containing environments should be taken into consideration when the friction between the archwire and bracket is a clinical concern.

Acidulated Phosphate Fluoride↗

PubMed2004

The measurement of degradation and wear of three glass ionomers following peroxide bleaching.

OBJECTIVES: To investigate, for three glass ionomer dental materials, the effects of a hydrogen peroxide solution on the elution of key elements, and the effects of a novel 6% hydrogen peroxide tooth whitening gel on subsequent wear rates with a toothpaste slurry. METHODS: Discs specimens of three glass ionomers (ChemFlex, Fuji II and Ketac-Fil) were prepared. One set of discs was exposed to either 6% hydrogen peroxide in phosphate buffer, phosphate buffer, water, a carbonated beverage or 38% orthophosphoric acid for 60 min. The ions eluted from the discs were determined by inductively coupled plasma-optical emmision spectroscopy. A second set of discs were conditioned with either a 6% hydrogen peroxide gel (30 min), water (30 min), a carbonated beverage (2 min) or 38% orthophosphoric acid gel (2 min) followed by a three-body abrasive wear treatment (2 min) with a toothpaste slurry. Changes in height of the samples were measured with a digital comparitor. The conditioning and abrasive cycles were repeated thirteen times. RESULTS: For the elution study, the solutions gave only minor release of sodium except orthophosphoric acid which showed increased elution levels of aluminium, silicon and sodium ions. For the wear study, the orthophosphoric acid gave the highest level of wear whilst for the other treatments there were no statistical significant differences in the level of wear (one-way ANOVA). CONCLUSIONS: A 6% hydrogen peroxide solution did not cause significant dissolution, and a novel 6% hydrogen peroxide tooth whitening gel did not significantly increase the three-body wear rate of any of the materials tested.

Aluminum↗

PubMed2001

The use of QLF to quantify in vitro whitening in a product testing model.

BACKGROUND: Professional and consumer interest in whitening products continues to increase against a background of both increased oral health awareness and demand for cosmetic procedures. In the current legal climate, few dentists are providing 'in-office' whitening treatments, and thus many patients turn to home-use products. The most common of these are the whitening toothpastes. Researchers are keen to quantify the effectiveness of such products through clinically relevant trials. AIM: Previous studies examining whitening products have employed a variety of stained substrates to monitor stain removal. This study aimed to quantify the removal of stain from human enamel using a new device, quantitative light-induced fluorescence (QLF). The experimental design follows that of a product-testing model. MATERIALS AND METHODS: A total of 11 previously extracted molar teeth were coated with transparent nail varnish leaving an exposed window of enamel. The sound, exposed enamel was subject to a staining regime of human saliva, chlorhexidine and tea. Each of the eleven teeth was subjected to serial exposures of a positive control (Bocasan), a negative control (water) and a test product (Yotuel toothpaste). Following each two-minute exposure QLF images of the teeth were taken (a total of 5 applications). Following completion of one test solution, the teeth were cleaned, re-stained and the procedure repeated with the next solution. QLF images were stored on a PC and analysed by a blinded single examiner. The deltaQ value at 5% threshold was reported. ANOVA and paired t-tests were used to analyse the data. RESULTS: The study confirmed the ability of QLF to longitudinally quantify stain reduction from human enamel. The reliability of the technique in relation to positive and negative test controls was proven. The positive control had a significantly (alpha = 0.05) higher stain removal efficacy than water (p = 0.023) and Yotuel (p = 0.046). Yotuel was more effective than water (p = 0.023). CONCLUSION: The research community, the practicing clinician and the consumer all require sound product evaluation data. The use of human enamel specimens may offer more relevant clinical data. QLF has been designed as an in vivo device. Further development of the technique should permit in vivo clinical whitening trials.

Analysis of Variance↗

PubMed1989

A photographically recorded assessment of enamel hypoplasia in fluoridated and non-fluoridated areas in England.

This study assesses the effect on enamel formation of the use of fluoride toothpaste in a fluoridated area. The prevalence of enamel hypoplasia in 251 9-10-year-old children born and raised in a fluoridated city (Birmingham) was compared with that in 319 similar children born and raised in a non-fluoridated city (Leeds). Observer bias was eliminated by the use of a new photographic technique, enabling colour slides of both groups to be assessed together in a random order. Scoring was done using both the Jackson-Al-Alousi (J-A) index, which is designed to record nonspecific hypoplasias and the Tooth Surface Index of Fluorosis (TSIF). Both were compared to the results from conventional clinical recording using the J-A index. The results showed that the photographic method was highly reproducible and more sensitive than conventional recording and showed a higher level of mild fluorosis in the fluoridated area. However, no evidence of an increase in the higher grades of fluorosis was found. It is concluded that the use of fluoride toothpaste by young children in fluoridated areas is unlikely to produce aesthetically unacceptable levels of enamel fluorosis.

Child↗

PubMed1996

Dental health related behaviours in toddlers in low and high caries areas in St Helens, north west England.

The aim of this investigation was to compare the dental health behaviour of toddlers in low caries (A) and high caries (B) communities in St Helens. Parents of 60 children aged between 17 and 20 months in community A, and 68 in community B were interviewed at home. Using 24-hour dietary recall, sugar intake was recorded as sugar episodes-a sugar episode being a half-hour period during which any amount of non-milk extrinsic sugars (NMES) was consumed. Exposure to fluoride was recorded according to the number of times fluoride toothpaste was used and whether a fluoride supplement was given in the 24-hour period. The median sugar episode score for community A was 6 per 24-hour period (interquartile range 5 to 8), compared with 10.5 (7 to 13) for community B. Sixty per cent of parents in community A compared with 37% in community B reported brushing their child's teeth twice daily with fluoride toothpaste. The respective figures for use of fluoride supplements were 12% and 6%. It is concluded that patterns of dental health behaviour are established early in children's lives, and that marked differences exist between communities within the same district. Recommendations are made for oral health promotion policy.

Dental Care↗