Influência da quantidade de dentifrício e concentração de fluoreto na retenção intrabucal e ingestão de fluoreto por crianças: estudo in vivo
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Data
2018-11-26
Autores
Sampaio, Caio [UNESP]
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Universidade Estadual Paulista (Unesp)
Resumo
O dentifrício fluoretado se constitui na forma mais amplamente difundida de uso de fluoretos (F), sendo considerado sua melhor forma de utilização, uma vez que combina a remoção mecânica do biofilme com os efeitos terapêuticos do flúor. No entanto, as evidências quanto às recomendações do uso deste produto em crianças ainda são inconsistentes, considerando o balanço entre cárie e fluorose dentária. Sendo assim, o presente estudo teve o objetivo de avaliar as concentrações de flúor na saliva de crianças após escovação com dentifrícios contendo diferentes concentrações de flúor, aplicados em diferentes quantidades, bem como avaliar a ingestão de flúor a partir escovação. Para isso, crianças (n=18, 2-3 anos de idade) foram aleatoriamente distribuídas em seis grupos experimentais, de acordo com possíveis combinações de dentifrícios (0/550/1100 ppm F, como NaF) e quantidade aplicada na escova (0,04/0,16/0,32 g, correspondendo a um grão de arroz, grão de ervilha e técnica transversal, respectivamente). Os voluntários fizeram uso de um dentifrício placebo durante uma semana. No sétimo dia, amostras salivares foram coletadas antes (baseline) e 5, 15, 30 e 60 minutos após a escovação com uma das possíveis combinações de tratamentos. Todo dentifrício expectorado após a escovação foi coletado. As concentrações de flúor foram determinadas após tamponamento com TISAB III (saliva) e por microdifusão facilitada por hexametildisiloxano (conteúdo expectorado). Os dados foram submetidos a ANOVA ou teste de Kruskal-Wallis, seguidos dos testes de Fisher LSD ou Student-Newman-Keuls, respectivamente (p<0.05). A escovação com 550 ppm F (grão de ervilha ou técnica transversal) aumentou os valores de área sob a curva (AUC) para níveis semelhantes aos alcançados a partir da escovação com 1100 ppm F (grão de arroz). O maior valor de AUC e níveis salivares de flúor 5 minutos após escovação foi obtido a partir do tratamento com 1100 ppm F (grão de ervilha), seguido por 550 ppm F (técnica transversal). Para a ingestão de flúor a partir da escovação, o maior valor foi observado para o dentifrício de 550 ppm F (técnica transversal), seguido pelo 1100 ppm F (grão de ervilha). Concluiu-se que a quantidade de dentifrício e a concentração de flúor no produto afetam significativamente as concentrações de F na saliva e a ingestão de flúor durante a escovação.
The use of fluoridated dentifrices is regarded as the best vehicle of fluoride (F) use, since it combines the mechanical removal of biofilms with the therapeutic effects of F. Nevertheless, the evidence for recommending such products to children are still inconsistent, given the balance between dental caries and fluorosis. Thus, the aim of the present study was to evaluate F concentrations in saliva of toddlers after brushing with dentifrices containing different F concentrations, applied in different quantities, as well as to estimate F intake from toothbrushing. Toddlers (n=18, 2-3 years old) were randomly assigned into six experimental groups, according to the possible combinations of dentifrices (0/550/1100 ppm F, as NaF) and amount applied on the toothbrush (0.04/0.16/0.32 g, corresponding to rice grain, pea-size and using the transverse technique, respectively). Volunteers used a placebo dentifrice during one week. On the 7th day, saliva samples were collected before (baseline), and at 5, 15, 30 and 60 minutes after toothbrushing with one of the possible treatment combinations. All toothpaste expectorated after brushing was collected. F concentrations were determined after buffering with TISAB III (saliva) and hexamethyldisiloxane-facilitated diffusion (expectorate). Data were submitted to ANOVA or Kruskal-Wallis test, followed by Fisher’s LSD or Student-Newman-Keuls’ tests, respectively (p<0.05). Brushing with the 550 ppm F toothpaste (pea-size or transversal technique) increased AUC values at similar levels to those attained by brushing with 1100 ppm F (rice grain). The highest AUC and salivary F at 5 min after brushing were achieved by brushing with 1100 ppm F (pea-size), followed by the 550 ppm F (transversal technique). As for F intake during toothbrushing, the highest values were observed for the 550 ppm F (transversal technique), followed by 1100 ppm F (pea-size). It was concluded that the amount of toothpaste and F concentration in the product significantly affected both salivary F concentrations and F intake during toothbrushing.
The use of fluoridated dentifrices is regarded as the best vehicle of fluoride (F) use, since it combines the mechanical removal of biofilms with the therapeutic effects of F. Nevertheless, the evidence for recommending such products to children are still inconsistent, given the balance between dental caries and fluorosis. Thus, the aim of the present study was to evaluate F concentrations in saliva of toddlers after brushing with dentifrices containing different F concentrations, applied in different quantities, as well as to estimate F intake from toothbrushing. Toddlers (n=18, 2-3 years old) were randomly assigned into six experimental groups, according to the possible combinations of dentifrices (0/550/1100 ppm F, as NaF) and amount applied on the toothbrush (0.04/0.16/0.32 g, corresponding to rice grain, pea-size and using the transverse technique, respectively). Volunteers used a placebo dentifrice during one week. On the 7th day, saliva samples were collected before (baseline), and at 5, 15, 30 and 60 minutes after toothbrushing with one of the possible treatment combinations. All toothpaste expectorated after brushing was collected. F concentrations were determined after buffering with TISAB III (saliva) and hexamethyldisiloxane-facilitated diffusion (expectorate). Data were submitted to ANOVA or Kruskal-Wallis test, followed by Fisher’s LSD or Student-Newman-Keuls’ tests, respectively (p<0.05). Brushing with the 550 ppm F toothpaste (pea-size or transversal technique) increased AUC values at similar levels to those attained by brushing with 1100 ppm F (rice grain). The highest AUC and salivary F at 5 min after brushing were achieved by brushing with 1100 ppm F (pea-size), followed by the 550 ppm F (transversal technique). As for F intake during toothbrushing, the highest values were observed for the 550 ppm F (transversal technique), followed by 1100 ppm F (pea-size). It was concluded that the amount of toothpaste and F concentration in the product significantly affected both salivary F concentrations and F intake during toothbrushing.
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Palavras-chave
Fluoretos, Saliva, Crianças, Dentifrícios, Fluorides, Saliva, Child, Dentifrices