“By informing an orthodontic patient that they are less likely to develop white spots after bracket removal if they utilize the remineralizating pastes and products that are available, dental health providers can help to motivate patients to use these products in their daily oral hygiene routine.” ᕡ Apply a small amount of product with a clean finger, and then move it around with the tongue. (Fig. 4) ᕢ It’s ok to swallow product. ᕣ It is not necessary to apply product with a tray. ᕤ People with kidney disease, autism, and actual milk protein allergies should avoid Recaldent. Some tips for using office applied fluoride varnish that should be brought to the attention of patients are: ᕡ Use fluoride varnishes that contain no plant based resins. ᕢ Apply a very thin layer of the product. ᕣ Apply the product to the occlusal surfaces of molars. (Fig. 5) ᕤ Stir the product to mix in the varnish that may have separated out from the product. Use the back of the brush handle for mixing to avoid coating the bristles with the matrix and poten-tially stopping transfer of fluoride to the teeth. Xylitol products seem to have increased in number over the years. Most fluoride varnishes boast that they contain xylitol. Xylitol at levels found in prophy paste or varnishes are not expected to alter the biofilm. One of the little known properties of xylitol that has still not been well studied, is that xylitol has a propensity of attracting calcium. This is the basis of studies that are looking at xylitol’s effect on osteoporosis. Xylitol also attracts moisture, this property is known as hygroscop-icity. 13 These two attributes make xylitol a perfect addi-tive to fluoride varnishes; it pulls in saliva and poten-tially holds the calcium molecules from the saliva against the tooth. Erthritol, an up and coming sugar alcohol is found in Truvia and PureVia, but xylitol in any daily form is still better then other available prod-ucts and can not be removed from any regimen for remineralization of enamel. Dental health providers often find patients are simply unaware of the outcomes that result from poor choices involving their oral care. When properly educated, patients are likely to modify their oral hygiene to do what is necessary to increase their health and further secure their investment of time and money that they put into their teeth. By informing an orthodontic patient that they are less likely to develop white spots after bracket removal if they utilize the remineralizating pastes and products that are available, dental health providers can help to motivate patients to use these products in their daily oral hygiene routine. Another good motivator is to inform any patient that they are less likely to develop decay if they continually use these products that help with making enamel stronger through remineralization. REFERENCES 1. Magalhães AC, Wiegand A, Rios D, Buzalaf MA, Lussi A. Fluoride in dental erosion. Monogr Oral Sci. 2011;22:158-70. doi: 10.1159/000325167. Epub 2011 Jun 23. 2. M. Vahid Golpayegani, A. Sohrabi, M. Biria, G. Ansari. Remineral-ization Effect of Topical NovaMin Versus Sodium Fluoride (1.1%) on Caries-Like Lesions in Permanent Teeth. J Dent (Tehran) 2012 Winter; 9(1): 68–75. 3. Newby CS, Creeth JE, Rees GD, Schemehorn BR. Surface micro-hardness changes, enamel fluoride uptake, and fluoride availabil-ity from commercial toothpastes. J Clin Dent. 2006;17(4):94-9. 4. Featherstone JD. The science and practice of caries prevention. J Am Dent Assoc. 2000 Jul;131(7):887-99. 5. Novel Anticaries and Remineralizing Agents: Prospects for the Future. JDR September 1, 2012 91: 813-815. 6. De Siena F, Del Fabbro M, Corbella S, Taschieri S, Weinstein R. Evaluation of chlorhexidine 0.05% with the adjunct of fluoride 0.05% in the inhibition of plaque formation: a double blind, crossover, plaque regrowth study. Int J Dent Hyg. 2012 Nov 26. doi: 10.1111/idh.12010. 7. Center for Disease Control and Prevention. http://www.atsdr.cdc.gov/ToxProfiles/tp11.pdf which creates better acid resistance. Accessed Jan 2013. 8. Ganss C, Klimek J, Schäffer U, Spall T. Effectiveness of two fluori-dation measures on erosion progression in human enamel and dentine in vitro. Caries Res. 2001 Sep-Oct;35(5):325-30. 9. Nonfluoride caries-preventive agents Executive summary of evidence-based clinical recommendationsThe Journal of the American Dental Association. September 1, 2011 vol. 142 no. 9 1065-1071. 10. Zweigoron RT, Binns HJ, Tanz RR. Unfilled prescriptions in pedi-atric primary care. Pediatrics. 2012 Oct;130(4):620-6. 11. Centers for Disease Control and Prevention. www.cdc.gov/mmwr/PDF/ss/ss5403.pdf Accessed Jan 2013. 12. Br Dent J. 2011 Dec 9;211(11):511-6. doi: 10.1038/sj.bdj.2011.1001. An effective oral health promoting message? Richards W., Filipponi T. Faculty of Health Sport and Science, University of Glamorgan, Pontypridd, CF37 1DL, UK. wrichard@glam.ac.uk. 13. Polyols: Beyond Sweet Taste. Food Product Design www.foodproductdesign.com/articles/2007/10/polyols-beyond-sweet-taste.aspx Accessed Feb 3, 2013 www.orthodontics.com March/April 2013 17
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