Keywords :
Enamel erosion, Fluoride dentifrices, Mouthwash, Scanning electron microscope
Citation Information :
Goyal S, Bhola L, Shivkumar AT, Manningal A, Moothedath M, Mishra D. Influence of Different Mouthwashes on the Efficacy of Fluoridated Dentifrices in Prevention of Enamel Erosion: An In Vitro Study. J Contemp Dent Pract 2023; 24 (10):739-742.
Aim: The purpose of the current study was to evaluate the impact of three various mouthwashes on the effectiveness of fluoride dentifrices in preventing enamel erosion.
Materials and methods: A total of 120 sound intact human premolar teeth which were extracted for orthodontic treatment were selected for the study. A 3 × 3 mm window section was positioned in the middle of the coronal surface of the tooth in order to define the study area. Each sample was placed in a solution of 1% citric acid (pH 3.5) for 10 minutes in order to produce an eroded surface. All samples were divided into two main groups (60 samples each) as follows: Group A for sodium fluoride dentifrices and group B for stannous fluoride dentifrices, again it is subdivided into: CHX: Chlohex ADS®, EO: Listerine®, CPC: Colgate® Plax (20 samples in each subgroup). After that, samples underwent the pH cycling model for 5 days. Samples were examined for surface loss using a scanning electron microscope.
Results: In sodium fluoride dentifrices group, before intervention, the surface loss was 3.12 ± 1.03 in CHX group, 3.08 ± 1.20 in EO group, and 3.09 ± 0.96 in CPC group. After intervention, the less surface loss found with CHX group (2.18 ± 0.84), followed by CPC (2.34 ± 0.74) and EO group (2.46 ± 0.97). In stannous fluoride dentifrices group, before intervention, the surface loss in CHX group was 3.26 ± 1.19, in EO group, it was 3.18 ± 1.31, and in CPC group, it was 3.22 ± 1.06. After intervention, the less surface loss found with CHX: group (1.90 ± 0.54), followed by CPC (2.24 ± 0.28) and EO group (2.38 ± 0.20).
Conclusion: The present study concluded that the fluoride dentifrices’ preventive effects against tooth surface loss were unaffected by a different mouthwashes with varying compositions and major constituents. In terms of erosion, fluoridated toothpaste containing stannous fluoride was found to provide better surface loss protection than sodium fluoride.
Clinical significance: Primary prevention and the eradication of contributing causes are the greatest strategies for preventing erosion. Simultaneously, antibacterial agent in the mouthwashes may help in enhancing the effect of fluoride in the enamel, owing to their high affinity for teeth structures. Therefore, in addition to cause-related treatment, further efforts to reduce tooth tissue loss are also necessary.
Wang GR, Zhang H, Wang ZG, et al. Relationship between dental erosion and respiratory symptoms in patients with gastro-oesophageal reflux disease. J Dent 2010;38(11):892–898. DOI: 10.1016/j.jdent.2010.08.001.
Picos A, Badea ME, Dumitrascu DL. Dental erosion in gastro-esophageal reflux disease. A systematic review. Clujul Med 2018;91(4):387–390. DOI: 10.15386/cjmed-1017.
Huysmans MC, Young A, Ganss C. The role of fluoride in erosion therapy. Monogr Oral Sci 2014;25:230–243. DOI: 10.1159/000360555.
Zero TD, Hara AT, Kelly SA, et al. Evaluation of a desensitizing test dentifrice using an in situ erosion remineralization model. J Clin Dent 2006;17(4):112–116. PMID: 17131714.
Mandel ID. Chemotheraputic agents for controlling plaque and gingivitis. J Clin Periodontal 1998;15:488–498. DOI: 10.1111/j.1600-051x.1988.tb01020.x.
Schlueter N, Hardt M, Lussi A, et al. Tin-containing fluoride solutions as anti-erosive agents in enamel: an in vitro tin-uptake, tissue loss, and scanning electron micrograph study. Eur J Oral Sci 2009;117(4): 427–434. DOI: 10.1111/j.1600-0722.2009.00647.x.
Somani R, Jaidka S, Singh DJ, et al. Remineralizing potential of various agents on dental erosion. J Oral Biol Craniofac Res 2014;4(2):104–108. DOI: 10.1016/j.jobcr.2014.05.001.
Fabritius-Vilpoux K, Enax J, Herbig M, et al. Quantitative affinity parameters of synthetic hydroxyapatite and enamel surfaces in vitro. Bioinspired Biomimet Nanobiomater 2019;8(2):141–153. DOI: 10.1680/jbibn.18.00035.
Carounanidy U, Sathyanarayanan R. Dental caries: a complete changeover, PART III: changeover in the treatment decisions and treatments. J Conserv Dent 2010;13(4):209–217. DOI: 10.4103/0972-0707.73383.
Attin T. Methods for assessment of dental erosion. Monogr Oral Sci 2006;20:152–172. DOI: 10.1159/000093361.
O'Toole S, Bartlett DW, Moazzez R. Efficacy of sodium and stannous fluoride mouthrinses when used before single and multiple erosive challenges. Aust Dent J 2016;61(4):497–501. DOI: 10.1111/adj.12418.
Paepegaey AM, Day TN, Boulding A, et al. In vitro comparison of stannous fluoride, sodium fluoride, and sodium monofluorophosphate dentifrices in the prevention of enamel erosion. J Clin Dent 2013;24(3):73–78. DOI: 10.1159/000111743.
Dehghan M, Vieira Ozorio JE, Chanin S, et al. Protocol for measurement of enamel loss from brushing with an anti-erosive toothpaste after an acidic episode. Gen Dent 2017; 65:63–68. PMID: 28682285.
Duckworth RM, Maguire A, Omid N, et al. Effect of rinsing with mouthwashes after brushing with a fluoridated toothpaste on salivary fluoride concentration. Caries Res 2009;43:391–396. DOI: 10.1159/000239753.
Diamanti I, Koletsi Kounari H, Mamai Homata E. Effect of toothpastes containing different NaF concentrations or a SnF2/NaF combination on root dentine erosive lesions, in vitro. J Clin Exp Dent 2016;8(5):e577–e583. DOI: 10.4317/jced.53047.
West NX, Hooper SM, O'Sallivan D, et al. In situ randomized trial investigating abrasive effects of two desensitizing toothpastes on dentine with acidic challenge prior to brushing. J Dent 2012;40(1): 77–85. DOI: 10.1016/j.jdent.2011.10.010.
Ganss C, KlimeK J, Schlueter N. Erosion/abrasion-preventing potential of NaF and F/Sn/chitosan toothpastes in dentine and impact of the organic matrix. Caries Res 2014;48(2):163–169. DOI: 10.1159/000354679.
