Effect of continuous fluoride gel use on plaque fluoride retention and microbial activity

Twelve consecutive wk of daily five-minute topical applications of 1% NaF gel by non-cancer control subjects did not significantly affect plaque concentrations of Streptococcus mutans or Lactobacillus spp. Plaque F- levels increased 150% (P less than .001), while production of acetate and lactate decreased 40% (P less than .007) and 66% (P less than .001), respectively. Long-term (12 wk to more than five yr) fluoride gel use by post-irradiation xerostomic cancer patients was associated with increases in plaque F- and decreases in acidogenesis similar to those observed in the control subjects. Plaque concentrations of cariogenic organisms increased during the first yr of radiation-induced xerostomia and fluoride gel use, before starting to decline. Although sustained fluoride treatment increased (P less than .001) the ratio of fluoride-resistant to fluoride-sensitive strains, the number of patients harboring detectable S. mutans was diminished (P less than .001).