title: The effect of dentifrice quantity and toothbrushing behaviour on oral delivery and retention of fluoride in vivo.
abstract: While toothpaste F(-) concentration and rinsing regimen have well-characterised impacts on fluoride's effectiveness, other aspects of brushing regimen have much less well-established effects, in particular, dentifrice quantity and brushing duration. An in vivo study (n = 42) of oral fluoride delivery (i.e. oral disposition post-brushing), and retention (i.e. concentration of F(-) in saliva post-brushing, a known efficacy predictor), was performed to compare effects observed with those of dentifrice F(-) concentration and rinsing regimen. Subjects brushed with a NaF-silica dentifrice (Aquafresh Advanced, 1,150 ppm F(-) ) or a control dentifrice (250 ppm F(-) , same base), for 45, 60, 120 or 180 seconds with 0.5 or 1.5 g dentifrice, and rinsed with 15 ml water once or three times in a cross-over design. The F(-) concentration was measured in post-brushing expectorate, rinse and toothbrush washing samples, and in saliva between 5-120 minutes after brushing. Using 1.5 g versus 0.5 g dentifrice increased F(-) in all samples: oral retention of F(-) was almost doubled by this increase. Increasing duration of brushing had more complex effects. The amount of F(-) in the expectorate increased but decreased in both rinse and toothbrush washing samples. Oral F(-) retention increased, but only in the period 30-120 minutes after brushing. Over the ranges investigated, the order of importance on oral F(-) retention was: dentifrice F(-) concentration > quantity > rinsing regimen > brushing duration. Hence, increasing dentifrice quantity and, to a lesser extent, the duration of brushing, can elevate oral fluoride post-brushing. Evidence is accumulating that the importance of these variables to fluoride efficacy may have been underestimated.
authors.affiliation: GlaxoSmithKline Consumer Healthcare, Weybridge, UK.
authors.forename: Jonathan
authors.initials: J
authors.lastname: Creeth
authors.forename: Domenick
authors.initials: D
authors.lastname: Zero
authors.forename: Melissa
authors.initials: M
authors.lastname: Mau
authors.forename: Mary Lynn
authors.initials: ML
authors.lastname: Bosma
authors.forename: Andrew
authors.initials: A
authors.lastname: Butler
mesh_terms: D000328:Adult; D002327:Cariostatic Agents / Q000008:administration & dosage / Q000032:analysis / Q000493:pharmacokinetics*; D018592:Cross-Over Studies; D005260:Female; D005459:Fluorides / Q000008:administration & dosage / Q000032:analysis / Q000493:pharmacokinetics*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009067:Mouthwashes / Q000008:administration & dosage; D012463:Saliva / Q000737:chemistry / Q000378:metabolism*; D016037:Single-Blind Method; D012969:Sodium Fluoride / Q000008:administration & dosage / Q000032:analysis / Q000493:pharmacokinetics; D013997:Time Factors; D014099:Toothbrushing / Q000379:methods*; D014100:Toothpastes / Q000008:administration & dosage*; D014867:Water / Q000008:administration & dosage; D055815:Young Adult
chemical_list: D002327:Cariostatic Agents; D009067:Mouthwashes; D014100:Toothpastes; D014867:Water; D012969:Sodium Fluoride; D005459:Fluorides
keywords: Toothpaste; behaviour; dose; fluoride; pharmacokinetics; rinsing