STATEMENT OF PROBLEM & PURPOSE: To study the effect of different fluoridation methods after in-office bleaching on the color of teeth during severe staining with coffee. MATERIAL AND METHODS: 44 specimens were randomly divided into four groups. Group 1 (no bleaching, no fluoride, coffee) was served as control for the influence of coffee on the color of untreated teeth. Group 2, 3 and 4 were undergone bleaching with 35% H2O2 for 30 minutes a day on 3 consecutive days. Group 2 was remained without fluoridation. Group 3 and 4 were fluoridated for 1 hour with either Cavity shield(R) or pH 7 Gel(R). All of groups were immersed in coffee solution for 7 days. Color determination was accomplished using the spectrophotometer (VITA Easyshade(R)). RESULTS: Delta L and Delta h increased, whereas Delta C decreased in the bleached groups. Pairwise comparisons with Tukey's HSD showed that there were statistically significant differences for Delta L and Delta h between the bleached groups and the non-bleached group (P < .05). Delta L and Delta h decreased continuously, while DeltaC showed an increase after a decrease in all of groups during immersion in coffee solution. After immersion in coffee solution for 7 days there were no statistically significant differences for Delta L, Delta C and Delta h between the groups (P > .05). Also there were no statistically significant differences for Delta L, Delta C and Delta h between the group 3 treated with Cavity shield(R) and the group 4 treated with pH 7 Gel(R) (P > .05). CONCLUSION: It was concluded that fluoridation was not beneficial to the prevention of extrinsic stains after bleaching.
Coffee ; Coloring Agents ; Fluoridation ; Fluorides ; Hydrogen-Ion Concentration ; Immersion ; Tooth

ABSTRACT This study aimed to determine the fluoride and pH levels of beverages likely to be consumed by children in Malaysia and to estimate daily fluoride intake from consumption of these beverages. A convenience sampling of 120 ready-to-drink beverages were purchased and categorised into 11 groups (UHT recombined milk, fresh milk [pasteurised], cultured milk [probiotic], yogurt beverages, fresh fruit juices, fruit flavoured beverages, soy-based beverages, malt-based beverages, tea, carbonated beverages and bottled waters). Fluoride concentration was measured using a fluoride ion-selective electrode while the pH level was measured using a pH meter. The fluoride concentration in the beverages ranged from 0.02±0.00 mg/L to 2.77±0.06 mg/L. Tea was found to have the highest fluoride concentration. The intake of fluoride from consumption of other types of beverages is below the lowest-observed-adverse-effect level (except tea). The pH of the beverages included in the study ranged from 2.20±0.01 to 7.76±0.00. Carbonated beverages (mean pH: 2.98±0.50) were found to be extremely acidic followed by fresh fruit juices (mean pH: 3.38±0.34) and fruit flavoured beverages (mean pH: 3.90±0.92). The correlation between fluoride and pH levels was weak, τ = 0.058 and not statistically significant (p < 0.35). The majority of the beverages had a low fluoride level and their consumption is unlikely to cause fluorosis except for tea. Almost half of the beverages had a low pH level with carbonated beverages being the most acidic.
Fluoridation ; Carbonated Beverages ; Dental Care for Children ; Acid-Base Imbalance

nformation regarding water fluoridation (WF) in Malaysia has been substantially documented, but is scattered in various government publications and may be lost to the stakeholders. This paper is a review of water fluoridation in Malaysia and its effect on oral health: a history of WF in Malaysia, the current policy, the evidence of its effectiveness, the challenges and the future directions. A search for relevant physical and electronic documents of WF in Malaysia resulted in the identification of 70 documents for review. WF was gazetted as national policy with an optimal fluoride level of 0.7 parts-per-million (ppm) in 1972, with a reduction of the level to 0.5 ppm in 2005. Evidence showed that WF effectively reduced population dental caries while fluorosis was not a prevalent public health concern. Strong collaboration between stakeholders and the extensive network of piped water supplies resulted in 80% of the population receiving WF in 2013. However, the coverage was reduced to 74.1% in 2018, largely due to the cessation of WF in Pahang. The key challenges in WF included a lack of funding, weak legislation, use of reverse osmosis water filtration system, difficulty to maintaining an optimal level of fluoride in the water, and lack of local data on the impact of WF cessation on oral health, and its cost-effectiveness. This review will provide dental health professionals with scientific evidence on WF and oral health in Malaysia and assist them in answering relevant questions about WF raised by the public.
Dental Caries ; Fluorosis, Dental ; Malaysia ; Review [Publication Type] ; Fluoridation

OBJECTIVES: This study aimed to confirm the efficacy of the urinary fluoride concentration/creatinine ratio for monitoring fluorine intake in fluoridated and non-fluoridated communities. METHODS: The correlations among the fluoride concentration in drinking water and that in the urine and fingernails of 52 preschool children (age, 60-72 months) from fluoridated and non-fluoridated communities were analyzed. RESULTS: The urinary fluoride concentration/creatinine ratio had a relatively high correlation with the fluoride concentration in drinking water (Pearson's correlation coefficient, 0.606; P<0.05). Further, this ratio was significantly positively correlated with the urinary fluoride concentration (Pearson's correlation coefficient, 0.374; P<0.01). However, there was no significant correlation between this ratio and the fluoride concentration in fingernails (Pearson's correlation coefficient, 0.145; P>0.05). CONCLUSIONS: The findings of this study suggest that the urinary fluoride concentration/creatinine ratio in children can be utilized as an index for monitoring excess fluoride intake in fluoridated communities.
Child ; Child, Preschool ; Drinking ; Drinking Water ; Fluoridation ; Fluorides ; Fluorine ; Humans ; Nails

OBJECTIVES: The aim of this study is to evaluate the effect of suburban community water fluoridation programs on preventing caries in permanent teeth. METHODS: In 2012, surveys were administered to children aged 8, 12, and 15 years residing in fluoridated Habcheon township area. Samples collected during the national survey in 2012 from children of the same age residing in non-fluoridated township areas were used as the control, and the caries prevalence data from this sample were used to estimate the caries preventive effect in the studied regions. This study included 457 subjects from the Habcheon township area and 1,792 in the control group. The data obtained from the survey were analyzed using the IBM SPSS statistical package version 21.0. The caries preventive effect exerted by fluoride in the community water supply was determined by calculating the differences in the DMFT and DMFS indices between the study and control groups. The cofounders of the mean number of fissure-sealed teeth and surfaces were controlled to estimate the effectiveness of caries prevention. RESULTS: The odds ratio of subjects with no dental caries in the fluoridated region was 0.75 compared to that in the control group. The mean DMFT scores or DMFS scores adjusted for the number of fissuresealed teeth or tooth surfaces were lower than those in the control group. The caries prevention fraction was estimated to be 23.4% based on the difference in the adjusted mean DMFT scores between the control and study groups. CONCLUSIONS: These results suggest that fluoridation of the community water in the suburban area was highly effective in preventing dental caries in permanent teeth, and therefore, this community water fluoridation program should be implemented in other regions in Korea.
Child ; Dental Caries ; Dentition, Permanent* ; Fluoridation* ; Fluorides ; Humans ; Korea ; Odds Ratio ; Prevalence ; Tooth* ; Water Supply ; Water*

OBJECTIVES: The water fluoridation program has been implemented since 2008, in a region of Geoje City. This study aimed to evaluate the effectiveness of the water fluoridation program on caries prevention in the permanent dentition. METHODS: Evaluation surveys were conducted on 8-, 10- and 12-year-old children in the fluoridated and non-fluoridated regions of Geoje City, in 2015. The survey included 834 children from the fluoridated regions and 703 from the non-fluoridated regions. The data obtained from the survey were analyzed using the IBM SPSS statistical package version 23.0. The effectiveness of community water fluoridation in caries prevention was estimated by the differences in the decayed, missing, filled teeth (DMFT) and decayed, missing, filled surfaces (DMFS) scores, between the program and control groups. The mean numbers of fissure-sealed teeth and surfaces were adjusted to reduce their confounding effect. RESULTS: The mean DMFT and DMFS scores (0.69 and 0.91, respectively) of 10-year-olds from the fluoridated regions, after adjusting for the numbers of fissure-sealed teeth and surfaces, were significantly lower than those of the 10 year olds (DMFT: 0.95, DMFS: 1.32) from the non-fluoridated regions. The effectiveness of water fluoridation on caries prevention in the permanent dentition, estimated based on the differences in the mean DMFT and DMFS scores, adjusted for the number of fissure-sealed teeth and surfaces, between the program and control groups of 10-year-old children, was 27.4% and 31.1%, respectively. CONCLUSIONS: These results suggest that the effectiveness of water fluoridation on caries prevention in the permanent dentition, in Geoje City was so high that this program should be implemented in other regions in Korea as well.
Child ; Dental Caries ; Dentition, Permanent ; Fluoridation* ; Fluorides ; Gyeongsangnam-do* ; Humans ; Korea ; Tooth* ; Water*

OBJECTIVETo determine the feasibility of water fluoridation to prevent caries in Kunming by investigating the epidemiological status of dental caries and dental fluorosis of children, and to provide the longitudinal reference data for the long-term epidemiology survey of dental caries and dental fluorosis in Kunming city.

METHODSThrough stratified cluster sampling method, 212 5-year-old children and 1149 12-year-old children were recruited in the survey. Dental caries condition of each child was clinically examined, dental fluorosis was examined in 12-year-old group.

RESULTSThe prevalence of dental caries of primary teeth in 5-year-old group was 73.6%, mean value was 4.47 +/- 4.39. The values of permanent teeth in 12-year-old group were 53.5% and 1.42 +/- 1.83. The prevalence of dental fluorosis in 12-year-old group was 4.1% and the average community fluorosis index was 0.03.

CONCLUSIONBased on the high prevalence of dental caries and the low prevalence of dental fluorosis, it is suggested that using water fluoridation to prevent caries is feasible and necessary in Kunming city.

OBJECTIVE: This study was performed to investigate the effects of external tooth bleaching with flouridation on the appearance of white spot lesions (WSLs) in vitro. METHODS: In total, 125 bracket-bonded bovine incisor enamel blocks with artificial WSLs were randomly divided into a control group and four treatment groups (home bleaching, home bleaching + fluoridation, in-office bleaching, and in-office bleaching + fluoridation). A spectroradiometer (SR) and digital images (DIs) were used to evaluate colorimetric parameters (Commission Internationale l'Eclairage L*a*b*) for all specimens. Color measurements were obtained before WSL formation (T1), after WSL formation (T2), and after completion of the external tooth bleaching treatment (T3). RESULTS: The SR-based color change after bleaching was significantly greater in the treatment groups than in the control group (p < 0.05). SR-based lightness (L*) and red-green (a*) values were significantly higher at T2 than at T1 (p < 0.001), with no significant changes in yellow-blue (b*) values. At T3, SR-based L* values had increased while a* and b* values had decreased in the treatment groups (p < 0.001). The DI-based color difference between the sound enamel and WSL areas (ΔE*DI) increased significantly from T1 to T2 in all groups (p < 0.001) and significantly decreased from T2 to T3 in the treatment groups (p < 0.001). No significant differences in ΔE*DI at T3 were shown between the four treatment groups (p > 0.05). CONCLUSIONS: The findings of this study suggested that external tooth bleaching with fluoridation can alleviate the conspicuity of WSLs.
Dental Caries* ; Dental Enamel ; Fluoridation* ; Fluorides ; In Vitro Techniques ; Incisor ; Tooth Bleaching

OBJECTIVES: The community water fluoridation program was implemented in 1998 in Jinju city. The aim of the present study was to evaluate the effect of this 17-year community water fluoridation program on caries reduction in permanent teeth. METHODS: Evaluation surveys were conducted in 2015 on subjects aged 8, 10, 12, and 15 years in Jinju city. The examined dental data were compared with that of subjects of the same age groups living in the medium-sized cities from the 6th Korea National Health and Nutrition Examination Survey (KNHANES) (2013–2015). The total number of subjects was 1,026 in Jinju city and 453 in the control group. The odds ratio of caries experience rate and untreated tooth rate on permanent teeth in Jinju city compared to control group was estimated based on the differences in DMF and untreated teeth rates after adjusting for gender, age, and mean number of fissure-sealed teeth. The effect of community water fluoridation program on caries reduction in permanent teeth was estimated by the differences in adjusted DMFT scores between the program and control groups. RESULTS: The odds ratio of caries experience rate and untreated tooth rate on permanent teeth in Jinju city compared to control group was estimated as 0.501 and 0.178, respectively. The effect of community water fluoridation program on caries reduction in permanent teeth was estimated as 40.0%. CONCLUSIONS: These results suggested that the effect of community water fluoridation program on caries reduction in permanent teeth in Jinju city was so high that similar programs should be developed in other regions in Korea.
Dental Caries ; Fluoridation ; Fluorides ; Gyeongsangnam-do ; Humans ; Korea ; Nutrition Surveys ; Odds Ratio ; Tooth ; Water

OBJECTIVES: The aim of this study was to evaluate the caries preventive effects of oral health programs composed of pit and fissure sealant and community water fluoridation in Hapcheon-Up, Hapcheon-Gun, the Republic of Korea. METHODS: Dental surveys were conducted on 6 to 14 year old children at Hapcheon-Up, Hapcheon-Gun in 2000 and 2009, respectively. The number of the subjects was 1,957 and 1,535 children in 2000 and 2009, respectively. The percentage of samples among total population aged 6 to 14 years in 2000 and 2009 was 90.6% and 92.3%, respectively. The obtained data from these surveys were analyzed with the PASW statistical package version 18.0 (SPSS Inc., Chicago, IL, USA). The 2009 dental health data including the prevalence of dental caries and fissure sealants on children's permanent teeth was compared to the 2000 dental health data, and assessed using chi-square test and independent-sample t-test. RESULTS: DMF rate of 12-year olds was 76.9% in 2000, and it significantly decreased to 42.5% in 2009. DMFT index of 12-year olds was 3.03 in 2000, and it significantly decreased to 1.07 in 2009. The prevalence rate of sealed permanent teeth among the 12-year olds was 15.4% in 2000, and it significantly increased to 97.2% in 2009. The caries reduction rate from pit and fissure sealant added by community water fluoridation program was calculated as 44.7% in 12-year olds by the difference of DMFT index between 2000 and 2009 year. Logistic regression analysis revealed that both programs were associated with an increasing likelihood of experiencing no dental caries (OR=4.00, 95% CI; 3.23-4.95). CONCLUSIONS: These results suggest that the oral health program composed of pit and fissure sealant and community water fluoridation in Hapcheon was very effective in caries prevention. The program should be expanded to other area to prevent dental caries among children.
Aged ; Chicago ; Child ; Dental Caries ; DMF Index ; Fluoridation ; Humans ; Logistic Models ; Oral Health ; Pit and Fissure Sealants ; Prevalence ; Tooth