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Microstructural changes of human enamel surfaces by brushing with and without dentifrice containing abrasive.

Toothbrushing with and without dentifrice containing abrasive was performed on human enamel pieces attached to resin plates exposed to the oral cavities of 3 human subjects for 8 weeks. The effects on the ground enamel surfaces with engraved scratches were examined by scanning electron and scanning laser microscopy. Brushing with such a dentifrice caused smaller scratches to disappear, large scratches to expand and new microwear to appear; in some samples, prism structures were exposed. Under brushing without dentifrice, these scratches were protected by an organic pellicle with mineral deposits, and also the experimental surface was entirely covered with these membranous deposits. The results indicate that toothbrushing with no dentifrice but saliva induces an organic-mineral protective membrane on the enamel surface. The membrane may increase the enamel resistance to caries. On the other hand, the use of abrasive-containing dentifrice causes slight abrasion with microwear. This roughness may contribute to the formation of dental plaque.

Adult↗

Effects of sodium bicarbonate dentifrices on the levels of cariogenic bacteria in human saliva.

This investigation evaluated the efficacy of two bicarbonate-containing dentifrices (one with fluoride and one without) against one placebo dentifrice (containing neither fluoride nor bicarbonate) in vivo in a panel of human volunteers to determine whether or not sodium bicarbonate would affect salivary mutans streptococci and lactobacilli. Ten caries-inactive adults were divided randomly into three groups, each of which was exposed to all three dentifrices, in a crossover manner, during three 4-week test periods. Saliva samples were taken at 1-week intervals. Samples were stored on ice, and microbiological analyses were conducted. The statistical analyses showed that, over a 4-week period, there was a statistically significant (p < 0.05) reduction in numbers of mutans streptococci with the two bicarbonate dentifrices as compared with the placebo dentifrice. Although not statistically significant, a similar trend was observed with lactobacilli. Longer-term, large-scale studies need to be conducted to investigate the possible mechanisms of action of sodium bicarbonate on these organisms and to relate the results to possible cariostatic effects in humans.

Adult↗

An in vivo investigation of the fluoride uptake in partially demineralized human enamel from several different dentifrices.

In this study, the total fluoride uptake in partially demineralized enamel from in situ brushing with six dentifrice systems was investigated in vivo among 22 panelists. Five dentifrices with different fluoride systems were compared with a placebo control. Two demineralized enamel discs were placed in proximal positions on specially fabricated dentures worn by each participant. Each treatment involved use of the placebo dentifrice for one week, followed by two weeks of twice-daily use of the test dentifrice. The F- contents of the dentifrices were: A = 1000 ppm F as Na2PO3F + 450 ppm F as NaF; B = 1100 ppm F as NaF; C = 1000 ppm F as Na2PO3F; D = 1000 ppm F as SnF2; E = 1500 ppm F as Na2PO3F; and P = 0 ppm F (placebo). The F- uptakes from A, C, D, and E were not significantly different from each other but were all significantly higher than the placebo. Statistical analysis showed a significantly higher F- level from the NaF-based paste B than that from all other systems. No differences existed between mesial-distal specimens; there was no correlation between F- uptake and age. Significant uptake differences were found between panelists with full and partial prostheses.

Adult↗

Remineralization by a monofluorophosphate dentifrice in vitro of root dentin softened by artificial caries.

Artificial caries-softened dentin lesions in root surfaces were treated with 50% slurries of a monofluorophosphate (MFP) dentifrice or a placebo dentifrice twice daily for ten days. Between dentifrice treatments, the lesions were kept in a remineralizing solution. Both treatments resulted in statistically significant remineralization, with the MFP dentifrice being significantly better than the placebo. Deposition of new mineral from the MFP dentifrice occurred about equally at or within the surface zone and at the deepest part of the lesion. Mineral deposition from the placebo appeared to be more uniformly distributed within the lesion.

Dental Caries↗

The effect of long-term use of a dentifrice containing zinc citrate and a non-ionic agent on the oral flora.

The effect on the oral ecology of daily use, for seven months, of a dentifrice containing 0.5% (w/w) zinc citrate and a non-ionic agent, i.e., 0.2% (w/w) Triclosan (2,4,4'-trichloro-2'-hydroxydiphenyl ether), has been monitored on 13 adult volunteers. Plaque and saliva were sampled monthly and the bacterial flora analyzed. Twenty-six volunteers used a placebo dentifrice as part of their normal oral hygiene for four months to establish the baseline microbial flora. The volunteers were then split into two equal groups: One group continued to use the placebo dentifrice; the other used the dentifrice containing zinc citrate and Triclosan. There was no evidence that seven months' use of a dentifrice containing 0.5% zinc citrate and 0.2% Triclosan caused shifts in the oral microbial ecology, nor was there any evidence of developing bacterial resistance to Triclosan.

Adult↗

The value of anti-caries and anti-plaque dentifrices at a community level.

Although dentifrices (in a modern sense) were first introduced at the turn of the century, it was not until the advent of fluoride-containing compounds that any of therapeutic value was produced. In the early post-war years, formulation compatibility difficulties occurred, with the result that none was demonstrated to have clinically proven efficacy until stannous fluoride was successfully incorporated in the "Crest" formulation of 1955. Thereafter, sodium monofluorophosphate (SMFP) appeared, to be followed by organic and acid-phosphate fluoride preparations, most of which were shown to produce clinical benefit over placebo controls. Since the late 1970's, however, such studies have been deemed unethical in many countries in view of the almost universal availability of efficacious fluoride dentifrices. While an NaF formulation was the first to be tested (albeit unsuccessfully) by Bibby (1945), there was a considerable time period before the arrival of both stable and effective silica-based systems in the early 1980's. Results of studies have varied, but the largest ever double-blind NaF/SMFP head-to-head dentifrice trial yet published (Stephen et al., 1994) has indicated a 6.4% significant benefit in favor of NaF (in silica) over SMFP. With respect to the effect of dentifrice fluoride levels, above 1000 ppm dose-response caries reductions have been obtained, but the efficacy of preparations containing 500 ppm F or less has yet to be demonstrated. In relation to root caries, Jensen and Kohout (1988) reported a 41.4% DFS significant reduction in subjects who used a NaF/silica dentifrice at 1100 ppm F, over a one-year period.

Clinical Trials as Topic↗

Study of a bland dentifrice for persons with radiation-induced mucositis and vesiculo-erosive disease.

Althought the patient group was limited to persons with radiation-induced mucositis, lichen planus, and erythema multiforme, the study indicates the potential usefulness of a bland dentifrice to other patients with sensitive mouths. Although it is presumed that regular brushing habits will aid in oral hygiene and health, the specific effect of a bland dentifrice on control of plaque, caries, and periodontal disease cannot be assessed in this preliminary study. Also, no comparison was made with cleaning techniques in which dentifrice is not used. Therefore, this study indicated only that dentifrice with reduced flavor, like the one used in this study, may encourage better oral hygiene through continued brushing when irritation from regular dentifrices discouages it.

Adult↗

Caries inhibition of mixed NaF-Na2PO3F dentifrices containing 1,000 and 2,500 ppm F: 3-year results.

The 3-year DMFS increments of 2,509 children were compared. Group 1 used a conventional Na2PO3F dentifrice (1,000 ppm F) and served as the active control. Groups 2 and 3 used mixed-fluoride dentifrices containing equimolar amounts of NaF and Na2PO3F, providing total fluoride concentrations of 1,000 and 2,500 ppm F, respectively. Dentifrice use was unsupervised in the subjects' homes. There were no statistically significant differences (F-test) between the 3-year DMFS increments of the dentifrice groups, nor were there any significant differences between the dentifrice groups when the analysis included subject compliance and caries risk.

Child↗

Assessing the efficacy of three dentifrices in the treatment of dentinal hypersensitivity.

A multicenter clinical trial conducted by the authors compared the desensitizing efficacy of a new 5 percent potassium nitrate: 0.243 percent sodium fluoride dentifrice along with two clinically proven, commercially available desensitizing dentifrices to a placebo dentifrice. Sensitivity to cold air and tactile stimulation, along with patients' subjective assessments, were evaluated to assess the dentinal desensitizing efficacy of the test dentifrices. Results demonstrated that after four weeks, participants who used the new dentifrice formulation experienced significant decreases in dentinal sensitivity compared to the placebo group for all measured indexes.

Adult↗

The effects of different application techniques and orifices on the amount of dentifrice.

The purpose of this study was to evaluate three different methods (ST: Standart technique; PS: Pea-size; TT: Transverse technique) for dentifrice use in children between 5 to 7 years of age, as well as to compare the amount of dentifrice dispensed by using tubes with different orifices (moon or round shaped). One hundred children who dispensed the dentifrice themselves were asked to apply the quantity of dentifrice they usually used (ST or TT) (Phase-I). In Phase-II, they were instructed to apply a pea-size amount (PS) and finally they were demonstrated to use the transverse technique (TT) in Phase-III. Statistical analysis was obtained by using Anova and t-test. As a result, most of the children (82 patient) preferred to use ST rather than TT (18 patient). A decrease in the amount was obtained with both of the shaped orifices after the instruction of PS or demonstration of TT (p< 0.05). It was observed that the amount of dentifrice dispensed decreased generally when a moon shaped orifice was used.

Cariostatic Agents↗

An investigation of the clinical and histologic effects of selected dentifrices on human palatal mucosa.

A study was undertaken in 24 human volunteer subjects to determine the possible effects of selected commercially available dentifrices on clinically normal masticatory mucosa. An acrylic stent was fabricated which was designed to hold four test dentifrices in close apposition to the palatal tissues for 1 hour. Evaluation approximately 8 hours later revealed pathologic responses which were evident clinically and histologically. 1. Clinically, palatal tissues exposed to Crest were not distinguishable from control areas, while Colgate (mfp), MacCleans, and Ultra Brite produced erythematous changes which were statistically significant when compared with adjacent control sites. 2. Histologically, epithelial changes were seen within the test sites which ranged from a parakeratin-like surface layer to necrosis and intraepithelial abcess formation. Control sites consisted of normal orthokeratinized palatal mucosa in all cases. 3. The more severe microscopic reactions were noted with MacCleans and Ultra Brite, while the milder reactions were associated with Colgate (MFP). Crest infrequently produced a parakeratin-like response. The response was not statistically significant when compared with controls. 4. The clinical and histologic reactions were generalized throughout the test population, suggesting that the responses were not due to individual hypersensitivity but due to irritation from one or more of the dentifrice components. Although the clinical significance of these findings could not be readily assessed, the potential for irritation of human palatal mucosa by selected dentifrices has been demonstrated. These findings support the suggestion by the World Workshop in Periodontics (1966)20 that efforts should be directed to the development of dentifrice materials less harsh to the oral tissues.

Connective Tissue Cells↗

Effectiveness of a dentifrice containing formalin and sodium monofluorophosphate on dental hypersensitivity.

A double-blind investigation comparing a control dentifrice with one containing active ingredients was conducted to determine their effect on dentinal hypersensitivity in 67 human subjects. Baseline data was obtained by patient questionnaire, dental examination and by soliciting subjective responses to controlled mechanical and thermal stimuli. A calcium carbonate-based toothpaste constituted the base for both the control and active dentifrice. The active dentifrice contained 0.8% sodium monofluorophosphate and 1.3% formalin while the control lacked these ingredients. Dentifrices were supplied to patients on a random basis, and patients were instructed to brush twice each day for 28 days. Mechanical and thermal response as accomplished at baseline were obtained at 14 and 28 days after baseline on 60 subjects. A statistically significant reduction was not obtained in response to mechanical stimulus. The active dentifrice demonstrated a statistically significant reduction (P less than 0.05) to thermal stimulus at both 14 and 28 days.

Adult↗

The effects of a dentifrice containing zinc citrate and 2,4,4' trichloro-2'-hydroxydiphenyl ether.

The effects of a dentifrice which contained 1% zinc citrate and 0.5% of a nonionic antimicrobial agent, 2,4,4' trichloro-2'-hydroxydiphenyl ether on plaque and gingival health have been investigated. In a 4-day nonbrushing study in which dentifrices were used as slurries, this dentifrice inhibited plaque accumulation significantly more than dentifrices which contained either zinc citrate or Triclosan separately. In a 28-day double-blind cross-over study, a significant reduction in plaque accumulation and improvement in gingival health was demonstrated for the test dentifrice compared to the placebo. The effect was demonstrated with a group of well motivated volunteers who had a good standard of oral health. Analysis of the data suggested that the benefit might be extended to a less motivated population.

Adult↗

Clinical effect of a sanguinaria dentifrice on plaque and gingivitis in adults.

A clinical trial was conducted to evaluate the effects of a sanguinaria-zinc chloride dentifrice on the prevention of plaque formation and gingivitis. A total of 59 young adults, 18 to 30 years of age, either performed supervised brushing with a 0.075% sanguinaria-0.05% zinc chloride dentifrice, a 0.24% sodium fluoride dentifrice, or rinsed daily with a 0.05% NaF solution. Clinical evaluations for plaque and gingivitis were performed after 7, 14, and 21 days of the test regimen. After 21 days, all subjects resumed twice daily supervised brushing and flossing and post-test evaluations were conducted after two weeks. The results showed that after 7, 14, and 21 days both groups using dentifrices had significantly less plaque and gingivitis than the group using the rinse, and there were no significant differences between the two groups using either the sanguinaria-ZnCl2 or the NaF dentifrices.

Adolescent↗

Effect of xylitol in an enzyme-containing dentifrice without sodium lauryl sulfate on mutans streptococci in vivo.

The aim of this investigation was to compare the effect of an enzyme-containing dentifrice without sodium lauryl sulfate but with addition of xylitol (Zendium Dentine) on mutans streptococci (MS) in saliva and dental plaque with that of the same dentifrice without xylitol. The subjects were divided into a test group, using a dentifrice with 10% xylitol (part A) or 5% xylitol (part B), and a control group, using a dentifrice without xylitol, for 3 months. In part A the MS counts in saliva and plaque were significantly lower in the xylitol group (n = 50) than in the control group (n = 57) (P < 0.01 and P < 0.001, respectively). In part B (n = 89 + 91), evaluating MS counts in saliva only, no significant difference was found. Thus, this study demonstrated I) that addition of 10% xylitol to an enzyme-containing dentifrice without sodium lauryl sulfate has an inhibitory effect on MS counts in saliva and dental plaque, and 2) that the inhibitory effect seems to be dose-dependent.

Adult↗

Caries-preventive effects of sodium and amine fluoride dentifrices.

PURPOSE: To determine the comparative effects of sodium (NaF) and amine fluoride dentifrices, as well as the effect of different silica abrasives used in NaF dentifrices, on caries formation in rats. MATERIALS AND METHODS: Harlan Sprague Dawley mixed sex, weanling, littermate rats were fed a cariogenic diet and inoculated with S. sobrinus strain 6715 to induce caries formation. The dentifrices evaluated contained 0.31% NaF with precipitated silica I as the abrasive system; 0.31% NaF with sodium bicarbonate and hydrated silica; placebo; amine fluoride (0.14%) containing silica (Elmex); 0.31% NaF with precipitated silica II (Sensodyne F); and 0.31% NaF with hydrated silica. Dentifrice slurries were administered 7 days per week for 3 weeks at which time the animals were euthanized and the hemijaws removed, coded and stained with a murexide solution. The recovery of S. sobrinus after the 3-week study clearly showed that all of the six groups were infected with S. sobrinus. The Keyes scoring method was then used to assess the caries formation within the six groups. RESULTS: Caries scores showed that all five experimental fluoride dentifrices were equally efficacious statistically in reducing caries formation when compared to the placebo with reductions ranging from 26 to 43%.

Amines↗

The in vitro demineralization potential of a sodium fluoride, calcium and phosphate ion-containing dentifrice under various experimental conditions.

While fluoride has had a dramatic effect in reducing the rate of caries, it has failed to provide complete protection against caries development, and tooth decay is still widely prevalent. The objective of this study was to determine the demineralization prevention potential of a remineralizing dentifrice with fluoride (Enamelon), and an assured supply of calcium and phosphate ions on bovine enamel in a cyclic remin/demin regimen using various experimental conditions. A conventional fluoride toothpaste, Crest, and a placebo dentifrice were used as controls. One-hundred and forty-four ground and polished 4 mm bovine enamel cores were prepared and assigned to various test treatments using six specimens per treatment group. They were subjected to six cyclic treatments consisting of one-minute exposures at room temperature to the test product diluted 1:2 in water, remineralization for a specified time at 37 degrees C, and demineralization for a specified time at 37 degrees C. The enamel specimens were tested for micro-hardness initially, and after the first, third and sixth treatment, remineralization and demineralization cycles using a Buehler Micro-hardness Tester with a 200 g load. Differences in micro-hardness between the test groups were analyzed for significance by performing multiple pair-wise comparisons using Bonferroni significance levels at the 95% confidence level. The results of this study showed that Enamelon Toothpaste was generally more effective in preventing demineralization of enamel than the fluoride dentifrice at 0.5 and 1.5 hours, and the non-fluoride control dentifrice at all time measurements. Prevention of enamel demineralization by the dentifrices was affected by changes in demineralization time and pH, but not by changes in remineralization time.

Animals↗

A six-week clinical efficacy study of four commercially available dentifrices for the removal of extrinsic tooth stain.

The objective of this double-blind clinical study was to compare the efficacy for extrinsic tooth stain removal of four commercially available dentifrices: Colgate Tartar Control with Baking Soda & Peroxide Fluoride Toothpaste; Aquafresh Advanced Whitening Toothpaste with Fluoride; Rembrandt Tartar Control Low Abrasion Fluoride Whitening Toothpaste; and Crest Regular Fluoride Toothpaste. Following a baseline examination for extrinsic tooth stain on the anterior six mandibular and maxillary teeth, qualifying adult male and female subjects from the Philadelphia, Pennsylvania area were randomized into four treatment groups which were balanced for age, gender, tobacco habits, and level of extrinsic tooth stain. Subjects were instructed to brush their teeth twice daily (morning and evening) for one minute with their assigned dentifrice using a soft-bristled toothbrush. Examinations for extrinsic tooth stain were repeated after six weeks' use of the study dentifrices. One hundred eighty (180) subjects complied with the protocol, and completed the entire study. At the six-week examination, subjects assigned to the Colgate Tartar Control with Baking Soda & Peroxide Fluoride Toothpaste treatment group exhibited statistically lower levels of extrinsic tooth stain area and extrinsic tooth stain intensity than did those subjects assigned to the Crest Regular Fluoride treatment group. Subjects assigned to the Aquafresh Advanced Whitening treatment group exhibited significantly lower levels of extrinsic tooth stain area than did those assigned the Crest Regular Fluoride group. No other significant differences among the four study dentifrices were noted. Thus, the results of this double-blind clinical study support the conclusion that Colgate Tartar Control with Baking Soda & Peroxide Fluoride Toothpaste provides significantly greater control of extrinsic tooth stain than does Crest Regular Fluoride, a sodium fluoride/silica dentifrice.

Adult↗