Objectives: To investigate the interplay among brushing frequency, dentifrice slurry abrasivity, and fluoride content on the surface loss (SL) of incipient enamel caries-like lesions. Methods: Lesions were created in 96 bovine enamel specimens (5 × 5 mm) using methylcellulose acid gel. Specimens were randomly allocated to 12 groups (n = 8), resulting from the association of three experimental factors: (1) slurry abrasive level [low: REA = 4/RDA = 69 and high: REA = 7/RDA = 208], (2) fluoride concentration [275 and 1250 ppm F as NaF], and (3) brushing frequency [1, 2 and 3× daily]. Specimens were kept in artificial saliva in between brushings and overnight. SL was determined by optical profilometry after lesion creation, 1, 3, 5, and 7 days. Data was analyzed with repeated measures ANOVA and Tukey's tests (α = 0.05). Results: High abrasive slurry caused significantly more SL than low with 275 ppm (p < 0.001) but not with 1250 ppm fluoride (p = 0.34). Fluoride at 275 ppm had significantly more SL than 1250 ppm with high abrasive slurry after 7 days (p = 0.008). Brushing 1×/day had significantly less SL than 3×/day after 7 days with high abrasive slurry (p = 0.016), especially in the 275 ppm fluoride groups. Conclusions: Higher fluoride concentration increased protection against the deleterious effect of high abrasive slurry. SL was higher if brushing was performed more than twice daily especially in low fluoride groups. Clinical significance: Highly abrasive toothpaste formulations might cause more surface wear to incipient caries lesions, especially at higher brushing frequencies. Increasing the fluoride content may be beneficial at these circumstances.
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