Prevention of Dental Demineralization by Fluoride Toothpastes Followed by Fluoride-Free Mouthwashes: A TMR-D Conventional and Single-Section Technique Study.

Background: The use of fluoride-free mouthwashes (FFM) can adversely affect the anticaries benefits of fluoride toothpaste.

Aim: This study investigated (i) the impact of FFM on the anticaries benefits of fluoride toothpaste and (ii) differences in enamel-lesion assessment between two TMR techniques.

Design: The study followed a 2 (technique) × 2 (toothpaste) × 4 (mouthwash) factorial design. Toothpaste (1100 ppm F) contained either NaF or SnF₂. Mouthwashes contained CPC or EOs. Control mouthwashes were DIW and not washed after toothpaste. Two TMR techniques, conventional specimens and single sections of enamel (n = 8), were utilized. During the 5-day/pH cycling, the specimens with artificial caries-like lesions were treated two times/day with toothpaste/1 min, followed by mouthwash/30s. There was a 4 h demineralization/day. Integrated mineral loss (ΔΔZ) and lesion depth (ΔL) were determined. Data were analyzed using three-way ANOVA.

Results: There was no statistically significant interaction between the three factors for ΔΔZ (p = 0.894) or ΔL (p = 0.410) and no difference between toothpaste for ΔΔZ (p = 0.977) or ΔL (p = 0.507). However, mouthwashes affected ΔΔZ and ΔL (both p < 0.001). The non-wash group resulted in the most remineralization. The technique did not affect ΔΔZ (p = 0.973).

Conclusion: Fluoride-free mouthwashes may decrease the remineralization potential of fluoride toothpaste, and the single-section technique is a suitable alternative in caries research. Pediatric dentists can emphasize proper hygiene and parental guidance in supervising children's brushing/rinsing.