An Experimental and Clinically Controlled Study of the Prevention of Dental Caries Using 1.23% Fluoride Gel in Elderly Patients

AIM: To describe the enamel and dentin fluoride mineralization process in practical application and assess the fluoride gel (NaF 1.23%) effectiveness in dental caries prevention for elderly patients. MATERIALS AND METHODS: Two different types of study were applied: (a) experimental study of fluoride mineralization of enamel and dentin in vitro; (b) clinical controlled interventional studies of the effectiveness in dental caries prevention using 1.23% fluoride gel. Experimental research was performed in laboratory conditions. Teeth of the elderly extracted due to dental diseases served as research objects. Enamel surface and dental root surface were examined under a scanning electron microscope (SEM) before and after demineralization with 37% phosphoric acid within 15 s, as well as after remineralization with toothpaste and 1.23% fluoride gel. Controlled clinical research included 218 older people divided into two groups (intervention group, n = 106; control group, n = 112). In the intervention group, the application of the gel lasts 4 min in the morning for 18 months. The control group received adult P/S toothpaste and a P/S toothbrush. The DIAGNOdent device was used to assess damage both before and after demineralization. For the clinical evaluation of dental caries, international caries detection and assessment system (ICDAS) has been used. Decay missing-filled index (DMFT), effective index (Ef-I), and intervention index (In-I) were determined. Statistical data were analyzed using Mann–Whitney U test and χ2 test. Differences were considered significant at P < 0.05. RESULTS: An SEM image of the enamel surface and dental root surface after teeth remineralization with fluoride gel shows a hard enamel surface without cracks, even in color and structure. After brushing with toothpaste, numerous cracks remain on the surface of the enamel, and the surface layer of the enamel with a depth of 9.64 microns remains damaged without remineralization. After 18 months of intervention, the rate of dental caries in the control group increased from 42.1% to 68.8%, and in the intervention group it increased from 30.8% to 17.0%. A comparison of the 1.23% fluoride gel with toothpaste shows that the former exhibits performance in protecting teeth from decay and it is 108.2% more effective than the latter. CONCLUSIONS: Practical experiments proved the function of remineralizing the enamel and dentin of 1.23% fluoride gel on the teeth of the elderly. Intervention research has proven the performance of preventing dental decay from 1.23% fluoride gel for the elderly in question.