Anticaries potential of commercial dentifrices as determined by fluoridation and remineralization efficiency

The aim of this in vitro study was to investigate fluoride uptake in human enamel after use of commercially available toothpastes containing different fluoride compounds, or combinations of fluoride actives formulated into a single product, as a means of determining the efficiency of each formula for delivering caries preventing fluoride to demineralized (caries active) enamel.

Four test dentifrices and two controls were assessed and placed in groups as follows: Group 1: Lacer (Spain); Group 2: Positive control-USP Reference Standard 1100 ppm F; Group 3: Fluocaril Bi-Fluoré 250 (France); Group 4: Colgate Fluor Active (Denmark); Group 5: Elmex (France); and Group 6: A placebo (formulated the same as the USP Reference Standard toothpaste with the exception that it contained < 1 ppm F). Cores 3 mm in diameter were removed from erupted human enamel specimens (extracted by local oral surgeons for orthodontic reasons) and stored in 1% Thymol solution prior to use. They were ground and polished to remove the natural fluoride rich enamel layer, then exposed to a demineralization solution, and assessed for surface microhardness to enable randomization for use in the study. Each group of five specimens underwent a daily pH cycling procedure that involved exposure to pooled human saliva (refreshed three times daily). The groups were then exposed to dentifrice slurries four times daily for one minute per exposure and to a demineralization solution for three hours. The cycling procedure was repeated for five days. Specimens were again analyzed for surface microhardness and fluoride uptake upon completion of five days of treatment.

Average surface hardness: Groups 2 and 3 showed a statistically significant greater (p<0.05) change indicating greater remineralization compared to all other groups. The average change was 23.45 for Group 2 and 22.65 for Group 3. All other groups had changes ranging from 4.25-8.62. No other statistically significant differences were observed between groups. Fluoride uptake results: Groups 2 and 3 showed statistically significantly greater fluoride uptake versus all other groups (p<0.05). Groups 1 and 5 were significantly different from Group 6. No other statistically significant differences were observed for either analysis.

Of the marketed products included in the study, the Fluocaril Bi-Fluoré 250 product formulation provided both the highest level of fluoride uptake and mineralization to the demineralized enamel. The clinical significance of these in vitro results is the confirmation Fluocaril Bi-Fluoré 250 is effective at remineralizing enamel caries lesions.