Brushing with fluoridated dentifrice is an essential part of daily oral hygiene. The use of fluoridated mouth rinse after brushing has been a debated issue within dentistry, due to the possibility of reducing the uptake of fluoride through washing out the dentifrice.
A study was reported in 2009 that investigated these issues. It investigated fluoride uptake under different circumstances. In this supervised, single-blind study, 3 oral care regimes were compared:1
Brushing for 1 minute with fluoridated toothpaste (0.3% NaF) followed by rinsing with water
Brushing for 1 minute with fluoridated toothpaste (0.3% NaF) followed by rinsing with fluoridated mouth rinse (0.02% NaF)
Brushing for 1 minute with fluoridated toothpaste (0.3% NaF) followed by rinsing with a non-fluoridated mouth rinse
Twenty-three adults applied each treatment once in a randomised order, separated by 1-week washout periods, and used a non-fluoridated toothpaste at home prior to and during the study.1
fluoride_2.1.3.jpg
It can be seen from the graph that the use of a fluoridated toothpaste only, and the use of a fluoridated toothpaste followed by fluoridated mouth rinse are similar in terms of mean salivary fluoride. In other words, using a fluoridated mouth rinse after fluoridated toothpaste does not reduce fluoride levels in the mouth.1
Using a non-fluoridated mouth rinse after brushing, however, significantly reduces the fluoride in the mouth. For such patients, a 0.02% NaF mouth rinse would help maintain the level of salivary fluoride attained post brushing.1
In conclusion, this study showed that the use of a fluoridated mouth rinse can help maintain high fluoride levels post brushing;1 in other studies effective mouth rinses have also been shown to deliver a reduction in plaque and improvements in gum health.2
The benefits of fluoride – inhibition of demineralisation, promotion of remineralisation and prevention of caries – are widely understood by dental professionals.
From the graph, the mouth rinses with higher fluoride concentrations delivered higher salivary fluoride concentrations. The 500 ppm F mouth rinse resulted in a 2660% increase in total fluoride salivary retention over 60 minutes when compared with the 0 ppm F group, and a 120% increase when compared with the 225 ppm F group.
For many patients, rinsing after brushing with dentifrice is common, whether with water or a fluoridated mouth rinse. An important question is whether rinsing with water reduces fluoride uptake, and whether this remains the case with a fluoridated mouth rinse, or whether the fluoride contained in the mouth rinse is sufficient to ensure fluoride uptake.
Rinsing with water after brushing with fluoride toothpaste can reduce the benefit of fluoride toothpaste.
References
Duckworth RM et al. Effect of rinsing with mouthwashes after brushing with a fluoridated toothpaste on salivary fluoride concentration. Caries Res 2009; 43: 391–396.
Sharma NC et al. Adjunctive benefit of an essential oil containing mouthrinse in reducing plaque and gingivitis in patients who brush and floss regularly. A six-month study. J Am Dent Assoc 2004; 135: 496–504.
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