Equilibrium Salivary Fluoride : a Measure of Compliance with Toothpaste Use

This study evaluates a new objective measure of compliance, with advice on toothpaste use, the equilibrium salivary fluoride level. This is the resting salivary fluoride level 18 hours post-brushing. Objectives: To measure the impact of an Oral Health Promotion (OHP) programme on equilibrium salivary fluoride levels. Methods: To evaluate an OHP programme in Dublin and Belfast four groups of less well off children age 7-8 years were recruited. In Dublin (n=98 ) and Belfast (n= 100 ) children in the experimental group (n=52 and 53 respectively) participated in an education/competition based OHP program. The programme was the same in both cities except that in Dublin fluoride toothpaste was explicitly supplied for the duration of the study. Children in the control groups (n=46 and n=47 respectively) received no intervention or toothpaste. Results: The mean baseline salivary fluoride in non-fluoridated Belfast was 0.016mg/L and 0.017mg/L in control and experimental groups respectively and 0.020mg/L and 0.019mg/L respectively in fluoridated Dublin. These levels increased in all four groups from baseline to 6-months indicating a possible response to the baseline visit by the dental team. However by 12 months mean salivary fluoride levels had decreased in all but the Dublin experimental group, to below baseline levels. In the Dublin experimental group, there was a significant increase in mean salivary fluoride concentrations between baseline and 6-months from 0.019mg/L to 0.023 mg/L (p<0.0001); at 12 months mean salivary fluoride was 0.024mg/L. These increases in salivary fluoride concentrations at the two time points indicate a progressive improvement over time in the group that received fluoride toothpaste. Conclusions: Equilibrium salivary fluoride measurement is a potentially useful method of assessing compliance with advice on use of fluoride toothpaste. (Funded by the Dental Health Foundation, Dublin and the R & D for HPSS, NI. Grant Number COM/1637/01)