Preliminary Report on Effect of Topical Applications of Titanium Tetrafluoride on Dental Caries ANDREW J. REED and BASIL G. BIBBY Eastman Dental Center, Rochester, New York 14603, USA
Materials and Methods Of 204 children in the 11- to 13-year-old age group who were given a dental examination, 144 elected to participate in the test. The remaining 60 children were used as an untreated control group. At the beginning of the study, all the children were given a dental prophylaxis after which the teeth acid phosphate fluoride. on one side of the mouth were treated with In a comparison of a variety of fluorides, it 1% titanium tetrafluoride (0.61% F) and was found' that titanium tetrafluoride was teeth on the other side with APF (1.25% more effective in reducing enamel solubility F). The side of the mouth to be treated by than the other agents used, and an aqueous the dental hygienist with a given solution solution remained active after several months was decided on the basis of the order of the of refrigerator storage. Enamel surfaces patient's appearance in the clinic. The first treated with a 1% aqueous solution of ti- patient received titanium fluoride on the tanium tetrafluioride showed more than a left side and the next on the right side 9070 reduction of solubility after seven ex- alternately until all study participants had posures to acid, whereas other agents such as been treated. acid phosphate fluoride (APF),a stannous Each titanium tetrafluoride treatment confluoride, or neutral sodium fluoride gave a sisted of isolating and drying the teeth and maximum reduction of less than 70% and thereafter keeping them wet with the test showed no protective effect after four ex- agent for one minute, then blotting out posures to acid. excess solution with a cotton roll. The APF Tests in rats showed that topical applica- treatment was similar except that the period tions of 1% titanium tetrafluoride solution of application was four minutes. To prevent were more effective in preventing caries in the agent used in one side from contaminatmolars than were stannous fluoride2 or APF.3 ing the other, a rubber dam was placed beThese results, together with the stability and tween central incisors and they were not lack of irritating properties of the 1% ti- included in the caries tabulations. Patients tanium tetrafluoride solution, indicated that were not allowed to rinse their mouths or it had potential as a topical agent for use in eat for 30 minutes after treatment. This the prevention of caries in man. procedure was repeated on approximately Arrangements were made to do a small the same dates for the succeeding two years. clinical test in a rural school in Western New Caries examinations were made with a York at which a stable population group and mirror and explorer with the patient seated the necessary support from the school au- in a dental chair under proper illumination. thorities were available. Because of the lim- All the children were examined at the start ited size of the school population and a and one, two, and three years thereafter by commitment to the cooperating parents, half- one dentist who had no knowledge of which mouth treatments were given using APF as agent had been used on which side of the the control agent. Children who did not mouth. The third examination, after two wish to participate were used as an un- treatment years, was also made by a second treated control group. dentist whose examination procedure had been calibrated with that of the original Received for publication July 7, 1975. Accepted for publication September 22, 1975. examiner. After three years, at the time of a Luride (acidulated sodium fluoride containing phosthe fourth examination, 154 of the original phate), Davies Rose Hoyt, Needham, Mass. 357 Downloaded from jdr.sagepub.com at UNIV CALIFORNIA SAN DIEGO on March 13, 2015 For personal use only. No other uses without permission. An annual, one-minute application of a 1% solution of titanium tetrafluoride to the teeth on one side of the mouth of each of 110 children offered greater protection against caries after three years than was given to teeth on the other side of the mouth treated with a four-minute application of
358
J Dent Res May-June 1976
REED AND BIBBY
TABLE
MEAN HALF-MOUTH CARIES SURFACE INCREMENTS Original DMFS
New Carious Surfaces
Treatment
1970
1970-1971
1970-1972
1970-1973
TiFS
3.85
APF
3.70
1.0 0.28* (N =123) 1.75 ± 0.32
1.94 ± 0.36 (N = 114) 2.60 ± 0.54
3.10 0.52 (N =110) 4.60 +±0.72 (N =110)
3.50
(N =123) 2.13 ± 0.20
(N =114)
None
3.89 ± 0.30
5.80 ± 1.72
(N =96)
(N =88)
(N =108)
Note: In the 1970-1971 group, between the TiF4 and APF treatment, P < 0.004; between the TiF4 and none, P < 0.004. In the 1970-1972 group, between the TiF4 and APF treatment, not significant; between TiF4 and none, P
Materials and Methods Of 204 children in the 11- to 13-year-old age group who were given a dental examination, 144 elected to participate in the test. The remaining 60 children were used as an untreated control group. At the beginning of the study, all the children were given a dental prophylaxis after which the teeth acid phosphate fluoride. on one side of the mouth were treated with In a comparison of a variety of fluorides, it 1% titanium tetrafluoride (0.61% F) and was found' that titanium tetrafluoride was teeth on the other side with APF (1.25% more effective in reducing enamel solubility F). The side of the mouth to be treated by than the other agents used, and an aqueous the dental hygienist with a given solution solution remained active after several months was decided on the basis of the order of the of refrigerator storage. Enamel surfaces patient's appearance in the clinic. The first treated with a 1% aqueous solution of ti- patient received titanium fluoride on the tanium tetrafluioride showed more than a left side and the next on the right side 9070 reduction of solubility after seven ex- alternately until all study participants had posures to acid, whereas other agents such as been treated. acid phosphate fluoride (APF),a stannous Each titanium tetrafluoride treatment confluoride, or neutral sodium fluoride gave a sisted of isolating and drying the teeth and maximum reduction of less than 70% and thereafter keeping them wet with the test showed no protective effect after four ex- agent for one minute, then blotting out posures to acid. excess solution with a cotton roll. The APF Tests in rats showed that topical applica- treatment was similar except that the period tions of 1% titanium tetrafluoride solution of application was four minutes. To prevent were more effective in preventing caries in the agent used in one side from contaminatmolars than were stannous fluoride2 or APF.3 ing the other, a rubber dam was placed beThese results, together with the stability and tween central incisors and they were not lack of irritating properties of the 1% ti- included in the caries tabulations. Patients tanium tetrafluoride solution, indicated that were not allowed to rinse their mouths or it had potential as a topical agent for use in eat for 30 minutes after treatment. This the prevention of caries in man. procedure was repeated on approximately Arrangements were made to do a small the same dates for the succeeding two years. clinical test in a rural school in Western New Caries examinations were made with a York at which a stable population group and mirror and explorer with the patient seated the necessary support from the school au- in a dental chair under proper illumination. thorities were available. Because of the lim- All the children were examined at the start ited size of the school population and a and one, two, and three years thereafter by commitment to the cooperating parents, half- one dentist who had no knowledge of which mouth treatments were given using APF as agent had been used on which side of the the control agent. Children who did not mouth. The third examination, after two wish to participate were used as an un- treatment years, was also made by a second treated control group. dentist whose examination procedure had been calibrated with that of the original Received for publication July 7, 1975. Accepted for publication September 22, 1975. examiner. After three years, at the time of a Luride (acidulated sodium fluoride containing phosthe fourth examination, 154 of the original phate), Davies Rose Hoyt, Needham, Mass. 357 Downloaded from jdr.sagepub.com at UNIV CALIFORNIA SAN DIEGO on March 13, 2015 For personal use only. No other uses without permission. An annual, one-minute application of a 1% solution of titanium tetrafluoride to the teeth on one side of the mouth of each of 110 children offered greater protection against caries after three years than was given to teeth on the other side of the mouth treated with a four-minute application of
358
J Dent Res May-June 1976
REED AND BIBBY
TABLE
MEAN HALF-MOUTH CARIES SURFACE INCREMENTS Original DMFS
New Carious Surfaces
Treatment
1970
1970-1971
1970-1972
1970-1973
TiFS
3.85
APF
3.70
1.0 0.28* (N =123) 1.75 ± 0.32
1.94 ± 0.36 (N = 114) 2.60 ± 0.54
3.10 0.52 (N =110) 4.60 +±0.72 (N =110)
3.50
(N =123) 2.13 ± 0.20
(N =114)
None
3.89 ± 0.30
5.80 ± 1.72
(N =96)
(N =88)
(N =108)
Note: In the 1970-1971 group, between the TiF4 and APF treatment, P < 0.004; between the TiF4 and none, P < 0.004. In the 1970-1972 group, between the TiF4 and APF treatment, not significant; between TiF4 and none, P
