In situ evaluation of 200 ppm fluoride toothpaste content trimetaphosphate, xylitol and erythritol on enamel demineralization and dental biofilm.

Abstract

OBJECTIVE\nTo evaluate the effect of low-fluoride (F-) toothpaste and sodium trimetaphosphate (TMP) associated with xylitol and erythritol (XE) on enamel demineralization and biofilm composition.\n\n\nMETHODS\nThis crossover double-blind in situ study consisted of five phases (seven days each) and 14 volunteers who wore oral appliances containing four enamel bovine blocks. The cariogenic challenge was performed by 30% sucrose solution (6x/day). The toothpaste treatments (3x/day) were as follows: placebo (no F-/TMP/XE); 200 ppm F- (NaF) (200F); 1,100 ppm F- (1100F); 16% Xylitol and 4% Erythritol (XE); and 200 ppm F-, 0.2% TMP, 16% xylitol, and 4% erythritol (200F-TMP-XE). Percentage of surface hardness loss (%SH) and integrated loss of subsurface hardness (ΔKHN), and calcium (Ca2+), phosphate (PO43-), and F- on enamel and biofilm were determined; as well as insoluble extracellular polysaccharide (EPS).\n\n\nRESULTS\nXE and 1100F groups showed no different for the %SH and ΔKHN values (p\u202f=\u202f0.220 and p\u202f=\u202f0.886), and the 200F-TMP-XE group had the lowest mineral loss (p < 0.001). Ca2+ and PO43- in the enamel showed the highest values (p < 0.001) for the 200F-TMP-XE group. Higher values of F- in the enamel and biofilm were observed for the 1100F group (p < 0.001). There was no difference for Ca2+ (p\u202f=\u202f1.00) and EPS (p =0.918) values between XE and 200-TMP-XE groups in the biofilm, but their values were higher and lower than the 1100F (p\u202f=\u202f0.002 and p\u202f=\u202f0.029), respectively.\n\n\nCONCLUSIONS\n200F-TMP-XE promoted a greater protective effect against enamel demineralization and significantly affected the composition of biofilm formed in situ compared to 1100F toothpaste.\n\n\nCLINICAL SIGNIFICANCE\nLow-F- toothpaste containing TMP and polyols can be considered an effective and safe measure to improve the oral health of individuals, especially patients with high caries activity.