An Extensive Comparison of the Clinical Efficiency of Acidulated Phosphate Fluoride (APF) and Neutral Sodium Fluoride (NaF) Oral Rinses in the Prevention of White Spot Lesions during Fixed Orthodontic Treatment: A Randomized Controlled Trial

Abstract

Background. The purpose of this randomized trial is to compare the efficacy of weekly once regime of neutral sodium fluoride (NaF) oral rinse with that of acidulated phosphate (APF) formulated daily mouth rinse in the reduction of white spot lesions (WSLs) associated with fixed orthodontic appliance treatment. Methods. The participants ( $n=90$ ) of this single-center, two-arm parallel study without a control group were randomly assigned with 1 : 1 distribution to each of the two groups after the bonding of brackets. Group A/test group 1 ( $n=45$ ) was given weekly rinse of neutral sodium fluoride (Colgate® PreviDent® Dental Rinse-0.2% NaF), and for group B/test group 2 ( $n=45$ ), an APF formulated daily oral rinse (Colgate® Ortho Defense@ PhosFlur® Rinse-0.044% w/v of NaF) was given for six months. The outcome was assessed by the International Caries Detection and Assessment System (ICDAS) index for scoring the demineralization, and for scoring gingivitis, Loe and Silness gingival index (GI) was utilized. Four different time points “T0”immediately before bonding procedures, “T1” after 4weeks, “T2” after 12 weeks, and “T3” after 24 weeks were taken to assess the ICDAS and GI scores. Results. The mean ICDAS scores for group A (NaF) were 0.025, 0.051, 0.093, and 0.113 and for group B (APF) were 0.014, 0.022, 0.038, and 0.015 at different points of time. The GI scores for group A were 0.008, 0.22, 0.33, and 0.38 and for group B were 0.003, 0.136, 0.181, and 0.097 at different time points. There was a statistically significant difference ( $p<0.05$ ) for both groups in terms of reducing WSL and GI. Conclusion. APF formulated daily oral rinse—0.044% w/v of NaF—is more effective than the weekly once regimen of 0.2% NaF oral rinse to prevent white spot lesions.