RESUMO
PURPOSE: To evaluate the type and the amount of fluoridated dentifrice applied on children's toothbrushes by parents/guardians according to descriptions typically recommended by scientific societies, as well as to assess the influence of demographic and socioeconomic variables on dentifrice use. METHODS: Parents/guardians of children (0-7 years old; n = 306; convenience sample) attending vaccination centres from Araçatuba (Brazil), answered to a structured questionnaire comprising items related to interviewees' education, child's age, gender, brushing habits and use of fluoridated dentifrice. The amount of toothpaste used by children during toothbrushing was estimated using a portable scale. Similarly, the interviewees were requested to apply dentifrices on toothbrushes according to eight descriptions, ranging from "smear" to "all bristles", following a random sequence. Data were submitted to Mann-Whitney's, Kruskal-Wallis' and Friedman's tests, and Spearman's correlation coefficient (p < 0.05). RESULTS: The type of toothpaste and the amount of product used at home were not affected by the respondents' educational level or family income. However, child's age was significantly correlated with the amount of toothpaste placed on the toothbrush (r = 0.324, p < 0.001). Also, the amount of toothpaste placed on the toothbrush increased according to what would be expected from the descriptions, although wide variations were observed within each description, with large interquartile and overall ranges. CONCLUSION: The amount and the type of dentifrice used by children were influenced by their age, while parents/caregivers' interpretation on verbal instructions regarding appropriate dentifrice quantities varied widely. This reinforces the need for educative measures on the appropriate use by dentifrices by children.
Assuntos
Dentifrícios , Brasil , Cariostáticos , Criança , Pré-Escolar , Fluoretos/análise , Hábitos , Humanos , Lactente , Recém-Nascido , Escovação DentáriaRESUMO
OBJECTIVES: This study evaluated the effect of conventional (CD, 1100ppm F) and low-fluoride (LFD, 550ppm F) dentifrices, applied in different quantities, on enamel demineralization, and on fluoride (F) concentrations in the dental biofilm formed in situ. METHODS: Five combinations of dentifrices and quantities were tested: placebo (P-F-free) applied on all brush bristles; LFD applied by the transversal technique (0.3g-T1) or on all bristles (0.6g-T2); and CD applied in a pea-sized amount (0.15g-T3) or by the transversal technique (0.3g-T4), in order to produce comparable intensities (F concentration in the dentifrice×amount applied to the brush). Volunteers (n=13, 20-36 years old) wore palatal devices containing 4 bovine enamel blocks, and performed cariogenic challenges (30% sucrose solution) 6×/day, and brushing 3×/day, following a double-blind, cross-over and randomized protocol. On the 8th day, biofilm was collected 5 and 60min after brushing. The percentage of surface hardness loss (%SH), integrated loss of subsurface hardness (ΔKHN) and biofilm F concentrations (solid and fluid phases) were determined. Data were analyzed by repeated-measures ANOVA, Student-Newman-Keuls test, and Pearson's correlation coefficient (p<0.05). RESULTS: Significantly lower ΔKHN was observed for treatments with higher intensity (T2 and T4) in comparison with the lower intensity (T1 and T3). A strong correlation was observed between ΔKHN and F concentrations in total biofilm (r=-0.71) and biofilm fluid (r=-0.72) 5min after brushing. CONCLUSIONS: The treatment intensity has a significant influence on the development of caries lesions in situ. CLINICAL SIGNIFICANCE: The intensity of treatment (amount of dentifrice×concentration) during brushing seems to be a more relevant parameter of clinical efficacy than simply observing the F concentration of the product. The use of a small amount of CD significantly reduced the protective effects against enamel demineralization.
Assuntos
Esmalte Dentário/efeitos dos fármacos , Dentifrícios/administração & dosagem , Fluoretos/administração & dosagem , Desmineralização do Dente/tratamento farmacológico , Adulto , Animais , Biofilmes/efeitos dos fármacos , Brasil , Cariostáticos/administração & dosagem , Cariostáticos/uso terapêutico , Bovinos , Estudos Cross-Over , Placa Dentária/tratamento farmacológico , Dentifrícios/uso terapêutico , Relação Dose-Resposta a Droga , Método Duplo-Cego , Fluoretos/análise , Fluoretos/uso terapêutico , Dureza , Humanos , Fosfatos/administração & dosagem , Fosfatos/uso terapêutico , Propriedades de Superfície , Fatores de Tempo , Escovação Dentária , Cremes Dentais/uso terapêutico , Resultado do Tratamento , Adulto JovemRESUMO
AIM: This study examined the antifungal activity of the combination of tyrosol and farnesol against Candida albicans and Candida glabrata in the planktonic state or forming biofilms. METHODS AND RESULTS: The effect of drug association against Candida planktonic cells was assessed by the fractional inhibitory concentration index. Mono- and dual-species biofilms were developed during 24 h and then treated with the compounds for 3 days, with two daily treatments of 1 min each. After, the total biomass, metabolic activity and the number of cultivable cells were quantified. Planktonic cells of the two species showed a similar susceptibility to the drug combination, however, a synergistic effect was only verified for C. glabrata. Regarding biofilm susceptibility, significant reductions in C. glabrata biomass, metabolism of C. albicans and mixed biofilms, and cultivable cells of single biofilms were verified for the drug combination, indicating an additive effect. For all other experiments, the effects were classified as indifferent. CONCLUSION: The combined use of tyrosol and farnesol was advantageous for some of the analysed parameters against Candida species. SIGNIFICANCE AND IMPACT OF THE STUDY: These findings may contribute to the development of oral care products containing tyrosol and farnesol to combat oral infections caused by Candida species.
Assuntos
Antifúngicos/farmacologia , Biofilmes/efeitos dos fármacos , Candida albicans/efeitos dos fármacos , Candida glabrata/efeitos dos fármacos , Farneseno Álcool/farmacologia , Álcool Feniletílico/análogos & derivados , Plâncton/efeitos dos fármacos , Candida albicans/genética , Candida albicans/fisiologia , Candida glabrata/genética , Candida glabrata/fisiologia , Sinergismo Farmacológico , Testes de Sensibilidade Microbiana , Álcool Feniletílico/farmacologia , Plâncton/genética , Plâncton/fisiologiaRESUMO
This double-blind crossover study assessed the effects of a low-fluoride (low-F) dentifrice containing nanosized sodium trimetaphosphate (TMP) on enamel demineralization in situ. Nineteen subjects wore palatal appliances containing 4 blocks of bovine enamel and were randomly assigned to brush their teeth with placebo (without F/TMP), 250-ppm F (250F), 250F plus 0.05% nanosized TMP (250F-TMPnano), and 1,100-ppm F (1,100F) dentifrices during 7 d, under cariogenic challenge. Enamel surface hardness and cross-sectional hardness (ΔKHN [Knoop hardness number]), as well as F, calcium (Ca), and phosphorus (P) concentrations, were determined. Also, biofilm that formed on the blocks was analyzed for F, Ca, P, and insoluble extracellular polysaccharide concentrations. Data were submitted to analysis-of-variance models and Student-Newman-Keuls test ( P < 0.05). The 250F-TMPnano dentifrice promoted the lowest ΔKHN among all groups ( P < 0.001), while the percentage of surface hardness loss was similar to 1,100F. Also, similar F, Ca, and P concentrations in enamel were observed for 1,100F and 250F-TMPnano. In the biofilm, the highest F content was observed for 1,100F; Ca content was similar between 1,100F and 250F-TMPnano; and P content was similar among all groups. Similar extracellular polysaccharide values were observed for 250F-TMPnano and 1,100F ( P < 0.001), ionic activity of CaHPO40, CaF+, and HF0 ( P < 0.05) and degree of saturation of hydroxyapatite and CaF2 ( P < 0.05). It was concluded that the protective effect of 250F-TMPnano dentifrice was similar to a conventional dentifrice for most of the variables studied, having a more pronounced effect on the subsurface lesion when compared with the conventional toothpaste (1,100F). Knowledge Transfer Statement: Although toothpastes containing ≥1,000-ppm fluoride are more effective than low-fluoride formulations against dental caries, their early use can lead to side effects. This has prompted intensive research on alternatives to increase the anticaries effect of low-fluoride toothpastes. The present in situ study demonstrated that the addition of sodium trimetaphosphate nanoparticles to toothpastes containing 250-ppm fluoride significantly enhances the protective effect of this formulation against enamel demineralization to levels comparable to a 1,100-ppm fluoride toothpaste in terms of most of the variables studied. Most important, this formulation promoted the lowest loss of subsurface hardness among all groups, suggesting that caries lesions would take longer to develop under clinical conditions when compared with a conventional (1,100-fluoride) toothpaste.
RESUMO
UNLABELLED: Low-fluoride dentifrices (LFD) have been recommended for young children aiming to minimize excessive fluoride intake during tooth brushing. Given the uncertainties surrounding the clinical efficacy of such formulations, alternatives to increase their anticaries effect have been investigated. OBJECTIVES: This double-blind, randomized controlled trial assessed the clinical efficacy of LFDs supplemented with Calcium Glycerophosphate (CaGP) or Sodium Trimetaphosphate (TMP) on the progression of dental caries in the deciduous dentition. METHODS: Children (average age 48 months old) from two Brazilian cities (Araçatuba and Fernandópolis) were randomly assigned into 3 groups, according to the dentifrice to be used: 500ppm F plus 1% TMP ("500TMP", n=206), 500ppm F plus 0.25% CaGP ("500CaGP, n=201) and 1100ppm F ('1100F', n=193). Clinical exams (dmfs) were performed at baseline and 18 months after dentifrices started to be used, and the increment in the number of carious lesions (final dmfs - initial dmfs) was calculated. Data were analyzed by multivariate linear regression analysis to verify the influence of city, gender, previous caries experience and type of dentifrice on dmfs increment (p<0.05). RESULTS: Mean caries increment observed for 500TMP (0.26) was significantly lower when compared with 1100F (0.74), while values found for 500CaGP (0.54) were not significantly different from 1100F. Caries increment was significantly higher in children from Araçatuba and in those with previous caries experience. CONCLUSION: The results indicate that clinical efficacy of LFDs supplemented with TMP is superior to that observed for a conventional formulation (1100F), while the addition of CaGP leads to similar efficacy when compared to 1100F. CLINICAL SIGNIFICANCE: Children brushing with 500ppm F toothpastes containing phosphate salts developed fewer caries lesions when compared with those using a 1100ppm F dentifrice. The tested toothpastes can be regarded as a safe alternative to conventional formulations for children under 6 years of age, based on risk-benefit considerations.
Assuntos
Dentifrícios , Brasil , Cariostáticos , Criança , Índice CPO , Cárie Dentária , Método Duplo-Cego , Fluoretos , Humanos , Fosfatos , Fluoreto de SódioRESUMO
AIM: This study aimed to evaluate the effect of tyrosol on the formation of single and mixed biofilms of Candida albicans ATCC 10231, Candida glabrata ATCC 90030 and Streptococcus mutans ATCC 25175 formed on acrylic resin (AR) and hydroxyapatite (HA) surfaces. METHODS AND RESULTS: Single and mixed biofilms were formed on AR and HA in the presence of tyrosol at 50, 100 and 200 mmol l(-1), during 48 h. Next, antimicrobial activity was assessed through metabolic activity (XTT reduction assay) and the number of colony-forming units (CFUs). Scanning electron microscopy observations were performed in order to analyse biofilm structure. Tyrosol, mainly at 200 mmol l(-1), significantly decreased the metabolic activity and number of CFUs for all single and mixed-species biofilms formed on both surfaces. SEM images suggested cell damage caused by tyrosol. CONCLUSION: Tyrosol showed inhibitory effects against biofilms formed by important oral pathogens. SIGNIFICANCE AND IMPACT OF THE STUDY: This is the first study showing the antibiofilm effect of tyrosol on Candida species and Strep. mutans in single and mixed cultures. These results may be useful in the development of topical therapies focused on preventing biofilm-associated oral diseases, such as denture stomatitis and dental caries.
Assuntos
Anti-Infecciosos/farmacologia , Biofilmes/efeitos da radiação , Candida albicans/fisiologia , Candida glabrata/fisiologia , Cárie Dentária/microbiologia , Álcool Feniletílico/análogos & derivados , Streptococcus mutans/fisiologia , Biofilmes/crescimento & desenvolvimento , Candida albicans/efeitos dos fármacos , Candida glabrata/efeitos dos fármacos , Contagem de Colônia Microbiana , Humanos , Álcool Feniletílico/farmacologia , Streptococcus mutans/efeitos dos fármacosRESUMO
OBJECTIVE: This study evaluated the effect of fluoride gels, supplemented or not with sodium hexametaphosphate (HMP), on enamel erosive wear in situ. METHODS: Twelve healthy volunteers wore palatal appliances containing four bovine enamel discs. Subjects were randomly allocated into four experimental phases (double-blind, crossover protocol) according to the gels: Placebo (no fluoride or HMP), 1% NaF, 2% NaF, and 1% NaF+9% HMP. Enamel discs were selected after polishing and surface hardness analysis, and treated only once with the respective gels prior to each experimental phase. Erosion (ERO) was performed by extra-oral immersion of the appliance in 0.05M citric acid, pH 3.2 (four times/day, five minutes each, 5 days). Additional abrasion (ERO+ABR) was produced on only two discs by toothbrushing with fluoridated dentifrice after ERO (four times/day, 30s, 5 days). The specimens were submitted to profilometry and hardness analysis. The results were analyzed by two-way ANOVA and the Student-Newman-Keuls test (p<0.05). RESULTS: The 1% NaF+9% HMP gel promoted significantly lower enamel wear for ERO compared to the other groups, being statistically lower than 1% NaF and Placebo for ERO+ABR. Similarly, the lowest values of integrated lesion area were found for 1% NaF+9% HMP and 2% NaF, respectively, for ERO and ERO+ABR. CONCLUSION: The addition of HMP to the 1% NaF gel promoted greater protective effect against ERO and ERO+ABR compared to the 1% NaF gel, achieving similar protective levels to those seen for the 2% NaF gel. CLINICAL SIGNIFICANCE: Gel containing 1% NaF+9% HMP showed a high anti-erosive potential, being a safer alternative when compared to a conventional 2% NaF gel.
Assuntos
Cariostáticos/uso terapêutico , Esmalte Dentário/efeitos dos fármacos , Fluoretos Tópicos/uso terapêutico , Fluoretos/administração & dosagem , Fosfatos/administração & dosagem , Erosão Dentária/tratamento farmacológico , Adulto , Animais , Cariostáticos/administração & dosagem , Cariostáticos/química , Bovinos , Estudos Cross-Over , Esmalte Dentário/patologia , Dentifrícios/uso terapêutico , Relação Dose-Resposta a Droga , Método Duplo-Cego , Feminino , Fluoretos Tópicos/administração & dosagem , Fluoretos Tópicos/química , Géis/administração & dosagem , Dureza/efeitos dos fármacos , Humanos , Incisivo/efeitos dos fármacos , Masculino , Propriedades de Superfície/efeitos dos fármacos , Abrasão Dentária/tratamento farmacológico , Abrasão Dentária/patologia , Abrasão Dentária/prevenção & controle , Erosão Dentária/patologia , Erosão Dentária/prevenção & controle , Escovação Dentária/métodosRESUMO
OBJECTIVE: To evaluate the effect of a low-fluoride dentifrice (LFD) containing sodium trimetaphosphate (TMP) on enamel erosion in vitro. DESIGN: Bovine enamel blocks (n=144) were selected by surface hardness (SH) and subjected to erosive challenges, in two sets of experiments for 2 and 5 days. Blocks were randomly assigned to groups treated with slurries (5mL/block, for 15s) of following dentifrices: Placebo (no fluoride or TMP); LFD (250ppm F); LFD plus 0.25, 0.5, or 1.0% TMP; and a commercial positive control (1,425ppm F). The erosive challenge was produced by immersion in a soft drink (pH 2.8) for 5min, four times/day, interspersed by immersion in artificial saliva for 1h. SH and surface wear were analyzed as response variables. Data were submitted to 2-way ANOVA, followed by Student-Newman-Keuls test (p<0.05). RESULTS: All groups treated with LFDs containing TMP had significantly lower enamel wear when compared with the other groups tested (p<0.001). Also, the LFDs containing TPM at lower concentrations promoted SH similar to the commercial positive control, both being significantly higher than the LFD without TMP and Placebo (p<0.001). CONCLUSION: The supplementation of LFDs with TMP is able to significantly increase the anti-erosive potential of these formulations in vitro.
Assuntos
Esmalte Dentário/efeitos dos fármacos , Fluoretos Tópicos/farmacologia , Polifosfatos/farmacologia , Erosão Dentária/tratamento farmacológico , Cremes Dentais/química , Animais , Bebidas Gaseificadas , Bovinos , Dureza , Técnicas In Vitro , Propriedades de SuperfícieRESUMO
OBJECTIVE: This study analyzed the effects of a fluoride (F) varnish supplemented with sodium trimetaphosphate (TMP) on the remineralization of caries-like lesions in situ. MATERIALS AND METHODS: Twelve subjects used palatal devices with demineralized enamel discs for 3 days, following a double-blind, crossover protocol. Test groups included placebo (no F or TMP), 5% NaF and 5% NaF/5% TMP varnishes. The percentage of surface hardness recovery (%SHR) and cross-sectional hardness (ΔKHN) were determined. RESULTS: Significant differences were observed among all varnishes regarding %SHR and ΔKHN. The highest %SHR and the lowest ΔKHN were seen for the 5% NaF/5% TMP varnish, followed by 5% NaF and placebo. CONCLUSION: The remineralizing effect of a 5% NaF varnish is significantly enhanced when associated with TMP. CLINICAL RELEVANCE: The reduction in the subsurface lesion area of enamel treated with the TMP-containing varnish implies that cavities would take longer to develop or might not develop at all depending on individual factors, resulting in lower net caries increments at individual and population levels.
Assuntos
Cárie Dentária/tratamento farmacológico , Cárie Dentária/metabolismo , Fluoretos Tópicos/administração & dosagem , Polifosfatos/administração & dosagem , Calcificação de Dente/efeitos dos fármacos , Adulto , Método Duplo-Cego , Feminino , Humanos , MasculinoRESUMO
OBJECTIVES: This study aimed to evaluate the effect of low-fluoride toothpastes with calcium glycerophosphate (CaGP) on enamel remineralization in situ. METHODS: Volunteers (n=10) wore palatal devices holding four bovine enamel blocks. The treatments involved 5 experimental phases of 3 days each according to the following toothpastes: placebo, 500 ppm F (500 NaF), 500 ppm F with 0.25% CaGP (500 NaF CaGP), 500 ppm F with 0.25% CaGP (500 MFP CaGP) and 1100 ppm F (1100; positive control). After this experimental period, the fluoride, calcium, and phosphorus ion concentrations from enamel were determined. Surface and cross-sectional hardness were also performed. Data were analysed by 1-way ANOVA, Student-Newman-Keuls' test and by Pearson's correlation. RESULTS: The addition of 0.25% CaGP improved the remineralization potential of low-fluoride toothpastes and the NaF as source of fluoride yielded the best results (p<0.001) as evidenced by the hardness analysis. The 1100 ppm F toothpaste provided higher presence of fluoride in the enamel after remineralization (p<0.001). The addition of CaGP to the NaF and MFP toothpastes led to similar calcium concentration in the enamel as the observed with the positive control (p=0.054). CONCLUSIONS: Toothpastes with 500 ppm F (NaF or MFP) and CaGP showed similar remineralization potential than 1100 ppm F toothpaste. CLINICAL SIGNIFICANCE: Toothpastes containing 500 ppm F associated to CaGP, with both fluoride source (NaF or MFP), showed a potential of remineralization similar to commercial toothpaste. Although there is a need for confirmation in the clinical setting, these results point to an alternative for improving the risk-benefit relationship between fluorosis and dental caries in small children.