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Effect of high-concentration ammonium and sodium fluoride rinses on dental caries in schoolchildren.

A double-blind clinical trial was conducted in a non-fluoridated community to determine the effect on enamel fluoride and caries experience of daily rinsing in school with 1,000 parts/10(6) solutions of ammonium fluoride or sodium fluoride at pH 4.4. Subjects were 10- to 12-year-old children (n approximately equal to 200/group at baseline), about one-half of whom reported the usage of fluoride supplements. Dental caries (DFS index) and enamel fluoride (in vivo biopsy) were evaluated at baseline, 12 months, and 24 months. Supplement users had higher enamel fluoride levels and less caries experience initially, as well as generally lower caries increments over the study. In year 1, the overall caries reductions (supplement users and non-users combined) were 23 % (ammonium fluoride) and 33 % (sodium fluoride), P less than 0.01. For year 2, treatment effects were significantly greater: 54 % (ammonium fluoride) and 47 % (sodium fluoride). In newly erupted teeth, the effects of the ammonium fluoride (70 % DFS reduction) was significantly greater (P = 0.013) than that of the sodium fluoride (48 % DFS reduction). Enamel fluoride levels at the end of 2 years were 3,124 parts/10(6) (ammonium fluoride), 2,771 parts/10(6) (sodium fluoride), and 2,603 parts/10(6) (placebo), P = 0.025.

Child↗

Total fluoride intake and urinary excretion in German children aged 3-6 years.

There have only been few investigations comparing total fluoride intake and the fluoride proportion excreted in urine in pre-school children. In addition, the results of available studies are conflicting. Total fluoride intake was assessed in 11 healthy children aged 3-6 years on 2 consecutive days and urinary fluoride excretion was determined. The duplicate-diet approach was used for the assessment of fluoride intake from solid and liquid foods. Fluoride intake from toothbrushing was calculated as the difference between the amount of fluoride in the paste put on the toothbrush and the drinking water (fluoride concentration 0.25 mg/l) used for rinsing vs. the fluoride amounts recovered in the toothpaste spat out and in the rinsing water. Use of fluoridated domestic salt and/or fluoride tablets was recorded. The children's intake of fluoride from food averaged 202.5+/-116.2 microg F/day. They swallowed an average amount of 273.9+/-175.6 microg F/day when brushing their teeth. Daily fluoride ingestion from all sources totalled 930.7+/-391.5 microg or 53.0+/-21.4 microg/kg body weight. On average 51.5% of the fluoride ingested was excreted in urine. The wide interindividual variation makes it necessary to evaluate the urinary excretion rate for fluoride in larger study populations with varied fluoride exposure.

Body Weight↗

Fluoride varnish use in primary care: what do providers think?

OBJECTIVE: A number of state Medicaid programs, including Washington, reimburse pediatricians and other pediatric health care providers to apply fluoride varnish, a caries preventive agent, to eligible patients' teeth. Little is known about the factors that encourage or impede diffusion of fluoride varnish into primary care physicians' (PCPs') offices. The objective of this study was to perform an in-depth case study of fluoride varnish diffusion in 12 pediatric, family medicine, and nurse practitioner offices that underwent fluoride varnish training. METHODS: We conducted focus groups with providers and staff in 12 community-based medical practices that had undergone fluoride varnish training within the previous 18 months. Topics of discussion included how the office staff learned about and sought fluoride varnish training, the perceived role of PCPs in oral health, oral health problems within the practice, specific details about the training, and organizational and logistic factors that promoted or impeded adoption. Focus groups were audiotaped and professionally transcribed; content analyses of the transcripts were conducted by the 3 authors. RESULTS: Three major themes emerged about the fluoride varnish diffusion process; these were preexisting factors, communication, and logistics. Within preexisting factors, PCPs learned about fluoride varnish through their involvement in public health-related activities and were influenced to participate in the training by their concerns for their patients' oral health and difficulty gaining access to professional dental care. Among communication factors identified as important were qualities of the training session and the communication that occurred within the practice about fluoride varnish. When staff were included in the fluoride varnish decision-making and planning process, the practice was more likely to be successful in implementing fluoride varnish. Logistic factors included systems used to identify and capture eligible patients for fluoride varnish application. Other important logistic factors that were considered included division of labor and timing of the fluoride varnish application during the visit. Access to dental care was a persistent theme throughout the focus group discussions that had an impact on the other 3 major themes. CONCLUSIONS: Fluoride varnish can be adopted successfully into medical practice given PCP and staff commitment and openness, training that leaves participants motivated, appropriate systems, and resources for professional dental care referral. In addition, PCP involvement with fluoride varnish provided opportunities to discuss preventive oral health with families. Specific recommendations to encourage fluoride varnish diffusion in other settings are offered for program planners and PCP offices.

Attitude of Health Personnel↗

Evaluation of an acid ammonium oxalate extraction to determine fluoride resident concentrations in soils.

Fluoride depositions near aluminum smelters and other fluoride-emitting plants can lead to fluoride accumulation in soils, which constitutes a risk for ground water contamination. This study was conducted to investigate the capacity of a 0.2 M acid ammonium oxalate solution to selectively and quantitatively extract fluoride accumulated in soils. The recovery of fluoride added to three soils was evaluated following 7- to 28-d incubations. Oxalate extraction was also compared with a total fluoride extraction method, using oxalate-extractable fluoride (Fox) and total fluoride (Ftot) accumulation profiles derived from column percolation experiments. To determine low-level fluoride concentrations without interference from high Al and Fe concentrations, an adapted ion chromatography method was used. Following soil incubations, oxalate extracted 42 to 86% of added fluoride. Recovery varied between soils and, in one soil, increased with added fluoride concentration. Recovery was unaffected by incubation time. Maximum recovery was obtained in a soil high in amorphous Fe and Al, low in clay, and free of carbonate. Lower recoveries were obtained in soils with higher clay or carbonate contents. Only 4 to 8% of Ftot was extracted in untreated samples using Fox, which suggests a high selectivity of this method for added fluoride. In percolation experiments, the use of Fox reduced considerably the background noise associated with Ftot for the evaluation of fluoride accumulation profiles. Because of its high selectivity and despite incomplete fluoride recovery, the use of Fox to determine fluoride resident concentrations in soils may improve environmental monitoring of fluoride accumulation and movement in contaminated soils.

Environmental Monitoring↗

Inappetence in ruminants as a measure of fluoride solubility in various phosphates.

Experiments with soft phosphate and fertilizer grade concentrated superphosphate and diammonium phosphate were to measure effects on voluntary intake of their fluoride in relation to that from calcium fluoride and sodium fluoride given once daily by capsule. Mature wethers were offered 1200 or 1400 g daily of mixed grain-roughage diet, and responses to fluoride were measured by inappetence, consumption of less than 10% of offered diet. When 40 ppm fluoride as sodium fluoride was given for 2 days, inappetence resulted, whereas 2,400 ppm fluoride as calcium fluoride did not decrease feed intake. Time required for recovery of appetite increased with more fluoride. When soft phosphate, concentrated superphosphate, and diammonium phosphate were tested at 100, 200, and 400 ppm fluoride, inappetence occurred always but severity of reduction of intake was related to parts per million fluoride. Solubility of fluoride in soft phosphate, concentrated superphosphate, and diammonium phosphate is more similar to sodium fluoride than to calcium fluoride, and their use should be in keeping with fluoride tolerances established for ruminants fed sodium fluoride.

Animals↗

[Modified microdiffusion method for fluoride analysis of foodstuffs].

In fluoride analysis, there are two procedures for the determination of fluoride depending on nature of samples. One procedure directly can determine fluoride contents by fluoride ion electrode, dissociating fluoride from the sample with the acid (perchloric acid). The other procedure needs to separate fluoride from biological sample using steam-distillation or micro-diffusion method, and then the determination by means of fluoride ion electrode can be applied. In this study, we applied a modified microdiffusion method by Hinoide (1990) for its availability in different temperatures and reaction time, and then estimated to determine fluoride contents of Shrimp (Sakura-shrimp) as a biological sample by this method. It is also very important to determine fluoride contents of foodstuffs and biological samples with regard to bioavailability of fluoride in vivo. The results were as follows: 1. Using the modified microdiffusion method, the fluoride recovery rate attained more than 95% in the range of 0.1-10 micrograms fluoride from a standard solution under the experimental condition of 60 degrees C and 90 degrees C of reaction temperatures and 60, 90 and 120 minutes of reaction time. 2. For the sample of shrimp, fluoride contents analyzed by means of the modified micro-diffusion and steam-distillation methods showed almost similar values, although the fluoride contents by steam-distillation method revealed relatively lower value. The difference might be derived from a loss of fluoride in ashing the sample before applying the steam-distillation method. The modified microdiffusion method used in this experiment can be utilized routinely and precisely in fluoride analysis for small amounts of biological sample.

Animals↗

Clinical evidence of the role of pre-eruptive fluoride in caries prevention.

Recent clinical and laboratory evidence has suggested that systemic fluoride plays a more minor role in caries inhibition than was previously believed. This paper reviews clinical data on water fluoridation, the topical administration of fluorides, and fluoride supplements in the light of more recent understanding of the disease dental caries. Due to reduced functional usage, erupting teeth tend to accumulate plaque which has cariogenic potential. For this reason, the period from tooth emergence to the establishment of interproximal contact and full occlusion is the most critical for caries initiation. Analyses of clinical data indicate that maximum protection against caries is obtained when teeth erupt into an environment with low concentrations of ionic fluoride. The similarity in caries reductions obtained in water fluoridation studies and long-term studies with topically administered fluoride regimens, including fluoride-containing dentifrices, indicates that the pre-eruptive effect of fluoride is of borderline significance relative to the more significant post-eruptive effect. Water fluoridation and topical fluoride programs are thus important measures for the control of caries at the community level. For the individual, topical application of fluoride is seen as an integral part of caries treatment aimed at arresting progressive caries. Fluoride application is thus considered a supportive therapy, in conjunction with cariogenic plaque control. Daily use of fluoridated dentifrices from tooth eruption is more efficacious than daily use of fluoride supplements from birth.

Dental Caries↗

The effects of fluoridated water on bone strength.

Fluoride from fluoridated water accumulates not only in the enamel of teeth but also in the skeleton. The effects of fluoridated water on the skeleton are not well understood, yet there is some evidence that fluoridated water consumption increases the incidence of fractures. In the present study, femoral bending strength was measured in rats on fluoride intakes that ranged from low levels to levels well above natural high fluoride drinking water. Bone strength followed a biphasic relationship with bone fluoride content. Fluoride had a positive effect on bone strength for lower fluoride intakes and a negative influence on bone strength for higher fluoride intakes. The vertebral fluoride content at which femoral strength was maximum was between 1,100 and 1,500 ppm. The increase in femoral strength at this fluoride level was not accompanied by an increase in femoral bone density. The optimal fluoride content is within the range of bone fluoride contents found in persons living in regions with fluoridated water (1 ppm) for greater than 10 years.

Animals↗

Fluoride intake from beverage consumption.

Previous studies have shown that fluoride is present in beverages prepared with fluoridated water. The purpose of this study was to determine the availability of fluoride from beverages consumed in adjacent fluoridated and non-fluoridated communities taking into account fluoride supplementation regimens. Children in grade six were invited to participate in recording of beverage intake in two cities in Alberta, Canada: Wetaskiwin, with water supplies fluoridated at 1.08 ppm F, and Camrose, non-fluoridated with water supplies at 0.23 ppm F. Three-day beverage intake records--"Drink Diaries"--were collected from 179 children in Wetaskiwin and 230 children in Camrose. Fluoride values, based on the analyses of Hargreaves, were assigned to the reported consumption of the children with the three highest and three lowest total beverage intakes in each community. A wide range of available fluoride was found. A substantial source of fluoride was shown to be available in the non-fluoridated community from beverages other than water, primarily from carbonated beverages commercially prepared with fluoridated water. Available beverages and actual consumption should be considered in the prescription of fluoride supplementation for children with minimal fluoride in their drinking water.

Alberta↗

Urinary fluoride excretion by preschool children in six European countries.

OBJECTIVE: To measure and compare 24-h urinary fluoride excretion in children aged 1.5-3.5 years from European study sites and to use these data to estimate the 24-h fluoride intake. METHOD: Twenty-four-hour urine samples were collected from 3-year-old children (n = 86) who were already participating in a European multicentre study. Samples were collected from Cork, Ireland (n = 19) where the water is fluoridated to a concentration between 0.8 and 1.0 ppm and from five sites with a water fluoride concentration <0.15 ppm: Knowsley, England (n = 18); Oulu, Finland (n = 18); Reykjavik, Iceland (n = 4); Haarlem, the Netherlands (n = 6); Almada/Setubal, Portugal (n = 21). The volume of the samples was measured; they were analysed for fluoride concentration and the 24-h urinary fluoride excretion was calculated. From this an estimate of the daily fluoride intake was made. RESULTS: It was found that the mean fluoride excretion in response to the usual conditions of fluoride intake in the children in the nonfluoridated areas ranged from 0.16 mg (+/-0.08) in Oulu to 0.33 mg (+/-0.27) in Almada/Setubal with an overall mean of 0.23 mg (+/-0.19). The mean 24-h fluoride excretion in fluoridated Cork was 0.37 mg (+/-0.11). There was a significant difference between the fluoride excretion in the nonfluoridated areas and that in the fluoridated areas, and the data were broadly in agreement with WHO standards. CONCLUSIONS: The daily urinary fluoride excretion and estimated fluoride intake in these children appeared to be within acceptable limits.

Cariostatic Agents↗

Chinese hamster cell lines resistant to the cytotoxic action of fluoride.

The proliferation and efficiency of colony formation of a Chinese hamster ovary cell line, CHO, was found to be inhibited by concentrations of fluoride greater than or equal to 10(-3) M. From mutagenized populations of CHO cells, clones were isolated that were from 1.6 to 13 times more resistant than the wild-type to the cytotoxic action of fluoride. The resistant clones were found to be stable in the absence of selection. The fluoride sensitivity of wild-type and fluoride resistant clones was not altered by changes in the pyruvate concentration in the culture medium, indicating that the cytotoxic effect of fluoride is not due to the action of fluoride on the glycolytic pathway. On the other hand, both the incorporation of 3H-leucine into acid precipitable material and the distribution of polyribosomes were sensitive only to fluoride concentrations that were cytotoxic, suggesting that the molecular basis of fluoride induced cytotoxicity in both wild-type and fluoride resistant cells is the sensitivity of protein synthesis to fluoride. At concentrations of fluoride at which the wild-type cells are inhibited but fluoride resistant cells are not, the intracellular concentration of fluoride in the fluoride resistant cells was found to be 1/5 to 1/10 that of the wild-type, suggesting that fluoride exclusion is the basis for resistance in the resistant lines.

Cell Line↗

The effect of intrinsic fluoride in cows' milk on in vitro enamel demineralization.

The fluoride concentration in cows' milk has been reported to vary with the fluoride levels in drinking water but it seldom exceeds 0.5 microg/ml. This raised a question as to whether any caries-protective effect could be attributed to the intrinsic fluoride of milk. Two samples of cows' milk with intrinsic fluoride concentrations of 0.03 and 0.3 microg/ml, respectively, were assessed for their protective effect on enamel in an in vitro demineralization model at relatively severe and mild acidic challenges (pH 4.6 and 5.0, respectively). Polished enamel discs were incubated individually in 5.0 ml of demineralization solution for 20 h per day alternated with 1-hour incubations in 1.0 ml of milk or control buffers: group 1, demineralization solution only (negative control); group 2, milk with 0.03 microg/ml fluoride; group 3, milk with 0.03 microg/ml fluoride; supplemented with NaF to 0.3 microg/ml fluoride; group 4, milk with 0.3 microg/ml fluoride; group 5, 0.3 microg/ml fluoride in 20 mM HEPES, pH 6.7; group 6, milk with 0.03 microg/ml fluoride supplemented with NaF to 5.0 microg/ml fluoride (positive control). The solutions were renewed each day and the calcium concentration in the demineralization solutions was followed during 4 days. The results showed that the protective effect of intrinsic milk fluoride on enamel is limited by the severity of the acidic challenge: There was a significant inhibition of the demineralization in groups 3-6 compared to groups 1 and 2, but only at pH 5.0 (p<0.0001) and not at pH 4.6 (p = 0.2). The organic components of milk had limited protection against demineralization because milk and HEPES with the same fluoride concentration gave similar results. The 36% reduction in calcium loss at pH 5.0 by treatment with milk with only 0.3 microg/ml fluoride is an indication that intrinsic milk fluoride has some caries-protective properties.

Acetates↗

Intake and metabolism of fluoride.

The purpose of this paper is to discuss the major factors that determine the body burden of inorganic fluoride. Fluoride intake 25 or more years ago was determined mainly by measurement of the concentration of the ion in the drinking water supply. This is not necessarily true today because of ingestion from fluoride-containing dental products, the "halo effect", the consumption of bottled water, and the use of water purification systems in the home. Therefore, the concentration of fluoride in drinking water may not be a reliable indicator of previous intake. Under most conditions, fluoride is rapidly and extensively absorbed from the gastrointestinal tract. The rate of gastric absorption is inversely related to the pH of the gastric contents. Overall absorption is reduced by calcium and certain other cations and by elevated plasma fluoride levels. Fluoride removal from plasma occurs by calcified tissue uptake and urinary excretion. About 99% of the body burden of fluoride is associated with calcified tissues, and most of it is not exchangeable. In general, the clearance of fluoride from plasma by the skeleton is inversely related to the stage of skeletal development. Skeletal uptake, however, can be positive or negative, depending on the level of fluoride intake, hormonal status, and other factors. Dentin fluoride concentrations tend to increase throughout life and appear to be similar to those in bone. Research to determine whether dentin is a reliable biomarker for the body burden of fluoride is recommended. The renal clearance of fluoride is high compared with other halogens. It is directly related to urinary pH. Factors that acidify the urine increase the retention of fluoride and vice versa. The renal clearance of fluoride decreases and tissue levels increase when the glomerular filtration rate is depressed on a chronic basis.

Animals↗

Dietary fluoride supplements for Ohio children--the role of the physician.

1. All children should receive one form of systemic fluoride and appropriate forms of topical fluoride. 2. If a child is not receiving optimally fluoridated water, the physician or dentist should prescribe dietary fluoride supplements (tablets or drops). 3. The correct dosage must be determined based on patient age and fluoride content of the patient's main water source(s). 4. Special attention is necessary concerning fluoride intake for children breast-feeding or consuming infant formula. 5. To determine the correct fluoride dose, these steps should be followed: A. Always have a sample of the main drinking water source (usually home water) analyzed for the fluoride content before prescribing a fluoride supplement, if you do not have other specific knowledge of water fluoride content. The Ohio Department of Health, Division of Laboratories can provide water fluoride-testing services. B. When the fluoride content of the water has been determined, the fluoride level and the child's age should be compared to the Supplemental Fluoride Dosage Schedule to identify the correct supplement dose. 6. The Division of Dental Health, Ohio Department of Health can provide a list of communities that are optimally fluoridated. Please contact: Ohio Department of Health Division of Dental Health 246 N. High Street Columbus, Ohio 43266-0588 (614) 466-4180

Administration, Oral↗

Caries reductions related to the use of fluorides: a retrospective cohort study.

AIM: To test whether topical fluoride regimes provided additional caries protection to the first molar teeth of children exposed to fluoridated toothpaste and optimally fluoridated water supplies. PARTICIPANTS AND METHODS: This two-year retrospective cohort study included 660, 8-year-old-children. A cluster sampling technique was used to select three groups of 220 children. Group 1 was selected from schools using fluoride mouthrinses (Programme 1). Group 2 was selected from schools applying fluoride gel (APF 1.23%) in addition to the weekly fluoride mouthrinse (Programme 2). Oral health education and oral hygiene instruction were provided to both groups. The control group was selected from schools in the same area that had not adopted any oral health preventive programme. All children were exposed to optimally fluoridated water and fluoridated toothpaste for the last two years or more. Participants were examined for DMFS scores of their first molars using WHO criteria by one examiner (MLRS). RESULTS: The percentage caries free children in Control, Programme 1 and Programme 2 were 55%, 65% and 65.5%, respectively. The differences between Programme 1 and 2 in relation to the Control Group were statistically significant (P < 0.05). There was no difference between Programme 1 and 2 (P = 0.92). CONCLUSIONS: Weekly fluoride rinsing combined whether or not with fluoride gel applications once every three months, provided additional caries-preventive benefits to children with high levels of caries and exposed to optimally fluoridated drinking water and toothpaste. There was no difference in caries levels between children having fluoride rinses and those having fluoride rinses and fluoride gel.

Acidulated Phosphate Fluoride↗

The effects of fluoride on bone and implant histomorphometry in growing rats.

The effects of fluoride at concentrations of 2.0 and 4.5 mM in drinking water on growth rate, vitamin D, water and mineral metabolism, bone histomorphometry, and osteoinduction of demineralized allogenic bone matrix (DABM) were compared in the rat. Whereas fluoride did not influence fluid intake or growth rate at the lower concentration, it increased fluid intake and inhibited growth rate at the higher concentration. Fluoride produced dose-related increases in serum fluoride and alkaline phosphatase but did not alter serum 25-hydroxyvitamin D or 1,25-dihydroxyvitamin D. Serum calcium and phosphate were reduced by fluoride at concentrations of 2.0 mM but not 4.5 mM. Cancellous bone fractional area was increased by fluoride at 2.0 mM and was reduced by fluoride at 4.5 mM. Fluoride had no effect on cancellous bone surface length or the percentage surface lined by osteoblasts and osteoclasts. Fluoride increased medullary area and decreased the endosteal bone formation rate. Fluoride increased periosteal bone formation and apposition rates at concentrations of 2.0 mM but not 4.5 mM. Fluoride inhibited mineralization in DABM implants, and at the higher concentration, fluoride increased the formation of new bone matrix. These results indicate that in the rat, fluoride increases cortical and trabecular bone at therapeutic doses and reduces trabecular bone at toxic doses. The serum concentration of fluoride at therapeutic doses in the rat is similar to that in patients with osteoporosis who are on treatment with fluoride. In the rat, there is a narrow range between toxic and therapeutic doses.

Alkaline Phosphatase↗

Fluoride uptake in dentin with and without simulating dentinal fluid flow.

The aim of the present study was to compare fluoride uptake of dentin with and without simulating dentinal fluid flow. Eighty-five dentinal discs were prepared from retained human molars. Seventeen discs were used to assess baseline fluoride content (controls). Sixty-eight discs were evenly distributed among two experimental groups and were fixed for 24 h in a two-chamber device allowing for simulating dentinal fluid flow. Thirty-four samples were treated with dentifrice slurry containing a low fluoride concentration (Elmex, dilution 1:5); the remaining discs were treated with a solution of a high fluoride concentration (Elmex Fluid). For the perfused group, each of the 17 discs of the high and low concentration fluoride groups were constantly perfused during the experiment. The remaining fluoridated specimens were not perfused. All specimens were assayed for KOH-soluble fluoride and structurally bound fluoride. Structurally bound fluoride was determined in three successive layers of 20 microns each. Uptake of KOH-soluble fluoride was significantly higher in the specimens fluoridated with Elmex Fluid compared to the samples treated with the dentifrice slurry. The uptake of KOH-soluble fluoride was not influenced by perfusion of the dentinal discs. However, perfusion resulted in lower acquisition of structurally bound fluoride in the samples treated with the dentifrice slurry. After application of Elmex Fluid, no significant difference was found in the amount of structurally bound fluoride between the perfused specimens and non-perfused samples. It is suggested that further studies on fluoride uptake in dentin should use a model simulating outward dentinal fluid flow.

Analysis of Variance↗

Effect of brushing on fluoride release from 3 bracket adhesives.

The purpose of this in vitro study was to compare fluoride ion release from 3 orthodontic bracket adhesives with and without brushing the bracketed teeth with a fluoridated dentifrice. The bracket adhesives included a light-cured composite resin (Transbond; 3M Unitek, Monrovia, Calif), a fluoride-releasing composite resin (Advance; L D Caulk Division, Dentsply International, Milford, Del), and a resin-modified glass ionomer (Fuji Ortho LC; GC America, Alsip, Ill). The teeth in the control group were not bonded with brackets. Sixty extracted human teeth were randomly assigned to 6 groups of 10 each: (1) Transbond, brushed; (2) Advance, brushed; (3) Advance, not brushed; (4) Fuji, brushed; (5) Fuji, not brushed; and (6) control, brushed. After bonding, each tooth was placed in a sealed plastic test tube containing 4 ml of deionized water. The toothpaste used in brushing contained 0.15% weight per volume sodium fluoride, 1500 parts per million parts fluoride (Winter-fresh gel; Colgate-Palmolive Co., New York, NY). Brushing began 24 hours after the teeth were bonded and placed in deionized water. After brushing, the teeth were thoroughly rinsed with deionized water and returned to a sealed test tube. Fluoride measurements were taken before brushing began, at intervals of 72 hours for 22 days, and 90 and 93 days after bonding. Findings included: (1) brushing significantly increased the release of fluoride ions from the teeth in the composite resin and control groups, (2) the enamel crowns of the unbonded control teeth absorbed and re-released a substantial amount of fluoride ions obtained from the toothpaste, (3) the brushed group of teeth bonded with the fluoride-releasing composite resin released significantly more fluoride on the last 4 days that measurements were taken after brushing than the nonbrushed group bonded with the same adhesive, (4) the brushed group of teeth bonded with the resin-modified glass ionomer released significantly more fluoride on the last 4 days that measurements were taken after brushing than the nonbrushed group bonded with the same adhesive, and (5) all groups released small amounts of fluoride ions 90 and 93 days after bonding (68.5 and 71.5 days after brushing ended); the resin-modified glass ionomer groups released significantly more fluoride than the other groups. Brushing with fluoridated toothpaste produced significantly greater fluoride release from teeth bonded with all 3 adhesives, and from the unbonded control teeth.

Acrylic Resins↗