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In this double-blind caries study, 1160 Taiwanese children (ages 8-15) completed a program using a test dentifrice containing 1.243 percent sodium fluoride and soluble pyrophosphates, or a control dentifrice without these agents. The average reduction of new carious tooth surfaces was 39 percent with the sodium fluoride dentifrice.
This report provides a series of statements on toothbrushes, toothbrushing, dentifrices and their abrasivity. The use of conventional toothbrushes and dentifrices will adequately cleanse the exposed surfaces of the teeth. Neither variations in the design of toothbrushes nor the formulation of dentifrices confer extra cleaning benefit. For efficient cleaning patient knowledge, motivation and dexterity are of overriding importance.
The aim was to study whether the use of a xylitol-containing dentifrice could affect the number of mutans streptococci and lactobacilli in preschool children with medium and high initial salivary counts. After screening 147 healthy preschool children, 3-6 years of age, 70 were selected and randomly assigned into two groups for 3-month's use of either a xylitol (9.7%) or a non-xylitol-containing fluoride dentifrice. The parents were trained to brush the teeth of their children twice daily in a standardized manner and the study was carried out double blind. Bacterial levels at screening and after 3 months were enumerated with aid of chair-side methods. No significant differences in mutans streptococci levels or lactobacilli counts after 3 months were obtained, either in comparison to baseline or between the groups. About 50% of all children exhibited unchanged bacterial scores at the end of the test period but more children in the xylitol group disclosed reduced scores of salivary mutans streptococci compared with the non-xylitol group (38% vs 16%). The results suggest that the dose level achieved by using this xylitol-containing dentifrice in preschool children, did not provide sufficient antibacterial action to suppress caries associated microorganisms in the saliva of those with high initial counts.
The aim of this study was to investigate the ability of Triclosan dentifrices to delay the development of gingivitis during a 21-day period without toothbrushing. Test pastes contained 0.3 per cent Triclosan; seven also contained 0.75 per cent zinc citrate; one other contained 2 per cent Gantrez. Plaque and gingivitis increased significantly (p < 0.001) between day 0 and day 21 in the control group. there was no evidence to reject the assumption of similar efficacy across the seven Triclosan/zinc citrate variants. For the combined Triclosan/zinc citrate groups, statistically significant reductions in plaque formation and in gingivitis relative to the control were recorded. Reductions in plaque and gingival bleeding compared to control for the Triclosan/Gantrez group were not statistically significant, although reductions in gingival indices were. The greater reduction in the Gingival Index of the Triclosan/zinc citrate group was also statistically significantly different from that of the Triclosan/Gantrez group, suggesting that a dentifrice containing the former would have a greater antigingivitis potential than a dentifrice containing the latter.
Ingestion of fluoride dentifrice by preschool children recently has been identified as a risk factor for dental fluorosis. There are relatively few published studies concerning patterns of fluoride dentifrice use and ingestion among preschool children at greatest risk for dental fluorosis. This paper reviews the literature on dentifrice use and ingestion in an attempt to emphasize to the practitioner the potential importance of this fluoride exposure in fluorosis etiology.
OBJECTIVE: The study was designed to test the hypothesis that a dentifrice with fluoride at the same concentration (1000ppm) from two sources, ie NaF and NaMFP, would provide a greater treatment effect than one with NaMFP alone. BASIC RESEARCH DESIGN: A double blind clinical trial with random assignment of children to one of two groups was carried out for three years. The two trial groups were similar at the outset in respect to those variables which might otherwise have affected the outcome, including age and gender, with means per subject of 98.4 sound surfaces and 2.2 decayed and filled surfaces in each group initially. CLINICAL SETTING: Secondary schools in the Isle of Wight, UK, an area of diminished caries experience. PARTICIPANTS: One thousand six hundred and thirty-three children aged initially 10-12 years. INTERVENTIONS: A test dentifrice containing 500ppm NaF plus 500ppm NaMFP, and a standard active control product containing 1000ppm NaMFP. Products were used in the home. OUTCOME MEASURES: Increment of DF teeth and surfaces measured over 36 months. RESULTS: After three years, mean approximal surface increments were 3.6 new DFS in the control group and 3.1 in the test group, a difference 13 per cent (P < 0.05). Thirty-four per cent of the subjects were caries free at the outset. In the 1075 subjects with caries at the outset, the total mean increment on all surfaces was 7.2 new DFS in the control group and 6.4 new DFS in the test group, a difference of 11 per cent (P < 0.05). However, those subjects with initial caries had approximal surface increments of 4.8 new DFS in the control group and 4.0 new DFS in the test group, a difference of 16 per cent (P < 0.01). Included separately along with the conventional rubric were enamel white spots on which no differential treatment effect was observed. CONCLUSIONS: Under the conditions of this study, the regular use of a dentifrice containing 1000ppm fluoride from two sources provided a significantly greater treatment effect than one with fluoride from a single source.
The purpose of this study was to examine the effect that brushing with a fluoridated dentifrice (Crest--Procter and Gamble) has on the fluoride release of restorative materials. Thirty standardized discs were fabricated; 10 were P-50 (3M) nonfluoridated composite resin (control), ten were Heliomolar Radiopaque (Ivoclar/Vivadent) fluoride releasing composite resin, and ten were Ketac Fil (ESPE) glass ionomer cement. Specimens were placed into separate containers of 10 mL deionized water. Half the specimens from each group were brushed with fluoridated dentifrice for two minutes twice per day and rinsed. The fluoride level of each specimen was evaluated for thirty days, using a fluoride specific ion analyzer. An analysis of variance (ANOVA) and Duncan's test (p < 0.05) indicated significant differences in fluoride release. The brushed glass ionomer was significantly higher than all other groups and the glass ionomer not brushed was significantly higher than all composite groups. Glass Ionomer Cement-brushed > Glass Ionomer Cement > Fluoridated Composite Resin-brushed = Fluoridated Composite Resin = Composite Resin-brushed = Composite Resin. Brushed glass ionomer appears to release the highest fluoride level, acting as a fluoride reservoir from the dentifrice for subsequent fluoride release.
The antimicrobial activity of six commercially available dentifrices and positive and negative controls as they come into contact with Streptococcus mutans, S. sanguis, and Actinomyces viscosus commonly found in the oral cavity. Sterile discs treated with the dentifrices were placed on agar plates with the controls. Zones of microbial inhibition were measured in millimeters after 48 hours. All of the test dentifrices demonstrated antimicrobial activity against the bacteria.
A randomized, double blind clinical trial of the caries inhibition effects of dentifrices containing respectively monofluorophosphate and amine fluoride was performed. A third control group used a toothpaste without fluoride. A total number of 2008 schoolchildren ranging in age from 6 to 8 years and living in Strasbourg (France) participated in this study. After a baseline examination three groups were constructed with the block randomization technic. The caries inhibition effects of the three dental pastes were compared after 3 years of unsupervised use. The monofluorophosphate dentifrice showed a reduction of 7.02% for DMFT, 5.17% for DMFS and 25.26% for the df rate. The reduction of amine fluoride dentifrice caries was respectively 21.62% for DMFT, 20.94% for DMFS and 48.66% for the df rate.
OBJECTIVES: The purpose of this study is to determine the efficacy and safety of a specially formulated remineralizing toothpaste in controlling caries in a group of high risk, head and neck radiation patients. DESIGN: The study compares the performance of the remineralizing toothpaste with a leading conventional fluoride dentifrice using double-blind randomization. TEST PRODUCTS: The products compared both contain equivalent quantities of fluoride (1150 ppm). The remineralizing toothpaste also delivers soluble calcium and phosphate ions, the essential components of teeth. SUBJECTS: On completion, 50 subjects who received > 50 Gy of radiation to the head and neck. MEASUREMENTS: Examinations include coronal and root caries using the Pitts Diagnostic Criteria, salivary flow rate, plaque and gingival indices and microbiological counts over one year. RESULTS: At this point subjects are enrolled in the study at various phases. However, the current average for the net increment per month per subject is -0.12 (+/- 1.30) for coronal caries and 0.06 (+/- 0.73) for root caries in subjects using the remineralizing toothpaste and 0.53 (+/- 1.62) for coronal caries and 0.45 (+/- 0.98) for root caries in subjects using the conventional fluoride dentifrice. Non-parametric analysis of rank scores for net root surface increments/month was statistically significant (p = 0.02), suggesting lower net root surface increment/month for the remineralizing toothpaste relative to the conventional toothpaste. No significant differences were noted on coronal surfaces. CONCLUSIONS: The results to date indicate that the remineralizing toothpaste is significantly superior to the conventional fluoride dentifrice in preventing root caries in high risk patients.
The increase of dental fluorosis is largely imputable to the ingestion of dietary fluoride supplements and fluoride toothpastes. However, the toothbrushing habits of very young children is poorly documented. The purpose of this pilot study was to determine the toothbrushing habits of 12- to 24-month-old children and to estimate the quantity of fluoride ingested during toothbrushing. Fifty-nine parents completed a questionnaire regarding the toothcleaning habits of their children. When a dentifrice was used, a dental hygienist scheduled a meeting with the parents in order to observe and measure the amount of toothpaste used. Of the 36 parents who cleaned the teeth of their children, 69% used a toothpaste. Furthermore 20% of the children ingested more than 0.25 mg of fluoride per day by toothbrushing alone. Therefore the practice of toothbrushing and the use of fluoridated dentifrices are widespread among 12- to 24-month old children, and the amount of fluoride ingested from toothpaste could constitute a substantial proportion of the total daily intake of fluoride. Several measures are suggested to enhance the safe use of fluoride dentifrices.
While our knowledge of the dental caries process and its prevention has greatly advanced over the past fifty years, it is fair to state that the management of this disease at the level of the individual patient remains largely empirical. Recommendations for fluoride use by patients at different levels of caries risk are mainly based on the adage that more is better. There is a general understanding that the fluoride compound, concentration, frequency of use, duration of exposure, and method of delivery can influence fluoride efficacy. Two important factors are (1) the initial interaction of relatively high concentrations of fluoride with the tooth surface and plaque during application and (2) the retention of fluoride in oral fluids after application. Fluoride dentifrices remain the most widely used method of delivering topical fluoride. The efficacy of this approach in preventing dental caries is beyond dispute. However, the vast majority of currently marketed dentifrice products have not been clinically tested and have met only the minimal requirements of the FDA monograph using mainly laboratory testing and animal caries testing. Daily use of fluoride dental rinses as an adjunct to fluoride dentifrice has been shown to be clinically effective as has biweekly use of higher concentration fluoride rinses. The use of remineralizing agents (other than fluoride), directed at reversing or arresting non-cavitated lesions, remains a promising yet largely unproven strategy. High fluoride concentration compounds, e.g., AgF, Ag(NH3)2F, to arrest more advanced carious lesions with and without prior removal of carious tissue are being used in several countries as part of the Atraumatic Restorative Treatment (ART) approach. Most of the recent innovations in oral care products have been directed toward making cosmetic marketing claims. There continues to be a need for innovation and collaboration with other scientific disciplines to fully understand and prevent dental caries.
The purpose of this work was to assess the in vitro antibacterial effectiveness of three dentifrices containing antimicrobial agents and to test the in vivo anti plaque and anti gingivitis effect of a toothpaste containing triclosan (CAOLA). The in vitro tests showed a marked antibacterial effect of both triclosan and chlorhexidine containing dentifrices. The randomized clinical trial presented good evidences that the triclosan had some but statistically non significant plaque and gingivitis reduction in patients even without previous mechanical cleaning. Nevertheless the triclosan dentifrice was effective in reducing the plaque and gingivitis scores in combination with initial mechanical debridement and oral hygienic instructions.
The effectiveness of 3 different brands of fluoride-containing dentifrices on the prevention of dental caries was investigated in molars of young rats. Forty albino Wistar rats weighing 50-80g, 28 males and 12 females were inoculated in the mouth with streptococcus viridans daily from day 1 to day 5 of the experiment. The animals were then divided into four groups and fed with rat pellets containing 60% sucrose added as granulated sugar. All the groups were given water ad libitum. Group I had daily tooth brushing with water and served as the control while groups II, III and IV received daily brushing of their molar teeth with different fluoride--containing dentifrices: (Maxam, Florish and Close-Up respectively. All topical treatments were given for one minute daily per rat from day 6 to day 56 of the experiment. At the end of the experiment the animals were sacrificed, the jaws removed and the teeth were scored for occlusal caries. All fluoride--containing dentifrices tested reduced caries in the following order: Maxam 37.86%, Florish 59.22% and Close-Up 57.28%. This study confirmed that fluoride incorporated in Florish and Close-Up showed significant levels of caries reduction (P <0.01) and (P <0.05) respectively in the rat. It also adds credence to Dental Health Education in the application of various tooth pastes in oral hygiene measures.
Relative 45Ca-uptake in vivo was determined by etchings after dentifrice application between 18 and 22 days of age; uptake increased and the Ca and P that dissolved decreased with application time. The mechanism of 45Ca-uptake from the dentifrice may be due to either isotopic exchange or to the precipitation or crystal growth of calcium and phosphate.
OBJECTIVE: To determine the effects of a detergent-free, whitening dentifrice using an in vivo plaque regrowth model with the novel application of QLF as a planimetric analysis tool. 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 2 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 the plaque index and area using both a photographic and novel fluorescent planimetric technique. A further 9-day washout was carried out and the rinse period repeated to ensure that each subject had used both experimental and comparator slurries. RESULTS: Twenty subjects completed the trial. The test product showed a significant inhibition of plaque re-growth (16.9%) compared with a fluoride-matched comparator using the Turesky index (P < 0.0001), the photographic planimetric technique (17.5%) (P < 0.0001) and the novel QLF technique (18.4%) (P < 0.0001). CONCLUSION: The results confirm that plaque inhibition capability of a detergent-free whitening dentifrice is at least as effective as a fluoride matched comparator. QLF is a promising tool for disclosed plaque quantification.
This study compares the abrasive effects of three dentifrices on three different denture base resins, a heat cured acrylic resin, a self cured acrylic resin and a light activated urethane dimethacrylate-based resin. Specimens of the resins were subjected to a regimen of mechanical brushing using measured amounts of paste on standard toothbrushes driven by a reciprocating device. The apparent wear of each specimen was assessed qualitatively using scanning electron microscopy and quantitatively using profilometry and reflex microscopy. The study showed that cleaning pastes play a significant role in the wear of conventional acrylic resins, the relative abrasivity of the dentifrices being substrate related. However, wear was less evident on the light activated urethane dimethacrylate resin. Brushing with water alone produced no detectable wear on any of the specimens.
Eight hundred fifty 11- to 14-year-old residents of nonfluoridated communities in Massachusetts and Connecticut, who were born between 1972 and 1975, were investigated in a case-control study of the possible association between enamel fluorosis and exposure to fluoride supplements, infant formula, and/or fluoride dentifrice. The effect of median household income, an indicator of socioeconomic status, was also examined. Clinical examination, using the Fluorosis Risk Index, a fluorosis index developed for this project, allowed cases and controls to be identified based upon the specific time period of exposure to the various sources of ingested fluoride. Risk factor exposure was assessed via a mailed questionnaire with a response rate of 80%. Mild-to-moderate enamel fluorosis was strongly associated with fluoride supplementation during the first six years of life (odds ratio = 4.0) and with median household income (odds ratio = 6.6). Subjects in the middle median household income group who had used fluoride supplements through the first six years of life had a 28-fold increase in the risk of fluorosis compared with unexposed subjects in the lower median household income group. An odds ratio of 1.7 associated with infant formula use was suggestive of an increased risk of enamel fluorosis as was an odds ratio of 2.9 associated with fluoride dentifrice use.