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The comparative anticaries efficacy of a dentifrice containing 0.3% triclosan and 2.0% copolymer in a 0.243% sodium fluoride/silica base and a dentifrice containing 0.243% sodium fluoride/silica base: a two-year coronal caries clinical trial on adults in Israel.

The purpose of this two-year clinical study was to provide a comparison of the anticaries efficacy associated with two commercially available, American Dental Association-accepted dentifrices: Colgate Total Toothpaste, which contains 0.3% triclosan and 2% copolymer in a 0.243% sodium fluoride/silica base; and Crest Cavity Fighting Toothpaste with Fluoristat, which contains 0.243% sodium fluoride in a silica base. The study was conducted in harmony with the published 1988 American Dental Association guidelines for studies geared toward the comparison of fluoride dentifrices. The study employed a double-blind parallel-group design, and involved adults living in communities throughout Israel. Qualifying subjects were randomly assigned to the two treatment groups, with multiple subjects in the same household all assigned to the dentifrice randomly allocated to the first among them. Caries examinations were conducted in accordance with U.S. Food and Drug Administration guidelines for the clinical evaluation of drugs to prevent dental caries. Two calibrated examiners performed all of the measurements. After treatment assignment, study participants were instructed to brush their teeth at home with their assigned dentifrice at least twice daily. Brushing instructions were reinforced by indoctrination in proper oral hygiene techniques by dental professionals, supplemented by pamphlets supplied by the sponsor and yearly mailings to participants, emphasizing good oral hygiene and the need to ensure compliance with the study. Post-baseline examinations were performed after one year of product use, and again after two years of product use. Three-thousand, three-hundred and ninety-two (3,392) subjects completed this two-year study. For these subjects, the mean caries scores (DFS, decayed or filled surfaces) at baseline were 21.96 for the Colgate Total Toothpaste group, and 21.49 for the Crest Cavity Fighting Toothpaste with Fluoristat group. For caries increment after one year, the respective means were 1.37 for the Colgate Total Toothpaste group, and 1.56 for the Crest Cavity Fighting Toothpaste with Fluoristat group. After two years, the mean caries increments were 1.46 for the Colgate Total Toothpaste group, and 1.75 for the Crest Cavity Fighting Toothpaste with Fluoristat group. No statically significant difference was indicated between the treatment groups at baseline. However, for both the one-year and two-year increments, there was a statistically significant difference between treatment groups. Relative to the Crest Cavity Fighting Toothpaste with Fluoristat group, the Colgate Total Toothpaste group presented a 12.2% reduction in caries increment scores at one year, and a 16.6% reduction in caries increment scores at two years. In accordance with the procedures and standards provided by the published guidelines of the American Dental Association for the comparison of the anticaries efficacy of fluoride dentifrices, the results of this study support the conclusion that Colgate Total Toothpaste provides a superior level of coronal anticaries efficacy compared to Crest Cavity Fighting Toothpaste with Fluoristat.

Adult↗

Fluoride levels in whole saliva of preschool children after brushing with 0.25 g (pea-sized) as compared to 1.0 g (full-brush) of a fluoride dentifrice.

Concerns regarding an increased risk of dental fluorosis related to ingesting fluoride-containing toothpastes by preschool children have led to recommendations to reduce the amount of toothpaste used for young children to a pea-sized amount. The purpose of this study was to determine the effect on salivary fluoride levels of reducing the amount of toothpaste used in a preschool-age (4-5 years) population. Salivary fluoride concentrations were determined for 10 children whose teeth were brushed with both 0.25 g and 1.0 g of a fluoridated toothpaste on two separate days. Initial salivary fluoride levels following the use of 0.25 g of toothpaste were less than half of the salivary fluoride concentrations when 1.0 g of toothpaste was used, and levels returned to baseline more rapidly. The reduced salivary fluoride levels when less toothpaste is used may result in a reduced efficacy for caries prevention. However, any potential reduction in caries prevention may still be outweighed by the risk of increased fluoride ingestion with larger amounts of toothpaste in preschool children. The results of this study suggest that a reduction in the amount of a fluoridated toothpaste to a pea-sized amount be limited only to young children who are at risk of ingesting toothpaste.

Cariostatic Agents↗

Double blind clinical trial of a remineralizing dentifrice in the prevention of caries in a radiation therapy population.

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.

Adult↗

Effectiveness of a sanguinarine regimen after scaling and root planing.

BACKGROUND: A variety of chemical agents have been evaluated relative to their abilities to inhibit dental plaque and to improve gingival health. Chlorhexidine gluconate is the best known and most widely used member of these agents, but its long-term use is compromised by different side effects, especially extrinsic tooth and tongue staining. Another agent, sanguinarine, which is currently used in both a mouthrinse and toothpaste, leads in some cases only to a transient burning sensation and could be used on a long-term basis. The purpose of this 14-week controlled clinical trial was to assess the effectiveness of a toothpaste and oral rinse containing sanguinaria extract after scaling, root planing and a chlorhexidine regimen. METHODS: Sixty patients diagnosed as having adult periodontitis received initial periodontal therapy including scaling and root planing, followed by a 2-week oral care regimen which included rinsing with 0.2% chlorhexidine gluconate oral rinse. Upon completion of this 2-week initial therapy phase, patients were randomly assigned to either sanguinarine toothpaste and oral rinse or to control toothpaste and oral rinse without sanguinarine. Plaque (modified Quigley-Hein index) and gingivitis (gingival index) were measured prior to periodontal therapy, at the end of the chlorhexidine phase (2 weeks), and after 8 and 14 weeks. RESULTS: Sanguinarine-containing toothpaste and oral rinse significantly inhibited the redevelopment of gingivitis through the 12 weeks following the chlorhexidine phase compared to the control toothpaste and rinse. Patients in the test group had 26% fewer bleeding sites at 8 weeks, and 32% fewer at 14 weeks, than the control group. CONCLUSIONS: Our results support the combined use of chlorhexidine mouthrinse for a short term (2 weeks) followed by sanguinaria mouthrinse and toothpaste up to 3 months in order to optimize the effectiveness of chlorhexidine without side effects. Further studies on the long-term effect of this combination should be established.

Adult↗

A clinical study to compare the anticalculus efficacy of three dentifrice formulations.

The objective of this double-blind clinical study, conducted in harmony with the accepted Volpe-Manhold design for studies of dental calculus, was to compare the supragingival anticalculus efficacy of three commercially available dentifrice formulations. The test toothpastes were Colgate Total Plus Whitening Toothpaste with an added high cleaning silica base, Crest Multi-Care Advanced Cleaning Toothpaste, and Colgate Winterfresh Gel. Adult male and female subjects from the northern New Jersey area were entered into the study based on a pre-test (baseline) Volpe-Manhold Calculus Index score of 7.0 or greater, provided a full oral prophylaxis, and stratified into three treatment groups which were balanced for age, sex and baseline calculus scores. 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 dental calculus were again performed after eight weeks' use of the study dentifrices. One hundred (100) subjects complied with the protocol and completed the entire study. At the eight-week examination, subjects using the Colgate Total Plus Whitening Toothpaste and subjects using the Crest Multi-Care Advanced Cleaning Toothpaste exhibited statistically significant (p < 0.05) reductions in mean Volpe-Manhold Calculus Index scores as compared to the negative control dentifrice group (Colgate Winterfresh Gel). There was no statistically significant difference in mean Volpe-Manhold Calculus Index scores between subjects using the Colgate Total Plus Whitening Toothpaste and subjects using the Crest Multi-Care Advanced Cleaning Toothpaste.

Adult↗

Prospective study of the effect of post-brushing rinsing behaviour on dental caries.

Previous studies have indicated that rinsing the mouth with a beaker of water after toothbrushing may compromise the caries reducing effect of fluoride toothpaste. A 3-year clinical trial of daily supervised brushing with fluoride toothpaste at school was used to test the effect of post-brushing rinsing with water on caries increment. A total of 407 children, mean age 11.8 years, attending three schools in Kaunas, Lithuania were enrolled following informed consent of the children and their parents. Caries was recorded at baseline and annually for 3 years. During the study, children in two schools (A and B) performed daily supervised brushing with a 1,500-ppm fluoride toothpaste. Children in school A rinsed their mouths thoroughly with a beaker of water after toothbrushing whereas children in school B were only permitted to spit out once after brushing. Furthermore, the children in these schools were supplied with toothpaste and toothbrushes for use at home and in school. A third school (C), without daily brushing and without supply of toothpaste, served as control. Compliance with the protocol was consistently better in school B. After 3 years 276 children were available for examination. Three-year DMFS increments, including non-cavitated lesions (mean, 95% CI), were: school A, 6.8 (5.3; 8.3); school B, 6.2 (4.6; 7.8), and school C, 12.4 (10.6; 14.1). Mean increments for schools A and B did not differ significantly but were both significantly lower than those of school C (p< 0.001). It is concluded that post-brushing rinsing with water, under the conditions of this study, does not significantly affect the caries reducing effect of a fluoride toothpaste.

Analysis of Variance↗

The effect of pH, temperature and plaque thickness on the hydrolysis of monofluorophosphate in experimental dental plaque.

Monofluorophosphate (MFP), an anti-caries agent commonly used in toothpaste, is known to be degraded to fluoride and orthophosphate by bacterial phosphatases in dental plaque. We have examined the effect of pH, temperature, plaque thickness and some ions on this process. Both natural plaque and artificial microcosm plaque incubated with purified MFP at pH 4-10 showed an optimum pH of approximately 8 for hydrolysis. Diffusion and concomitant hydrolysis were examined in an apparatus in which artificial plaque was held between rigid membranes separating two chambers. When MFP diffused through a plaque of 0.51-mm thickness over 4 h it was almost completely hydrolysed at pH 8, but hydrolysis on diffusion decreased as the pH deviated from 8. MFP in toothpaste extract showed a similar pH susceptibility to hydrolysis, according to the inherent pH of the toothpaste. Hydrolysis of MFP in the toothpaste was reduced by no more than 10% when compared with a matched-pH control, suggesting that other toothpaste ingredients had no major influence on hydrolysis. Transport was slower and hydrolysis at pH 6 more complete the thicker the plaque, but hydrolysis was not significantly slower at 23 degrees C than at 37 degrees C. The addition of various potential activating or inhibiting ions at 0.1 and 1.0 mmol/l had small and non-significant effects on hydrolysis. The results suggest that MFP toothpaste should be formulated and used to maximise enzymic hydrolysis of this complex anion, and that plaque pH control is probably the most important factor.

Analysis of Variance↗

Salivary fluoride concentration in adults after different fluoride procedures.

Today, several alternatives for fluoride therapy are available. To give advice on the choice of method, the dentist should have information on how effective different fluoride treatments are in increasing salivary fluoride concentration. The aim of the present study was to measure the fluoride concentration of saliva after the use of four different fluoride methods commonly used in the Nordic countries: F mouthrinse (0.023% F), F toothpaste (1.1% F). F lozenge (0.25 mg F), and F chewing gum (0.25 mg F). In addition, a new method using toothpaste water mixture as a mouthrinse was included in the study. Fourteen adult volunteers used each of the five methods on separate days. Unstimulated saliva samples were collected at base line and 0, 10, 20, 30, 45, and 60 min after the fluoride procedure. Fluoride was separated by the microdiffusion method and analyzed using a fluoride-specific electrode. Fluoride mouthrinse and fluoride toothpaste increased the fluoride concentration of saliva significantly more than fluoride lozenge and fluoride chewing gum. For both of the latter, salivary fluoride concentration was still increased after 1 h. Toothpaste-water rinse was more effective than brushing with toothpaste. Rinsing with toothpaste-water mixture appears a good alternative for adults who need extra fluoride therapy but are not motivated enough to brush their teeth several times a day.

Administration, Oral↗

Remineralization by fluoride enhanced with calcium and phosphate ingredients.

The effectiveness of fluoride ions provided by toothpastes and mouthrinses in promoting remineralization can be limited by the low concentrations of calcium and phosphate ions in saliva. The purpose of this study was to determine whether improved remineralization can be obtained from toothpastes or mouthrinses that simultaneously deliver fluoride, calcium, and phosphate ions from dual-dispensing systems. Enamel specimens with artificial lesions between 60 and 90 microns deep were cycled 15 times through demineralization for 30 minutes, treated for 5 minutes with an experimental or control fluoride toothpaste or mouthrinse, and remineralized for 60 minutes. In the toothpaste study, surface hardness increased by 11.5 +/- 9.2 and 2.7 +/- 3.6 Vickers hardness units, and enamel fluoride content was 5984 +/- 521 ppm and 3971 +/- 531 ppm for the experimental and control fluoride toothpastes, respectively. Remineralization was confirmed by x-ray microradiography. In the mouthrinse study, surface hardness increased by 8.8 +/- 7.7 and 2.2 +/- 3.7 Vickers hardness units, and enamel fluoride content was 6111 +/- 1078 ppm and 3160 +/- 364 ppm for the experimental and control fluoride mouthrinses, respectively. Use of a non-fluoride control mouthrinse led to a decrease in surface hardness of 3.7 +/- 5.2 Vickers hardness units despite a fluoride content of 402 ppm. The results demonstrate that calcium and phosphate supplementation in a toothpaste or mouthrinse can improve remineralization and increase fluoride uptake.

Calcium Phosphates↗

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↗

A six-week clinical study to compare the stain removal efficacy of three dentifrices.

The objective of this double-blind clinical study was to compare the tooth whitening efficacy (stain removal) of a new commercially available tooth whitening dentifrice (Colgate Total Plus Whitening Toothpaste) containing 0.2% triclosan and 3.0% PVM/MA copolymer in a 0.243% sodium fluoride/high cleaning silica base, with that of two commercially available dentifrices, Crest Multi-Care Advanced Cleaning Toothpaste and Colgate Winterfresh Gel Fluoride Toothpaste. Following a baseline examination to assess extrinsic tooth stain, qualifying adult male and female subjects were randomized into three treatment groups which were balanced for gender, age and level of extrinsic tooth stain. Subjects were asked to brush their teeth twice (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 and twenty-three (123) subjects complied with the protocol and completed the study. At the six-week examination, subjects assigned to the Colgate Total Plus Whitening Toothpaste treatment group exhibited statistically significant reductions in extrinsic tooth stain area and extrinsic tooth stain intensity relative to those subjects assigned to the Crest Multi-Care Advanced Cleaning Toothpaste and the Colgate Winterfresh Gel Fluoride Toothpaste.

Adolescent↗

Comparison of two dentifrices with respect to efficacy for the control of plaque and gingivitis, and with respect to extrinsic tooth staining: a six-month clinical study on adults.

The objective of this six-month, double-blind clinical study, conducted in harmony with American Dental Association guidelines, was to provide a comparison between Colgate Total Toothpaste and Crest Gum Care Toothpaste with respect to their levels of efficacy for the control of supragingival dental plaque and gingivitis, and with respect to the levels of tooth staining associated with their use. Adult male and female subjects from the Edinburgh, Scotland area were entered into the study and stratified into two treatment groups which were balanced for age, sex, baseline Quigley-Hein Plaque Index scores and baseline Löe-Silness Gingival Index scores. Subjects received an oral prophylaxis, and 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 plaque, gingivitis and extrinsic tooth staining were conducted after three months' and again after six months' use of the study dentifrices. One-hundred and nine (109) subjects complied with the protocol and completed the entire six-month clinical study. At both the three- and six-month study examinations, the Colgate Total Toothpaste group exhibited statistically significantly less plaque, gingivitis and extrinsic tooth staining compared to the Crest Gum Care Toothpaste group. At the six-month examination, the magnitude of these differences exceeded 18% for all six parameters measured (18.7% for Plaque Index, 60.5% for Plaque Severity Index, 22.2% for Gingival Index, 85.1% for Gingivitis Severity Index, 45.3% for stain intensity, and 46.3% for stain area). Thus, the results of this six-month clinical study support the conclusion that Colgate Total Toothpaste provides a statistically significant, substantive advantage in efficacy for the control of plaque and gingivitis over Crest Gum Care Toothpaste, while, at the same time, providing better control against the development of extrinsic tooth staining.

Adult↗

The relative anticaries effectiveness of sodium monofluorophosphate and sodium fluoride as contained in currently available dentifrice formulations.

A 36-month double-blind clinical caries study was conducted to determine the comparative anticaries efficacy of sodium monofluorophosphate (MFP) and sodium fluoride (NaF) as incorporated in dentifrice formulations. The test dentifrices which were utilized are commercially available in the United States and all have been granted the American Dental Association Seal of Acceptance for anticaries efficacy. The study was conducted in accordance with the 1988 Guidelines of the American Dental Association Council on Dental Therapeutics. The two formulations used in the NaF versus MFP comparison were Colgate Winterfresh Gel with 0.76% sodium monofluorophosphate in a silica base and Crest Regular Flavor Toothpaste with 0.24% sodium fluoride in a silica base. A third commercially-available NaF dentifrice, Colgate Junior Toothpaste with 0.243% sodium fluoride in a silica base, was included in the study for further comparison. Schoolchildren residing in Maine, U.S.A. received a baseline caries clinical examination and then were randomly assigned to the twice-daily use of one of the three dentifrices which were purchased in the marketplace and repackaged in plain white tubes. Caries clinical examinations were subsequently conducted after 2 and 3 years' use of the dentifrices. A total of 2,222 children participated in both the 2 and 3-year caries clinical examinations. The 36-month DFS (decayed and filled surfaces) and the DFT (decayed and filled teeth) mean caries increments for the three dentifrice groups were virtually identical. The children using the MFP formulation experienced a DFS of 1.50 and a DFT of 1.08; those using the Crest NaF formulation experienced a DFS of 1.48 and a DFT of 1.07; subjects in the third group (Colgate Junior Toothpaste, 0.243% NaF) had a DFS of 1.49 and DFT of 1.06. The statistical evaluation of the data consisted of the calculation of 90% confidence bounds for the ratio of (true) mean increments, in accordance with the 1988 American Dental Association Guidelines. Expressed in the language of the Guidelines, the analyses indicated that, (1) the anticaries efficacy provided by the MFP formulation, (Colgate Winterfresh Gel with 0.76% MFP) is "as good as" that provided by the NaF formulation, (Crest Regular Flavor Toothpaste, with 0.243% NaF), and (2) the anticaries efficacy provided by the one NaF formulation (Colgate Junior Toothpaste, with 0.243% NaF) is "as good as" that provided by the other, (Crest Regular Flavor Toothpaste, with 0.243% NaF).

American Dental Association↗

Long-term evaluation of a SnF2 gel for control of gingivitis and decalcification in adolescent orthodontic patients.

The purpose of this paper is to review two recently reported, long-term studies of several chemical methods to control gingivitis and decalcification in in adolescent orthodontic patients. The first study (gingivitis study) was designed to determine whether conventional toothbrushing and twice daily use of a brush-on 0.4 per cent SnF2 gel containing more than 90 per cent available Sn2+ would be more effective for controlling plaque accumulation and gingivitis in the presence of orthodontic appliances than conventional toothbrushing alone. The second study (decalcification study) was designed to compare the effectiveness of controlling decalcification in orthodontic patients with either a 1100 ppm F toothpaste used alone, this same toothpaste and a 0.05 per cent NaF rinse or this toothpaste and a 0.4 per cent SnF2 gel. In the gingivitis study, sixty-five consecutively treated adolescents who were to receive full-mouth fixed orthodontic appliances were assigned to two groups according to age and sex criteria. In the decalcification study an additional 30 subjects (95 total) were similarly assigned to a third group. The first group (control, n = 35) used only toothbrushing with a standard fluoride (1100 ppm F) toothpaste. The second group used toothbrushing with a similar dentifrice supplemented with a 0.4 per cent SnF2 gel (SnF2 gel group, n = 30) used twice daily for the entire 18-month study period. The third group (in the decalcification study only) used a similar toothpaste and 0.05 per cent NaF rinse (NaF rinse group, n = 30). Clinical assessments of plaque accumulation using the Plaque Index, gingival inflammation using the Gingival Index, and coronal staining were completed single-blind before appliances were placed and 1, 3, 6, 9, 12 and 18 months after appliances were placed. Decalcification was assessed single blind on all labial surfaces of all erupted teeth before appliances were placed and 3 months after appliances were removed. The results of the gingivitis study indicated that the SnF2 gel group had significantly lower scores for the Plaque Index (p < 0.01) and the Gingival Index (p < 0.001) at all examinations during orthodontic treatment than did the control group. In the SnF2 gel group, one subject developed mild coronal staining and two subjects developed moderate staining. In the decalcification study, when pre-treatment levels of decalcification were subtracted from post-treatment values, significantly lower decalcification scores (p < 0.05) were found for both whole mouth and first molars in the NaF rinse and gel groups as compared with the control group (toothpaste alone).(ABSTRACT TRUNCATED AT 400 WORDS)

Adolescent↗

Fluoride dentifrices: current status and prospects.

Toothpastes have developed from the poorly effective formulations using incompatible abrasive systems to the highly effective products now being given credit for the decline in dental caries in most developed countries. The earliest toothpastes used sodium fluoride but this was soon replaced by stannous fluoride, sodium monofluorophosphate and amine fluoride. Monofluorophosphate has the advantage that it is compatible with a wide variety of abrasive systems. Although most toothpastes world-wide currently contain monofluorophosphate, sodium fluoride formulations are growing in availability because of the development of compatible abrasives. Clinical caries trials have indicated that, with proper formulation, there is little or no difference in effectiveness among toothpastes prepared with different fluoride agents, but that increasing the fluoride concentration will enhance the anti-caries effect. The addition of other active agents to fluoride toothpaste has been a relatively recent occurrence, and it is important to be assured that they do not interfere with the anti-caries activity of fluoride. Pyrophosphate, a calculus control agent, is one additive that was considered to be a potential problem; however, human and animal tests have shown that both caries and calculus inhibiting effects can be obtained from a single formulation. With the use of modern methodology to evaluate toothpaste formulations before clinical trials, many new products containing anti-calculus and other agents will probably become available in the coming years.

Dentifrices↗