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

PubMed ID	Author / Year	Patient Group	Study type (level of evidence)
19204390	Nordstom/2009	26 healthy, aged 19-	Randomized Controlled trial, 4-leg
Key results	Fluoride 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.
11813383	Sjogren/2001	21 healthy, aged 23	Randomized Controlled Trial
Key results	In 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).
14684972	Issa/2004	10 healthy adults	Double-blind study
Key results	Using 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

(General Dentistry) (Orthodontics) (Pediatric Dentistry) (Periodontics) (Dental Hygiene)

Keywords

Fluoride, Toothbrushing, Water rinsing, Dentifrice, Saliva, Dental plaque

ID#

2493

Date of submission

07/25/2013

E-mail

stoker@ohsu.edu

Author

Amelia Stoker

Co-author(s)

Co-author(s) e-mail

Faculty mentor

Ronald Sakaguchi, DDS, MS. PhD, MBA & Eli Schwarz, DDS, MPH, PhD

Faculty mentor 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?)

None available

Comments and Evidence-Based Updates on the CAT
(FOR PRACTICING DENTISTS', FACULTY, RESIDENTS and/or STUDENTS COMMENTS ON PUBLISHED CATs)

None available