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PubMed2005

Comparison of two cleansing pastes for the removal of biofilm from dentures and palatal lesions in patients with atrophic chronic candidiasis.

The efficacy of 2 oral hygiene products, an experimental toothpaste specific for complete denture cleansing and a regular standard toothpaste, was compared in terms of denture biofilm removal and cure of palatal lesions in patients with atrophic chronic candidiasis. The degree of correlation between presence of biofilm and mucosa erythema was also evaluated. Twenty-four complete denture wearers (45-80 years old) were divided into 2 groups: experimental paste and standard toothpaste (Sorriso-Kolynos, Brazil). Both groups received soft toothbrushes. The internal surfaces of upper dentures were stained using 1% sodium fluorescein and photographed at a 45 masculine angle at 0, 15, 30 and 60 days. The slides were scanned and the areas of interest (denture total area and biofilm area) were measured (Image Tool software). The degree of erythema was evaluated on slides according to the Prosthesis Tissue Index. There was a significant reduction (1%) in the degree of biofilm (ANOVA/Tukey) between the two initial visits (0 and 15 days) and the two final visits (30 and 60 days), and in the average erythema scores (Kruskal-Wallis) between 0 and 60 days, in both groups. The Mann-Whitney test showed a significant difference (1%) between pastes in terms of biofilm degree, but no difference was found for the erythema score. Correlation values between biofilm and erythema degree were 0.3801 (experimental paste) and (0.3678 (standard toothpaste). We may therefore conclude that the experimental product was efficient for the removal of denture plaque biofilm.

Aged↗
PubMed1998

Evaluation of the effects of brushing on the removal of dental plaque.

The ability of three different toothpaste abrasive systems--sodium bicarbonate, hydrated silica, and dicalcium phosphate--to remove dental plaque has been examined. A total of 34 volunteers participated in an independent, double-blind, crossover clinical investigation that compared the amount and percentage of plaque removed with a single brushing with Arm & Hammer Dental Care (sodium bicarbonate), Crest Regular Toothpaste (hydrated silica), and Colgate Regular Toothpaste (dicalcium phosphate) after 48 hours of limited oral hygiene. All three dentifrices removed from 58% to 68% of plaque, but the percentage removed after brushing with Arm & Hammer Dental Care was significantly greater than with either Crest (p = 0.0001) or Colgate (p = 0.0002) during a controlled, 1-minute toothbrushing. The mean amount of plaque removed with Arm & Hammer Dental Care was also significantly greater than that with Crest or Colgate (p = 0.0002 and p = 0.0004, respectively). These results indicate that the abrasive system in Arm & Hammer Dental Care was the most efficient in removing plaque and improving oral hygiene. In the second half of the study, Arm & Hammer Dental Care was compared with Arm & Hammer Peroxicare and Mentadent toothpaste in 45 subjects. All three dentifrices removed from 57% to 70% of the plaque, with Arm & Hammer Dental Care removing significantly more than Mentadent (p = 0.007).

Adolescent↗
PubMed1999

The clinical effectiveness of a dentifrice containing triclosan and a copolymer for providing long-term control of breath odor measured chromatographically.

The objective of this double-blind clinical study was to investigate the effectiveness of a commercially available dentifrice containing triclosan and a copolymer (Colgate Total Toothpaste) for controlling long-term, i.e., seven-hour and overnight breath odor. In particular, a comparison was made between the level of control of breath odor provided by the test dentifrice, and that provided by a placebo dentifrice which did not contain triclosan or a copolymer. This study followed a two-treatment, two-period crossover design. Prospective subjects were provided with a supply of a commercially available fluoride dentifrice, which was used for a one-week period prior to the two seven-day treatment periods. During each treatment period, subjects were instructed to brush their teeth twice a day, morning and evening, for sixty seconds with their assigned study dentifrice, using the soft-bristled toothbrush which had been provided. On the morning following the seventh day of each treatment period, subjects reported to the clinical facility for overnight breath odor assessments. Directly following this, subjects brushed their teeth, ate and drank normally, and reported once again to the clinical facility at seven hours post-toothbrushing for another breath odor assessment. Prior to the overnight breath odor assessments, subjects refrained from brushing their teeth, rinsing their mouths or using breath mints, and from eating or drinking anything on the morning of the evaluation. Subjects refrained from the use of tobacco products, and from eating onions, garlic, or strong spices throughout the entire study. Breath odor was instrumentally evaluated by measuring the level of volatile sulfur compounds in the mouth air using a 565 Tracor gas chromatograph equipped with a flame photometric detector. Measurements were taken in duplicate, and then averaged. Levels of volatile sulfur compounds were expressed in nanograms per milliliter (ng/ml) of mouth air. The two dentifrices exhibited statistically significant differences (p < 0.05) with respect to both overnight breath odor and seven-hour post-toothbrushing breath odor. The mean overnight breath odor scores were 9.63 ng/ml for Colgate Total Toothpaste, and 12.64 ng/ml for the placebo dentifrice. For seven-hour breath odor, the mean scores were 5.62 ng/ml for Colgate Total Toothpaste, and 7.10 ng/ml for the placebo dentifrice. Thus, the results of this double-blind clinical study on 19 subjects support the conclusion that Colgate Total Toothpaste provides effective seven-hour and overnight control of breath odor.

Adult↗
PubMed2004

Plaque reduction over time of an integrated oral hygiene system.

This article compares the efficacy of a prototype integrated system (the IntelliClean System from Sonicare and Crest) in the reduction of supragingival plaque to that of a manual toothbrush and conventional toothpaste. The integrated system was compared to a manual toothbrush with conventional toothpaste in a randomized, single-blinded, parallel, 4-week, controlled clinical trial with 100 subjects randomized to each treatment group. There was a low dropout rate, with 89 subjects in the manual toothbrush group (11% loss to follow-up) and 93 subjects in the integrated system group (7% loss to follow-up) completing the study. The Turesky modification of the Quigley and Hein Plaque Index was used to assess full-mouth plaque scores for each subject. Prebrushing plaque scores were obtained at baseline and at 4 weeks after 14 to 20 hours of plaque accumulation. A survey also was conducted at the conclusion of the study to determine the attitude toward the two oral hygiene systems. The integrated system was found to significantly reduce overall and interproximal prebrushing plaque scores over 4 weeks, both by 8.6%, demonstrating statistically significant superiority in overall plaque reduction (P = .002) and interproximal plaque reduction (P < .001) compared to the manual toothbrush with conventional toothpaste, which showed no significant reduction in either overall plaque or interproximal plaque. This study demonstrates that the IntelliClean System from Sonicare and Crest is superior to a manual toothbrush with conventional toothpaste in reducing overall plaque and interproximal plaque over time.

Adolescent↗
PubMed2004

Pharmacodynamic and pharmacokinetic effects in gingival crevicular fluid from re-dosing during brushing.

The IntelliClean System from Sonicare and Crest combines a rechargeable sonic power toothbrush and a novel liquid toothpaste into one integrated system, providing the opportunity to re-dose with toothpaste during the brushing cycle. The purpose of this study was to investigate cleaning effects from in-mouth re-dosing with toothpaste during the brushing cycle vs conventional bolus dosing. This was a randomized, examiner-blind, six-period, crossover clinical study. Eighteen adult subjects used an experimental integrated system employing either a re-dosing regimen (2 doses at the start of brushing with 1 additional in-mouth dose during the last 30 seconds of brushing [2+1]) or a conventional regimen (2 doses at the start of brushing only [2+0]). Gingival crevicular fluid (GCF) was sampled at the final brushing quadrant from a preselected site in the gingival sulcus using filter strips at baseline and at 4, 15, and 120 minutes postbrushing. Mean change from baseline in the concentrations of total facultative anaerobes (TFAs) and gram-negative anaerobes (GNAs) in the GCF at 120 minutes posttreatment were modeled separately using general linear mixed models. Area under the curve of surfactant (sodium dodecyl sulfate [SDS]) in GCF over 2 hours postbrushing was calculated and modeled using an analysis of variance model. All hypotheses were tested 2-sided at the 5% significance level. Relative to the conventional regimen, the re-dosing (2+1) regimen produced a significantly greater reduction in log10 (TFA colony-forming units [CFU]/microL GCF) after brushing, 0.99+/-0.12 vs 0.65+/-0.12 (mean change +/- standard error), and a significantly greater reduction in log10 (GNA CFU/microL GCF) after brushing, 0.75 +/-0.14 vs 0.45 +/- 0.14. The re-dosing regimen led to significantly more SDS in GCF relative to the conventional regimen over the 2-hour time period. Re-dosing of liquid toothpaste during the brushing cycle with the IntelliClean System leads to a significantly increased cleaning effect, as defined by a reduced bacterial count in GCF, and significantly higher levels of surfactant in the GCF up to 2 hours after the brushing event.

Adult↗
PubMed1991

The effect of oral topical fluorides on the surface of commercially pure titanium.

This study investigated the risk of corrosion of titanium abutments by the accidental or unauthorized use of preventive fluorides in the mouth. Polished test pieces of commercially pure ASTM grade 1 titanium were immersed in topically used fluorides (toothpaste, gel, and varnish). They were brushed in vitro with toothpaste and gel, corresponding to the time and effect of brushing with toothpaste twice a day for 6 years and with gel once a week for 12 years. Results indicate that an aminofluoride toothpaste with low ionizable fluoride content (0.125%) used in brushing natural teeth does not cause deterioration of the titanium abutments in the same mouth if the titanium is grade 1 purity. Carefully controlled use of fluoride gel (F 1.25%) and varnish (F 2.25%) is likewise not dangerous. The mechanical abrasion caused by toothbrush bristles appears to be the main deteriorating factor for the titanium surface.

Corrosion↗
PubMed1991

A study of developmental defects in enamel in 10-year-old high social class children residing in a non-fluoridated area.

This study investigated the relationship between reported exposure to fluoride in the form of toothpaste and fluoride supplements, the level of observed developmental defects in enamel and the caries experience in a sample of 10-year-old children. Using a modified and simplified version of the developmental defects of enamel index, 300 10-year-old children who had been continually resident in non-fluoridated high social class areas were examined. The examination was followed by a questionnaire to parents on their child's fluoride supplement and toothpaste usage, and toothbrushing habits in early childhood. The prevalence of developmental defects in enamel was lower than that reported elsewhere. A large number of children had diffuse developmental defects but had no history of exposure to fluoride supplements. The only differentiating factor between this group and a similar group with no diffuse defects was in the amount of toothpaste dispensed during toothbrushing prior to the age of six. There was no association between caries experience and the presence or absence of developmental defects. It was concluded that parents of children from a high social class background should supervise the brushing of their children's teeth and use only a pea-sized amount of toothpaste.

Age Factors↗
PubMed1985

Lustre changes on teeth. The use of laser light for reflexion measurements on the tooth surface--in vivo.

Lustre changes on teeth in vivo were studied with the use of equipment based on a helium-neon gas laser. Variations of the intensity of laser light reflected from the tooth surface were measured under different conditions of accumulation and removal of deposits, which were assumed to consist mainly of the pellicle. The possibility of using fluoride varnish as an artificial surface layer in this kind of investigation was also tested but rejected. Measurements were made after toothbrushing with water alone and with two toothpastes possessing different degrees of abrasivity. Teeth that had been left without toothbrushing for 24 hours showed statistically significant (p less than 0.05) lower light reflexion values than those recorded immediately after the teeth had been brushed with a toothpaste. During a period of seven months, persons brushing their teeth with water alone generated lower intensity values than did those brushing with the two toothpastes. The more abrasive paste yielded the highest intensity values, indicating a more polished or cleaner surface. The results suggest that the use of a toothpaste containing abrasives contributes to the cleaning effect of toothbrushing.

Adult↗
PubMed2005

The effective use of fluorides in public health.

Dental caries remain a public health problem for many developing countries and for underprivileged populations in developed countries. This paper outlines the historical development of public health approaches to the use of fluoride and comments on their effectiveness. Early research and development was concerned with waterborne fluorides, both naturally occurring and added, and their effects on the prevalence and incidence of dental caries and dental fluorosis. In the latter half of the 20th century, the focus of research was on fluoride toothpastes and mouth rinses. More recently, systematic reviews summarizing these extensive databases have indicated that water fluoridation and fluoride toothpastes both substantially reduce the prevalence and incidence of dental caries. We present four case studies that illustrate the use of fluoride in modern public health practice, focusing on: recent water fluoridation schemes in California, USA; salt fluoridation in Jamaica; milk fluoridation in Chile; and the development of "affordable" fluoride toothpastes in Indonesia. Common themes are the concern to reduce demands for compliance with fluoride regimes that rely upon action by individuals and their families, and the issue of cost. We recommend that a community should use no more than one systemic fluoride (i.e. water or salt or milk fluoridation) combined with the use of fluoride toothpastes, and that the prevalence of dental fluorosis should be monitored in order to detect increases in or higher-than-acceptable levels.

Adolescent↗
PubMed1994

Effect of rotary electric toothbrush versus manual toothbrush on decalcification during orthodontic treatment.

The purpose of this study was to determine whether daily use of a rotary electric toothbrush (Rota-dent, Prodentec Corp., Batesville, Ark.) and a 0.05% sodium fluoride (NaF) rinse would significantly reduce decalcification when compared with manual toothbrushing only (control group) or manual toothbrushing and daily use of a NaF rinse (rinse group). All three groups used a standard fluoride toothpaste. Ninety consecutive adolescent patients who were to receive orthodontic treatment were placed into one of three groups according to age and sex criteria. Decalcification was evaluated single blind by two calibrated examiners on the facial surfaces of all permanent teeth before appliances were placed (baseline) and 3 months after appliances were removed (posttreatment). Data were analyzed by analysis of covariance with the dependent variable derived by subtracting the baseline decalcification scores from the posttreatment scores and using the baseline scores as the covariate. The results showed that although there were no significant differences between the three groups at baseline, the Rota-dent group showed significantly (p < 0.05) less posttreatment decalcification than either the control or rinse groups. In a separate analysis of first molars, the Rota-dent group again showed the least decalcification and the control group showed the most. These data suggest that twice daily use of the Rota-dent electric toothbrush with a standard fluoride toothpaste and once daily use of a 0.05% NaF rinse is more effective for preventing decalcification in adolescents during orthodontic treatment with fixed appliances than either conventional toothbrushing with a fluoride toothpaste, or similar toothbrushing and toothpaste with a once daily NaF rinse.

Adolescent↗
PubMed2006

Clinical monitoring of the effect of fluorides on long-existing white spot lesions.

The aim of this examiner-blind, clinical monitoring was to observe long-existing white spot lesions over a period of 6 months and to evaluate the effectiveness of fluoridated toothpastes on these lesions. Thirty-nine subjects with at least one lesion participated in the study. They were randomly divided into two groups (n=20 and n=19) and instructed to brush their teeth either with toothpaste containing sodium fluoride (1500 ppm) (group 1) or with toothpaste containing amine fluoride (1250 ppm) (group 2). Lesions were measured with quantitative light-induced fluorescence (QLF) and alterations were quantified by DeltaQ as fluorescence loss integrated over the lesion area (% x mm(2)). All QLF images were taken by one examiner at baseline (DeltaQ1) and follow-up visits after 2, 4, 6, 8, 10, and 12 weeks, and after 4, 5, and 6 months (DeltaQ10). The results showed a slight but not significant progression of DeltaQ (% x mm(2)) in group 1 ((p>0.05; t-test), DeltaQ1 -20.31 (+/-41.06); DeltaQ10 -26.2 (+/-47.69)) and in group 2 ((p>0.05), DeltaQ1 -22.28 (+/-43.86); DeltaQ10 -26.39 (+/-46.4)). The results indicated no significant differences regarding the influence of the fluoridated toothpastes (p>0.05). It can be concluded that within 6?months the long-existing white spot lesions are stable concerning fluorescence loss over the lesion area. Moreover, fluoride does not seem to have any effect on long-existing white spot lesions.

Adolescent↗
PubMedDate not supplied

Fluoride concentration in saliva after use of oral hygiene products.

The purpose of this in vivo, single-blind, randomized study was to compare fluoride concentrations in saliva of patients treated with oral hygiene products containing different fluoride salts. The study involved 104 students attending the University of Sassari. Participants were subdivided: group A used a sodium monofluorophosphate (NaMFP) toothpaste; groups B and C used an amine fluoride (AmF) toothpaste; group D used a toothpaste and a mouthwash both based on AmF, and group E used a toothpaste and a varnish both on an NaMFP base. Samples of unstimulated saliva were collected at baseline (t(0)), at the end of the 20 days' treatment phase (t(1)) and after 24 h, during which the volunteers refrained from any oral hygiene measure (t(2)). Saliva fluoride concentrations were measured using an ion-specific electrode. All measurements were made in triplicate and analysed statistically using ANOVA. In saliva, the mean fluoride concentration increased significantly in each treatment group. In conclusion, the fluoride concentration in saliva can be maintained to an optimal therapeutic level with the regular use of fluoridated products.

Adult↗
PubMedDate not supplied

An in situ investigation into the abrasion of eroded dental hard tissues by a whitening dentifrice.

This crossover study aimed to investigate abrasion of previously eroded hard dental tissues by a whitening dentifrice compared to a regular dentifrice. After a 3-day lead-in period, 14 volunteers were randomly assigned to use one of the toothpastes while wearing a removable appliance, containing 3 enamel and 3 root dentine slabs on each side. On the first day salivary pellicle was allowed to form. Twice daily for the following 3 days, one side of each appliance was immersed in an acidic carbonated drink ex vivo while the other side remained unexposed. Specimens were then brushed with the allocated dentifrice. After a 3-day washout period, new sets of enamel and dentine slabs were mounted in the appliances and the participants commenced period 2 using the alternative toothpaste. Acid-treated specimens always showed more wear than untreated specimens. The whitening dentifrice did not significantly increase the wear of softened enamel compared with the regular dentifrice. Brushing with the whitening toothpaste led to significantly greater wear of sound enamel and of both eroded and sound dentine than the regular dentifrice. The results suggest that whitening dentifrices may not increase the wear of acid-softened enamel but may have a more deleterious effect on dentine than regular toothpastes.

Adult↗
PubMed2006

Prevention of erosion and abrasion by a high fluoride concentration gel applied at high frequencies.

The aim of this study was to determine maximum attainable protection of enamel from erosion and erosion abrasion using a highly fluoridated gel with and without additional fluoride from toothpaste. Thirty-six bovine enamel specimens were subjected to six erosive attacks per day (1% citric acid with pH 2.3 for 30 s), while the rest of the day the specimens were in artificial saliva. There were four treatment groups (9 specimens in each group): fluoride-free toothpaste/saliva slurry twice daily (group T0), fluoride-containing toothpaste/saliva slurry twice daily using 1,250 ppm F toothpaste (group TF), fluoride-containing toothpaste/saliva slurry twice per day plus application of a highly fluoridated gel (12,500 ppm F) twice a day for 120 s (group 2F) and a group with gel application 8 times a day (group 8F). Additionally, half of each specimen in all groups was subjected to brushing abrasion during application of the toothpaste/saliva slurry. Brushing abrasion alone led to no observable enamel loss measured with profilometry. After 14 days of cycling of erosion without toothbrushing abrasion, high-fluoride gel application 2 or 8 times daily showed significantly less enamel loss (median 24/19 microm) than with toothpaste with or without fluoride (41/45 microm). After 14 days of cycling of erosion and toothbrushing abrasion, gel application 2 or 8 times daily (33/29 microm) showed significantly less enamel loss than toothpaste with or without fluoride (57/62 microm). We conclude that a highly fluoridated acidic gel is able to protect enamel from erosion and toothbrushing abrasion while fluoridated tooth paste provides little protection.

Amines↗
PubMed1993

Control of calculus formation by a dentifrice containing calcium lactate.

The aim of this study was to re-investigate the anticalculus effects of calcium lactate. To this end calcium lactate was incorporated into experimental toothpastes. Three groups of 20 human volunteers brushed their teeth at least twice daily with three different toothpastes: (1) one containing calcium lactate, (2) one containing calcium lactate plus sodium lauryl sulphate, and (3) a control toothpaste. Plaque accumulation, gingival bleeding and calculus formation were scored at the beginning and at the end of the 3-month experimental period. After the first clinical examination the dentition was professionally cleaned to remove all dental deposits. The use of the calcium lactate containing toothpastes had no significant effects on plaque accumulation and gingival bleeding. However, calculus scores were significantly reduced in the calcium lactate groups at the end of the experiment. The results confirm and extend previous findings that the topical use of calcium lactate reduces calculus formation by, as yet, unexplained mechanisms.

Adolescent↗
PubMed1998

Clinical comparison of two tartar control dentifrices: a twelve-week study.

The objective of this double-blind clinical study was to investigate the anticalculus efficacy of a new improved tartar control dentifrice formulation containing tetrasodium pyrophosphate, sodium tripolyphosphate, PVM/MA copolymer and 0.243% sodium fluoride in a silica base (New and Improved Colgate Tartar Control Fluoride Toothpaste with Micro-Cleaning Crystals) as the test dentifrice, compared to a previously marketed, American Dental Association-accepted, tartar control dentifrice formulation containing tetrasodium pyrophosphate, PVM/MA copolymer and 0.243% sodium fluoride in a silica base (Colgate Tartar Control Fluoride Toothpaste with Micro-Cleaning Crystals), as the positive control dentifrice. Adult male and female subjects 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 two 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 the formation of supragingival dental calculus were performed after twelve-weeks' use of the study dentifrices. Seventy-three (73) subjects complied with the protocol and completed the entire study. At the 12-week examination, the test dentifrice group exhibited a statistically significant (p < 0.0008) 44.1% reduction in the mean Volpe-Manhold calculus index score compared to the mean calculus scores of the previously marketed, positive control dentifrice group. Thus, the results of this clinical study support the conclusion that the New and Improved Colgate Tartar Control Fluoride Toothpaste with Micro-Cleaning Crystals is more efficacious in controlling the development of supragingival calculus formation than the previously marketed Colgate Tartar Control Fluoride Toothpaste with Micro-Cleaning Crystals.

Adolescent↗
PubMed2000

Comparative anticaries efficacy of sodium fluoride and sodium monofluorophosphate dentifrices. A two-year caries clinical trial on children in New Jersey and Puerto Rico.

PURPOSE: To provide a head-to-head comparison of the anticaries efficacy associated with two commercially-available and American Dental Association-accepted dentifrices: Crest Cavity Fighting Toothpaste with Fluoristat, containing 0.243% sodium fluoride in a silica base, and Colgate Great Regular Flavor Fluoride Toothpaste, containing 0.76% sodium monofluorophosphate in a dicalcium phosphate dihydrate base. The study was conducted in harmony with the published 1988 American Dental Association guidelines for studies geared toward this purpose. MATERIALS AND METHODS: The study employed a double-blind, parallel-groups, multi-center two-treatment design, and involved third, fourth, and fifth grade schoolchildren from Newark, New Jersey, and from the Cidra and Lares areas of Puerto Rico. Qualifying subjects were stratified according to age and sex, and 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. 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 the presentation of educational films and lectures at school, by semi-annual mailings to parents, and through the periodic distribution of small novelty gifts along with the dentifrice deliveries, in order to enhance the interest and enthusiasm of study participants. Post-baseline examinations were performed after 1 and after 2 yrs of product use. Two thousand four hundred seventy-nine (2,479) subjects completed this 2-yr study. For these subjects, the mean (S.D.) DFS scores at baseline were 2.77 (3.35) for the Crest group, and 2.66 (3.18) for the Colgate group. For caries increment after 1 yr, the respective means were 1.68 (2.53) and 1.70 (2.57). After 2 yrs, the mean caries increments were 3.56 (4.11) for the Crest group, and 3.56 (4.05) for the Colgate group. RESULTS: The analysis of the 2-yr caries increment scores support the conclusion that the anticaries efficacy associated with Colgate Great Regular Flavor Fluoride Toothpaste is equivalent to that associated with Crest Cavity Fighting Toothpaste with Fluoristat, in accordance with the procedures and standards provided by the published guidelines of the American Dental Association. Further, consistent with those same standards, the results of this study serve to lend additional support to the conclusion that dentifrices formulated with sodium monofluorophosphate provide an equivalent level of anticaries efficacy as to those formulated with sodium fluoride.

Calcium Phosphates↗
PubMed2006

Tooth brushing, tooth wear and dentine hypersensitivity--are they associated?

Evidence suggests that patients suffer the painful symptoms of dentine hypersensitivity when dentine is exposed and the dentinal tubule system is opened to the oral cavity to allow stimuli to trigger a neural response in the pulp via a hydrodynamic mechanism. The processes needed to localise lesions of dentine hypersensitivity include loss of enamel and/or gingival recession. Whilst tooth brushing with or without toothpaste appears to cause minimal wear to enamel (in the absence of acids), circumstantial evidence implicates tooth brushing with gingival recession and exposure of dentine. Other tooth wear processes, notably attrition and acid erosion, cause loss of enamel and can expose dentine. Therefore, sensitivity may result. How lesions of dentine hypersensitivity are initiated is a matter of conjecture and based on extrapolating data from studies, mainly in vitro, to effect in vivo. Again, this circumstantial type of evidence suggests that abrasion by some toothpastes and erosion by dietary acid could open the tubule system. Little is known about the actual effect of de-sensitising toothpastes on lesions of dentine hypersensitivity even though they are formulated to either occlude dentinal tubules or block the neural response in the pulp. Clinical studies have produced contradictory findings for the efficacy of products and there have been extremely few evidence-based reviews. In conclusion, available evidence supports a probable link of tooth brushing, with or without toothpaste and an acidic diet, to both tooth wear and dentine hypersensitivity, and also suggests that dentine hypersensitivity is a tooth wear phenomenon. Although there is a need for more direct clinical and scientific evidence for these associations, it is recommended that they be taken into consideration when planning management strategies for the dentine hypersensitivity sufferer.

Journal Article↗