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Prevention of Dental Demineralization by Fluoride Toothpastes Followed by Fluoride-Free Mouthwashes: A TMR-D
Astrid Carolina Valdivia-Tapia1, Anderson Takeo Hara1, Frank Lippert1
1Department of Biomedical and Applied Sciences, Indiana University School of Dentistry, Indianapolis, Indiana, USA.
Background:
The use of fluoride-free mouthwashes (FFM) can adversely affect the anticaries benefits of fluoride toothpaste.
Aim:
This study investigated (i) the impact of FFM on the anticaries benefits of fluoride toothpaste and (ii) differences in enamel-lesion assessment between two TMR techniques.
Design:
The study followed a 2 (technique) × 2 (toothpaste) × 4 (mouthwash) factorial design. Toothpaste (1100 ppm F) contained either NaF or SnF2. Mouthwashes contained CPC or EOs. Control mouthwashes were DIW and not washed after toothpaste. Two TMR techniques, conventional specimens and single sections of enamel (n = 8), were utilized. During the 5-day/pH cycling, the specimens with artificial caries-like lesions were treated two times/day with toothpaste/1 min, followed by mouthwash/30s. There was a 4 h demineralization/day. Integrated mineral loss (ΔΔZ) and lesion depth (ΔL) were determined. Data were analyzed using three-way ANOVA.
Results:
There was no statistically significant interaction between the three factors for ΔΔZ (p = 0.894) or ΔL (p = 0.410) and no difference between toothpaste for ΔΔZ (p = 0.977) or ΔL (p = 0.507). However, mouthwashes affected ΔΔZ and ΔL (both p < 0.001). The non-wash group resulted in the most remineralization. The technique did not affect ΔΔZ (p = 0.973).
Conclusion:
Fluoride-free mouthwashes may decrease the remineralization potential of fluoride toothpaste, and the single-section technique is a suitable alternative in caries research. Pediatric dentists can emphasize proper hygiene and parental guidance in supervising children's brushing/rinsing.
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