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Efficacy of an experimental dentifrice formulation on primary school children in Ga-Rankuwa, Pretoria.

The purpose of this study was to assess the efficacy of a dentifrice containing 1 per cent chlorhexidine gluconate at reducing plaque formation and gingival inflammation over a 12 week period. The effects of the test toothpaste were compared with control and conventional dentifrices in a randomised double-blind clinical trial of parallel design. Following baseline examination at which gingival and plaque indices (GI and PI) were measured, 156 primary school children were assigned to one of three groups that were matched for age, gender, GI and PI. After plaque control instruction the pupils were requested to use the dentifrice twice daily. After 6 and 12 week intervals the PI and GI were reassessed. There was no significant difference in GI between groups. The PI was significantly lower (p < 0.002) after use of the chlorhexidine containing dentifrice compared with the other two products.

Adolescent↗

Evaluation of fluoride uptake by enamel in children from fluoride dentifrices.

Fluoride dentifrices are well accepted for their caries preventive effects. Although it is generally accepted that the presence of fluoride in the enamel protects teeth against carious attack, at the same time, there is some concern that ingestion of fluoride from toothpastes may substantially contribute to the total intake of this element. The present study was undertaken to clinically evaluate the fluoride uptake by human enamel after the use of lower concentrations of fluoride dentifrices and compare their potency to higher concentration in increasing the uptake of fluoride by enamel. Enamel biopsy was conducted on first permanent molars of 100 school children, aged 6-8 years before brushing and at intervals of one hour, 3 weeks, 6 weeks and 12 weeks following brushing with different concentrations of fluoride dentifrices. The fluoride content of the enamel biopsy samples were estimated using the Orion microprocessor ion analyser and by taking into consideration the enamel biopsy mass and depth of the etch. The results of the present study suggest that low fluoride concentration dentifrices provide similar fluoride uptake by enamel when compared with that of higher concentrations.

Analysis of Variance↗

Reversal of incipient and radiographic caries through the use of sodium and stannous fluoride dentifrices in a clinical trial.

Experimental evidence has clearly demonstrated that the early stages of lesion formation (enamel demineralization) are reversible following exposure to saliva and/or fluoride. Clinical evidence for remineralization has also been reported extensively in the literature. However, the literature is lacking with respect to data from well-controlled clinical studies regarding the quantitative contribution of remineralization to arrestment and reversal of caries. Retrospective analysis of an existing clinical trial database provided an opportunity to examine the incidence of clinical lesion reversals in a placebo-controlled, double-blinded caries clinical study. The clinical study examined three treatment groups: 1) 0.243% sodium fluoride/silica dentifrice, 2) 0.4% stannous fluoride/calcium pyrophosphate (positive control) dentifrice and 3) non-fluoridated placebo/calcium pyrophosphate (negative control) dentifrice. Clinical measures in this study included both radiographic and visual-tactile assessments of caries. Examination of all subjects revealed a statistically greater frequency for caries reversals in the sodium fluoride group as compared to the placebo group at Year 3, for both total and radiographic caries. In contrast, while caries reversals in the stannous fluoride group occurred with greater frequency than in the placebo group at Year 3, for both total and radiographic caries, the differences were not statistically significant. When only subjects who were "at risk" for potential reversals (i.e., those with a minimum of one carious lesion at baseline) were examined, a statistically greater frequency in caries reversals was observed in both the sodium fluoride (total, incipient, and radiographic caries) and stannous fluoride (total and radiographic caries) groups as compared to the placebo group at Year 3. Collectively, these data confirm the ability of both 0.243% sodium fluoride/silica and 0.4% stannous fluoride/calcium pyrophosphate dentifrices to clinically reverse caries. The results suggest that sodium fluoride may deliver a greater frequency of caries reversals than stannous fluoride, although these treatments were not found to be significantly different.

Adolescent↗

In vitro tooth whitening by a sodium bicarbonate/peroxide dentifrice.

The main purpose of this laboratory study was to determine the tooth whitening effect of a baking soda dentifrice containing stabilized 1% hydrogen peroxide following repeated applications to intrinsically stained teeth. Additional objectives were to investigate (1) the influence of tooth surface curvature and moisture on color measurements, (2) preliminary treatment parameters using 1% hydrogen peroxide solution, and (3) the relationship between Vita shade guide standards and instrumental color readings. Human tooth specimens with intrinsic stain were specially prepared and measured for color (L*a*b*) by means of diffuse reflectance spectrophotometry. Specimens were measured under wet and dry conditions with natural and flattened enamel surfaces. A preliminary test was conducted with 1% H2O2 solution to establish tooth whitening versus treatment time. Then, new tooth specimens were treated repeatedly with slurries of silica, baking soda, or baking soda/peroxide dentifrices at 30-minute intervals, and color measurements were taken under both wet and dry conditions after 4, 8, 16 and 24 hours. L*a*b* color measurements of the Vita shade guide teeth were also made in order to relate laboratory color changes to clinical effects. The parameter testing results showed that flattening the enamel surface had no effect on tooth color, but the teeth rapidly became lighter and less yellow upon air-drying. The 1% H2O2 solution caused both a significant decrease in yellow (b*) and an increase in lightness (L*). Since the reduction for b* occurred more rapidly and to a greater extent than the L* factor, the b* component may be the more important indicator of tooth whitening by bleaching. Compared to the silica and baking soda dentifrices, the baking soda/peroxide dentifrice significantly decreased the yellow color (b*) of the teeth after 8 or more hours of topical treatment. The instrumental color readings of the Vita Shade guide teeth showed that the color differences between the standards were not linear or consistent, and their accuracy for assessing clinical changes in tooth whiteness is questionable.

Color↗

A review of dentifrices.

Dentifrices have a role to play in the prevention of certain oral diseases, such as dental caries and gingivitis. The use of fluoridated dentifrices has had a dramatic effect on the caries rate in the western world over the last 30 years, and antibacterial, desensitizing and anticalculus dentifrice formulations have recently been developed. This paper provides a brief overview of the dentifrices currently available.

Cariostatic Agents↗

Relationship between daily fluoride intake from diet and the use of dentifrice and human plasma fluoride concentrations.

The literature contains reports of the relationship between the fluoride concentrations in drinking water and human plasma. None of these studies, however, documented individual levels of daily fluoride intake, which can vary considerably among individuals served by the same water supply. Furthermore, while water can be an important source of fluoride, other sources, especially fluoridated dentifrices, also contribute substantially. This 2-day study with five 25-35-year-old subjects in each of three communities (Bauru, 0.6-0.8 ppm F; Domelia, 0.7 ppm F; Floresta, 0.3 ppm F) determined plasma fluoride concentrations and fluoride intake from diet and the use of dentifrice which, together, approximate total daily fluoride intake. The purposes were to determine: (1) the extent to which plasma fluoride concentrations approached levels known to affect the quality and quantity of bone; (2) the relationship between fluoride intake and plasma concentrations. Plasma was collected at 4-h intervals starting at 0800 h and ending at 2000 h each day. Average fluoride intakes from diet and the use of dentifrice in the three communities ranged from 0.16 to 0.82 mg/day and from 0.29 to 3.16 mg/day, respectively. The overall average plasma concentrations in the three communities were 0.44, 0.45 and 0.54 micromol/l (P<0.005). They were directly related to intake from the use of dentifrice (P=0.030) and to total intake (P=0.033), but were not related to dietary intake (P=0.176). In conclusion, despite fluoride intake from various sources, the plasma fluoride concentrations of the study subjects remained at levels far below those associated with effects on bone production.

Adult↗

Effectiveness of a chlorhexidine dentifrice in orthodontic patients: a randomized-controlled trial.

This blind and randomized-controlled trial analysed chlorhexidine dentifrices in relation to dental plaque, gingivitis, bleeding, calculus and enamel extrinsic staining development. Volunteers in fixed orthodontic therapy used the following dentifrices: 1100 ppmF, NaF (group A, n=27); experimental, 1100 ppmF, NaF and chlorhexidine 0.95% (group B, n=28); and experimental, chlorhexidine 0.95% (group C, n=28). At baseline, after 6, 12 and 24 weeks, clinical examinations were carried out. The gingivitis, bleeding and plaque data were tested by anova and Tukey's post hoc tests. Stain and calculus data were analysed by Kruskal-Wallis and Dunn's post hoc tests (p<0.05). Plaque, gingivitis and bleeding scores improved in all three groups, but up to the 6 and 12 weeks examination the products containing chlorhexidine were statistically better. The chlorhexidine dentifrices significantly increased the mean of the stain index, although most of the patients did not notice the stains. The calculus index was not significantly modified. In summary, this study suggests that the use of dentifrices containing chlorhexidine seems to be effective for the treatment of gingivitis in orthodontic patients, although the intense motivating contact that the volunteers had with the researchers may have also played a role.

Adolescent↗

Clinical effect of a herbal dentifrice on the control of plaque and gingivitis: a double-blind study.

The aim of this randomized, double-blind clinical trial was to evaluate the effect of the Paradontax dentifrice on the reduction of plaque and gingivitis. Subjects were randomly allocated into either the test group (n = 15, Paradontax) or the control group (n = 15, standard dentifrice with fluoride). Plaque levels were measured using the Turesky modification of the Quigley & Hein Plaque Index (PI), and gingivitis was evaluated with the Gingival Index (GI). Subjects were asked to brush their teeth with the allocated dentifrice, three times a day, for 21 days. There was no significant difference between groups in relation to the PI and GI medians, at baseline and at the end of the 21-day period. There was no significant reduction in PI in either the test or control groups. There was a significant decrease in GI in the test group. The authors concluded that there was no difference between the dentifrices in the reduction of plaque and gingivitis.

Adolescent↗

A novel dentifrice technology for advanced oral health protection: A review of technical and clinical data.

Throughout the world, dentifrices have played a key role in the practice of good oral hygiene and promotion of better oral health. In addition to providing general dental cleaning, toothpastes also have served as an excellent vehicle for the introduction of new agents that deliver therapeutic and cosmetic benefits. Key examples of using dentifrices to provide added benefits include the introduction in 1955 of the first fluoridated toothpaste clinically proven to fight caries (Crest Cavity Protection) and the launch of the first tartar-control dentifrice (Crest Tartar Control) in the mid-1980s. To continue expanding the health and esthetic benefits offered by a single dentifrice, a multitude of agents have been investigated over the past 3 decades. The focus of these investigations has been in the multibenefit segment, the most widely used among US consumers.

Anti-Bacterial Agents↗

Dentifrice abrasiveness on microfill composite resin and dentin: a comparative study.

This in vitro study evaluated the abrasiveness of seven dentifrices on microfill composite resin discs and dentin surfaces. The composite resin discs and dentin surfaces were brushed in groups using slurries of the different dentifrices. Each specimen was subjected to 2400 strokes using medium bristle toothbrushes at a brush tension of 150 g. Any changes in surface roughness were noted through the use of a mechanical profiler or profileometer and scanning electron micrographs. The results of this study have indicated that Rembrandt Whitening Toothpaste was significantly less abrasive to the microfill composite discs and dentin surfaces compared to the other dentifrices tested (p < .05, ANOVA). Further clinical studies may be warranted to test the abrasiveness of dentifrices, especially if they are used over extended periods of time.

Analysis of Variance↗

Fluoride and abrasive content in commonly used dentifrices on the Kenyan market.

About one decade ago, a heated debate on the appropriateness of fluoride dentifrices in Kenya culminated in the introduction of no-fluoride brands. Analysis of dentifrices that were available on the market in 1989/1990 confirmed two distinctly different categories, the fluoride and the low or no-fluoride types. Among the former, the mean ionic fluoride concentration ranged between 0.4 and 1.36 mg/g while the total fluoride concentration ranged between 1.15 and 114.68 mg/g. The low or no-fluoride dentifrices had less than 0.03 mg/g ionic fluoride and less than 2.14 mg/g total fluoride. The mean abrasive (powder) content ranged between 26.5 g% and 78.5 g%. The gel categories had markedly lower powder values than the pastes. The ash values of the powders ranged between 15.8 g% and 85 g% and did not have an obvious relationship with the powder content. Despite the obvious risk of increasing exposure to excessive fluoride among children, presently, the situation has reverted to the pre-debate time. Given the ubiquitous nature of ingestable fluoride in the region, provision of guidelines and guidance on the sale of dentifrices by the government and consumer organisations, and increased accountability of the manufacturers are recommended.

Data Collection↗

Surface texture changes of a composite brushed with "tooth whitening" dentifrices.

OBJECTIVES: The aim of this investigation was to evaluate the significance of selected surface texture parameters used to describe and quantify the effect of tooth brushing with various "tooth whitening" dentifrices on a resin composite surface in vitro. METHODS: Specimens of a microfil resin composite were brushed with selected dentifrices. Surface texture profiles were acquired and analyzed both pre- and post-brushing using a contact diamond stylus. The selected parameters chosen to describe the surface texture were Ra, Rz, Rpm and the Rpm:Rz ratio. Differences between toothpastes were assessed using an ANOVA and a multiple comparisons test, the Student Newman-Keuls procedure. P and t values were calculated to determine if any of the surface roughness parameters were significantly changed by brushing. RESULTS: The results indicate that there were significant changes in the surface texture of the resin composite following tooth brushing with the selected dentifrices. For example, the use of Clinomyn significantly increased the surface roughness of the resin composite, as measured by the Rz parameter, from 2.19 +/- 1.67 microns to 10.02 +/- 2.57 microns (p < 0.05). In addition, the surface texture parameters chosen to describe the properties of the surface should reflect a knowledge of profile shape such as Rpm:Rz ratio, and care should be taken if measurements of surface texture of dental restorative materials are to be used as predictors of clinical performance. SIGNIFICANCE: All the toothpastes chosen for this investigation left a surface on the resin composite which may be prone to crack propagation during "vertical barrelling" movements generated during mastication. However, this may be more of a function of the rigidity of the restorative material rather than the surface left after tooth brushing.

Analysis of Variance↗

In vitro toothbrush-dentifrice abrasion of resin-modified glass ionomers.

OBJECTIVES: This study was conducted to compare the rate of abrasive wear and change in surface roughness of resin-modified and conventional acid-base glass ionomers when subjected to toothbrush-dentifrice abrasion. METHODS: Two resin-modified and two conventional glass ionomers were used. Samples of a high-copper amalgam and a hybrid resin composite were used as reference materials. Specimens of each material were prepared and subjected to toothbrush-dentifrice abrasion using 20,000 strokes of brushing. The amount of vertical loss of material was determined by profilometry (Surfcom-4A, Tokyo-Seimitsu, Tokyo, Japan). The surface characteristics after abrasion were evaluated on secondary electron images by SEM, and the surface hardness (KHN) was also measured for all materials. Data were analyzed by one-way ANOVA (p < 0.05), followed by a multiple comparisons test using LSD (Least-significant difference) at a level of p < 0.05. RESULTS: The abrasion resistance of resin-modified glass-ionomers was statistically lower for the amalgam and the resin composite reference materials. Statistically lower abrasion resistance and surface hardness were observed for the resin-modified glass ionomers than for their conventional acid-base counterparts when two forms of products from the same manufacturer were compared. SEM observations made after abrasion testing showed a significantly rougher surface for all glass ionomer materials than for the amalgam and the resin composite. SIGNIFICANCE: When comparisons were made between products from the same manufacturers, it was found that in vitro resistance to toothbrush-dentifrice abrasion of the resin-modified glass ionomers is inferior to that of the conventional acid-base glass ionomers. The lower abrasion resistance found in the resin-modified products appears to be related to their lower surface hardness.

Aluminum Hydroxide↗

A study to assess the effects of a new detergent-free, olive oil formulation dentifrice in vitro and in vivo.

OBJECTIVE: To determine the effects of a detergent-free dentifrice containing olive oil using in vitro microbiological tests and an in vivo plaque re-growth model. METHOD: A total of 20 subjects took part in a double blind, single-centre, crossover study in which slurry rinses were the only form of plaque control over a 5-day period. Following a washout and prophylaxis the subjects used 2x daily rinses in the absence of all other plaque control methods. Subjects returned to the clinic on the afternoon of day 5 when plaque was disclosed and assessed by plaque index and area. A further 9-day washout was carried out and the rinse period repeated to ensure that each subject had used both experimental and control slurries. In vitro microbiological experiments were conducted to examine the effects of olive oil alone and in the new dentifrice on bacterial growth and adhesion. RESULTS: 20 subjects completed the trial. The olive oil product showed a significant inhibition of plaque re-growth (17.2%) compared with a fluoride-matched control using the Turesky index (p<0.0001) and also using the planimetric technique (22.0%) (p<0.0001). Significant decreases in bacterial growth and adhesion (measured as total viable count) were detected in the presence of olive oil and the new dentifrice. CONCLUSION: The results suggest that the experimental olive oil containing paste has potential value in the inhibition of plaque.

Adult↗

The effect of a triclosan/copolymer dentifrice on healing after non-surgical treatment of recurrent periodontitis.

The present study examined whether the daily use of a triclosan/copolymer dentifrice enhanced healing following non-surgical periodontal therapy at sites with progressive attachment loss in periodontitis-susceptible subjects: 60 subjects who had been (i) treated for advanced periodontal disease using nonsurgical means and (ii) had been enrolled, for at least 3-5 years, in a maintenance care program that called for prophylaxis once every 3 months. During the course of this maintenance period, all 60 subjects had suffered recurrent periodontitis at > or = 2 sites at several intervals. Following a baseline examination, all 60 subjects received, on an individual basis, detailed instruction in proper self-performed plaque control methods. They were stratified in 2 balanced groups (test and control groups). The members of the test group were assigned to use a triclosan/copolymer/fluoride-containing dentifrice, while the control group used a placebo dentifrice. During the following 3 years, all participants were recalled every 3 months for an evaluation of their oral hygiene standard. Re-examinations were performed after 6, 12, 24 and 36 months. In conjunction with the re-examinations, sites (loser sites) which exhibited additional probing attachment loss (> or = 2 mm) were identified. The loser sites were exposed to professional therapy. Thus, the site was anaesthetized and the surface carefully scaled and root planed (S/RP). Alterations regarding probing pocket depth (PPD), probing attachment level (PAL), and bleeding on probing (BoP) that occurred in the interval between S/RP and 36 months were analyzed. In the control group, 126 loser sites, 67 identified at the 12-month and 59 at the 24-month examinations, were subjected to S/RP. The corresponding number of loser sites in the test group was 85 (48 at 12 months and 37 at 24 months). At the time of S/RP, about 60% of the sites were BoP (+) in both groups. Following treatment, there was a reduction in the number of sites with gingivitis. While the reduction in the control group was modest (6.8%), in the test group, the improvement was more marked (27.5%). Following S/RP, there was also a reduction of the mean PPD in both groups. This decrease amounted to 1.7 mm in the test group and was significantly (p<0.05) smaller (0.6 mm) in the control. Finally in the interval between S/RP and 36 months, there was an improvement of the probing attachment level in both groups. The mean PAL gain was, however, significantly higher in the test than in the control group (1.8 mm versus 0.7 mm; p<0.01).

Anti-Infective Agents, Local↗

Simultaneous determination of potassium nitrate and sodium monofluorophosphate in dentifrices by single column ion chromatography.

The simultaneous determination of potassium nitrate and sodium monofluorophosphate in dentifrices by single column ion chromatography is described. Nitrate and monofluorophosphate are extracted from the dentifrice with deionized water and separated by a low capacity anion separator column with 0.2% sodium benzoate (adjusted to pH 5.8 +/- 0.1 with formic acid) as the mobile phase. A conductivity meter is used for concentration measurements. The method has been applied to commercial dentifrices containing both potassium nitrate and sodium monofluorophosphate. The mean recoveries for potassium nitrate and monofluorophosphate from spiked samples were 99.0% and 99.2%, respectively, with corresponding standard deviations of 1.73% and 2.55%. The minimum detectable concentration is 5 micrograms/ml for both nitrate and monofluorophosphate.

Chromatography, Ion Exchange↗

Clinical uses of an enzyme-containing dentifrice.

Previous studies have shown that the inclusion of certain enzymes in mouthrinses and dentifrices will reduce plaque and gingivitis scores. The enzymes that are most effective clinically have, as their active ingredients, amyloglucosidase and glucose oxidase. These produce hydrogen peroxide from dietary fermentable carbohydrates which in turn converts thiocyanate to hypothiocyanite in the presence of salivary lactoperoxidase. The resultant hypothiocyanite acts as a bacterial inhibitor by interfering with cell metabolism; thus, there is a reduction in plaque accumulation and therefore in gingival inflammation. Pilot studies have compared over a short period the action of the trial dentifrice with enzymes and fluoride at 1100 ppm, using as controls the paste without enzymes but with fluoride and a commercial fluoride paste. There was an expected reduction in all scores with all products due to the mechanical removal of plaque, but a significantly greater reduction in gingivitis was noted in the paste with enzymes. This study is of longer duration with many more subjects. Baseline data include plaque and gingival indices and Periotron readings for crevicular fluid. The trial is of a double-blind non-crossover study design using a split-mouth technique. One side of the mouth is given a prophylaxis and the subject given one of the 3 test pastes to use. Readings were repeated every 2 weeks for 3 months. The results show a significant reduction in gingivitis scores in the enzyme-containing dentifrice group.

Adult↗

Anti-caries effect of a 2% Na2PO3F-dentifrice in a Danish fluoride area.

A 3-year experimental toothbrushing study was conducted in a natural fluoride area in Denmark to evaluate the anti-caries effect of a 2% sodium monofluorophosphate dentifrice. In a previous report the results for the total population of 1,407 schoolchildren, representing a broad age-span (7-12 years), at the commencement of the study in 1970 were given. In the present report results are presented for two subpopulations of "8-year-olds" and "11-year-olds" at the commencement of the study. Differential analysis of the effect of the test dentifrice on defined types of surfaces for the two subpopulations is given. The evaluation was performed using both the conventional DMF-indices and the recently published ECSI-Index6. The evaluation showed that the test dentifrice had a valuable anti-caries effect in both age groups, above and beyond the effect of the waterborne fluoride. Proximal surfaces were affected most baneficially by the active agent both in relative and absolute terms. However, an appreciable caries-preventive effect was also found on the "pit and fissure" surfaces.

Child↗