METHODS: A total of 15 subjects, aged 4 to 10 years, with at least one cavity on a primary tooth, were recruited for this study. Urine samples were collected at baseline, first 24 h (F1) and second 24 h (F2) after SDF treatment for analysis of silver and fluoride content. Hair samples were also collected at baseline and at 7, 14, 30, 60, 75, and 90 days after SDF treatment to analyze silver content.
RESULTS: Participants with under or over-collection of urine, or failure to provide urine collection were excluded for fluoride analysis. As a result, eight subjects' urine samples were eligible for fluoride analysis. Significant correlations were observed between baseline urinary fluoride levels and F1/F2 levels. Pairwise comparisons from Friedman's test showed significant differences between baseline and F1 fluoride levels. For silver analysis, 15 subjects were studied. F1 urinary silver levels were higher than baseline and F2 levels. Subsequent to SDF treatment, hair silver levels displayed fluctuations around the baseline. None of the participants reported adverse effects, and all caries teeth ceased progression within 30 days.
CONCLUSIONS: The urinary fluoride levels after SDF treatment, although higher, were not clinically significant. Urinary and hair silver levels were negligible. Therefore, SDF appears safe to be used among children.
AIM: To summarize and rank the effectiveness of clinical interventions using different agents for primary prevention of early childhood caries (ECC).
DESIGN: Two reviewers independently searched PubMed, Embase, and Cochrane Library to identify randomized controlled trials with at least 12-month follow-up. The network meta-analysis (NMA) on different agents was based on a random-effects model and frequentist approach. Standardized mean differences (SMD) with 95% CI of the caries increment were calculated in terms of either dmft or dmfs and used in the NMA. Caries incidences at the child level were compared using odds ratios (ORs) with 95% CI. The effectiveness of the agents was ranked using the surface under the cumulative ranking curve (SUCRA).
RESULTS: After screening 3807 publications and selection, the NMA finally included 33 trials. These trials used either a single or combination of agents such as fluorides, chlorhexidine, casein phosphopeptide-amorphous calcium phosphate, probiotics, xylitol, and triclosan. Compared with control, fluoride foam (FF; SMD -0.69, 95% CI: -1.06, -0.32) and fluoride salt (F salt; SMD -0.66, 95% CI: -1.20, -0.13) were effective in preventing caries increment. Probiotic milk plus low fluoride toothpaste (PMLFTP; OR 0.34, 95% CI: 0.15, 0.77), FF (OR 0.48, 95% CI: 0.37, 0.63), fluoride varnish (FV; OR 0.63, 95% CI: 0.48, 0.81), and fluoride varnish plus high fluoride toothpaste (FVHFTP; OR 0.73, 95% CI: 0.57, 0.93) were effectively preventing caries incidence. According to the SUCRA, FF ranked first in preventing caries increment, whereas PMLFTP ranked first in preventing caries incidence.
CONCLUSION: Fluoride foam, F salt, PMLFTP, FV, and FVHFTP all effectively reduce caries increment or caries incidence in preschool children, but the evidence indicates low degree of certainty. Considering the relatively small number of studies, confidence in the findings, and limitations in the study, clinical practitioners and readers should exercise caution when interpreting the NMA results.
METHODS: L-arginine (2 % w/v.) was added to five commercial fancy waters: Oasis-Lemon, Oasis-Lemon Mint, Perrier-Lemon, Perrier-Grapefruit, Pellegrino-Lemon; and deionized water served as a negative control. The pH, buffer capacity of added Arg, and F- concentrations were measured. Tooth specimens were prepared and baseline volumetric assessment (T0) was conducted using micro-CT. Subsequently, the specimens were immersed in fancy waters for 72 h, kept in an incubator (37 ℃) and solutions were changed every 24 h. After the experimental cycle (T1), 3D volumetric analysis was performed, and 3D structural images were reconstructed for qualitative assessment.
RESULTS: The pH and F- concentrations of fancy waters with Arg were significantly higher than the control (p < 0.001). The buffer capacity of added Arg with Perrier-Grapefruit was significantly higher than Oasis-Lemon, Oasis-Lemon Mint & Pellegrino-Lemon (p < 0.05), except for Perrier-Lemon (p > 0.05). At T1, the specimen volume in Oasis-Lemon Mint (+/- Arg) and Pellegrino-Lemon (control) was significantly lower than T0 (p < 0.05). At T1, the specimen volume of Oasis-Lemon Mint and Pellegrino-Lemon (control) was significantly lower than Arg-containing fancy waters (p < 0.05). Surface contrast indicating wear was evident from T0 to T1 in specimens from the Oasis-Lemon Mint (+/- Arg) and Pellegrino-Lemon (- Arg).
CONCLUSION: Incorporating Arg in fancy waters reduces the potential of erosive tooth wear associated with these beverages.
CLINICAL SIGNIFICANCE: Consuming fancy water beverages (flavoured sparkling/carbonated) can lead to erosive tooth wear in young people. Incorporating Arg in fancy water beverages can prevent the erosive wear potential of these beverages while alleviating the burden of oral care on individuals at risk to erosive wear.