Caries, Dental Clinical Trial
Official title:
Dental Fluorosis Risk by the Use of Acidulated Fluoride Dentifrice: Clinical Trial - Epidemiological Study With Children Residing in an área Without Public Water Fluoridation
This research aimed to evaluate the risk of dental fluorosis by using an experimental fluoridated acidulated dentifrice compared to conventional dentifrices in two-to-four-year-old children residing in a non fluoridated area by the concentration of fluoride incorporated in childrens' nails, as well as the incorporation of F into the biofilm. Two hundred and ten children participated on this study. They were randomly allocated into three groups differing according to the type of dentifrice used over 12 months: G1:1100 ppm F, pH 4.5; G2:750 ppm F, pH 4.5; G3:1100 ppm F, pH 7.0. The dentifrice was placed on the toothbrush using the "drop" technique. The toenails of the biggest toe were collected in three moments, corresponding to the experimental period of use of the dentifrices (T1, T2 and T3), as well as the biofilm which was collected twice, 5 and 60 minutes after brushing. The nails and biofilm fluoride concentration were analyzed on a specific electrode using the HMDS diffusion facilitated technique.
This is a randomized, double-blind, interventional trial, adopting a strategy for collecting
data, collecting data from the children's biofilm. This study was carried out in three Child
Education Reference Centers (CREIs) located in different points of the city of João Pessoa
PB.
The city is located in the Northeast region of Brazil, on the coast of the state of Paraíba
and has about 600 thousand inhabitants (IBGE, 2013). João Pessoa has already had fluoridated
water for a period of two years until the mid-1980s, but so far the project has been
deactivated.
The 452 children participating in the study were divided into three groups according to the
dentifrice used in a 12 - month period: G1: 1,100 ppm F - pH 4.5; G2: 750 ppm F-pH 4.5; and
G3: 1100 ppm F-pH 7.0. The toothpaste was supplied by Oralls (São Jose dos Campos-SP, Brazil)
and dental brushes by Bitufo (Hypermarcas, São Paulo, SP-, Brazil) and there was no conflict
of interest. For the random distribution of the groups, the CREIs were considered as units,
so that only one type of toothpaste was distributed in each CREI, thus facilitating the
control of the dentifrices delivery by the teachers, as well as the supervised brushing in
CREI itself.
The toenails of the biggest toe were collected in three moments, corresponding to the
experimental period of use of the dentifrices (T1, T2 and T3), as well as the biofilm which
was collected twice, 5 and 60 minutes after brushing. The nails and biofilm fluoride
concentration were analyzed on a specific electrode using the HMDS diffusion facilitated
technique.
Nails of the large toes were collected because they provide a sufficient nail mass for
analysis and because there has been a reported possibility of contamination of the toenails
(Buzalaf, Pessan et al., 2006). The nail samples of each child were cleaned with deionized
water using a dental brush, taken to the ultrasound apparatus with deionized water for 10
min, dried at 60 ± 5 ° C and weighed on the analytical balance The presence of F was analyzed
as described in the previous item, according to the method of Taves (1968), as modified by
Whitford (1996). F patterns (0.00475, 0.0095, 0.019, 0.095, 0.190 and 0.95 mg F) were
prepared by serial dilution of a stock solution of 0.1 MF (Orion) in triplicate and diffused
in the same manner as the samples. The average repeatability of the readings based on
duplicate samples was 95%. Whenever the sample weight was> 20 mg, the analysis was performed
in duplicate.
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