Fluoride and the caries lesion interactions and mechanism of action

Les conséquences sont une inhibition de la prolifération bactérienne de la plaque dentaire et une inhibition de la formation des acides cariogènes. Le fluor ne saurait toutefois suffire à l'élimination de la plaque bactérienne ou au traitement des caries.

Certains minéraux tels que le calcium, le magnésium, l'aluminium ou le fer peuvent chélater les ions fluor et diminuer leur absorption. L'ingestion simultanée de produits laitiers ou d'antiacides à base de sels de magnésium ou d'aluminium doit être évitée.

Prendre les topiques gastro-intestinaux à distance du fluorure de sodium plus de 2 heures, si possible quand un effet systémique est recherché. Elle se manifeste par des troubles digestifs : vomissements, diarrhée, douleurs abdominales et peut mener exceptionnellement au décès.

Lors d'ingestion importante accidentelle, le traitement immédiat consiste en lavage d'estomac ou vomissements provoqués, ingestion de calcium importante quantité de lait et surveillance médicale de plusieurs heures. Aspect tacheté ou moucheté de l'émail dentaire pouvant apparaître à partir d'une absorption quotidienne d'une dose de fluor supérieure à 1. Elle s'accompagne d'une fragilité de l'émail dans les formes sévères. Il n'y a pas de bénéfice pour les dentitions provisoire et définitive de l'enfant, à supplémenter sa mère en fluor en cours de grossesse ou en période d'allaitement.

Menu Dossiers. BeautyLab Doctipharma. Un article Un médicament. Forums Médicaments. Interactions Surdosage Grossesse et allaitement Autres informations. Prévention de la carie dentaire.

Ce dosage à 0,50 mg est particulièrement adapté à l'enfant de 10 à 15 kg. Dès l'apparition des premières dents jusqu'à 18 ans : Les comprimés peuvent être croqués ou sucés, en une seule prise quotidienne. Chez l'adulte : Seul l'effet topique est recherché. Déclaration des effets indésirables suspectés La déclaration des effets indésirables suspectés après autorisation du médicament est importante. Contre-indications : quand ne pas utiliser ce médicament? Présentation de ce médicament Comprimés en tube Polypropylèneavec bouchon à fermeture sécurité enfant Polyéthylèneboîte de Aspect et forme Comprimé.

Excipients à effets notoires? Autres excipients: Magnésium stéarate, Menthe poivrée, huile essentielle, Fer oxyde jaune, Silice colloïdale, Mélange colorant : Fer oxyde rouge, Fer oxyde jaune, Fer oxyde noir, Titane dioxyde. Competing interests: The authors declare that they have no conflict of financial and non-financial interests Political, personal, religious, ideological, academic, intellectual, commercial, or any other.

The increasing elderly population in many developed countries is expected to retain their teeth into old age [ 1 ]. Simultaneously, the number of exposed root surfaces and non-carious cervical lesions in elderly people is steadily increasing[ 2 ]. The need for adequate prevention and treatment of this condition is of high relevance. The treatment options for non-carious cervical lesion include either to watch and wait or to intervene early with restorations [ 3 — 5 ].

Clinically, the most critical step is the detection of the disease and the identification of the cause before the etiological factors can be addressed. Non-carious cervical lesions often are the result of substance loss that results from mechanical interaction between toothbrush, toothpaste and tooth. Frictional forces are increased by small particles contained in toothpaste [ 67 ]. The abrasivity is modified by the type of toothbrush and the applied brushing force [ 8 ].

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Today power toothbrushes are widely used and power toothbrushes show more benefits with regard to reducing gingivitis and plaque in comparison to manual toothbrushes in short- and long-term observation periods [ 910 ].

However, it is plausible that the use of power toothbrushes—albeit more effective for plaque removal—might be associated with a higher risk of loss of tooth substance.

According to a recent review article, a comparison of power and manual brushes revealed that power brushes are less abrasive than, or similarly abrasive as manual brushes. Additionally, the comparison of different power toothbrushes has shown significant differences in abrasivity [ 11 ]. A recent consensus report concluded that there is currently no evidence from studies regarding the development or progression of non-carious cervical lesions [ 12 ].

Non-carious cervical lesions are seen daily by clinicians in dental practice. It is unknown whether the higher cleaning efficacy of power toothbrushes with an abrasive toothpaste used over long period of time might be harmful for hard tissues. Thus, the aim of this study was to evaluate the brushing abrasion of dentin using four different toothbrushes with toothpaste with a relative dentin abrasiveness index RDA of in a simulated long-term setting. Two power toothbrushes and two manual toothbrushes were included.

The null hypothesis was that there are no differences between the tested toothbrushes in abrasiveness.

Based on an effect size of 1. Only extracted teeth with prior written consent were collected. In addition, all patients were verbally informed that their extracted molars would be used for research purposes.

Extracted teeth were de-identified before they were passed on to the investigator. Seventy-two extracted human molars were used to generate dentin specimens. Molars were inspected for imperfections in the surface. Teeth with cracks, caries, discolorations or loss of hard tissue were excluded.

Fluoride and the caries lesion interactions and mechanism of action

Teeth were stored in 0. Only one specimen was prepared from each tooth. The enamel layer was removed with a diamond bur until the dentin layer was exposed, which was verified under a light microscope 10x magnification. After removal of the enamel, the dentin surface was flattened and progressively polished with abrasive paper up to grit using a polishing machine EXAKT, Norderstedt, Germany. The tooth brushing machine included six holders for toothbrushes Fig 1.

Each toothbrush worked on up to three specimens. The holders for the toothbrushes were customized for the toothbrush handle with silicone putty Eurosil, Henry Schein, Melville, NY, USA to hold the toothbrush in place.

The specimens were mounted with standardized key lock fixations. The bristles of the toothbrush were aligned without pressure contacting the specimen surface in perpendicular fashion. A linear cleaning movement of 3 cm length was selected for the experiments with power and manual toothbrushes. A force of 2 N was chosen for brushing. The cleaning force was generated using a compressing spring and an extending screw.

Before the brushing procedure was initiated, half of the dentin surface was covered with an adhesive tape Tesa, Beiersdorf, Hamburg, Germany parallel to the long axis of the direction of the brushing movement [ 14 ]. Experiments were performed using two power and two manual toothbrushes Fig 2. The ingredients of the toothpaste included water, sorbitol, hydrated silica, potassium citrate, propylene glycol, glycerin, sodium bicarbonate, sodium C 14—16 olefin sulfonate, cellulose, gum, aroma, tetrapotassium pyrophosphate, sodium fluoride, sodium, saccharin, allantoin, sodium methylparaben, titanium dioxide, limonene, and CI ppm fluoride.

Specimens were randomly allocated to four groups Fig 2. The total brushing strokes were calculated to be equivalent to 8. Based on this estimation, the maximum contact time for one tooth surface per day is 5 seconds [ 16 ].

The total brushing time was calculated to be min. The brush head should be replaced after 45 days a typical time period to replace the brush. This represents minutes of cumulative use for 28 teeth 72 surfaces with 5 s brushing per day. The total surface of the three specimens with 6 mm diameter approximately equalled the surface of one tooth. A brushing time of 5 s per day for 8.

Therefore, the brushing time of min was selected for the study. The movement of the power toothbrushes differs from brushing with a manual toothbrush. With oscillating-rotating technology, the brush head oscillates from a center point but does not rotate in a full circle [ 17 ].

Considering these differences in brushing movement, each sample was submitted to 31, brushing strokes at a rate of strokes per minute for manual toothbrushes [ 18 ] and 2, brushing strokes at a rate of 10 strokes per minute for activated power toothbrushes. Brushing movements were executed with the slurry applied to the surface of the specimens.

Specimens were rinsed with tap water for 30 seconds and received new slurry automatically every 2 minutes. The cleaning force was set to 2 N, and the cleaning movement was set at 3 cm longitudinally. After the final cleaning run all samples were stored in saline to avoid sample disintegration due to dehydration.

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After removal of the adhesive tape, the dentin specimen was carefully dried with cotton rolls and briefly air dried to retain moisture in the specimen.

Differences in surface abrasion between the exposed and protected area of the dentin specimens were evaluated using optical profilometry InfiniteFokus G3, Alicona, Graz, Austria with the corresponding software IFM 2. For quantitative measurements of the surface abrasion, a 3D image at 20 x magnification and resolution was taken at the border of the exposed and protected dentin surface to include both areas in equal parts.

The scanned area was equally divided between the area covered with tape and the area exposed to toothbrushing Fig 3. Frontal view of a scan with the reference area on top and the brushed area on the bottom. Measurements were made under moist conditions at all times. Excess of water was blotted with absorbent tissue without touching the specimen surface. Surface scans were performed with a 20x magnification lens and a vertical depth of nm. The mean of 15 measurements of the surface height served as the primary outcome of this study.

Immediately after the completion of the profilometry measurement, specimens were placed back into saline. Fig 4A—4D. The Kolmogorov-Smirnov test showed a homogeneous distribution of the data. Alpha was adjusted to avoid alpha-error accumulation with regard to multiple paired comparisons. The power toothbrushes caused significantly higher dentin abrasion compared to the manual toothbrushes using the same brushing force and time. Highest dentin abrasion was measured for sonic toothbrush and lowest for the rippled-shaped manual toothbrush.

The order of the highest to the lowest abrasion after simulation of eight years and six months is as follows: sonic toothbrush, oscillating-rotating toothbrush, manual toothbrush with flat trim, rippled-shaped manual toothbrush. This study evaluated the effect of four toothbrushes on dentin abrasion over a simulated long-term period in vitro. Patients with cervical abrasions were found to have less plaque than those without abrasions [ 19 ]. In vitro studies showed that the abrasive effect of tooth brushing on the gingiva depends on the direction and frequency of the brushing movement and other factors such as applied force as well as quality and arrangement of the toothbrush bristles [ 20 ].

Our study shows that abrasion of dentin by tooth brushing depends to a significant degree on the type of toothbrush. Two power toothbrushes with two different modalities side-to-side-action, oscillating-rotating and two different manual toothbrushes were tested in the present study. Hence, the null hypothesis of this study was rejected.

Brushing force is a crucial factor for the development of abrasions. Regime special diabete gestationnel 5sa brushing force of 3 N in an in-vitro study was shown to produce increased loss of dentin in vitro [ 21 ]. Loss of enamel can be induced when challenged with acid under a similar brushing force of 2.

Brushing forces from 0. For manual toothbrushes, brushing forces ranged from 1. Pour tout problème ne concernant pas le site www. Contact Webmaster. Merci de saisir le code présenté : Cliquez-ici pour recharger l'image. Vos préférences de navigation ont bien été enregitrées. Refuser tout Accepter tout. Cookies tracking. En savoir plus Adobe analytics Google analytics Mediametries analytics. Cookies sociaux. En désactivant ces cookies, vous ne pourrez plus partager les articles depuis le site Vidal sur les réseaux sociaux.

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