Search Results (61)

Fluoride prophylaxis is a cornerstone in preventing dental caries, a disease for which orthodontic patients are at high risk due to the reduced effectiveness of home oral hygiene and increased plaque accumulation. Recent evidence defines caries as polymicrobial, involving Streptococcus mutans, Lactobacilli, and emerging species such as Selenomonas sputigena. This prospective, randomized, controlled study evaluated professional topical fluoride in the form of gel and varnish in 68 patients aged 8–17 years wearing fixed orthodontic appliances. Participants were divided into three equal groups: two intervention groups and one control group. Clinical parameters (DMFT, salivary pH, PCR%) and microbiological analyses of plaque and saliva (oral Streptococci, S. mutans, S. sputigena, Lactobacilli, total bacterial count) were assessed at baseline (T0) and after 4 months (T1), following professional hygiene and fluoride application for the intervention groups. At T1, salivary pH increased in the gel group, and PCR% decreased significantly in all groups, with the most pronounced decrease observed in the varnish group. PCR analysis showed a higher rate of S. mutans and S. sputigena negativization in intervention groups. Culture-based analyses revealed reductions in oral Streptococci and Lactobacilli in intervention groups, while levels increased in controls. Overall, both clinical and microbiological variables indicated improvements in the fluoride-treated groups compared to controls, highlighting the efficacy of professional fluoride prophylaxis in orthodontic patients. Full article

Background/Objectives: Dental caries, one of the most common oral diseases worldwide, represents a major public health concern. Contemporary dentistry has established several non-invasive approaches and resin infiltration, as a micro-invasive path, in the treatment of white spot lesions (WSLs). This study aimed to evaluate the effect of different WSL treatments on enamel surface microhardness. Materials and Methods: Seventy-five intact human premolars extracted upon orthodontic indication and the demineralizing solution composed of acetic acid, monopotassium phosphate and calcium chloride with pH = 4.4 and exposure time 96 h were used. The samples were randomly divided into five groups (n = 15): I—intact enamel (control group); II—artificial white spot lesion; III—artificial WSL treated with fluoride varnish; IV—artificial WSL treated with casein phosphopeptide—amorphous calcium phosphate (CPP-ACP) paste; V—resin-infiltrated artificial WSL. The surface microhardness was determined using the Oliver–Pharr method and a spherical indenter (Shimadzu Indenter, Kyoto, Japan). One-way analysis of variance (ANOVA) followed by a Post Hoc test (Bonferroni) was used with a level of significance set at p < 0.05. Results: Resin-infiltrated white spot lesions showed comparable microhardness mean value as the control group: 68.23 (±21.45) and 63.57 (±18.89), respectively (p > 0.05). Also, resin infiltration increased enamel microhardness compared to WSL values, with a statistically significant difference (p < 0.05). Fluoride varnish and CPP-ACP treatment resulted in equivalent values (50.84 ± 14.35 and 50.99 ± 15.31, respectively). Conclusions: Different WSL treatments (fluoride varnish, CPP-ACP and resin infiltration) produced comparable enamel microhardness values. Among the tested agents, resin infiltration resulted in higher microhardness values, while fluoride varnish and CPP-ACP demonstrated equivalent outcomes. Full article

Dental caries is a prevalent health condition affecting 87% of the population. The application of fluorinated varnishes to incipient lesions promotes remineralization. To evaluate the remineralizing effect of three fluorinated varnishes through chemical and physical characterization of incipient enamel lesions in vitro, a total of 150 enamel surfaces were randomly divided into five groups (n = 30): healthy enamel, initial lesion, Fluor-Protector, β-Clinpro-White-Varnish, and Duraphat. All groups, except for the healthy enamel, were immersed in a demineralizing solution (pH 4.4) for 96 h. Remineralization was assessed using a pH cycling model over 5, 10, and 15 days. Fluoride release was measured via ISE-F, and enamel was analyzed by Raman spectroscopy (PO₄³⁻), roughness, and Vickers hardness. Data were analyzed using ANOVA and a post hoc test (Tukey). Ion Selective Electron-Fluor showed a residual F concentration of 0.40 ppm for the Fluor-Protector remineralizing solution: 40.00 ppm for Clinpro-White-Varnish, and 50.0 ppm for Duraphat. Raman analysis confirmed PO₄³⁻ at 956 cm⁻¹ mainly in CDu group. Roughness decreased with varnish application: Fluor-Protector (0.36 µm), β-Clinpro-White-Varnish (0.73 µm), and Duraphat (0.65 µm). Hardness increased with Fluor-Protector. Statistically significant differences were found between FP and other types of varnish. Fluorinated varnishes enhance remineralization and reduce enamel roughness and demineralization. Fluor Protector and β-Clinpro-White-Varnish showed the most favorable results, suggesting their recommendation for high-risk pediatric patients. Full article

Background: Dental caries remains one of the most prevalent chronic diseases worldwide. Fluoride has long been recognized as a cornerstone of caries prevention through enamel remineralization, inhibition of demineralization, and antibacterial activity. However, controversies persist regarding systemic exposure, potential health risks, and ethical debates over community water fluoridation. Previous reviews often focused on isolated interventions, whereas a critical synthesis of mechanisms, clinical efficacy, safety, and public health perspectives is still lacking. Methods: This narrative review synthesized peer-reviewed publications from 2000 to 2025 retrieved from PubMed, Scopus, Web of Science, and leading dental journals. Emphasis was placed on randomized controlled trials, systematic reviews, meta-analyses, and major policy documents. Evidence was thematically appraised across mechanisms of action, clinical applications, comparative efficacy, safety, and sociocultural considerations. Results: Fluoride consistently shows preventive and therapeutic benefits across multiple delivery forms, including toothpaste, varnishes, mouthrinses, supplements, and silver diamine fluoride, with particular advantages for high-risk groups such as children, orthodontic patients, and older adults. Nonetheless, study heterogeneity, variations in protocols, and concerns regarding fluorosis and possible neurodevelopmental effects highlight persistent uncertainties. Comparative analyses reveal trade-offs between efficacy and acceptance, for example, the high caries-arrest rate of silver diamine fluoride compared with its esthetic drawback. Emerging alternatives such as nano-hydroxyapatite, fluoride-containing bioactive glass, and probiotic-based approaches are promising but currently supported by limited clinical data. Conclusions: Fluoride remains central to caries prevention, yet its optimal use requires balancing benefits against risks, addressing cultural and socioeconomic barriers, and tailoring strategies to individual and community contexts. This narrative synthesis underscores the need for well-designed multicenter randomized controlled trials, longitudinal studies to refine safe exposure thresholds, evaluations of novel biomaterials and delivery systems, and the incorporation of patient-reported outcomes to guide future evidence-based policies and clinical practices. Full article

Background: Dental enamel demineralization is a critical early event in the development of dental caries. To address this, bioactive compounds have been explored for their potential to mitigate enamel demineralization and promote remineralization. Previous studies have demonstrated that varnishes containing natural compounds such as trans,trans-farnesol (tt-farnesol), quercetin, and theobromine exhibit antimicrobial activity, suggesting potential in caries prevention. Thus, this laboratory study assessed the ability of these varnishes to prevent enamel caries lesion formation by using a chemical model to determine whether these natural compounds interfered with de- and remineralization processes in the absence of a cariogenic biofilm. Methods: Sixty bovine enamel specimens, each measuring 5 × 5 × 2 mm, were selected according to their initial surface hardness (SHI), measured by Knoop hardness in three indentations spaced 100 µm apart. The specimens were allocated to the following groups in a random manner (n = 15): an experimental varnish without compounds (NC/negative control); experimental varnishes containing the combination of tt-farnesol, quercetin, and theobromine at concentrations of 1.5% (E1) and 4.5% (E2); and Duraphat™ (NaF 5%/gold standard—D). After applying the varnishes, they remained in artificial saliva for 6 h. The specimens were then subjected to 8 pH cycles, including 4 h of demineralization and 20 h of remineralization. Surface hardness was measured again to calculate the percentage of surface hardness loss (%SHL), and three specimens from each group were examined using scanning electron microscopy. Comparisons were made using ANOVA (p < 0.05). Results: The D group (5% NaF) demonstrated a significantly lower %SHL (75.5% ± 7.88) than the other groups (p < 0.05). E1 (86.3% ± 5.33) was statistically similar to NC (81.8% ± 4) but lower than E2. E2 showed the highest %SHL (91.6% ± 3.64) compared to the other groups. Surface demineralization was evident in all specimens post pH cycling. Conclusion: The bioactive varnishes containing tt-farnesol, quercetin, and theobromine at concentrations of 1.5% and 4.5% did not exhibit a protective effect against mineral loss in dental enamel in the absence of a cariogenic biofilm. Full article

Proximal caries presents diagnostic and therapeutic challenges. Recent understanding of the etiology and pathology of dental caries has led to the adoption of non-invasive and/or minimally invasive approaches in the early stages of caries lesions. This clinical study aimed to compare the efficacy of resin infiltration and remineralization in the treatment of initial proximal caries lesions over a 1- and 2-year follow-up period. The study involved 47 patients aged between 18 and 38 years. Patients were clinically examined and underwent bitewing radiography to detect at least three initial proximal caries lesions. Each detected lesion (180 in total) was randomly assigned to one of three treatment groups: (1) resin infiltration with Icon Proximal Infiltrant (DMG); (2) remineralization with Clinpro White Varnish (3M); and (3) a control group receiving no treatment. One year after treatment, caries progression was found in 30 lesions (16.6%) with the following distribution across the three treatment groups: 2/60 (3%) in the infiltration group; 11/60 (18%) in the remineralization group; 17/60 (28.30%) in the no treatment control group with a significant statistical difference between the groups (p = 0.001). In terms of lesion depth, 12 (11%) out of 106 E2 lesions progressed and 18 out of 74 (24%) D1 lesions progressed, with a significant difference (p = 0.037). Two years after treatment, five new lesions were found to have progressed (one E2 and four D1), distributed as follows: 0% in the infiltration group, 3.6% in the remineralization group, and 5% in the control group. In conclusion, resin infiltration exhibited the lowest percentage of progressed lesions and could be considered a reliable, non-invasive treatment for initial proximal caries. Full article

White spot lesions (WSLs) are early clinical stages of enamel demineralization, often related to orthodontic treatment or poor oral hygiene. The use of gels such as fluoride for topical application inhibits demineralization and promotes remineralization of dental tissues through various mechanisms. A variety of therapeutic approaches are available; however, recent research indicates that combined treatment strategies may yield superior clinical outcomes compared to monotherapy. The aim of this study was to critically compare the efficacy of combining multiple treatment techniques for WSLs compared to using these techniques alone. A systematic search was conducted in PubMed, Scopus, and Cochrane databases according to PRISMA guidelines. The PICO strategy was used to formulate the research question: Which clinical approaches combined or isolated (C) influence the treatment and prevention effectiveness (O) of white spot lesions (I) in humans (P) in the last ten years (T)? Inclusion criteria focused on clinical studies from the last ten years evaluating the combined use of at least two treatment techniques for WSL, resulting in a total of 8 randomized controlled trials selected from an initial pool of 1185 articles. Our results suggest that combined treatment strategies, including resin infiltration with fluoride varnish and ozone therapy combined with fluoride application, demonstrated enhanced efficacy in lesion masking and remineralization compared to single-treatment approaches. CPP-ACP and hydroxyapatite-based creams improved aesthetics, particularly when used alongside fluoride varnish. Our study concluded that the combination of remineralization agents like fluoride gel, infiltrative resins, and antimicrobial treatments offers superior outcomes on white spot lesion treatment than using these techniques alone. However, long-term clinical studies are needed to standardize treatment protocols and confirm durability. Full article

(1) Background: White spot lesions (WSLs) on enamel result from demineralization and are an early sign of dental caries. Glass ionomer cement (GIC) has been widely used for its remineralization potential, and zinc-containing GIC (zGIC) has been introduced to enhance this effect. However, its efficacy compared to conventional GIC (cGIC) remains unclear. This study aimed to evaluate and compare the remineralization effects of cGIC and zGIC on WSLs. (2) Methods: Thirty-six bovine enamel specimens were prepared, demineralized for four days, and divided into three groups: control, cGIC, and zGIC. Half of each specimen’s treated window was covered with varnish, and a two-week pH cycling protocol was conducted. Mineral density (MD) changes were assessed using microcomputed tomography (Micro-CT) at five time points: pre-demineralization, after demineralization, immediately after treatment, and 1- and 2-weeks post-treatment. Scanning electron microscopy (SEM) was also performed. (3) Results: MD values in the zGIC and cGIC groups were significantly higher than in the control group throughout every post-treatment assessment (p < 0.05). zGIC demonstrated significantly higher MD than cGIC (p < 0.05), and SEM images revealed inferior mineral deposition. (4) Conclusions: These findings suggest that zGIC is more effective in remineralizing WSLs than cGIC over two weeks. Full article

Background/Objectives: The implementation of preventive treatments in pediatric dental care has been a priority in recent years. Understanding the factors that influence the timing and frequency of childhood preventive treatments, such as the impacts of the COVID-19 pandemic, are the focus of many health informatics researchers. Methods: A retrospective study was approved to assess changes in specific preventive treatments at a pediatric dental school clinic (sealants, fluoride varnish, and silver diamine fluoride) in the three years prior to (2017–2019) and following the COVID-19 pandemic (2020–2022). Results: A detailed analysis of these data revealed significant and unexpected shifts in these preventive services, with significant increases in dental sealants from pre- to post-pandemic (35.1%, p = 0.012), but corresponding decreases in other preventive treatments, such as the number of fluoride varnish (−37.6%, p = 0.011) and SDF treatments (−24.0%, p = 0.032), among this patient population. Conclusions: These data suggest that the selective pursuit of particular preventive dental services and treatments rather than others and understanding these shifts might help health informatics and dental public health researchers understand which factors influenced these decisions and behaviors, such as long-term durability and efficacy (sealants) or changing public perceptions of safety (fluoride and SDF). Full article

Background/Objective: The taste perception of clinical materials used in dental treatment procedures can influence the compliance of autistic children during dental visits due to their heightened anxiety and sensory processing difficulties. This study aimed to evaluate the taste acceptance of different fluoride varnish preparations among children with autism spectrum disorder (ASD) in a clinical setting. Methods: This parallel-arm single-blinded randomized clinical study included autistic children aged 6–14 years, referred to a community dental clinic unit for preventive dental care. Non-verbal behavior, as a measure of taste acceptance, was assessed using the Frankl behavior rating scale. Additionally, subjective taste responses were recorded using a 3-point facial hedonic scale. Data were analyzed using descriptive statistics and the chi-square test. Results: There was no statistically significant difference in non-verbal behavior between the three fluoride varnish groups before application (p = 0.094) or immediately after application (p = 0.718). However, when comparing pre- and post-application responses within each group, Duraphat^® showed a significant improvement in non-verbal behavior (p = 0.020), while no significant changes were observed for Profluorid^® (p = 0.196) or MI Varnish^® (p = 0.704). Subjective taste acceptance, as measured by the 3-point facial hedonic scale, showed no significant differences among the varnish groups (p = 0.406). Conclusions: Flavored fluoride varnishes may improve the compliance of autistic children with preventive oral care procedures. Although no significant differences in taste acceptance were observed among the three varnishes, Duraphat^® was associated with a significant improvement in non-verbal positive behavior, suggesting a more favorable response in autistic children. Full article

Background and Objectives: Contemporary caries treatment seeks to preserve hard dental tissues as well as to promote lesion remineralization and biological tissue regeneration. While fluoride-based treatments remain the gold standard, their effectiveness has limitations, prompting interest in innovative remineralization technologies. Nano-hydroxyapatite (nano-HA) varnish and self-assembling peptide (SAP) P11-4 are promising biomimetic materials that promote enamel repair, yet long-term data on their efficacy are limited. The objectives of this study were to evaluate the effectiveness of nano-HA varnish and peptide P11-4 in restoring enamel surface hardness after artificial lesions in vitro and to compare them to a control group and fluoride varnish. Materials and Methods: Artificial enamel lesions were created on the buccal surfaces of 36 extracted human molars, which were randomly divided into four groups (n = 9): control, peptide P11-4, fluoride varnish, and nano-hydroxyapatite varnish. After applying the materials as per manufacturer instructions, specimens were stored in artificial saliva for 14 days. Enamel surface hardness was measured using the Vickers hardness test (HV) at baseline, after demineralization, and after remineralization. Statistical analysis was performed with “IBM SPSS 27.0” using non-parametric Kolmogorov–Smirnov, Kruskal–Wallis, Dunn’s, and Wilcoxon tests. Results: The mean baseline enamel hardness value was 323.95 (SD 33.47) HV. After 14 days of demineralization, the mean surface hardness of artificial enamel lesions significantly plummeted to 172.17 (SD 35.96) HV (p = 0.000). After 14 days of remineralization, the mean value significantly increased to 213.21 (SD 50.58) HV (p = 0.001). The results of the study revealed statistically significant enamel remineralization of the peptide P11-4 group in regard to the demineralized enamel (p < 0.05). In contrast, there were no significant results in other treatment groups (p > 0.05). Remineralization of enamel was the highest in samples from the P11-4 group (54.1%), followed by the nano-HA group (35.4%), FV group (17.8%), and control group (11.2%). There was a significant difference (p < 0.05) in the remineralizing ability between the peptide P11-4 and all other treatment groups. Conclusions: Self-assembling peptide P11-4 effectively remineralized artificial enamel lesions and proved to be significantly more effective compared to fluoride varnish and nano-hydroxyapatite varnish, showcasing its superior performance as a remineralizing agent. Full article

Background/Objectives: In Marburg (Hesse, Germany), the selective intensive preventive program (SIP) with fluoride varnish applications had to be interrupted due to the COVID-19 pandemic. The aim of this retrospective anonymized evaluation was to investigate possible effects of SIP interruption on oral health in socially vulnerable 7- and 8-year-olds. Methods: The caries increment in 7- and 8-year-olds for the test group (N = 180) between last dental check-up before the interruption of SIP (02/2019–02/2020) and the first check-up after restart (01/2022–07/2022) were calculated from dental public health service data. The test group was compared to a control group of children (N = 215; same age and schools, with SIP, data collected between the school year 2017/18 and 2019/20). One dentist conducted the dental examinations. The University of Marburg ethics committee approved the study. The Mann–Whitney U test and Pearson’s chi-square test were used for statistical analysis. Results: There was no significant difference in the caries increment in the first dentition between the test and the control group for both age groups. In the different groups, a maximum of 61% of the children with caries experience were completely treated. There was no significant difference between the test and control groups in either the percentage of sealed first permanent molars or the degree of restoration. Conclusions: The interruption of SIP had no negative impact on caries increment. It is possible that the children examined went through the pandemic without a significant increase in tooth decay because the children were well-trained in tooth brushing since kindergarten. Full article

Oral health is fundamental to overall well-being, especially in childhood, when dental structures and lifelong habits are established. This review provides a comprehensive analysis of children’s dental development, common oral health challenges, and evidence-based preventive strategies. Key topics include the mechanisms of tooth development, the eruption processes of primary and permanent dentition, and the management of developmental abnormalities. The prevalence, risk factors, and health impacts of dental caries in children are examined, underscoring the need for early intervention and targeted prevention. This review evaluates the effectiveness of preventive measures such as dental sealants, fluoride varnishes, and fluoride mouth rinses while highlighting the influence of dietary habits, toothbrush selection, and parental involvement on oral health outcomes. Additionally, it explores the synergistic benefits of combining preventive approaches, such as the concurrent use of dental sealants and fluoride applications, which have demonstrated superior caries prevention compared to either method alone. The effectiveness of these strategies is analyzed across different age groups, from early childhood to adolescence, with tailored recommendations for each developmental stage. Furthermore, the role of education, policy interventions, and community-based programs in addressing oral health disparities is discussed. By integrating developmental insights with epidemiological data and clinical evidence, this review provides a comprehensive framework for advancing pediatric dentistry, informing best practices, and enhancing preventive strategies to reduce the burden of oral diseases in diverse pediatric populations. Full article

This study introduces innovative varnishes incorporating natural bioactive compounds to inhibit the formation of oral dual biofilms, a critical contributor to dental caries and other oral diseases. The purpose of this study was to evaluate the effectiveness of bioactive varnishes containing tt-farnesol, quercetin, and theobromine in inhibiting the formation of mixed Streptococcus mutans and Candida albicans biofilms. Mixed biofilms of Streptococcus mutans UA159 and Candida albicans SC5314 were grown in 96-well plates containing a specialized culture medium. Approximately 0.2 mL of experimental varnishes with A—1.5% or B—4.5% concentrations of tt-farnesol, quercetin, and theobromine were separately added to the wells using a disposable applicator, with a vehicle varnish (lacking bioactives) serving as the control. Biofilms were incubated at 37 °C with 5% CO₂ for 24 h. Microbial viability was determined in terms of colony-forming units per milliliter (CFU/mL), and biofilm morphology was evaluated qualitatively via scanning electron microscopy (SEM). Statistical analyses were performed using ANOVA/Tukey tests at a 5% significance level. Varnishes A and B achieved significant reductions in microbial populations within the biofilms (p < 0.05) compared to the vehicle control (C). SEM imaging revealed marked structural disruptions in the biofilms, validating the quantitative results. Higher bioactive concentrations demonstrated enhanced inhibitory effects. Bioactive varnishes enriched with theobromine, quercetin, and tt-farnesol represent a novel and effective strategy for inhibiting oral dual biofilm development, offering a promising advancement in preventive dentistry. Full article

Objectives: Dental erosion has evolved into a common condition with growing concern in the dental community. The aim of this study was to explore the protective effects of two highly fluoridated products, silver fluoride solution (silver diamine fluoride-potassium iodide solution, SDF-KI) and fluoride varnish, on dental erosion in mouse. Methods: Two groups of ten young CD-1 mouse were given a cola drink ad libitum over a 6-week period. A prophylactic treatment with a silver fluoride solution (38% SDF 48,000 ppm F with a silver concentration of 253,900 ppm) and a fluoride varnish (NaF, 22,600 ppm F) were applied on the mandibular molars, performed under sedation twice a week during the whole experiment. Furthermore, two control groups of ten mice were included, a positive (cola drink) and a negative (distilled water) control. A terminal procedure was followed by dissection of mandibular molars and analysis of them using scanning electron microscopy (SEM). The first molars were transversely ground, further analyzed by SEM, and measured for tooth height and tooth tissue loss. Results: Analyses of mandibular molars treated with a fluoride varnish indicated a 5% decreased tooth tissue loss, compared to the molars which served as a positive control. The best effect was achieved with the application of silver fluoride solution, displaying a 35% decreased tooth tissue loss compared to the positive control group. Conclusions: Preventive treatment with a solution of silver fluoride solution exhibits greater protection against dental erosion compared to a traditional fluoride varnish. This study indicates that silver fluoride solution is an effective fluoride compound and is highly beneficial in a clinical setting with the aim of preventing dental erosion. Full article