For further information visit:

www.AquafreshScienceAcademy.com

Science focus RESOURCE

Science focus on...

Fluoride
The anti-caries effect of
fluoride is well established
and it has been used as an
ingredient in dentifrices for
decades. Extensive studies
have demonstrated the main
effects of fluoride are to
promote remineralization
of early caries and prevent
demineralization.
Research into this remarkable mineral
continues in the 21st century. Scientists
continue to investigate mode of action
and the effects of different fluoride
formulations are constantly being
explored. Read on for a summary of recent
data comparing the release of fluoride
from different sources and advances in
fluoride uptake from dentifrices.
Sources of fluoride in
Although SnF2 and AmF are used in
dentifrices, the majority of formulations
use either NaF or MFP as fluoride sources.
Comparing these two, Bowen’s Journal of
the Royal Society of Medicine paper (1995)
has indicated that fluoride ions are freely
available in NaF; however, MFP needs to
be broken down by salivary phosphatases
in order to release fluoride.
Na+
O-

P
F F

dentifrices
O F
Na+ Sn Na
F
O-

There are four sources of fluoride used in Sodium

monofluorophosphate Stannous fluoride Sodium fluoride

dentifrices, which include: F- F-

O
N+ N+

• sodium fluoride (NaF)

• sodium monofluorophosphate (MFP) O O
Amine fluoride

• stannous fluoride (SnF2)

• amine fluoride (AmF).
Different fluoride sources, pH and
the choice of other ingredients in the
formulation can affect fluoride delivery –
and not all fluoride dentifrices are equally
effective, even if they contain equivalent
concentrations of fluoride.
‘Two recent GSK caries model
studies demonstrate that NaF provides
greater remineralization and increased
fluoride uptake than MFP’
Differences in fluoride uptake
While there have been numerous studies
to compare anti-caries effects between
the two most common sources of fluoride
in dentifrices – NaF and MFP – there is
some debate regarding their respective
mechanisms of anti-caries action.
Two recent GSK caries model studies
demonstrate that NaF provides greater
remineralization and increased fluoride
uptake than MFP. The studies compared
a) changes in surface microhardness
and fluoride uptake using a 20-day in
vitro caries cycling model and b) the
remineralization potential and fluoride
uptake of NaF and MFP dentifrices using
an in situ caries model.

www.AquafreshScienceAcademy.com
 For further information visit:
www.AquafreshScienceAcademy.com

Science focus RESOURCE

Surface microhardness cycling regimen. Surface microhardness

changes and fluoride uptake was measured at baseline, 10 and 20 days.
with NaF and MFP in an in vitro Fluoride uptake in the enamel specimens
caries cycling model was measured at 20 days using the
microdrill technique.
This study, published in Caries Research,
was undertaken by Newby et al (2007) After 20 days of treatment significantly
with the objectives of determining the greater surface microhardness was
relative efficacies of marketed observed with Aquafresh Advanced
dentifrices to: than with both MFP pastes and the
other NaF paste, as a result of improved
• promote enamel fluoride uptake
remineralization and increased fluoride
• promote lesion remineralization uptake (figure 1).
• diminish subsequent demineralization
under dynamic conditions simulating in This study by Newby demonstrates that
vivo caries formation. dentifrices with similar available fluoride
and the same fluoride source can be
The study compared MFP-containing formulated to provide increased enamel
dentifrices with different formulations hardness and fluoride uptake. This was
of NaF-containing pastes, including demonstrated by the fact that Aquafresh
Aquafresh Advanced (NaF in silica base A, Advanced (NaF in silica base A, 1100ppm
1100ppm fluoride) and an experimental fluoride) was associated with greater
GSK formulation (NaF in silica base B, surface microhardness and fluoride uptake
1100ppm fluoride). after 20 days of treatment (p<0.05) than
the experimental Aquafresh variant (NaF
Artificial lesions were formed in human
in silica base B) (figure 1).
enamel specimens and subjected to a daily

Figure 1: Results after 20 days of treatment [Newby, 2007]

Surface hardness
Surfacechanges
Surface
hardness
hardness
changes
changes Enamel fluoride uptake
Enamel
Enamel
fluoride
fluoride
uptake
uptake

80 80 6000
6000
* * * *
Enamel Fluoride Uptake (µgF/cm3)
Enamel Fluoride Uptake (µgF/cm3)

70 70 50005000
Vickers Hardness Number
Vickers Hardness Number

60 60 4000
4000
1 1
50 50 3000
3000

40 40 20002000 1 1

30 30 10001000

20 20 20 20
FF FF MFdiMFdi
MFchMFch B B A A FF FF MFdiMFdi
MFchMFch B B A A

1. Aquafresh
1. Aquafresh
CavityCavity
Protection.
Protection.
Data expressed
Data expressed
as as FF FF = Fluoride
= Fluoride
free free
mean mean
± s.e.mean
± s.e.mean
n=18 n=18 MFdi MFdi
= MFP
= dicalcium
MFP dicalcium
phosphate
phosphate
MFch MFch
= MFP
= calcium
MFP calcium
carbonate
carbonate
All dentifrices
All dentifrices
testedtested
contained
contained
a nominal
a nominal
1100ppm
1100ppm
F F B B = Experimental
= Experimental
NaF/silica
NaF/silica
B B
* p<0.05
* p<0.05
compared
compared
with all
with
other
all other
dentifrices
dentifrices
testedtested
A A = Experimental
= Experimental
NaF/silica
NaF/silica
A (Aquafresh
A (Aquafresh
Advanced)
Advanced)

www.AquafreshScienceAcademy.com
 For further information visit:
www.AquafreshScienceAcademy.com

Science focus RESOURCE

Remineralization potential and This study used two gauze-covered,

fluoride uptake from a NaF partially demineralized human enamel
dentifrice compared with an blocks that were placed in subjects’ partial
MFP dentifrice using an in situ dentures. Subjects then brushed using the
caries model test dentifrices twice a day for 14 days.
In this randomised, controlled in situ Changes in mineral content of enamel
clinical study by Zero et al, published in specimens were assessed using the surface
Caries Research (2007), the change in microhardness test and fluoride uptake
mineral content of partially demineralized was assessed using the microdrill enamel
enamel specimens was assessed using the biopsy technique.
surface microhardness test after 14 days of
twice-daily brushing with test dentifrices Results showed that surface hardness
(Aquafresh Advanced, which is NaF recovery and fluoride uptake were
1100ppm fluoride, silica base; and MFP significantly greater (p<0.001) with
1100ppm fluoride, dicalcium phosphate Aquafresh Advanced than MFP after 14
base). Fluoride uptake was evaluated using days of treatment (figure 2).
the microdrill enamel biopsy technique.
Figure 2: Results after 14 days of treatment [Zero, 2007]
Surface hardness recovery Fluoride uptake
Surface hardness
Surfacerecovery
hardness recovery Fluoride uptake
Fluoride uptake

60 60 30 30

50 50 25 25
% Surface Hardness Recovery

% Surface Hardness Recovery

Fluoride Uptake (µgF/cm2)

Fluoride Uptake (µgF/cm2)

* *

40 40 20 20
* *
30 30 15 15

20 20 10 10

10 10 5 5

0 0 0 0
Fluoride DoseFluoride
response Dose
1100ppm
responseAquafresh
1100ppm Aquafresh Fluoride DoseFluoride
response Dose
1100ppm
responseAquafresh
1100ppm Aquafresh

Further reading
free control
free control
MFP Advanced
MFP Advanced free control
free control
MFP Advanced
MFP Advanced
(0ppm MFP) (250ppm
(0ppm MFP) F, (250ppm F, (0ppm MFP) (250ppm
(0ppm MFP) F, (250ppm F,
NaF silica base)NaF silica base) NaF silica base)NaF silica base)
Bowen WH. The role of fluoride toothpastes in
Data expressed asData
leastexpressed
square mean
as least
± s.e.mean
square n=39
mean ± s.e.mean n=39
the prevention of dental caries. J Royal Soc Med * p<0.001 compared
* p<0.001
with 1100ppm
comparedMFPwith 1100ppm MFP
1995; 88: 505–507.
ten Cate JM. Eur J Oral Sci 1997; 105: 461–465.
Zero DT, et al. Comparison of Marketed NaF and Conclusion
MFP dentifrice products using and In Situ Caries
Model. Caries Res 2007; 41: 268–334. The studies by Newby and Zero, detailed above, demonstrate that Aquafresh Advanced
Zero DT, Proskin HM, Buch RM, et al. 0502 provides greater remineralization and increased fluoride uptake compared to MFP
Efficacy of Marketed Dentifrices Using an In situ
Caries Model. Presented at the 85th General toothpastes. Interestingly, it has also been demonstrated that different formulations of
Session & Exhibition of the International
Association for Dental Research (IADR), New
NaF, with similar available fluoride, can provide increased enamel hardness and fluoride
Orleans, USA, 2007. uptake, illustrated by the fact that Aquafresh Advanced is superior to another NaF
Newby EE, et al. Caries Res 2007; 41: 328 (abs 173). formulation (figure 1).

www.AquafreshScienceAcademy.com