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Effect of Bottled Water and Fluoride Toothpaste Usage on Caries Lesion Remineralization.

Indiana University-Purdue University Indianapolis (IUPUI) / Background: The importance of fluoride in the prevention of dental caries has
been well documented in the literature, as it inhibits demineralization of the tooth
structure and enhances remineralization. One of the major public health policies to
prevent caries is to provide the population with an adequate amount of fluoride through
community water fluoridation. Nowadays many people drink bottled water instead of tap
water due to its easy access, convenience, and low cost. Besides fluoride, other minerals
present in tap and bottled water, such as calcium and magnesium, are also important in
decreasing dental caries prevalence. However, our knowledge of the role of bottled water
in caries prevention and especially when combined with fluoride toothpaste usage is still
poor.
Objectives: The aim of this in-vitro study was to evaluate the effects of some
bottled waters on fluoride toothpaste efficacy in enhancing caries lesion remineralization.
Methodology: Early caries lesions were created in bovine enamel specimens and
stratified into treatment groups based on Vickers surface microhardness (VHN). The
present study followed a two (fluoride and fluoride-free toothpaste) by five (four bottled
waters and tap water) factorial design. The treatment groups were bottled water with the
following attributes: a) 309.9 ppm Ca/1.20 ppm F; b) 118.4 ppm Ca/0.16 ppm F; c) 1.00
ppm Ca/1.01 ppm F; d) 0.1 ppm Ca/0.04 ppm F, and tap water (48.7 ppm Ca/0.7 ppm F).
The five water groups were paired either with 1100 ppm fluoride or fluoride-free
toothpaste, yielding 10 groups. Specimens were pH-cycled for 10 days with the daily
regimen comprised of twice daily toothpaste slurry, with four exposures to water in
between. VHN was measured, again, and the difference calculated (ΔVHN). Data were
analyzed using two-way ANOVA at a 5-percent significance level.
Results: The two-way interaction between water and toothpaste was significant (p
< 0.001). All groups except fluoride-free toothpaste/bottled water with 0.1 ppm Ca/0.04
ppm F (p = 0.411) had significant increases in VHN after pH cycling (p ≤ 0.023).
Fluoridated toothpaste resulted in a higher rate of remineralization compared to fluoridefree
toothpaste (all p < 0.001). Bottled water with 1.20 ppm F/309.9 ppm Ca exhibited
the greatest extent of remineralization within fluoride toothpaste groups (p < 0.001) and
higher remineralization than lower fluoride water in fluoride-free toothpaste groups (p ≤
0.006). Within the fluoridated toothpaste group, tap water exhibited significantly less
remineralization compared to all bottled waters (all p < 0.001).
Conclusion: Within the limitation of this study, bottled water with higher fluoride
and calcium concentrations might improve fluoridated toothpaste efficacy by enhancing
remineralization of early enamel caries-like lesions.

Identiferoai:union.ndltd.org:IUPUI/oai:scholarworks.iupui.edu:1805/34444
Date January 2023
CreatorsQaw, Masoumah Samir
ContributorsLippert, Frank, Al Dehailan, Laila, Hara, Anderson T, Cook, N. Blaine
Source SetsIndiana University-Purdue University Indianapolis
LanguageEnglish
Detected LanguageEnglish
TypeThesis

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