Long-term clinical observation of dental caries in salivary hypofunction patients using a supersaturated calcium-phosphate remineralizing rinse.
OBJECTIVE
One therapeutic approach to the management of xerostomia and its related oral sequelae is the use of a supersaturated Ca2+/PO4(3-) rinse in conjunction with fluoride. This study evaluated the use of the supersaturated rinse in high-risk patients from a single dental clinic.


METHODS
Patients (n = 134) at high risk for caries due to xerostomia were prescribed the calcium phosphate rinse and 1.1% NaF for daily use, and were evaluated for caries incidence over an average observation period of five years. All patients were instructed to use the rinse three to four times a day, depending on the severity of dryness of the mouth and rate of salivary flow. Compliance, or regular use of the rinse, was determined through monitoring by staff at each visit, a self-administered clinic questionnaire pertaining to usage of the rinse, and records from a single hospital pharmacy that supplied the rinse to all participating patients. Those patients who were found to typically use the remineralizing solution at least once a day during the entire follow-up period were classified as compliant. All individual surfaces at risk for caries (SAR) were examined and recorded at each visit to determine changes in average SAR per patient


RESULTS
Patients who regularly used the supersaturated rinse, along with commercially available prescription sodium fluoride, were found to experience a significant increase in reversals of caries, and a significant decrease in net coronal and root surface caries increment. The mean for the compliant group was 0.034 (SD 0.303), and the non-compliant mean was 0.315 (SD 0.735) with p > 0.0001 per surfaces/month.


CONCLUSIONS
These observations suggest that long-term compliance with the daily supersaturated rinse was protective against caries progression in a high-risk population.
Singh
Mabi L
ML
Tufts-New England Medical Center, Tufts University School of Dental Medicine, Boston, MA, USA.
Papas
Athena S
AS
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002130:Calcium Phosphates / Q000737:chemistry / Q000627:therapeutic use*; D003731:Dental Caries / Q000453:epidemiology / Q000209:etiology / Q000382:microbiology / Q000517:prevention & control*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009067:Mouthwashes / Q000737:chemistry / Q000627:therapeutic use*; D052016:Mucositis / Q000209:etiology / Q000517:prevention & control; D012189:Retrospective Studies; D012969:Sodium Fluoride / Q000737:chemistry / Q000627:therapeutic use; D016896:Treatment Outcome; D014987:Xerostomia / Q000188:drug therapy* / Q000453:epidemiology / Q000209:etiology
D002130:Calcium Phosphates; D009067:Mouthwashes; D012969:Sodium Fluoride