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Root caries prevention via sodium fluoride, chlorhexidine and silver diamine fluoride in vitro

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Abstract

Uncertainty exists as to how to best prevent root caries development. The aim of the present study was to compare sodium fluoride (NaF), chlorhexidine (CHX) and silver diamine fluoride (SDF) varnishes (V) and rinses (R) regarding their caries preventive effect in an artificial caries biofilm model. 140 bovine root dentin samples were cut, polished and embedded. Samples were allocated to seven treatment groups (n = 20/group): Four varnishes (applied once prior biofilm challenge): 38% SDF (SDFV), 35% CHX-varnish (CHXV), 22,600 ppm NaF-varnish (NaFV), placebo-varnish (PV); two rinses (applied once daily during biofilm challenge): 500 ppm NaF solution (NaFR), 0.1% CHX solution (CHXR); one untreated group. Caries was induced in a multi-station, continuous-culture Lactobacillus rhamnosus GG (LGG) biofilm model. Bacteria were inoculated 1 × daily, while 2% sucrose was supplied 8 ×/day followed by artificial saliva for 10 min. After 12 days, mineral loss (ΔZ) was measured in the effect area and adjacent to the varnished areas. Bacterial counts were assessed on de-Man-Rogosa-Sharpe agar. ΔZ was significantly lower in the NaFR group compared with all other groups. Varnishes did not significantly prevent mineral loss in adjacent areas. None of the agents had a significant antimicrobial effect on LGG. Regular fluoride rinses showed highest root caries-preventive effect.

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References

  1. Griffin SO, Griffin PM, Swann JL, Zlobin N. Estimating rates of new root caries in older adults. J Dent Res. 2004;83(8):634–8.

    Article  PubMed  Google Scholar 

  2. Bernabe E, Sheiham A. Age, period and cohort trends in caries of permanent teeth in four developed countries. Am J Public Health. 2014;104(7):e115–21. https://doi.org/10.2105/AJPH.2014.301869.

    Article  PubMed  PubMed Central  Google Scholar 

  3. Hoppenbrouwers PM, Driessens FC, Borggreven JM. The vulnerability of unexposed human dental roots to demineralization. J Dent Res. 1986;65(7):955–8.

    Article  PubMed  Google Scholar 

  4. Peltola P, Vehkalahti MM, Wuolijoki-Saaristo K. Oral health and treatment needs of the long-term hospitalised elderly. Gerodontology. 2004;21(2):93–9.

    Article  PubMed  Google Scholar 

  5. Zenthofer A, Rammelsberg P, Cabrera T, Hassel AJ. Increasing dependency of older people in nursing homes is associated with need for dental treatments. Neuropsychiatr Dis Treat. 2014;10:2285–90. https://doi.org/10.2147/NDT.S71184.

    Article  PubMed  PubMed Central  Google Scholar 

  6. Hiraishi N, Yiu CK, King NM, Tagami J, Tay FR. Antimicrobial efficacy of 3.8% silver diamine fluoride and its effect on root dentin. J Endod. 2010;36(6):1026–9. https://doi.org/10.1016/j.joen.2010.02.029.

    Article  PubMed  Google Scholar 

  7. Chi DL, Berg JH, Kim AS, Scott J. Northwest practice-based RCiE-bD. Correlates of root caries experience in middle-aged and older adults in the Northwest Practice-based REsearch Collaborative in Evidence-based DENTistry research network. J Am Dent Assoc. 2013;144(5):507–16.

    Article  PubMed  PubMed Central  Google Scholar 

  8. Tan HP, Lo EC. Risk indicators for root caries in institutionalized elders. Commun Dent Oral Epidemiol. 2014;42(5):435–40. https://doi.org/10.1111/cdoe.12104.

    Article  Google Scholar 

  9. Michelis W, Schiffner U. Vierte deutsche mundgesundheitsstudie (DMS IV). Köln: DÄV; 2006.

    Google Scholar 

  10. White D, Pitts N, Steele J, Sadler K, Chadwick B. Disease and related disorders—a report from the adult dental health survey 2009. http://www.ic.nhs.uk2011. Accessed Jan 2016

  11. Dye BA, Tan S, Smith V, Lewis BG, Barker LK, Thornton-Evans G, et al. Trends in oral health status: United States, 1988–1994 and 1999–2004. Vital Health Stat (data from the national health survey). 2007;11(248):1–92.

    Google Scholar 

  12. Petersen PE, Yamamoto T. Improving the oral health of older people: the approach of the WHO Global Oral Health Programme. Commun Dent Oral Epidemiol. 2005;33(2):81–92. https://doi.org/10.1111/j.1600-0528.2004.00219.x.

    Article  Google Scholar 

  13. Wierichs RJ, Meyer-Lueckel H. Systematic review on noninvasive treatment of root caries lesions. J Dent Res. 2015;94(2):261–71. https://doi.org/10.1177/0022034514557330.

    Article  PubMed  PubMed Central  Google Scholar 

  14. Gluzman R, Katz RV, Frey BJ, McGowan R. Prevention of root caries: a literature review of primary and secondary preventive agents. Spec Care Dent. 2013;33(3):133–40. https://doi.org/10.1111/j.1754-4505.2012.00318.x.

    Article  Google Scholar 

  15. Walls AW, Meurman JH. Approaches to caries prevention and therapy in the elderly. Adv Dent Res. 2012;24(2):36–40. https://doi.org/10.1177/0022034512453590.

    Article  PubMed  Google Scholar 

  16. Slot DE, Vaandrager NC, Van Loveren C, Van Palenstein Helderman WH, Van der Weijden GA. The effect of chlorhexidine varnish on root caries: a systematic review. Caries Res. 2011;45(2):162–73. https://doi.org/10.1159/000327374.

    Article  PubMed  Google Scholar 

  17. Tan HP, Lo EC, Dyson JE, Luo Y, Corbet EF. A randomized trial on root caries prevention in elders. J Dent Res. 2010;89(10):1086–90. https://doi.org/10.1177/0022034510375825.

    Article  PubMed  Google Scholar 

  18. Mei ML, Chu CH, Low KH, Che CM, Lo EC. Caries arresting effect of silver diamine fluoride on dentine carious lesion with S. mutans and L. acidophilus dual-species cariogenic biofilm. Med Oral Patol Oral Cir Bucal. 2013;18(6):e824–31.

    Article  PubMed  PubMed Central  Google Scholar 

  19. Hamama HH, Yiu CK, Burrow MF. Effect of silver diamine fluoride and potassium iodide on residual bacteria in dentinal tubules. Aust Dent J. 2015;60(1):80–7. https://doi.org/10.1111/adj.12276.

    Article  PubMed  Google Scholar 

  20. Fernandez CE, Tenuta LM, Cury JA. Validation of a cariogenic biofilm model to evaluate the effect of fluoride on enamel and root dentine demineralization. PLoS ONE. 2016;11(1):e0146478. https://doi.org/10.1371/journal.pone.0146478.

    Article  PubMed  PubMed Central  Google Scholar 

  21. Chu CH, Mei L, Seneviratne CJ, Lo EC. Effects of silver diamine fluoride on dentine carious lesions induced by Streptococcus mutans and Actinomyces naeslundii biofilms. Int J Paediatr Dent. 2012;22(1):2–10. https://doi.org/10.1111/j.1365-263X.2011.01149.x.

    Article  PubMed  Google Scholar 

  22. Mei ML, Li QL, Chu CH, Lo EC, Samaranayake LP. Antibacterial effects of silver diamine fluoride on multi-species cariogenic biofilm on caries. Ann Clin Microbiol Antimicrob. 2013;12:4. https://doi.org/10.1186/1476-0711-12-4.

    Article  PubMed  PubMed Central  Google Scholar 

  23. Mei ML, Chu CH, Lo EC, Samaranayake LP. Preventing root caries development under oral biofilm challenge in an artificial mouth. Med Oral Patol Oral Cir Bucal. 2013;18(4):e557–63.

    PubMed  PubMed Central  Google Scholar 

  24. Garcia-Godoy F, Flaitz C, Hicks J. Role of fluoridated dentifrices in root caries formation in vitro. Am J Dent. 2014;27(1):23–8.

    PubMed  Google Scholar 

  25. Sissons CH, Cutress TW, Hoffman MP, Wakefield JS. A multi-station dental plaque microcosm (artificial mouth) for the study of plaque growth, metabolism, pH, and mineralization. J Dent Res. 1991;70(11):1409–16.

    Article  PubMed  Google Scholar 

  26. Schwendicke F, Dorfer C, Kneist S, Meyer-Lueckel H, Paris S. Cariogenic effects of probiotic Lactobacillus rhamnosus GG in a dental biofilm model. Caries Res. 2014;48(3):186–92. https://doi.org/10.1159/000355907.

    Article  PubMed  Google Scholar 

  27. Schwendicke F, Eggers K, Meyer-Lueckel H, Dorfer C, Kovalev A, Gorb S, et al. In vitro Induction of residual caries lesions in dentin: comparative mineral loss and nano-hardness analysis. Caries Res. 2015;49(3):259–65. https://doi.org/10.1159/000371897.

    Article  PubMed  Google Scholar 

  28. Wong L, Sissons C. A comparison of human dental plaque microcosm biofilms grown in an undefined medium and a chemically defined artificial saliva. Arch Oral Biol. 2001;46(6):477–86.

    Article  PubMed  Google Scholar 

  29. Heijnsbroek M, Paraskevas S, Van der Weijden GA. Fluoride interventions for root caries: a review. Oral Health Prev Dent. 2007;5(2):145–52.

    PubMed  Google Scholar 

  30. Tavss EA, Mellberg JR, Joziak M, Gambogi RJ, Fisher SW. Relationship between dentifrice fluoride concentration and clinical caries reduction. Am J Dent. 2003;16(6):369–74.

    PubMed  Google Scholar 

  31. Baygin O, Tuzuner T, Kusgoz A, Senel AC, Tanriver M, Arslan I. Antibacterial effects of fluoride varnish compared with chlorhexidine plus fluoride in disabled children. Oral Health Prev Dent. 2014;12(4):373–82. https://doi.org/10.3290/j.ohpd.a32129.

    PubMed  Google Scholar 

  32. Zheng CY, Wang ZH. Effects of chlorhexidine, listerine and fluoride listerine mouthrinses on four putative root-caries pathogens in the biofilm. Chin J Dent Res. 2011;14(2):135–40.

    PubMed  Google Scholar 

  33. Autio-Gold J. The role of chlorhexidine in caries prevention. Oper Dent. 2008;33(6):710–6. https://doi.org/10.2341/08-3.

    Article  PubMed  Google Scholar 

  34. Papas AS, Vollmer WM, Gullion CM, Bader J, Laws R, Fellows J, et al. Efficacy of chlorhexidine varnish for the prevention of adult caries: a randomized trial. J Dent Res. 2012;91(2):150–5. https://doi.org/10.1177/0022034511424154.

    Article  PubMed  PubMed Central  Google Scholar 

  35. Knight GM, McIntyre JM, Craig GG, Mulyani, Zilm PS, Gully NJ. Inability to form a biofilm of Streptococcus mutans on silver fluoride- and potassium iodide-treated demineralized dentin. Quintessence Int. 2009;40(2):155–61.

    PubMed  Google Scholar 

  36. Zaura-Arite E, ten Cate JM. Effects of fluoride- and chlorhexidine-containing varnishes on plaque composition and on demineralization of dentinal grooves in situ. Eur J Oral Sci. 2000;108(2):154–61.

    Article  PubMed  Google Scholar 

  37. Al Dehailan L, Martinez-Mier EA, Lippert F. The effect of fluoride varnishes on caries lesions: an in vitro investigation. Clin Oral Investig. 2015. https://doi.org/10.1007/s00784-015-1648-4.

    PubMed  Google Scholar 

  38. Preza D, Olsen I, Aas JA, Willumsen T, Grinde B, Paster BJ. Bacterial profiles of root caries in elderly patients. J Clin Microbiol. 2008;46(6):2015–21. https://doi.org/10.1128/JCM.02411-07.

    Article  PubMed  PubMed Central  Google Scholar 

  39. Tang G, Yip HK, Cutress TW, Samaranayake LP. Artificial mouth model systems and their contribution to caries research: a review. J Dent. 2003;31(3):161–71.

    Article  PubMed  Google Scholar 

  40. Vogel GL. Oral fluoride reservoirs and the prevention of dental caries. Monogr Oral Sci. 2011;22:146–57. https://doi.org/10.1159/000325166.

    Article  PubMed  Google Scholar 

  41. Mei ML, Ito L, Cao Y, Li QL, Lo EC, Chu CH. Inhibitory effect of silver diamine fluoride on dentine demineralisation and collagen degradation. J Dent. 2013;41(9):809–17. https://doi.org/10.1016/j.jdent.2013.06.009.

    Article  PubMed  Google Scholar 

  42. Arends J, Ruben JL, Inaba D. Major topics in quantitative microradiography of enamel and dentin: R parameter, mineral distribution visualization, and hyper-remineralization. Adv Dent Res. 1997;11(4):403–14.

    Article  PubMed  Google Scholar 

  43. Willershausen I, Schulte D, Azaripour A, Weyer V, Briseno B, Willershausen B. Penetration potential of a silver diamine fluoride solution on dentin surfaces. An ex vivo study. Clin Lab. 2015;61(11):1695–701.

    PubMed  Google Scholar 

  44. Lippert F, Churchley D, Lynch RJ. Effect of lesion baseline severity and mineral distribution on remineralization and progression of human and bovine dentin caries lesions. Caries Res. 2015;49(5):467–76. https://doi.org/10.1159/000431039.

    Article  PubMed  Google Scholar 

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Acknowledgements

Silver diamine fluoride (Riva Star™) was supported by SDI Germany GmbH.

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Correspondence to Gerd Göstemeyer.

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Göstemeyer, G., Kohls, A., Paris, S. et al. Root caries prevention via sodium fluoride, chlorhexidine and silver diamine fluoride in vitro. Odontology 106, 274–281 (2018). https://doi.org/10.1007/s10266-018-0341-x

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