ORAL HEALTH EVIDENCE-BASED PRACTICE PROGRAM
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Title Fluoride Retention Greater if no Post Brushing Water Rinsing Routine is Used
Clinical Question In adults, does not rinsing with water after brushing teeth with fluoride toothpaste versus rinsing after brushing teeth with fluoride toothpaste increase fluoride retention?
Clinical Bottom Line Fluoride retention is greater without post brushing water rinsing compared to rinsing with water after brushing with fluoride toothpaste.
Best Evidence (you may view more info by clicking on the PubMed ID link)
PubMed ID Author / Year Patient Group Study type
(level of evidence)
#1) 19204390Nordstom/200926 healthy, aged 19-Randomized Controlled trial, 4-leg
Key resultsFluoride retention in plaque and saliva was highest after using 5,000 ppm F toothpaste without post brushing water rinsing compared to using 1,450 ppm F toothpaste with water rinsing which had the lowest retention. The increase of F in plaque between 1,450/rinsing and 5,000/no rinsing was 2.1 times (2.7/1.3) expressed as ppm F and 2.75 (0.11/0.04) times expressed on a weight basis (both, p<0.05). The increase of F in saliva using toothpaste with 5,000 ppm F without postbrushing water rinsing was 4.2 times (685/165; p< 0.001) compared to 1,450 ppm F toothpaste with water rinsing.
#2) 11813383Sjogren/200121 healthy, aged 23Randomized Controlled Trial
Key resultsIn saliva, the concentration of fluoride increased as an effect of the increased volume of water, but not as an effect of duration of rinsing (p=0.023). The difference in fluoride concentration in saliva was significant with respect to the amount of water (10mLx3 compared to 5mL at various rinsing times; p<0.05) and compared to fluoride-free brushing (p<0.001).
#3) 14684972Issa/200410 healthy adultsDouble-blind study
Key resultsUsing AmF toothpaste (1,400 ppm F) resulted in the highest fluoride content of saliva without water rinsing after 120 min (0.52 ppm F, Cl 0.23, 0.81).
Evidence Search “Fluoride retention with water rinsing after toothbrushing” a second search used “Rinsing with water after brushing teeth.” Both used the same filters on PubMed, English, clinical trial, randomized control trial, humans, 5 or 10 years, abstract or full text available.
Comments on
The Evidence
Patient groups could be larger. However, the articles all supported the notion that fluoride retention is greater with no post brushing rinsing routine is.
Applicability In order to achieve the maximum anticaries effect from home care, there should be emphasis on post brushing routines. Applies especially to patients who are at risk of developing caries.
Specialty/Discipline (General Dentistry) (Orthodontics) (Pediatric Dentistry) (Periodontics)
Keywords Fluoride, Toothbrushing, Water rinsing, Dentifrice, Saliva, Dental plaque
ID# 2493
Date of submission: 07/25/2013spacer
E-mail stoker@ohsu.edu
Author Amelia Stoker
Co-author(s)
Co-author(s) e-mail
Faculty mentor/Co-author Ronald Sakaguchi, DDS, MS. PhD, MBA & Eli Schwarz, DDS, MPH, PhD
Faculty mentor/Co-author e-mail schwarz@ohsu.edu; sakaguch@ohsu.edu
Basic Science Rationale
(Mechanisms that may account for and/or explain the clinical question, i.e. is the answer to the clinical question consistent with basic biological, physical and/or behavioral science principles, laws and research?)
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None available
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Comments on the CAT
(FOR PRACTICING DENTISTS' and/or FACULTY COMMENTS ON PUBLISHED CATs)
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