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Fluoride concentration in plaque and saliva and its effects on oral ecology after intake of fluoridated milk
Umeå University, Faculty of Medicine, Odontology.
2008 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

According to WHO, the addition of fluoride to milk could be considered as an alternative to water fluoridation for community-based caries prevention in childhood. School-based schemes in developing as well as industrial countries have demonstrated substantial benefits on oral health, but there are limited data available on the local events in the oral cavity after consumption of fluoridated milk. The general aim of the present investigations was to investigate the concentration of fluoride obtained in saliva and dental plaque after ingestion of Fmilk and to explore the possible effects on the oral ecology. A series of controlled studies were performed in vivo in which samples of saliva and dental plaque were collected and analysed with respect to fluoride content, microbial composition and acidogenicity. An in vitro study evaluated the effect on enamel lesion formation. In paper I, significantly increased concentrations of fluoride (p<0.05) were disclosed in saliva 15 minutes after drinking the fluoride-containing water or milk. In the plaque samples however, the F-increase remained significantly elevated still after 2 hours. The availability of fluoride from milk was generally somewhat lower than from water but the differences were not statistically significant in either plaque or saliva. In paper II, the fluoride concentration in plaque was further explored after a single intake or habitual consumption of fluoridated milk together with a regular meal. The results showed that cariesinhibiting levels of fluoride persisted up to 4 hours after intake. There were no significant differences between the single intakes when compared with repeated intakes. In paper III, the influence of fluoridated milk on the salivary microorganisms associated with dental caries was evaluated. No significant alterations of the microflora were found compared with baseline. There was a slight reduction in the proportion of mutans streptococci after 2 and 4 weeks during consumption with fluoridated milk but the difference failed to reach statistical significance. In paper IV it was demonstrated that fluoridated milk significantly (p<0.05) could counteract the lactic acid formation in dental plaque as initiated with sucrose. In paper V, laser fluorescence technique was used to monitor the effect of fluoridated milk on enamel lesion formation in an experimental caries model. The results reinforced previous research and showed a hampering effect of fluoridated milk. No side effects were reported in any of the investigations. The findings of this thesis substantiate that milk is a suitable vehicle for fluoride administration and contribute to the understanding and possible explanations for the anti-caries properties of fluoridated milk. The main conclusions were: a) intake of fluoridated milk resulted in significantly elevated fluoride levels in saliva within the first 15 minutes and up to 4 hours in dental plaque when fluoridate milk was consumed together with meal, b) no significant alteration of the salivary microflora was disclosed after habitual intake of fluoridated milk but a delayed carbohydrate-mediated lactic acid formation in suspensions of dental plaque could be demonstrated, c) the fluoride concentrations in plaque were not negatively influence by the food intake, and d) the in vitro findings advocated that fluoride added to milk reduced enamel lesion formation as assessed by laser fluorescence technique in an experimental caries model.According to WHO, the addition of fluoride to milk could be considered as an alternative to water fluoridation for community-based caries prevention in childhood. School-based schemes in developing as well as industrial countries have demonstrated substantial benefits on oral health, but there are limited data available on the local events in the oral cavity after consumption of fluoridated milk. The general aim of the present investigations was to investigate the concentration of fluoride obtained in saliva and dental plaque after ingestion of Fmilk and to explore the possible effects on the oral ecology. A series of controlled studies were performed in vivo in which samples of saliva and dental plaque were collected and analysed with respect to fluoride content, microbial composition and acidogenicity. An in vitro study evaluated the effect on enamel lesion formation. In paper I, significantly increased concentrations of fluoride (p<0.05) were disclosed in saliva 15 minutes after drinking the fluoride-containing water or milk. In the plaque samples however, the F-increase remained significantly elevated still after 2 hours. The availability of fluoride from milk was generally somewhat lower than from water but the differences were not statistically significant in either plaque or saliva. In paper II, the fluoride concentration in plaque was further explored after a single intake or habitual consumption of fluoridated milk together with a regular meal. The results showed that cariesinhibiting levels of fluoride persisted up to 4 hours after intake. There were no significant differences between the single intakes when compared with repeated intakes. In paper III, the influence of fluoridated milk on the salivary microorganisms associated with dental caries was evaluated. No significant alterations of the microflora were found compared with baseline. There was a slight reduction in the proportion of mutans streptococci after 2 and 4 weeks during consumption with fluoridated milk but the difference failed to reach statistical significance. In paper IV it was demonstrated that fluoridated milk significantly (p<0.05) could counteract the lactic acid formation in dental plaque as initiated with sucrose. In paper V, laser fluorescence technique was used to monitor the effect of fluoridated milk on enamel lesion formation in an experimental caries model. The results reinforced previous research and showed a hampering effect of fluoridated milk. No side effects were reported in any of the investigations.

The findings of this thesis substantiate that milk is a suitable vehicle for fluoride administration and contribute to the understanding and possible explanations for the anti-caries properties of fluoridated milk. The main conclusions were: a) intake of fluoridated milk resulted in significantly elevated fluoride levels in saliva within the first 15 minutes and up to 4 hours in dental plaque when fluoridate milk was consumed together with meal, b) no significant alteration of the salivary microflora was disclosed after habitual intake of fluoridated milk but a delayed carbohydrate-mediated lactic acid formation in suspensions of dental plaque could be demonstrated, c) the fluoride concentrations in plaque were not negatively influence by the food intake, and d) the in vitro findings advocated that fluoride added to milk reduced enamel lesion formation as assessed by laser fluorescence technique in an experimental caries model.

Place, publisher, year, edition, pages
Umeå: Odontologi , 2008. , 51 p.
Series
Umeå University odontological dissertations, ISSN 0345-7532 ; 100
Keyword [en]
children, enamel, demineralisation, fluoride, lactic acid, laser fluoroscense, milk, plaque, saliva, salivary bacteria
Research subject
Odontology
Identifiers
URN: urn:nbn:se:umu:diva-1542ISBN: 978-91-7264-4864-4 OAI: oai:DiVA.org:umu-1542DiVA: diva2:141335
Public defence
2008-02-29, sal B, Tandläkarhögskolan 9tr, Umeå, 10:00 (English)
Opponent
Supervisors
Available from: 2008-02-14 Created: 2008-02-14 Last updated: 2009-04-09Bibliographically approved
List of papers
1. Fluoride concentration in saliva and dental plaque in young children after intake of fluoridated milk
Open this publication in new window or tab >>Fluoride concentration in saliva and dental plaque in young children after intake of fluoridated milk
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2002 In: Caries research, Vol. 36, no 1, 40-43 p.Article in journal (Refereed) Published
Identifiers
urn:nbn:se:umu:diva-2946 (URN)
Available from: 2008-02-14 Created: 2008-02-14Bibliographically approved
2. Fluoride concentraition in supragingival dental plaque after a singel intake or habitual consumption of fluoridated milk
Open this publication in new window or tab >>Fluoride concentraition in supragingival dental plaque after a singel intake or habitual consumption of fluoridated milk
2002 In: Acta odontologica Scandinavica, Vol. 60, no 5, 311-314 p.Article in journal (Refereed) Published
Identifiers
urn:nbn:se:umu:diva-2947 (URN)
Available from: 2008-02-14 Created: 2008-02-14Bibliographically approved
3. Composition of the salivary microflora during habital consumption of fluoridated milk
Open this publication in new window or tab >>Composition of the salivary microflora during habital consumption of fluoridated milk
2004 (English)In: Acta Odontologica Scandinavica, ISSN 0001-6357, E-ISSN 1502-3850, Vol. 62, no 3, 143-146 p.Article in journal (Refereed) Published
Abstract [en]

The aim was to evaluate the effect of habitual consumption of fluoridated milk on the composition of the salivary microflora. The study group comprised 20 healthy schoolchildren and young adults with a mean age of 13.6 years and the investigation had a randomized double-blind crossover design with a washout period of 1 month. After professional tooth-cleaning at baseline, the subjects were supplied with either fluoridated (250 mL, 5 ppm F) or non-fluoridated milk for one daily intake during a period of 4 weeks. Salivary samples were collected immediately before tooth-cleaning and after 1, 2, and 4 weeks, respectively. The samples were immediately cultivated for total viable counts, oral streptococci, mutans streptococci, lactobacilli, and actinomyces spp. Bacterial counts were logarithmically transformed before statistical evaluation using ANOVA. No significant alterations of the salivary microflora were found during any of the milk regimens compared with baseline. There was a slight reduction in the proportion of mutans streptococci after 2 and 4 weeks during consumption with fluoridated milk but the difference failed to reach statistical significance. In conclusion, this study was unable to disclose any significant alteration of the composition of the salivary microflora following daily intake of fluoridated milk.

Place, publisher, year, edition, pages
Oslo: Taylor & Francis, 2004
Identifiers
urn:nbn:se:umu:diva-2948 (URN)10.1080/00016350410001487 (DOI)
Available from: 2008-02-14 Created: 2008-02-14 Last updated: 2017-12-14Bibliographically approved
4. Lactic acid formation in supragingival dental plaque after schoolchildren's intake of fluoridated milk.
Open this publication in new window or tab >>Lactic acid formation in supragingival dental plaque after schoolchildren's intake of fluoridated milk.
2004 (English)In: Oral Health Prev Dent, ISSN 1602-1622, Vol. 2, no 1, 13-17 p.Article in journal (Refereed) Published
Abstract [en]

Purpose: Milk can be used as vehicle for fluoride administration. The aim of this study was to investigate the lactic acid formation in dental plaque after daily intake of fluoridated milk. Materials and Methods: The study group consisted of 15 healthy schoolchildren, 6-15 years of age, in a double-blind crossover study design. After a one-week fluoride depletion period, 250 ml of fluoridated standard milk (5ppm; total amount 1.25 mg F) or non-fluoride control milk was consumed once daily together with an ordinary meal during 3 days of plaque accumulation with no oral hygiene. On the fourth day, plaque samples were collected immediately before a final milk intake and then after 30, 60 and 180 minutes. After a washout period of at two weeks, the whole procedure was repeated with the corresponding fluoridated or non-fluoridated milk regimen. All samples were suspended and the sucrose-challenged lactic acid formation rate was determined enzymatically. Results: The results showed a statistically significant (p<0.05) increase of the lactic acid levels 30 min after the intake of the standard (control) milk while no such elevation was evident after the fluoride-containing milk. No differences were found after 60 and 180 min compared with baseline for any of the milks. Conclusion: The findings suggest that fluoride added to milk may counteract the lactic acid formation that follows a non-fluoridated milk intake.

Keyword
Adolescent, Adult, Animals, Cariostatic Agents/*administration & dosage, Child, Cross-Over Studies, Dental Plaque/*metabolism/prevention & control, Double-Blind Method, Female, Fluorides/*administration & dosage, Gingiva, Humans, Lactic Acid/*metabolism, Male, Milk, School Dentistry/methods
Identifiers
urn:nbn:se:umu:diva-13050 (URN)15641760 (PubMedID)
Available from: 2007-05-01 Created: 2007-05-01Bibliographically approved
5. Inhibition of enamel lesion formation by fluoridated milk assessed by laser fluorescence: an in vitro study.
Open this publication in new window or tab >>Inhibition of enamel lesion formation by fluoridated milk assessed by laser fluorescence: an in vitro study.
2006 (English)In: Clinical oral investigations, Vol. 10, no 3, 249-252 p.Article in journal (Refereed) Published
Abstract [en]

The aim of this study was to investigate the effect of fluoridated milk on enamel lesion formation as assessed by laser fluorescence (LF). The material consisted of 18 extracted premolar teeth that were cut in mesial-distal direction and pairwise assigned to either test or control samples in an experimental caries model. The teeth were exposed to a low-pH 5% cellulose gel for 4 h, 5 days per week immediately followed by a 4-h period in either fluoridated (5 ppm, test) or nonfluoridated milk (control). In the meantime, the specimens were stored in pooled human-stimulated whole saliva in room temperature. All teeth were examined by visual inspection with a magnifying glass and by LF readings (DIAGNOdent) at baseline and after 2 and 4 weeks. The baseline LF readings ranged from 3 to 7 with a mean value of 5.6+/-0.9. The mean values increased with time in both groups but the increase was more marked in the control teeth, 8.7+/-2.3 vs 12.8+/-3.3 after 4 weeks, this difference being statistically significant (p<0.01). The visual examination could not distinguish between the test or control samples after 2 and 4 weeks, respectively. The findings indicated that fluoride added to milk may to some extent counteract enamel lesion formation as assessed by LF in an experimental caries model.

National Category
Dentistry
Identifiers
urn:nbn:se:umu:diva-15671 (URN)10.1007/s00784-006-0053-4 (DOI)
Available from: 2007-02-04 Created: 2007-02-04Bibliographically approved

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