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PubMed1989

Salivary and plaque triclosan levels after brushing with a 0.3% triclosan/copolymer/NaF dentifrice.

The concentration and elimination rate of triclosan in saliva was assessed as part of a six week clinical study which evaluated the antiplaque efficacy of a 0.3% triclosan/PVM/MA copolymer/NaF dentifrice. On day one of the study the concentration of triclosan in whole saliva was determined at various times after dentifrice use for both the triclosan/PVM/MA copolymer/NaF and placebo dentifrice groups. The results indicated that the salivary triclosan levels ranged from 19.7 micrograms/ml at 5 minutes to 1 microgram/ml at 2 hours after use of the 0.3% triclosan dentifrice. The triclosan elimination curve for saliva exhibited a mono-exponential decline with a half-life of 26 minutes. The plaque content of triclosan, one hour after dentifrice use, which was determined at the end of the study, was found to be relatively high (25 micrograms/g) compared to that seen in saliva at the same time (6.2 micrograms/ml). It was concluded that the 0.3% triclosan/PVM/MA copolymer/NaF test dentifrice provided effective delivery and bioavailability of the antiplaque agent, triclosan. This was based on the relatively high salivary and plaque triclosan levels observed and the concomitant reduction in plaque formation seen at the end of the study.

Dental Plaque↗
PubMed1993

Dentifrices: recent clinical findings and implications for use.

Since fluoride dentifrices first became available over 30 years ago many formulation changes regarding fluoride type, concentration and abrasive systems have occurred to improve stability, compatibility, and also bioavailability of active ingredients. As a result, it is now established that from 1000-2800 ppm F, there is a dose-response relationship. However, at fluoride levels below 1000 ppm, efficacy has yet to be established fully. In the recent past, meta-analytic techniques employed on data concerning > 14,000 clinical trial subjects from 12 studies, have established that the use of NaF in a correctly formulated silica base provides superior caries protection than does either an NaF + SMFP, or SMFP dentifrice. Furthermore, the incorporation of anti-calculus and anti-microbial agents into fluoride dentifrices has not been shown to have any effect--either beneficial or adverse--on caries levels. Investigations designed to optimise the benefit obtained from fluoride-containing toothpastes, have demonstrated that toothbrushing frequency and post-brushing oral rinsing habits can significantly affect caries levels, as assessed over a 3-year period. However, as dentifrice ingestion by young children is now an established fact, care must be exercised when advising parents regarding fluoridated dentifrice usage as part of a prevention regime for children under 6-7 years of age. Nonetheless, while there would appear to be a dentifrice-related fluorosis problem in North America, such evidence as currently exists within the UK, does not indicate that the level of symmetrical mottling currently observed (< 6 per cent in > 8,500 12-14-year-olds) constitutes any public health problem.(ABSTRACT TRUNCATED AT 250 WORDS)

Dental Caries↗
PubMed1992

A critical comparison of dentifrice abrasion scores on dentine recorded by gravimetric and radiotracer methods.

Dentifrice abrasivity on dentine is conventionally ranked by various in vitro methods. The abrasivity of selected dentifrices in Switzerland was ranked in 1985 by the gravimetric and in 1989 by the radiotracer method. Because same-named brands of dentifrices were differently ranked by these methods, Swiss clinicians were unsure which ranking to follow. This paper lists the errors known to occur in both techniques, but unfortunately it is difficult to quantitate the magnitudes of these errors. Consequently, it is impossible to determine which method yields the more reliable results. Thus, researchers should look into the problem of dentifrice abrasion scores and try to formulate tests which could simplify the selection of brand-named dentifrices by clinicians and the consumers.

Densitometry↗
PubMed1999

Abrasion of human enamel by brushing with a commercial dentifrice containing hydroxyapatite crystals in vitro.

Automatic toothbrushing with a commercial dentifrice containing hydroxyapatite (HAP) crystals was performed on the tangential polished surfaces of sound human enamel, mainly consisting of biological apatite similar to HAP, for 10 min in vitro. The X-ray diffraction peaks of HAP, brushite (DCPD), and monetite (DCP) crystals were detected from the dentifrice. After brushing, the enamel surfaces were observed with a scanning electron and a confocal scanning laser microscope. The brushing caused larger abrasive loss and more remarkable roughness of the enamel surfaces following the broad traces of brush bristles and the exposure of prism structures than brushing with a dentifrice containing only DCPD, which we previously reported. We claim that the fine granular-shaped HAP crystals of the dentifrice indicated as an active ingredient for preventing enamel caries possess stronger abrasivity of sound enamel than the DCPD and DCP as abrasives on account of their Mohs hardness values rather than sizes and shapes. The HAP crystals of dentifrices may not occlude the small defects of early caries enamel, but erode them more strongly as an abrasive than the other abrasives.

Adolescent↗
PubMed2004

Effect of a combination of amine/stannous fluoride dentifrice and mouthrinse in periodontal maintenance patients.

AIM: The purpose of the present study was to evaluate the beneficial effect of using a dentifrice and mouthrinse containing amine fluoride (AmF) and stannous fluoride (SnF(2)) in a group of periodontal maintenance patients. Efficacy parameters were plaque, gingival inflammation, pocket depth and attachment loss. An additional parameter was development of stain. MATERIAL AND METHODS: In total, 80 patients who had been treated for moderate-to-severe periodontitis agreed to participate in this study. Subjects received supportive periodontal therapy at regular intervals of 3-4 months for at least a period of 1 year. The patients were randomly divided into two groups: (1). the test group used an AmF/SnF(2) dentifrice and mouthrinse and (2). the control group used a sodium fluoride (NaF)-containing dentifrice and mouthrinse. Clinical assessments were performed at baseline, 3, 6, 12, 18 and 24 months. RESULTS: The mean plaque index score after 3 months in the test group (0.24) was significantly lower than that in control group (0.34) (p<or=0.05), a difference that was maintained throughout the remainder of the study. In terms of bleeding on probing, at no point in time were significant differences between test and control group found. No significant differences were noted between the two groups, nor were there any significant changes in comparison with baseline values with respect to pocket depth and attachment level. At baseline, the mean percentage of sites with no staining was 98% for both the test and control groups. At all further assessments, the staining in both groups was elevated as compared with baseline. Smoking did not affect the outcome of the study. CONCLUSION: The combined use of an AmF/SnF(2) dentifrice and mouthrinse did not affect the parameters of inflammation (bleeding upon marginal probing and probing pocket depth), but it has shown to be more effective in terms of plaque reduction when compared with the use of an NaF dentifrice and mouthrinse in a group of periodontal patients placed under regular maintenance care.

Amines↗
PubMed1991

Dentifrices containing new agents for the control of plaque and gingivitis: microbiological aspects.

Antimicrobial agents have been proposed as playing an important role in controlling plaque and gingivitis. Unfortunately, a large number of potential compounds are unsuitable for use in dentifrices because they lack "substantivity", produce undesirable side-effects, or are incompatible with toothpaste ingredients. New agents that have been successfully incorporated into dentifrices include plant extracts, phenolic compounds and metal salts. Several products are currently being based on the phenol, Triclosan. Triclosan has a broad spectrum of antimicrobial activity against yeasts and oral bacteria. To enhance its clinical efficacy, Triclosan has been combined either with a co-polymer or with another compatible antimicrobial agent, zinc citrate. The co-polymer acts to increase the oral retention of Triclosan, and has resulted in further reductions in salivary bacterial counts in vivo. Zinc salts also have antimicrobial activity, and at low concentrations, can inhibit glycolysis and bacterial proteases. In mixed culture chemostat studies, Triclosan selectively inhibited Gram-negative periodontopathic bacteria; additive effects were obtained when zinc citrate and Triclosan were combined. In an experimental human gingivitis study, a zinc citrate/Triclosan dentifrice reduced plaque accumulation and gingivitis compared to a placebo paste; the ratio of anaerobic/aerobic bacteria and the proportions of Actinomyces species in plaque were also reduced. The prolonged use of a zinc citrate/Triclosan dentifrice neither significantly altered the ecology of supragingival plaque nor led to the selection of Triclosan-resistant bacteria. The data suggest that dentifrices containing new antimicrobial agents could be of clinical relevance in the prevention and control of plaque and gingivitis.

Anti-Bacterial Agents↗
PubMed1991

Antibacterial dentifrices. Clinical data and relevance with emphasis on zinc/triclosan.

The present review concerns the effect on plaque and gingivitis of some antibacterial dentifrices. The difficulties of including cationic agents in conventional dentifrice formulations are briefly discussed. The focus is on 2 recently introduced dentifrices with triclosan as the active ingredient. One aims at providing a slow release reservoir of triclosan in the oral cavity by delivering the substance dissolved in a lipophilic copolymer. 3-month results indicate a modestly improved effect on plaque and gingivitis compared to that of triclosan alone. Long-term studies are needed before conclusions on the clinical relevance can be drawn. The other dentifrice on the market utilises the principle of additive effects by combining triclosan and zinc citrate in the formulation. The combination appears to be more effective against plaque and gingivitis than either compound alone. Studies of up to 1 year duration indicate that the level of oral hygiene and gingival health obtained through an initial period of motivation and oral hygiene instruction can be maintained by regular use of the test dentifrice, while most subjects in the control group returned to pre-experimental levels. Microbiological monitoring indicates no major shifts in plaque ecology nor any development of resistant bacteria, and adverse side-effects have not been observed. It is concluded that the new approaches to chemical plaque control may be beneficial to the population at large, and thus of great clinical relevance.

Anti-Bacterial Agents↗
PubMed1994

The effect of a dentifrice containing chlorhexidine and zinc on plaque, gingivitis, calculus and tooth staining.

In this 6 months randomized, stratified double-blind parallel study, plaque, gingivitis, calculus formation and tooth staining were assessed in 208 participants. The participants either used a 0.12% chlorhexidine rinse and a gum care dentifrice (positive control) or a placebo rinse and the gum care dentifrice (control) or the placebo rinse and an experimental dentifrice containing 0.4% chlorhexidine and 0.34% Zn2+ (experimental group). After 6 months product use, all groups had less plaque, less gingivitis and all developed calculus and tooth staining. For the positive control group and for the experimental group, significant reductions in plaque and gingivitis (gingival index and number of bleeding sites) were seen compared with the control group. Significantly more calculus developed in the positive control group, while the experimental group was not different from the control group. Finally, tooth staining was significantly higher for the groups using chlorhexidine containing products compared with the control group. The experimental dentifrice users however did develop significantly less staining compared with the positive control. It is concluded that the experimental dentifrice will contribute to a significant improvement in oral hygiene with less staining compared with using a 0.12% chlorhexidine rinse.

Adolescent↗
PubMed1998

Effect of a triclosan/copolymer dentifrice on the incidence of periodontal attachment loss in adolescents.

The aim of this study was to assess the effectiveness of a dentifrice containing 0.3% triclosan, 2.0% copolymer and 0.243% sodium fluoride (Colgate Total) in the prevention of periodontal attachment loss in adolescents. A 3-year, double-blind, randomised, controlled, clinical trial was conducted on 641 adolescents, initially aged 11-13 years. The participants were enrolled from schools in economically deprived areas of Manchester, England, which had a high % of Asian pupils originating from India, Pakistan and Bangladesh. After the baseline examination, which included assessments of pocket depth, attachment loss and subgingival calculus, the adolescents were randomly allocated to use either a triclosan/copolymer or control dentifrice. The control was identical to the test dentifrice with the exception that it did not contain triclosan/copolymer. Participants were re-examined after 18 and 36 months. After 3 years, a total of 239 adolescents remained in the test and 241 in the control group. The prevalence of attachment loss increased from 2% at baseline to 24% after 3 years. The mean increment of attachment loss during the study was 0.025 mm per site in the control group and 0.018 mm per site in the test group. A linear regression model showed a statistically significant difference in attachment loss between the test and control group, in adolescents with high mean pocket depths at baseline. No adverse effects attributable to the test or control dentifrices were observed during the study. This study has demonstrated that unsupervised use of a triclosan/copolymer dentifrice can significantly reduce periodontal attachment loss, particularly in adolescents with high mean pocket depths.

Adolescent↗
PubMed2006

Anti-gingivitis effect of a dentifrice containing bioactive glass (NovaMin) particulate.

BACKGROUND: The objective of this pilot clinical trial was to evaluate the anti-gingivitis and anti-plaque effects of a dentifrice containing bioactive glass (NovaMin) compared with a placebo control dentifrice in a 6 weeks clinical study. METHODS: The study design was a randomized, double-blinded, controlled clinical trial. One hundred volunteers took part in the study and were matched for plaque index (PLI), gingival bleeding index (GBI), age and gender. The protocol was reviewed and approved by the Ethical Committee of the University. The subjects received a supragingival prophylaxis to remove all plaque, calculus and extrinsic stain. Following the baseline examination, subjects were instructed to brush with their assigned dentifrice and toothbrush. The PLI and GBI were determined for the baseline and 6 weeks. The data were analysed using a repeated-measures anova conducted on the two dependent measures to compare the effect between the test and control group. RESULTS: Ninety-five subjects finished the study. The results showed that the PLI (baseline=1.54, 6 weeks=1.29) and GBI (baseline=1.14, 6 weeks=0.47) were significantly reduced, respectively, over the 6 weeks period in the test group (p<0.001 for each measure). There was a 58.8% reduction in gingival bleeding and a 16.4% reduction in plaque growth. There was no difference of the PLI (baseline=1.60, 6 weeks=1.57) and GBI (baseline=1.18, 6-week=1.02) over the 6 week period in the control group. CONCLUSION: This study demonstrated that a dentifrice containing NovaMin significantly improves oral health as measured by a reduction in gingival bleeding and reduction in supragingival plaque compared with a negative dentifrice over the 6 weeks study period.

Adult↗
PubMed1989

The effect of a dentifrice containing zinc citrate and Triclosan on developing gingivitis.

A partial mouth experimental gingivitis model was employed to establish the potential efficacy of a dentifrice containing a zinc salt and the antimicrobial agent Triclosan to prevent or delay the development of gingivitis over a period of 28 days. Initially, gingival health was established in 34 subjects following a 6-week period of professional tooth cleaning and oral hygiene instruction. A toothshield was constructed to fit 4 posterior mandibular teeth. Undiluted test or placebo dentifrice was applied to the experimental teeth via the toothshield, which also prevented plaque removal from these teeth during habitual brushing of the remainder of the dentition. The presence of plaque, bleeding after probing and visual signs of inflammation were independently assessed. Plaque accumulated rapidly and gingivitis developed in both groups. At the 2-wk assessments, lower mean plaque scores were recorded for the group using the test dentifrice. At the 4-wk assessment a significantly lower level of gingivitis was recorded for the test group. It is concluded that (a) the model can be used to establish the potential efficacy of a dentifrice to maintain gingival health, (b) the dentifrice containing zinc citrate and Triclosan was efficacious and (c) the Gingival Index possibly overestimates the proportion of healthy gingival sites.

Adult↗
PubMed1993

Validation of a 21-day, partial-mouth gingivitis model for evaluating chemotherapeutic dentifrices.

The experimental gingivitis model has long been used to evaluate chemotherapeutic agents in mouthrinses. Only recently however has the model been modified to test undiluted dentifrices by using a toothshield both to apply dentifrice and to protect selected teeth from toothbrushing. This also enables participants to brush the rest of the mouth and avoid the unpleasantness of 3 weeks without oral hygiene. Because of its well-documented efficacy, chlorhexidine was used in a toothpaste formulation to investigate the validity of the partial-mouth, experimental gingivitis model for evaluating therapeutic dentifrices. Optimal gingival health was established in 88 adults, who then were randomly assigned to two equal groups. A toothshield was constructed for each subject to fit the teeth of one mandibular quadrant. During the trial chlorhexidine or placebo dentifrice was applied undiluted to the test teeth via the toothshield, which also prevented plaque removal during brushing of the remaining dentition. After 21 days, plaque and gingivitis had developed in both groups. However, the chlorhexidine group had significantly less plaque and gingivitis than the placebo group. No adverse soft tissue effects were observed. This study demonstrated that the partial-mouth, experimental gingivitis model allowed unhindered development of plaque and gingivitis that was comparable to whole-mouth studies in which oral hygiene was suspended for 3 weeks. By corroborating with chlorhexidine, it is concluded that this short-term clinical model is valid for evaluating the chemotherapeutic effects of dentifrices.

Adolescent↗
PubMed1991

A critique of topical fluoride methods (dentifrices, mouthrinses, operator-, and self-applied gels) in an era of decreased caries and increased fluorosis prevalence.

Within the last 20 years there has been a decrease in the caries prevalence of US schoolchildren, a change in the intraoral caries pattern, and a slowing of the progress of lesions. Simultaneously, the prevalence of enamel milder, cosmetically acceptable forms and is more noticeable in fluoride-deficient communities than those with optimal or above-optimal water fluoride concentrations. Circumstantial evidence indicates that a principal contributor to the caries decline is the extensive use of fluoride dentifrices. Conversely, although use of a fluoride dentifrice can add to the total daily amount of ingested fluoride in preschool children, there is little evidence to suggest that dentifrice ingestion is a principal factor causing the fluorosis increase. The value of fluoride methods may be assessed in relative or absolute terms. The relative, or percentage, caries reduction attributed to fluoride mouthrinses and gels appears to be a property intrinsic to the methods themselves and generally is little affected by the caries activity of the population being treated. Conversely, the absolute, or numerical, caries reduction is dependent upon the level of disease in the population. Thus, the reported caries decline reduces the number of surfaces prevented from developing caries, even though the percentage reduction remains substantially unchanged. Although inadvertent ingestion of fluoride can result from the use of mouthrinses and gels, there is little evidence to suggest that they have contributed to the fluorosis increase. When using topical methods, prudence should prevail to avoid ingestion of fluoride. Fluoride dentifrices should continue to be used routinely, and although lower potency dentifrices may be considered, the literature does not provide strong support for their need. Use of fluoride mouthrinses and gels for individual patients should be predicted upon their caries activity or risk. Use of these methods in public health programs is a matter of cost-effectiveness, which will be influenced by the caries prevalence of the target population.

Adolescent↗
PubMed1994

Factors associated with the use of fluoride supplements and fluoride dentifrice by infants and toddlers.

Dental fluorosis may be associated with the inappropriate use of fluoride dentifrices and/or dietary fluoride supplements by young children, especially for those who consume optimally fluoridated water. Studies to date have used retrospective designs that rely on anamnestic responses of adults to determine fluoride exposures in their children. The 1986 National Health Interview Survey (NHIS) collected information on current use of fluoride-containing dental products (dentifrices, drops, tablets, and mouthrinses) by all household members during home interviews. This report contains information obtained from adults for 1,996 children younger than two years of age. Nearly half of the children used fluoride dentifrices or dietary fluoride supplements. Eleven percent of the children younger than one year of age and nearly 60 percent of children between one and two years of age reportedly used a fluoride toothpaste. Dietary fluoride supplements were used about equally in these age groups (about 16%). The use of a fluoride dentifrice was similar across racial-ethnic groups, but the use of dietary fluoride supplements was less among blacks and Hispanics. A significantly higher proportion of children whose respondent knew the purpose of water fluoridation used some type of fluoride product. Because young children tend to swallow dentifrices, the findings of this study suggest the need for educational programs targeted to parents and health care providers regarding the appropriate use of fluorides and the risk of fluorosis when they are used inappropriately.

Black or African American↗
PubMed2000

The effect of different commercial dentifrices on enamel lesion progression: an in vitro pH-cycling study.

AIMS/OBJECTIVES: To evaluate and compare the de/remineralization effects of dentifrices manufactured locally in some developing countries. DESIGN: Utilisation of the in vitro single-section and the pH-cycling model. SETTING: Laboratory. TEST MATERIALS: Dentifrices: Maxam DFP, Maxam Tartar Control, First, Tianqi Medicated from China; Vicco Vajradenti from India; Colgate MFP2, Crest Tartar Control from USA; and one non-fluoride dentifrice as control. METHODS: Sound molars were painted, leaving a 1 mm wide 'window' on the buccal and/or lingual surface and placed in a demineralisation solution for 96 h to produce artificial caries lesion approximately 80-100 mm deep. The teeth were then longitudinally sectioned (approximately 100 mm thick), and randomly divided into 8 groups (22 sections/group). The pH cycling model was utilised for 10 days. OUTCOME MEASURES: Polarised light microscopy and microradiography were used to evaluate the lesion progression before and after treatment. RESULTS: The control group showed an increase in lesion depth of 70 per cent and was statistically different from some test groups which ranged from -2 per cent to 68 per cent (P < 0.01, t-test). Statistically significant differences were also observed among some of the fluoride containing groups. CONCLUSIONS: This study suggests that, when compared to 'multinational dentifrices', Chinese and Indian dentifrices manufactured locally failed to show 'healing' efficacy even though they claimed to contain varying levels of fluoride.

China↗
PubMed2004

Sustained oral health improvement and use of toothbrushes and dentifrice by previous users of traditional materials in a rural population in Andhra Pradesh, India.

AIM: To follow-up, one year later, a double-blind, randomised study, which investigated the effect of regular brushing with dentifrices on the oral health of an economically disadvantaged rural population in Andhra Pradesh, India who were primarily users of traditional materials. SUBJECTS: 150 of the original study population. METHOD: Examination to determine whether the improvements in oral health status and oral health behaviour (use of toothbrush and dentifrice), being unsupported, had been sustained since completion of the original study. RESULTS: Data analysis showed sustained, statistically significant improvements in gingival health as measured by gingival bleeding and plaque indices (GBI and PI) comparing users and non-users of toothbrushes and dentifrice in the original study (PI: p = 0.04; GBI: p = 0.03) and sustained use of toothbrushes and dentifrice by 60% of the subjects at follow-up one year later. CONCLUSIONS: This study shows a beneficial effect on oral hygiene indices following the introduction of toothbrushes and dentifrices to a community using traditional oral hygiene materials and sustainability of use of these materials with motivation and support. It may therefore be concluded that it is feasible to achieve significant use of conventional toothbrushes and toothpastes, with consequent major and sustained improvements in plaque control and gingival health in a disadvantaged population hitherto often considered as not amenable to conventional oral hygiene for cultural or economic reasons.

Adolescent↗
PubMedDate not supplied

Effect of dentifrice containing fluoride and/or baking soda on enamel demineralization/remineralization: an in situ study.

The additive effect of baking soda on the anticariogenic effect of fluoride dentifrice is not well established. To evaluate it, a crossover in situ study was done in three phases of 28 days. Volunteers, using acrylic palatal appliances containing four human enamel blocks, two sound (to evaluate demineralization) and two with artificial caries lesions (to evaluate remineralization), took part in this study. During each phase, 10% sucrose solution was dripped (3 times a day) only onto the sound blocks. After 10 min, a slurry of placebo, fluoride (F) or fluoride and baking soda (F+NaHCO(3)) dentifrice was dripped onto all enamel blocks. The results showed a higher F concentration in dental plaque formed during treatment with F+NaHCO(3) than placebo (p<0.05), but the difference related to F dentifrice was not significant. The enamel demineralization was lower, and remineralization was greater, after treatment with F+NaHCO(3) than placebo (p<0.05), but the difference related to F dentifrice was not significant. The data suggest that baking soda neither improves nor impairs the effect of F dentifrice on reduction of demineralization and enhancement of remineralization of enamel.

Buffers↗
PubMedDate not supplied

The relative anticaries effectiveness of three fluoride-containing dentifrices in Puerto Rico.

The objective of this research was to evaluate the anticaries effectiveness of a low-dose (500 ppm F, low-NaF) sodium fluoride dentifrice, a high-dose (2,800 ppm F, high-NaF) sodium fluoride dentifrice and an experimental 0.454% stabilized stannous fluoride (1,100 ppm F) with sodium hexametaphosphate (SnF2-HMP) dentifrice, each relative to a standard 1,100 ppm F sodium fluoride positive control dentifrice. Subjects (n = 955, with approximately 239 per group) with a mean age of 10.6 (approximately 9-12 years) were randomly assigned to one of four dentifrice treatments. Two calibrated examiners independently measured visual-tactile caries as DMFS that was supplemented with a radiographic examination at baseline, 12 months and 24 months for each subject. Generally similar results were independently observed by both examiners at the conclusion of the 2-year study period. Considering all subjects that attended at least 60% of the supervised brushing sessions, statistically significantly less caries was observed in the high-NaF group compared to the control group. Similarly, statistically significantly less caries was observed in the SnF2-HMP group as compared to the control group. Differences in caries increments between the low-NaF and control groups were not statistically significant. One of the examiners observed these same statistically significant differences after 1 year. In conclusion, the results of this clinical trial indicated that while no difference in caries increments was observed between the low-NaF and control groups, both the high-NaF and the SnF2-HMP groups experienced significantly fewer lesions than the control group.

Cariostatic Agents↗