Fluoride concentration in saliva and biofilm fluid following the application of three fluoride varnishes.
OBJECTIVE
Most of the commercially available fluoride varnishes (FV) have not been evaluated for their cariostatic properties. Consequently, the aim of this in vivo study was to investigate intra-oral fluoride retention and clearance patterns from three different FV.


METHODS
Eighteen subjects (7-11 years) participated in a laboratory analyst-blinded, randomized, crossover study comparing the ability of 5% sodium fluoride varnishes (CavityShield-CS, Enamel Pro-EP, Vanish-V) to enhance fluoride concentrations in biofilm fluid, centrifuged and whole saliva over a period of 48h after a single FV application.


RESULTS
Similar fluoride concentration×time patterns were noted for all investigated FV and studied variables, with the highest fluoride concentrations observed for the first biological sample collected after FV application (30min). Mean±SE (area under fluoride clearance curve) values were (μg F/g or ml×min): biofilm fluid - CS (472±191), EP (423±75),V (1264±279); centrifuged saliva - CS (42±7), EP (19±3),V (41±8); whole saliva - CS (68±11), EP (64±10),V (60±7).V delivered more fluoride to biofilm fluid than CS (p=0.0116) and EP (p=0.0065), which did not differ (p=0.27). For centrifuged saliva, CS and V were not significantly different (p=0.86), but resulted in higher fluoride retention than EP (p<0.0008). No significant differences among FV were observed for whole saliva (p=0.79).


CONCLUSIONS
The present study has shown that FV vary in their ability to deliver fluoride intra-orally potentially related to formulation differences. To what extent the present findings relate to clinical efficacy remains, however, to be determined.


CONCLUSIONS
Clinical research that investigates fluoride release patterns into saliva and biofilm fluid from different FV products is insufficient. More research is needed to investigate different FV formulations for their efficacy in order to help clinicians make better evidence based treatment choices.
Department of Cariology, Operative Dentistry and Dental Public Health, Indiana University School of Dentistry, Indianapolis, IN, USA; Department of Restorative Dental Sciences, College of Dentistry, University of Dammam, Kingdom of Saudi Arabia. Electronic address: ldehailan@uod.edu.sa.
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Al Dehailan
Department of Cariology, Operative Dentistry and Dental Public Health, Indiana University School of Dentistry, Indianapolis, IN, USA. Electronic address: flippert@iu.edu.
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Lippert
Department of Cariology, Restorative Sciences and Endodontics, School of Dentistry, University of Michigan, Ann Arbor, MI, USA. Electronic address: carlosgc@umich.edu.
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González-Cabezas
Department of Biostatistics, School of Medicine, Indiana University, Indianapolis, IN, USA. Electronic address: geckert@iu.edu.
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Eckert
Department of Cariology, Operative Dentistry and Dental Public Health, Indiana University School of Dentistry, Indianapolis, IN, USA. Electronic address: esmartin@iu.edu.
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Martinez-Mier
D018441:Biofilms / Q000187:drug effects*; D002130:Calcium Phosphates; D002648:Child; D018592:Cross-Over Studies; D003731:Dental Caries / Q000517:prevention & control; D003743:Dental Enamel / Q000187:drug effects; D005459:Fluorides / Q000737:chemistry*; D005460:Fluorides, Topical / Q000737:chemistry* / Q000493:pharmacokinetics; D006801:Humans; D007196:Indiana; D008422:Materials Testing; D010710:Phosphates / Q000737:chemistry*; D012463:Saliva / Q000737:chemistry*; D012969:Sodium Fluoride; D012995:Solubility; D013997:Time Factors; D014100:Toothpastes
D002130:Calcium Phosphates; C000612969:Enamel Pro Varnish; D005460:Fluorides, Topical; D010710:Phosphates; D014100:Toothpastes; C454339:cavity shield; C012980:fluorophosphate; D012969:Sodium Fluoride; D005459:Fluorides
Biofilm fluid; Caries; Fluoride varnish; Saliva