Fluoride Plus Calcium Phosphate Varnishes: A Possible Link between Mineral Phase Formations and Observed Clinical Outcomes

Incorporation of calcium phosphate agents into fluoride varnishes might improve anticaries benefits. But when clinical results do not mirror this view, explanations remain unclear.

Our hypothesis is that better clinical outcomes are obtained from fluoride plus calcium phosphate varnishes when there is sustained, controlled release of mineralizing ions.

Calculations of ion activity products and putative mineral phases have been underutilized in assessing clinical outcomes of fluoride varnishes with calcium phosphate agents. In this study, a mineral phase comparison between a low-release varnish comprising functionalized tricalcium phosphate (fTCP) against a high-release varnish comprising casein phosphopeptide-amorphous calcium phosphate (CPP-ACP) was made. These calculations revealed the predominance of hydroxyapatite, fluorapatite, and calcium fluoride formation for the varnish containing fTCP, whereas the varnish containing CPP-ACP produced the same minerals along with b-TCP and octacalcium phosphate. This hypothesis shows the mineral phases expected to form from fluoride plus calcium phosphate varnishes might bear on clinical outcomes.