Comparative effect of fluoridated toothpaste with or without arginine on the remineralization of white spot lesions in primary teeth: a randomized controlled clinical trial

Abstract

Objective: To compare the remineralizing effect of a toothpaste containing 1,450 ppm sodium monofluorophosphate (MFP) (control), with or without 1.5% arginine (test), on active white spot lesions (WSLs) in primary teeth of preschool children (4-5 years) in a double-blind, randomized controlled clinical trial. Material and Methods: Upper primary anterior teeth with WSLs (control: 47; test: 41) from 35 children were analyzed at baseline and after 3 months of supervised toothbrushing performed three times daily. Examinations were conducted in a school setting by a calibrated examiner using the dmft index. WSLs were assessed visually with ICDAS criteria, including caries activity, and monitored using a laser fluorescence device (LFpen). The lesion area (mm2 ) was measured using digital photographs with ImageJ. Results: The dmft index increased in both groups after 3 months (p = 0.0084), with no significant difference between them (p > 0.05). No significant differences were observed in WSLs area and LFpen values for treatment type, phase, or interaction (p > 0.05). WSLs’ activity showed significant differences between study phases for each treatment (p < 0.0001). The progression or regression of WSLs did not differ significantly (p > 0.05), regardless of caries experience (odds ratio [OR] = 1.65; 95% confidence interval [CI] = 0.59-4.65, low experience OR = 1.33; 95% CI = 0.20-9.08; high experience OR = 1.63; 95% CI = 0.45-5.82). Conclusion: The addition of 1.5% arginine to toothpaste containing 1,450 ppm sodium monofluorophosphate did not provide an additional remineralizing effect on active WSLs in primary teeth of preschool children after 3 months of follow-up.

KEYWORDS

Arginine; Dental caries; Dentifrices; Fluoride treatment; Tooth remineralization.