Milk

1. Introduction
- Dental caries : multi-factorial, highly transmissible disease
of dental tissues

- Fluoride : identified as one of the protective factors

- constant presence of low levels of fluoride in the mouth
inhibits de-mineralization and enhance re-mineralization

- Fluoridation of milk is recommended where fluoride conc.
in drinking water is suboptimal

- Fluoridated milk provided children experienced significantly
less dental caries

* Object of this study
- Investigating whether increase
1) The concentration of fluoride in milk
2) The volume of fluoridated milk
alters re-mineralizing efficacy

* Hypothesis
- increasing the fluoride conc. and volume of fluoridated milk
would increase its remineralization efficacy

2. Materials and method

2.1 Preparation of de-mineralizing and re-remineralizing sln.

1) De-mineralizing sln. : 2.2 mM CaCl2, 2.2 mM NaH2PO4,
0.15M KCl, pH 4.4

2) Re-mineralizing sln. : 1.5 mM CaCl2, 0.9 mM NaH2PO4,
0.15 M KCl at pH 7.0

3) F- milk : Milk was mixed with 100 ppm and 500 ppm F- sln.
to make 2.5, 5, 7.5, 10, 15, 20 and 250 ppm
fluoridated milk sln.

2.2 Lesion formation
1) Extracted 3rd molar were cleaned
2) The teeth were painted with acid resistant nail varnish
leaving window on the buccal and/or lingual surface
3) Immersed in de-mineralizing sln. (10 ml/tooth) for 96hr
to produce artificial lesion
4) sectioned longitudinally to produce 100-150 ㎛
thickness
5) 375 sections were selected
6) Polarized light microscopy (PLM) and micro-radiography
(MRG) were used to analyse the lesion depth and
mineral
content of the lesion

2.3 The pH cycling model
1) The section were placed in the pH cycling system
for 20 days at room temp.
2) Each cycle involved 4h of demineralzation, 6 h of
fluoride milk treatment followed by 14 h of
remineralization

2.4 Evaluation technique
2.4.1. Polarizing light microscopy
- evaluate the body of the lesion in the enamel sample

2.4.2. Microradiography
- X-ray
- changes in mineral content and lesion depth by
using computer software

3. Results
1) No statistically significant difference amongst pre-treatment
lesion depth between the groups
2) The post-treatment lesion depths differed significantly
between groups : 15.53 % reduction ~ 43.71 % increase

3) All test groups showed a statistically significant decrease
in the lesion depth after treatment with fluoridated milk

4) Significant increase in the lesion depths for tests with
plain milk and DI water

5) No significant difference in percentage of lesion depth
reduction when F- milk was doubled

6) Significant relationship between [F-] and lesion depth change
and no significant relationship with volume

7) ΔZ values for all test groups : statistically lowered after
treatment with fluoridated milk

8) Significant increase in ΔZ for Plain milk and DI water

9) PLM photomicrographs
- treatment groups showed a decrease in lesion depth

10) Microradiographs
- changes of mineral content after pH cycling

4. Discussion
1) The caries protective effect of fluoride in milk on early
enamel carious lesion was shown by significant decrease
in the lesion depth and ΔZ values

2) When volume was doubled, there was no significant
differences on overall remineralization efficacy

5. Conclusion
1) Fluoridated milk appears to have a protective effective on
early enamel carious lesion

2) 2.5 ppm fluoride milk provided similar remineralization
potential to that of higher fluoride conc. in milk

3) Increasing the volume of fluoridated milk has little effect
on its remineralizing efficacy

Milk

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Editor's Notes