Study of the Salivary Retention Of Fluorides After The Application Of Various Topical Reagents And Their Effect On Streptococcus Mutans
B Gupta, R Anegundi, P Sudha
B Gupta, R Anegundi, P Sudha. Study of the Salivary Retention Of Fluorides After The Application Of Various Topical Reagents And Their Effect On Streptococcus Mutans. The Internet Journal of Dental Science. 2006 Volume 5 Number 1.
Topical fluoride therapy (TFT) in the form of toothpastes, mouthrinses, varnishes and gels are effective caries preventive measures. Different fluoride compounds, different vehicles, and vastly different concentrations have been used with different frequencies and durations of application. These variables can influence the clinical outcome with respect to caries prevention and management. The efficacy of topical fluoride in caries prevention depends on a) the concentration of fluoride used, b) the frequency and duration of application, and to a certain extent, c) the specific fluoride compound used. Factors besides efficacy, such as practicality, cost, and compliance, influence the clinician's choice of preventive therapy. This study was conducted with the aim & objective to compare the retention of fluorides produced by various topical agents and compare the effects of fluoride on Streptococcus Mutans.
Fluoride has played a pivotal role in oral health promotion over the past 50 years. The understanding of the process of dental caries and the mode of action of fluoride has changed in recent years. Dental caries is a continuous process of demineralization and remineralization of the enamel and fluoride plays a key role in this process through its action at the plaque enamel interface. It is now accepted that the primary mode of action of fluoride is post-eruptive. The post-eruptive action of fluoride has resulted in new methods of delivering fluoride.
The current health care trend is to provide evidence-based recommendations and treatment. Many literature reviews have shown fluoride's effectiveness against caries. The current use of fluoride in the prevention of dental caries is based on community, professional, and individual strategies. Personalized fluoride regimens should include a risk analysis and a review of the patient's current fluoride exposure. Fluoride use should be part of any preventive programme for the control of dental caries in children. Each child under the care of a dentist should have a carefully planned programme appropriate to the level of caries risk and age of each child.(1-3)
A study was conducted in the Dept of Pedodontics, SDM College of Dental Sciences,Dharwad with the following Aims and objectives:
Aims & Objectives
To study the salivary retention of fluoride in saliva after application of various topical agents.
To compare the retention of fluorides produced by various topical agents.
To study and compare the effects of fluoride on streptococcus Mutans.
Materials and Method
The Sample consisted of randomly selected 25 children from the age group 8-12 years studying in a local school in Dharwad. The children were further divided into five groups consisting of five children each. The Armamentarium for the Fluoride Estimation consisted of
APFgel, FluorideFoam, Varnish, Dentrifice, toothbrushes, Foam application trays, probe, mirror, tweezer and applicator tips. The armamentarium for the microbial analysis comprised of Mitis Agar, Culture plates, Burner and loops. The Groups were treated with APF gel, Fluoride foam, Fluoride varnish, Fluoride dentifrice and Control group. The saliva samples were collected at various sample intervals. The Sample intervals were at baseline, 6 hours after application and 24 hours after application. The microbial analysis was carried out by streaking the agar in the culture plates with the saliva samples at the same intervals.
Armamenterium for microbial analysis
6 hours after application.
24 hours after application.
Methods of conducting the study:
1. For fluoride estimation - SPADNS method.
Principle: The presence of fluoride affects the rate of absorption of light leading to change in optical density and from the optical density the fluoride content in PPM can be derived.
2. Microbiological Analysis
Using a standard loop the saliva was streaked into the mitis salivarius agar. The colonies were identified on the basis of colony morphology and the colonies were scored arbitrarily.
Less than 25 +
25 to 50 colonies ++
50 to 100 colonies +++
More than 100 ++++
Observations and Results
1) Comparison of the Control group,APF gel,Flouridated foam,Flouride varnish&Dentrifice
Results and Discussion
The efficacy of topical fluoride in caries prevention depends on a) the concentration of fluoride used, b) the frequency and duration of application, and to a certain extent, c) the specific fluoride compound used. The more concentrated the fluoride and the greater the frequency of application, the greater the caries reduction. Factors besides efficacy, such as practicality, cost, and compliance, influence the clinician's choice of preventive therapy
Clinically, fluoride varnish showed an increase in 6 hours and 24 hours depicting the substantivity in the oral cavity. In the intergroup comparison, the retention of fluoride varnish in the saliva was greater as compared to other topical reagents.This finding was in accordance with other studies. In studies comparing Duraphat varnish and APF gel, Duraphat varnish was equally or more effective than APF gel. Sealants were most effective in preventing occlusal caries. Four applications per year, or three weekly applications once a year, have been found to be effective. However, several studies have shown that two applications per year may provide comparable results. Application is fast and easy. Professional prophylaxis is not necessary, and the patient can leave immediately after the treatment. No acute toxicity has been reported after using any fluoride varnish.(15-18)
In this study, it was observed that F ions in oral cavity inhibit the growth of S.mutans. The intragroup study, the difference in the baseline, 6 hours and 24 hours were statistically significant as the colony count decreased after 6 hours and 24 hours showing inhibition in the growth of streptococcus mutans. This finding was in accordance with other researchers. Van et al (1984) studied the effect of fluoride on the production of organic acids by Streptococcus Mutans in dental plaque. No difference was found in the accumulation of S. Mutans on the teeth between the fluoride-adapted and the control groups. However, there was a significant difference in the amount of lactic acid in metabolically resting plaque between the groups, lactic acid being lower in the fluoride-adapted plaque. Van Loveren C(1991) suggested that, if S. Mutans acquires fluoride resistance in vivo, the rate of acid production in dental plaque may be decreased at pH greater than or equal to 6, but increased at lower pH levels. Low concentrations of fluoride inhibit acid production less effectively.(19-22)
The Conclusions that could be drawn from this study were clinically, fluoride varnish showed substantivity in the oral cavity. and the retention of fluoride in saliva can be correlated to the inhibition of the growth of S.mutans.,The methods used for the Fluoride estimation should be more specific, moreover there remains a need for further trials. It is important that these trials should be of high quality and include assessment of potential adverse effects.