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Original Research

Open Access

Acceptance and awareness of southeastern and western private practice pediatric dentists of fluoride-free toothpastes: a survey study

  • Milen K Patel1
  • Michael Milano2,*,
  • Regina L Messer3

1The Dental College of Georgia at Augusta University, Augusta, GA 30912, USA

2The Department of Pediatric Dentistry at the Dental College of Georgia, Augusta, GA 30912, USA

3Oral Biology at The Dental College of Georgia at Augusta University, Augusta, GA 30912, USA

DOI: 10.22514/jocpd.2023.055 Vol.47,Issue 5,September 2023 pp.73-80

Submitted: 30 December 2022 Accepted: 19 May 2023

Published: 03 September 2023

*Corresponding Author(s): Michael Milano E-mail: mmilano@augusta.edu

Abstract

The American Academy of Pediatric Dentistry (AAPD) affirms that the use of fluoride, as an adjunct in the prevention of caries, is safe and effective. The AAPD encourages dentists, other healthcare providers, and parents to optimize fluoride exposures to reduce the risk of caries and to enhance the remineralization of affected teeth. However, there is resistance amongst patients towards fluoride overexposure and despite there being research on other effective remineralizing agents, most pediatric dentists primarily cater their practice to fluoride-based products. The objective of the study is to survey pediatric dentists’ acceptance and awareness of fluoride-free remineralizing agents. A listserv of the southeastern and western private practice pediatric dentists was obtained from the AAPD consisting of 6490 email addresses. A questionnaire consisting of 15 questions was sent to each address using Qualtrics. Different trends in fluoride-free acceptance and awareness were seen based on region of practice, region of training and age of practitioner. Region of practice, residency training and age can be contributing factors toward fluoride-free remineralizing agent opinion. The data gathered trends towards western-trained pediatric dentists are more likely to recommend a fluoride-free toothpaste than a southeastern-trained dentist.


Keywords

Fluoride; Fluoride-free; Nano-hydroxyapatite; Theobromine; Phosphate; Casein; Phosphopeptide; Arginine; Xylitol; Remineralize


Cite and Share

Milen K Patel,Michael Milano,Regina L Messer. Acceptance and awareness of southeastern and western private practice pediatric dentists of fluoride-free toothpastes: a survey study. Journal of Clinical Pediatric Dentistry. 2023. 47(5);73-80.

References

[1] Goff SL, Gahlon G, Geissler KH, Dick AW, Kranz AM. Variation in current guidelines for fluoride varnish application for young children in medical settings in the United States. Frontiers in Public Health. 2022; 4: 785296.

[2] American Academy of Pediatric Dentistry. Fluoride therapy. The reference manual of pediatric dentistry (pp. 302–305). American Academy of Pediatric Dentistry: Chicago. 2021.

[3] Hamba H, Nakamura K, Nikaido T, Tagami J, Muramatsu T. Remineralization of enamel subsurface lesions using toothpaste containing tricalcium phosphate and fluoride: an in vitro µCT analysis. BMC Oral Health. 2020; 20: 292.

[4] NIH Office of Dietary Supplements. Fluoride. 2022. Available at: https://ods.od.nih.gov/factsheets/Fluoride-HealthProfessional/ (Accessed: 5 February 2022).

[5] Centers for Disease Control and Prevention. Achievements in public health, 1900–1999: fluoridation of drinking water to prevent dental caries. Available at: https://www.cdc.gov/mmwr/preview/mmwrhtml/mm4841a1.htm (Accessed: 21 March 2022).

[6] Iheozor-Ejiofor Z, Worthington HV, Walsh T, O’Malley L, Clarkson JE, Macey R, et al. Water fluoridation for the prevention of dental caries. Cochrane Database of Systematic Reviews. 2015; 2015: CD10856.

[7] Simon MJK, Beil FT, Rüther W, Busse B, Koehne T, Steiner M, et al. High fluoride and low calcium levels in drinking water is associated with low bone mass, reduced bone quality and fragility fractures in sheep. Osteoporosis International. 2014; 25: 1891–1903.

[8] U.S. Department of Health and Human Services Panel on Community Water Fluoridation. U.S. public health services recommendation for fluoride concentration in drinking water for the prevention of dental caries. Public Health Reports. 2015; 130: 318–331.

[9] Goodman CV, Bashash M, Green R, Song P, Peterson KE, Schnaas L, et al. Domain-specific effects of prenatal fluoride exposure on child IQ at 4, 5 and 6–12 years in the ELEMENT cohort. Environmental Research. 2022; 211: 112993.

[10] Grandjean P. Developmental fluoride neurotoxicity: an updated review. Environmental Health. 2019; 18: 110.

[11] Ullah R, Zafar MS, Shahani N. Potential fluoride toxicity from oral medicaments: a review. Iranian Journal of Basic Medical Sciences. 2017; 20: 841–848.

[12] Guth S, Hüser S, Roth A, Degen G, Diel P, Edlund K, et al. Toxicity of fluoride: critical evaluation of evidence for human developmental neurotoxicity in epidemiological studies, animal experiments and in vitro analyses. Archives of Toxicology. 2020; 94: 1375–1415.

[13] Amaechi BT, AbdulAzees PA, Alshareif DO, Shehata MA, Lima PPCS, Abdollahi A, et al. Comparative efficacy of a hydroxyapatite and a fluoride toothpaste for prevention and remineralization of dental caries in children. BDJ Open. 2019; 5: 18.

[14] Bossù M, Saccucci M, Salucci A, Di Giorgio G, Bruni E, Uccelletti D, et al. Enamel remineralization and repair results of Biomimetic Hydroxyapatite toothpaste on deciduous teeth: an effective option to fluoride toothpaste. Journal of Nanobiotechnology. 2019; 17: 17.

[15] Amaechi BT, Porteous N, Ramalingam K, Mensinkai PK, Ccahuana Vasquez RA, Sadeghpour A, et al. Remineralization of artificial enamel lesions by theobromine. Caries Research. 2013; 47: 399–405.

[16] Cardoso CAB, de Castilho ARF, Salomão PMA, Costa EN, Magalhães AC, Buzalaf MAR. Effect of xylitol varnishes on remineralization of artificial enamel caries lesions in vitro. Journal of Dentistry. 2014; 42: 1495–1501.

[17] Daas I, Badr S, Osman E. Comparison between fluoride and nano-hydroxyapatite in remineralizing initial enamel lesion: an in vitro study. The Journal of Contemporary Dental Practice. 2018; 19: 306–312.

[18] Memarpour M, Shafiei F, Rafiee A, Soltani M, Dashti MH. Effect of hydroxyapatite nanoparticles on enamel remineralization and estimation of fissure sealant bond strength to remineralized tooth surfaces: an in vitro study. BMC Oral Health. 2019; 19: 92.

[19] Razeghian-Jahromi I, Babanouri N, Ebrahimi Z, Najafi HZ, Sarbaz M, Montazeri-Najafabady N. Effect of 8% arginine toothpaste on Streptococcus mutans in patients undergoing fixed orthodontic treatment: randomized controlled trial. Dental Press Journal of Orthodontics. 2022; 27: e2220322.

[20] Thimmaiah C, Shetty P, Shetty S, Natarajan S, Thomas N. Comparative analysis of the remineralization potential of CPP-ACP with Fluoride, Tri-Calcium Phosphate and Nano Hydroxyapatite using SEM/EDX—an in vitro study. Journal of Clinical and Experimental Dentistry. 2019; 11: e1120–e1126.

[21] Perrott K. Health effects of fluoridation on IQ are unproven. The New Zealand Medical Journal. 2020; 133: 177–179.

[22] Community water fluoridation exposure: a review of neurological and cognitive effects—a 2020 update. Canadian Agency for Drugs and Technologies in Health: Ottawa. 2020.


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