Toothpaste technique. Studies on fluoride delivery and caries prevention

The aim of the investigations was to evaluate the cariostatic effects of a modified toothpaste technique using fluoride (F) toothpaste. The modification consisted of an active mouthrinse with the toothpaste slurry and a sip of water for one minute after brushing. Toothpaste technique and salivary F concentration after toothbrushing were recorded in a caries active and a caries inactive group. The level of F in whole saliva, the concentration of F in plasma, the effect on demineralised enamel and dentine samples, and the accumulation of F in interdental plaque when using the modified toothpaste technique were studied. In a 3-year clinical trial, 4-year old children were trained in the toothpaste technique. The results showed that in the caries active group, the water rinsing was more thorough and more water was used compared to a caries inactive group. Rinsing with water and eating immediately after toothbrushing decreased the F level in whole saliva. Mouthrinsing with either a NaF solution or a slurry of toothpaste foam and water increased the F concentration in saliva compared to when a single or double water rinse was performed. The degree of F absorption in plasma, the accumulation of F in approximal plaque and the interdental clearance after toothbrushing were strongly related to the mode of water rinsing. The degree of demineralisation of enamel and dentine at approximal sites was also related to the mode of water rinsing. The clinical study showed that the cariostatic effect of the modified toothpaste technique resulted in 26% less approximal caries in the test group. It is concluded that a toothpaste technique where a slurry rinse was carried out after brushing increased the efficacy of F toothpaste.