Long-term clinical observation of dental caries in salivary hypofunction patients using a supersaturated calcium-phosphate remineralizing rinse

J Clin Dent. 2009;20(3):87-92.

Abstract

Objective: One therapeutic approach to the management of xerostomia and its related oral sequelae is the use of a supersaturated Ca2+/PO4(3-) rinse in conjunction with fluoride. This study evaluated the use of the supersaturated rinse in high-risk patients from a single dental clinic.

Methods: Patients (n = 134) at high risk for caries due to xerostomia were prescribed the calcium phosphate rinse and 1.1% NaF for daily use, and were evaluated for caries incidence over an average observation period of five years. All patients were instructed to use the rinse three to four times a day, depending on the severity of dryness of the mouth and rate of salivary flow. Compliance, or regular use of the rinse, was determined through monitoring by staff at each visit, a self-administered clinic questionnaire pertaining to usage of the rinse, and records from a single hospital pharmacy that supplied the rinse to all participating patients. Those patients who were found to typically use the remineralizing solution at least once a day during the entire follow-up period were classified as compliant. All individual surfaces at risk for caries (SAR) were examined and recorded at each visit to determine changes in average SAR per patient

Results: Patients who regularly used the supersaturated rinse, along with commercially available prescription sodium fluoride, were found to experience a significant increase in reversals of caries, and a significant decrease in net coronal and root surface caries increment. The mean for the compliant group was 0.034 (SD 0.303), and the non-compliant mean was 0.315 (SD 0.735) with p > 0.0001 per surfaces/month.

Conclusion: These observations suggest that long-term compliance with the daily supersaturated rinse was protective against caries progression in a high-risk population.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Calcium Phosphates / chemistry
  • Calcium Phosphates / therapeutic use*
  • Dental Caries / epidemiology
  • Dental Caries / etiology
  • Dental Caries / microbiology
  • Dental Caries / prevention & control*
  • Female
  • Humans
  • Male
  • Middle Aged
  • Mouthwashes / chemistry
  • Mouthwashes / therapeutic use*
  • Mucositis / etiology
  • Mucositis / prevention & control
  • Retrospective Studies
  • Sodium Fluoride / chemistry
  • Sodium Fluoride / therapeutic use
  • Treatment Outcome
  • Xerostomia / drug therapy*
  • Xerostomia / epidemiology
  • Xerostomia / etiology

Substances

  • Calcium Phosphates
  • Mouthwashes
  • Sodium Fluoride