Caries incidence, salivary flow rate and efficacy of fluoride gel treatment in irradiated patients.
The caries-preventive effect of daily applications of a fluoride gel was studied in 55 patients receiving radiotherapy for tumors of the head and neck. The study was designed as a randomized, double-blind study with two parallel groups. From the start of radiotherapy one group received a 0.42% F gel once a day for 1 year. The other group received a daily application of a 1.23% F gel for 4 weeks followed by the use of the 0.42% F gel daily for 1 year. The results showed that in patients with an unstimulated saliva flow of > 0.1 ml/min daily fluoride gel treatment with a fluoride concentration of 0.42% F was sufficient to inhibit caries almost completely. The use of the 1.23% F gel was not superior to the 0.42% gel treatment program alone. In an attempt to evaluate the salivary flow rate as a diagnostic criterion for increased caries risk, sensitivity and specificity were evaluated. It was found that with an unstimulated saliva flow rate of < 0.1 ml/min the positive predictive value was 80%. The corresponding value for stimulated salivary flow rate of < 0.5 ml/min was 85%. One can therefore predict that 80% of patients with flow rates < 0.1 ml/min will develop at least one carious lesion per year. The corresponding negative predictive value for unstimulated saliva flow > 0.1 ml/min was 75%. That means that 75% of patients using the 0.42% F gel daily and with at least some saliva secretion will not develop any new carious lesions.
Spak
C J
CJ
Department of Cariology, School of Dentistry, Karolinska Institute, Huddinge, Sweden.
Johnson
G
G
Ekstrand
J
J
D003731:Dental Caries / Q000209:etiology / Q000517:prevention & control*; D004311:Double-Blind Method; D005260:Female; D005460:Fluorides, Topical / Q000008:administration & dosage / Q000627:therapeutic use*; D005500:Follow-Up Studies; D005544:Forecasting; D005782:Gels; D006258:Head and Neck Neoplasms / Q000532:radiotherapy*; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D011878:Radiotherapy / Q000009:adverse effects; D011879:Radiotherapy Dosage; D012307:Risk Factors; D017213:Root Caries / Q000209:etiology / Q000517:prevention & control; D012463:Saliva / Q000378:metabolism* / Q000528:radiation effects; D012636:Secretory Rate / Q000528:radiation effects; D012680:Sensitivity and Specificity; D012969:Sodium Fluoride / Q000008:administration & dosage / Q000627:therapeutic use
D005460:Fluorides, Topical; D005782:Gels; D012969:Sodium Fluoride