Control of decalcification in orthodontic patients by daily self-administered application of a water-free 0.4 per cent stannous fluoride gel.

A ny successful program of preventive dentistry for orthodontic patients must be based upon the realization that these patients represent an advanced caries risk.l One may argue at length as to the specific causes of decalcification frequently encountered in patients over long periods of banding, and there are differences of opinion as to the progression or regression of these lesions after the bands are removed. The disturbing and unequivocal fact remains, however, that decalcification under and around orthodontic bands is a problem of significance. Past work in this laboratory has pointed out that, while both stannous fluoride ( SnF,) and acidulated phosphate fluoride (APF) treatments produce relatively high initial solubility reduction on enamel surfaces, a large amount of this protection is removed from the surface with relative ease.2-4 Recent clinical research has also pointed out that a very low concentration of SnF, (0.1 per cent) is highly effective in reducing dental caries, even in a population of schoolchildren who are already receiving maximal protection from lifelong exposure to appropriately fluoridated water.5 The foregoing suggests that frequent applications of low concentrations of stannous fluoride might be effective in reducing decalcification in orthodontic patients by rendering the enamel surfaces less susceptible. This suggestion was confirmed in a short-term study recently conducted in thirty children over a 7-week period.6 The present study was designed with a twofold purpose. One was the mea-