The Effect of Silver Diamine Fluoride, CPP-ACP/NaF, and Sodium Fluoride Varnish on Deciduous Enamel Erosion by Daily Snack ( Drink) in Children/ An In Vitro Study
Keywords:Tooth erosion, Tooth demineralization, CPP-ACP, Primary teeth, Sodium fluorides, Silver diamine fluoride, Fluoride varnish
Objective: Most children consume carbonated soft drinks and fruit juices daily, inducing detrimental low pH and contributing to dental erosion. The current study aimed to assess and compare the efficacy of a single application of 38% Silver diamine fluoride (38% SDF), CPP-ACP/NaF varnish, and Sodium fluoride varnish (NaF) in the prevention of enamel demineralization in primary teeth against daily snack drink in children.
Methods: Forty primary anterior teeth (n=40) were divided into four groups and exposed to the following treatments (n=10): G1= 38%SDF (e- SDF TM); G2= CPP-ACP/NaF (MI VarnishTM); G3= NaF varnish (FluoroDose®); G4= Distilled water. The specimens were submitted for four days, with six pH cycles per day (10 minutes in orange juice) (SUNQUICK, IRAQ). Artificial saliva was used to remineralize the specimens after erosion challenges and as storage media between cycles. After four days of pH cycling, all the specimens were subjected to an atomic absorption spectrometer (AAS) to measure the amount of Calcium and phosphorus loss in each acidic solution. Scanning Electron Microscope evaluated the enamel topographic characteristics.
Results: All varnishes promoted better results for protecting enamel than the distilled water, with a difference. However, 38% of SDF demonstrated less Calcium and phosphorus loss than CPP-ACP/NaF, NaF varnish, and distilled water (p < 0.001).
Conclusions: Considering calcium and phosphorus loss values, a single application of each 38% SDF, MI varnish, and Naf effectively inhibited enamel erosion after four days of an erosive challenge, although the best protective effect was in favor of SDF.
Marqués M L, Leyda AM, Ribelles LM. Dental erosion. Etiologic factors in a sample of Valencian children and adolescents. Eur J Paediatr Dent. 2019;20(3):189-93.
Serra MC, Messias DC, Turssi CP. Control of erosive tooth wear: possibilities and rationale. Braz Oral Res. 2009;23(Suppl 1):49-55.
Magalhães AC, Wiegand A, Rios D, Honório HM, Buzalaf MA. Insights into preventive measures for dental erosion. J Appl Oral Sci. 2009;17(2):75-86.
Ainoosah SE, Levon J, Eckert GJ, Hara AT, Lippert F. Effect of silver diamine fluoride on the prevention of erosive tooth wear in vitro. J Dent. 2020;103S:100015:1-6.
Bayrak S, Tuloglu N, Bicer H, Tunc ES. Effect of fluoride varnish containing CPP-ACP on preventing enamel erosion. Scanning. 2017;1897825:1-7.
Tuloglu N, Bayrak S, Tunc ES, Ozer F. Effect of fluoride varnish with added casein phosphopeptide-amorphous calcium phosphate on the acid resistance of the primary enamel. BMC Oral Health. 2016;16(1):1-7.
Dai Z, Liu M, Ma Y, Cao L, Xu HH, Zhang K, et al. Effects of fluoride and calcium phosphate materials on remineralization of mild and severe white spot lesions. Biomed Res Int. 2019;1271523:1-13.
Gokkaya B, Ozbek N, Guler Z, Akman S, Sarac AS, Kargul B. Effect of a single application of CPP-ACPF varnish on the prevention of erosive tooth wear: An AAS, AFM and SMH study. Oral Health Prev Dent. 2020;18(1):311-8.
Alhothali M, Exterkate R, Lagerweij M, Buijs M, Loveren C, Strijp G. The effect of equal fluoride concentrations in silver diamine fluoride and potassium fluoride on demineralized dentin during pH-cycling: chemical data. Eur J Oral Sci.2021;129(4):1-8.
Salas MM, Nascimento GG, Huysmans MC, Demarco FF. Estimated prevalence of erosive tooth wear in permanent teeth of children and adolescents: an epidemiological systematic review and meta-regression analysis. J Dent. 2015;43(1):42-50.
Lussi A, Buzalaf MA, Duangthip D. The use of fluoride for the prevention of dental erosion and erosive tooth wear in children and adolescents. Eur Arch Paediatr Dent. 2019;20(6):517-27.
Correa-Afonso AM, Palma-Dibb RG, Pécora JD. Composite filling removal with erbium: Yttrium- aluminum-garnet laser: morphological analyses. Lasers Med Sci. 2010;25(1):1-7.
de Siqueira Mellara T, Palma-Dibb RG, de Oliveira HF, Garcia Paula-Silva FW, Nelson-Filho P, da Silva RA, et al. The effect of radiation therapy on the mechanical and morphological properties of the enamel and dentin of deciduous teeth--an in vitro study. Radiat Oncol. 2014;9(1):1- 7.
Kasraei S, Kasraei P, Valizadeh S, Azarsina M. Rehardening of eroded enamel with CPP-ACFP paste and CO2 laser treatment. Biomed Res Int. 2021; 3304553:1-7.
Alexandria A, Valença AM, Cabral LM, Maia LC. Comparative effects of CPP-ACP and xylitol F- varnishes on the reduction of tooth erosion and Its progression. Braz Dent J 2020;31(6):664-72.
Meral E, Dursun MN, Oz A, Ergin E. Effect of fluoride-releasing materials on the prevention of enamel erosion: a microhardness and scanning electron microscopic evaluation. FLUORIDE. 2021;54(3):257-68.
Da Cunha WA, Palma LF, Shitsuka C, Corrêa FP, Duarte DA, Corrêa MP. Efficacy of silver diamine fluoride and sodium fluoride in inhibiting enamel erosion: an ex vivo study with primary teeth. Eur Arch Paediatr Dent. 2021;22(3):387-92.
Vieira A, Ruben JL, Huysmans MC. Effect of titanium tetrafluoride, amine fluoride and fluoride varnish on enamel erosion in vitro. Caries Res. 2005;39(5):371-9.
Mohammadi N, Farahmand MH. Effect of fluoridated varnish and silver diamine fluoride on enamel demineralization resistance in primary dentition. J Indian Soc Pedod Prev Dent. 2018;36(3):257-61.
Alexandria AK, Valença AG, Cabral LM, Maia LC. Fluoride varnishes against dental erosion caused by soft drink combined with pediatric liquid medicine. Braz Dent J. 2017;28(4):482–8.
Sales-Peres AC, Marsicano JA, Garcia RP, Forim MR, Silva MF, Sales-Peres SH. Effect of natural gel product on bovine dentin erosion invitro. J Appl Oral Sci. 2013;21(6):597-600.
Parry J, Shaw L, Arnaud MJ, Smith AJ. Investigation of mineral waters and soft drinks in relation to dental erosion. J Oral Rehabil. 2001;28(8):766-72.
Murakami C, Bönecker M, Corrêa MP, Mendes FM, Rodrigues CD. Effect of fluoride varnish and gel on dental erosion in primary and permanent teeth. Arch Oral Biol. 2009;54(11):997-1001.
Ollie YY, May LM, Zhao IS, Quan-Li L , Chi- Man L, Chun-Hung C. Remineralisation of enamel with silver diamine fluoride and sodium fluoride. Dent Mater. 2018;34(12):e344-52.
Alexandria AK, Vieira TI, Pithon MM, da Silva Fidalgo TK, Fonseca-Gonçalves A, Valença AM, et al. In vitro enamel erosion and abrasion- inhibiting effect of different fluoride varnishes. Arch Oral Biol. 2017;77(2017):39-43.
Shellis RP, Barbour ME, Jesani A, Lussi A. Effects of buffering properties and undissociated acid concentration on dissolution of dental enamel in relation to pH and acid type. Caries Res. 2013;47(6):601-11.
Colombo M, Dagna A, Moroni G, Chiesa M, Poggio C, Pietrocola G. Effect of different protective agents on enamel erosion: An in vitro investigation. J Clin Exp Dent. 2019;11(2):113-8.
Larsen MJ, Richards A. Fluoride is unable to reduce dental erosion from soft drinks. Caries Res. 2002;36(1):75-80.
Joshi M, Joshi N, Kathariya R, Angadi P, Raikar S. Techniques to Evaluate Dental Erosion: A Systematic Review of Literature. J Clin Diagn Res. 2016;10(10):e1-7.
Hannig C, Hamkens A, Becker K, Attin R, Attin T. Erosive effects of different acids on bovine enamel: release of Calcium and phosphate in vitro. Arch Oral Biol. 2005;50(6):541-52.
Patel MV, Fox JL, Higuchi WI. Effect of acid type on kinetics and mechanism of dental enamel demineralization. J Dent Res. 1987;66(9):1425-30.
Olivan SR, Sfalcin RA, Fernandes KP, Ferrari RA, Horliana AC, Motta LJ, et al. Preventive effect of remineralizing materials on dental erosion lesions by speckle technique: An in vitro analysis. Photodiagnosis Photodyn Ther. 2020;29:101655:1-13.
Hjortsjö C, Jonski G, Young A, Saxegaard E. Effect of acidic fluoride treatments on early enamel erosion lesions--a comparison of calcium and profilometric analyses. Arch Oral Biol. 2010;55(3):229-34.
Sorvari R, Meurman JH, Alakuijala P, Frank RM. Effect of fluoride varnish and solution on enamel erosion in vitro. Caries Res. 1994;28(4):227-32.
Barclay E. Fruit juice vs. soda? Both beverages pack in sugar, health risks. Hawai’i Public Radio; 2014. Available at https://www.npr.org/sections- /thesalt/2014/06/09/319230765/fruit-juice-vs- soda-both-beverages-pack-in-sugar-and-health- risk.
Copyright (c) 2022 Alaa S. Hussein, Fadil A. Kareem
This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.