A prospective, randomized placebo-controlled clinical trial on the effects of a fluoride rinse on white spot lesion development and bleeding in orthodontic patients.
Demineralizations around orthodontic brackets are a main disadvantage of orthodontic treatment. Several methods have been advocated to prevent their development, such as fluoride rinses or varnishes. In this randomized clinical trial, a fluoride rinse (a combination of sodium fluoride and amine fluoride) was compared with a placebo rinse, to be used every evening after toothbrushing. A total of 81 participants (mean age: 13.3 yr) completed the study (mean treatment period: 24.5 months). Demineralizations, measured using quantitative light-induced fluorescence and the decayed, missing, and filled surfaces (DMFS) index, were assessed before treatment (baseline) and around 6 wk after debonding (post treatment). Bleeding scores were measured at baseline, and during and post treatment. The incidence rate ratio for demineralizations was 2.6 (95% CI: 1.1-6.3) in the placebo group vs. the fluoride group. In the fluoride group, 31% of participants developed at least one demineralization, compared with 47% in the placebo group. Relative to baseline, gingival bleeding increased significantly in the placebo group 1 yr after the start of treatment and onwards. For the fluoride group, bleeding scores during treatment were not different from those at baseline. In conclusion, using a fluoride rinse helps to maintain better oral health during fixed appliance treatment, resulting in fewer demineralizations.
Department of Orthodontics, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and Free University Amsterdam, Amsterdam, the Netherlands.
Nicoline C W
NC
van der Kaaij
Monique H
MH
van der Veen
Marleen A E
MA
van der Kaaij
Jacob M
JM
ten Cate
D000293:Adolescent; D002327:Cariostatic Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D002648:Child; D004245:DMF Index; D003731:Dental Caries / Q000517:prevention & control*; D003959:Diamines / Q000008:administration & dosage / Q000627:therapeutic use; D004338:Drug Combinations; D005260:Female; D005453:Fluorescence; D005459:Fluorides / Q000008:administration & dosage / Q000627:therapeutic use*; D005500:Follow-Up Studies; D005884:Gingival Hemorrhage / Q000517:prevention & control*; D006801:Humans; D008297:Male; D009067:Mouthwashes / Q000627:therapeutic use*; D016910:Orthodontic Brackets; D010919:Placebos; D011446:Prospective Studies; D016037:Single-Blind Method; D012969:Sodium Fluoride / Q000008:administration & dosage / Q000627:therapeutic use; D014099:Toothbrushing / Q000379:methods
D002327:Cariostatic Agents; D003959:Diamines; D004338:Drug Combinations; D009067:Mouthwashes; D010919:Placebos; C495399:Olaflur; D012969:Sodium Fluoride; D005459:Fluorides
caries prevention; fixed orthodontic appliances; fluoride rinse; gingival bleeding; tooth demineralization