Recognizing the global distribution and the disproportionate representation of caries in low socioeconomic status (SES) population, our goal was to evaluate an 1) alternative inexpensive caries prevention and 2) an intervention to standard treatments. Both WHO and the U.S. Institute of Medicine have determined that SDF is a beneficial material that effects biofilms.
Method:
A Calgary Biofilm Device coated with hydroxyapatite was utilized to represent normal tooth structure. Bacteria at 1 x 106 CFU/ml (Lactobacillus sp.) and yeast (Candida albicans) grown in biofilm phenotype for 48 hrs. were utilized. Measurement of efficacy and therapeutic effects were established utilizing three assays: CFU’s, crystal violet (CV), and SEM by WVU School of Engineering. Comparative treatments were 5% NaF and 38% SDF applied either prior (preventative) to organism challenge or after (therapeutic), and compared to control pegs.
Result:
SDF displayed significant (P<0.001) anti-biofilm effectiveness versus NaF in both preventative (260 vs. 0 cfu/ml) and therapeutic (350 vs. 10 cfu/ml) applications. There was no significant difference of biofilm reduction displayed by the NaF applied pegs. There was also no statistical significance between preventative or therapeutic application for either organism or either fluoride. Comparison of the three assays emphasized that 1) CFU’s showed the highest level of differentiation with 2) SEM and 3) CV following, respectively. SEM at 10/20/100 microns revealed demonstrable change in 3-D architecture and % coverage emphasizing a stage II (logarithmic) growth pattern.
Conclusion:
SDF demonstrated superior anti-biofilm effectiveness vs. NaF in both applications and also against both biofilm phenotypes. This supports our concept that SDF can be used as both a preventative and therapeutic agent for low SES and rural area populations; enhanced by the ease of application and lower cost incurred, given half the treatments needed versus NaF.