Stannous fluoride

Stannous fluoride has been shown to manage and prevent dental caries and gingivitis by promoting enamel mineralization, reducing gingival inflammation and bleeding, its potential broad-spectrum antibiotic effect, and through modulation of the microbial composition of the dental biofilm. It works by depositing a stable acid-resistant layer on the tooth surfaces which is composed of calcium fluoride produced when stannous fluoride converts the calcium mineral apatite into fluorapatite. Tin and fluoride mediate anti-erosive actions by interacting with and modifying the absorbent layer composed of salivary proteins such as mucins, perhaps by enhancing the cross-linking between the proteins to result in a more resistant and protective layer against erosion. The efficacy of stannous fluoride solutions seems to depend mainly on the incorporation of tin in the mineralized dentine when the organic portion is preserved but on surface precipitation when the organic portion is continuously digested. Moreover, the relative erosion-inhibiting effects of stannous fluoride strongly depend on the presence or absence of the demineralized organic dentine matrix.