title: Calcium Prerinse before Fluoride Rinse Reduces Enamel Demineralization: An in situ Caries Study.
abstract: A calcium (Ca) prerinse before a fluoride (F) rinse has been shown to increase oral F levels. We tested the anticaries effect of this combination in a dose-response in situ caries model. In a double-blind, crossover experiment, 10 volunteers carried enamel slabs in palatal appliances for 14 days, during which they rinsed twice/day with one of four rinse combinations: (1) a placebo prerinse (150 mM sodium lactate) followed by a distilled water rinse (negative control); (2) a placebo prerinse followed by a 250 ppm F rinse; (3) a placebo prerinse followed by a 1,000 ppm F rinse, or (4) a Ca prerinse (150 mM Ca, as calcium lactate) followed by a 250 ppm F rinse. Sucrose solution was dripped onto the slabs 8×/day to simulate a high cariogenic challenge. The percent surface hardness loss (%SHL) was significantly lower in the Ca prerinse used with the 250 ppm F rinse group (%SHL = 38.0 ± 21.0) when compared with the F rinse alone (%SHL = 59.5 ± 24.1) and similar to the 1,000 ppm F rinse group (%SHL = 42.0 ± 18.3). Compared with the 250 ppm F rinse, the Ca prerinse increased biofilm fluid F only twice (nonsignificant). However, it greatly increased F in biofilm solids (∼22×). The Ca prerinse had little effect on loosely or firmly bound enamel F. The results showed an increased level of protection against demineralization by the use of a Ca prerinse, which seems to be caused by the enhancement of F concentration in the biofilm.
authors.affiliation: Piracicaba Dental School, UNICAMP, Piracicaba, Brazil.
authors.forename: João Gabriel S
authors.initials: JG
authors.lastname: Souza
authors.forename: Livia Maria Andaló
authors.initials: LM
authors.lastname: Tenuta
authors.forename: Altair Antoninha
authors.initials: AA
authors.lastname: Del Bel Cury
authors.forename: Diego Figueiredo
authors.initials: DF
authors.lastname: Nóbrega
authors.forename: Renan R
authors.initials: RR
authors.lastname: Budin
authors.forename: Mateus X
authors.initials: MX
authors.lastname: de Queiroz
authors.forename: Gerald L
authors.initials: GL
authors.lastname: Vogel
authors.forename: Jaime A
authors.initials: JA
authors.lastname: Cury
mesh_terms: D000293:Adolescent; D000328:Adult; D000818:Animals; D018441:Biofilms / Q000187:drug effects; D002118:Calcium / Q000008:administration & dosage / Q000494:pharmacology*; D002327:Cariostatic Agents / Q000008:administration & dosage / Q000494:pharmacology*; D002417:Cattle; D018592:Cross-Over Studies; D003743:Dental Enamel / Q000187:drug effects* / Q000473:pathology; D004305:Dose-Response Relationship, Drug; D004311:Double-Blind Method; D005460:Fluorides, Topical / Q000008:administration & dosage / Q000494:pharmacology*; D006801:Humans; D009067:Mouthwashes / Q000008:administration & dosage* / Q000494:pharmacology; D012463:Saliva / Q000187:drug effects; D019354:Sodium Lactate / Q000008:administration & dosage / Q000494:pharmacology; D013395:Sucrose / Q000009:adverse effects; D013997:Time Factors; D017001:Tooth Demineralization / Q000209:etiology / Q000628:therapy*
chemical_list: D002327:Cariostatic Agents; D005460:Fluorides, Topical; D009067:Mouthwashes; D013395:Sucrose; D002118:Calcium; D019354:Sodium Lactate