• Pootrampai Chantarawaratit D.D.S.
• Rujira Puaniyaka D.D.S. (Honours), Cert. Clinical Science (Pediatric Dentistry), Dip. Thai Board (Pediatric Dentistry)
• Kanok Sorathesn D.D.S. (Honours), M.Sc. (Orthodontics), Dip. Thai Board (Orthodontics)

Objective To compare white spot lesion regression on mild fluorosed upper central incisors
(TSIF score 1-3) after 2 times daily application of CPP-ACP and CPP-ACFP paste for 3 months.

Materials and methods One hundred and forty mild fluorosed upper permanent central incisors
(#11, #21) from 70 children aged 10-15 years in Kratumban district, Samutsakorn province, where
fluoride level in tap water was 0.541 ppm, were recruited for this study. The subjects were divided into
three groups. In Group 1 (control group), the children daily used only 1,000 ppm fluoridated toothpaste
whereas those in Group 2 and 3 daily applied CPP-ACP paste and CPP-ACFP paste on labial surface
of affected teeth respectively and the children also kept on using 1,000 ppm fluoridated toothpaste.
Standardized digital photographs were taken before and after 3 months. Luminance intensity of the
white spot lesions was measured using computerized image analysis with Image-Pro^® Plus program in
order to compare lesion regression. Paired t-test was used to compare differences within group, while
one way ANOVA was used to compare differences between groups. Changes of fluorosis severity
according to TSIF score were assessed by five calibrated dentists using the Chi-square test. Statistical
tests were performed at 0.05 significant level.

Results Luminance intensity of white spot lesion in all groups was statistically regressed at 3-month
recall (p = 0.003, p < 0.001). However, there was no difference between groups (p = 0.194). Most of
severity levels of fluorosis were unchanged. There was no statistically significant difference between
groups in terms of severity of fluorosis (p = 0.067).

Conclusion This study shows no difference in white spot lesion regression after 3-month daily
application of CPP-ACP paste, CPP-ACFP paste and 1,000 ppm fluoridated toothpaste.

(CU Dent J. 2011;34:31-44)