Curodont^TM Repair
Fluoride Plus

Alternatives to sodium hypochlorite include air polisher, prophy paste, pumice etc. as mechanical means of removal of organic content and the salivary pellicle. If these alternative methods are used, it is important to rinse the tooth thoroughly after this step.

The use of 2% sodium hypochlorite may be a more ‘thorough’ way to remove the salivary pellicle and organic matter.

Yes, the use of fluoride varnish or any other remineralizing paste is permitted after the use of CRFP. These agents act as suppliers of calcium, phosphate, and/or fluoride ions to the CRFP technology within early carious lesions (watch areas/white spot lesions), thus supporting the Guided Enamel Remineralization.

When using these agents, they must be applied at least 5 minutes after the application of CRFP in-office or after the appointment, at home.

An ideal complement to Curodont Repair Fluoride Plus is Curodont Protect. This anti-cavity dental gel can be applied once a day for one week (or until the tube is finished) on a lesion that has been treated in-office with Curodont Repair Fluoride Plus.

1. If CRFP treatment is done first, it is recommended to wait 2 weeks before the bleaching treatment.
   After treatment with CRFP, the vVARDIS technology diffuses within the body of the early carious lesion (watch area/white spot lesion) and remineralization begins. A gap of 2 weeks between the CRFP treatment and the bleaching treatment is recommended, to maximize effectiveness of CRFP.
2. If the bleaching is done first, CRFP can be used immediately.
   Peroxide, in addition to bleaching, ‘cleans up’ the tooth surface well and removes the need for the pre-treatment steps of salivary pellicle removal and etching before using CRFP. However, if a few days have passed after the bleaching, it is recommended to follow the entire protocol as per instructions. In fact, CRFP will also help tackle the demineralization occurring due to bleaching.

In the CRFP protocol, we suggest using unwaxed floss to effectively apply the phosphoric acid gel on proximal surfaces. There are two reasons for preferring unwaxed floss over waxed floss:

1. Unwaxed floss is thinner than waxed floss and may slip through tighter contacts better. One of the purposes of waxed floss is the ease of movement on tooth surfaces due to the wax. However, in the present case, the etchant gel acts as a ‘lubricant’ for the unwaxed floss.
2. Waxed floss is known to sometimes leave waxy residues on tooth surfaces. These residues run the risk of getting lodged in the pores of the surface of early caries (watch area/white spot lesion) and blocking them, which might interfere with the diffusion of the CRFP liquid through the lesion surface. Additionally, wax is hydrophobic (non-polar) while the CRFP solution is hydrophilic (polar); this difference in nature will also cause the wax to interfere with the diffusion of the solution.

CRFP is a treatment for early caries. The CRFP technology works by enabling the diffusion of remineralizing ions into the body of early carious lesions (watch areas/white spot lesions). Thus, it is not an appropriate product to use on intact tooth surfaces.

Curodont Protect, an anti-cavity dental gel, would be an ideal product for caries prevention, including for patients at high caries risk.

Whitening toothpastes depend on different mechanisms to achieve the whitening effect. Many toothpastes depend on hydroxyapatite for whitening, in which case, there is absolutely no issue with using it right after a Curodont Repair Fluoride Plus treatment. The hydroxyapatite may assist in the remineralizing action of Repair.

However, even if the whitening toothpaste is peroxide-based, it may be used post-CRFP application. The peroxide content in whitening toothpastes is fairly minimal and the ‘brushing’ action ensures that the contact time of the agent with the CRFP technology within early lesions will also be quite low. Thus, the probability of peroxide from these toothpastes interfering with the action of CRFP is very low.

In most cases, except when caries involves the outer third of dentin while the lesion is still non-cavitated, we would not recommend using CRFP.

CRFP works by enabling the diffusion of remineralizing ions, such as Ca2+ and F-, in early carious lesions. The pseudo-intact surface of the early enamel caries provides an ‘undisturbed compartment’ for the CRFP technology to ‘stay’ in and perform its action. Caries extending into dentin are complicated due to two factors:

1. By the time caries extends into dentin, the tooth structure is often undermined enough to undergo a break down, converting the lesion into a cavity. A cavity is a contaminated area with degraded organic matrix, bacteria, food debris etc., all of which must be excavated before the tooth can be restored.
2. The lack of an ‘intact’ surface layer in a cavitated lesion precludes the presence of an ‘undisturbed compartment’ for CRFP to stay in and work.
   Both these factors mean that cavitated lesions extending significantly into the dentin cannot be treated using CRFP.
3. However, in cases where caries extending to the dentino-enamel junction or to the outer 1/3rd of dentin are still non-cavitated, CRFP can be used to treat these lesions.