Two Modified Fluoride-mouthwash Delivery Methods for Special-Needs Patients Are Effective

Objective: Special-needs patients with high caries risk suffer from poor rinsing compliance and a lack of home-use fluoride recommendations. This study aimed to evaluate whether two modified delivery methods, spray or swab application, could raise the salivary fluoride level similar to that of rinsing. Methods: Twenty one consenting volunteers participated in this crossover study. They were five healthy males and sixteen healthy females, aged 18-22 years, residents of Bangkok, Thailand. The subjects performed a standardized brushing routine twice a day with 1,000 ppm fluoride dentifrice one week prior to and along the experimental period. The investigators were trained in performing all experiment procedures prior to beginning the study. The three fluoride mouthwash (0.05% NaF; 226 ppmF) administration methods consisted of rinsing, spray and cotton swab application. Each application was separated by at least one week. Unstimulated whole saliva was sampled for two minutes at baseline and at 0, 5, 10, 20, 30, 60 and 120 minutes after each fluoride mouthwash application, and then the salivary fluoride level in ppm was measured using an ion-specific electrode (ORION EA940) by a blinded investigator. Differences in salivary fluoride concentration for each mode of application were analyzed by ANOVA at p<0.05 significant level. Results: The newly designed fluoride mouthwash delivery methods yielded similar fluoride level in whole saliva at all time-points compared to that of rinsing (p>0.05). Conclusion: Fluoride mouthwash delivery by both spray and cotton swab application can raise salivary fluoride concentration comparable with conventional rinsing.