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PubMed1995

Relative contribution of dental services to the changes in caries levels of 12-year-old children in 18 industrialized countries in the 1970s and early 1980s.

The contribution of health services to improvements in health is contentious. The main aim of the present study was to assess the relative contribution that dental services may have made to the changes in dental caries (decayed, missing or filled permanent teeth) level of 12-year-old children in some industrialized countries in the 1970s and early 1980s. A secondary aim was an analysis of the association of the changes in caries levels with broad socioeconomic factors. In this study aggregate (ecological) data from 18 industrialized countries were analyzed at a national level. Data were obtained from published papers and official publications and included 3 kinds of variables: caries, presence of dental service and broad socioeconomic factors (including fluoridated toothpastes). Dental services explained 3% of the variation in changes in 12-year-old caries levels in the 1970s and early 1980s period whereas broad socioeconomic factors (including or excluding fluoridated toothpastes) explained 65%. The findings suggest that dental services were relatively unimportant in explaining the differences in changes in 12 year-old caries levels in the 1970s and early 1980s in the 18 countries. The view that fluoride in toothpaste was the only important cause of the declines in decayed, missing or filled permanent teeth in industrialized countries was questioned. A possible important contribution of the dental services to the declines was a change in the diagnostic and treatment criteria of caries.

Australia↗
PubMed2004

Effective use of fluorides for the prevention of dental caries in the 21st century: the WHO approach.

Despite great improvements in the oral health of populations across the world, problems still persist particularly among poor and disadvantaged groups in both developed and developing countries. According to the World Oral Health Report 2003, dental caries remains a major public health problem in most industrialized countries, affecting 60-90% of schoolchildren and the vast majority of adults. Although it appears that dental caries is less common and less severe in developing countries of Africa, it is anticipated that the incidence of caries will increase in several countries of that continent, due to changing living conditions and dietary habits, and inadequate exposure to fluorides. Research on the oral health effects of fluoride started around 100 years ago; the focus has been on the link between water and fluorides and dental caries and fluorosis, topical fluoride applications, fluoride toothpastes, and salt and milk fluoridation. Most recently, efforts have been made to summarize the extensive database through systematic reviews. Such reviews concluded that water fluoridation and use of fluoride toothpastes and mouthrinses significantly reduce the prevalence of dental caries. WHO recommends for public health that every effort must be made to develop affordable fluoridated toothpastes for use in developing countries. Water fluoridation, where technically feasible and culturally acceptable, has substantial advantages in public health; alternatively, fluoridation of salt and milk fluoridation schemes may be considered for prevention of dental caries.

Child↗
PubMed1985

The future of the caries decline.

Dental caries declined in prevalence and severity among schoolchildren in the United States during the 1970s, although it still remains a problem in some areas. The decline could have started well before the 1970s, even though it was only recently identified. Caries should continue to decline as long as fluoride use remains around current levels. Use of fluoride toothpaste seems to be increasing. Sugar consumption is stable, although sucrose consumption as a proportion of total sugar consumption is declining. Increased tooth retention is thought to increase the risk of root caries in older persons, but the continued use of fluoride toothpaste should minimize any such increase. The main growth area for fluoride use may be in toothpastes. Monitoring caries trends in the future will require good data on the epidemiology of caries in young and middle-aged adults.

Adolescent↗
PubMed2003

Antimicrobial effects of a novel Triclosan/zinc citrate dentifrice against mixed culture oral biofilms.

AIM: To compare the antimicrobial efficacy in vitro of a new fluoride system containing 0.3% Triclosan and 2.0% zinc citrate with a standard fluoride toothpaste against bacteria commonly isolated from dental plaque. METHOD: Mature biofilms of fixed depth containing ten oral bacterial species were developed in a model system and then exposed to the formulations both in situ and ex situ. RESULTS: The standard fluoride toothpaste had limited activity against the Gram positive species following 1 and 5 minutes ex situ exposure (p = 0.004 and p = 0.02, respectively) but none against the Gram negative species; also, no overall effect following repeated pulsing in situ was observed. In contrast, viable counts of Gram positive and Gram negative species were markedly reduced following ex situ exposure for 1 and 5 minutes to the new formulation (Gram positive: p = 0.0007 and p = 0.04; Gram negative: p = 0.04 and p = 0.00001, respectively). Counts of Gram positive bacteria were reduced by 99.9% over a 4-day in situ pulsing period, while no Gram negative species were recoverable from the biofilm by day 4. CONCLUSION: The new toothpaste formulation had a broad spectrum of antimicrobial activity against biofilm consortia containing bacteria associated with both dental caries and periodontal diseases.

Anti-Infective Agents, Local↗
PubMedDate not supplied

Oral fluoride retention in saliva following toothbrushing with child and adult dentifrices with and without water rinsing.

Ten healthy adult volunteers were recruited to participate in this double-blind randomised 18-leg crossover designed study. The subjects either rinsed their mouth with 10 ml de-ionised distilled water for 10 s or just spat out once after 1-min brushing with one of nine different toothpastes: NaF (500, 1,000 and 1,450 ppm F), SMFP (525, 1,000, 1,450 ppm F), AmF (250, 1,400 ppm F) or fluoride-free dentifrice. Samples of whole mixed unstimulated saliva were collected at different time intervals. The results showed that the use of the AmF toothpaste (1,400 ppm F) resulted in the highest fluoride content of saliva without water rinsing after 120 min (0.52 ppm F, CI 0.23, 0.81). Two hours after brushing with fluoride toothpaste containing AmF and NaF, the salivary fluoride levels were still higher than baseline levels.

Adult↗
PubMed1994

Effect of water rinsing after toothbrushing on fluoride ingestion and absorption.

This investigation was done to determine the bioavailability of fluoride (F) after toothbrushing associated with different water rinsing procedures. Eight adult subjects participated in four experiments, conducted with a randomised, crossover design: (A) 2 min brushing with an F dentifrice, followed by three quick (3 x 2 s) rinses, each with 10 ml of water; (B) brushing as in A followed by one long-lasting (1 min) rinse with 5 ml of water combined with the toothpaste-saliva mixture; (C) brushing as in A followed by expectoration but without any water rinse afterwards; and (D) ingestion of the toothpaste as a slurry with 100 ml of de-ionized water. Blood samples were collected before and frequently for 6 h after each experiment and analyzed for F content. The area under the plasma F concentration vs. time curves (AUC) was calculated and the degree of F absorption estimated. AUC values obtained in experiment D were assumed to represent 100% F bioavailability. The plasma values recorded during experiment A were not significantly greater than the baseline values, indicating almost no F absorption when 3 quick water rinses were performed after toothbrushing. The degrees of F absorption after one long-lasting water rinse (B) were 7.6 +/- 4.2% and with no water rinse after toothbrushing (C) 23.8 +/- 13.5%, respectively. The results showed that the degree of F absorption after toothbrushing using an F toothpaste is strongly related to the mode of water rinsing.

Absorption↗
PubMed1990

The future of water fluoridation.

Recently, questions have been raised about the possible reduced effectiveness and cost-effectiveness of water fluoridation in the prevention of dental caries in developed countries. The increase in environmental fluorides since water fluoridation was first introduced in 1945 (particularly from fluoride toothpastes, mouthrinses, and from foods and drinks) generally provided the basis for these questions. A related phenomenon which might decrease the efficiency of water fluoridation is the reduced caries levels in many developed countries. It has also been suggested that excessive fluoride intake, especially in fluoridated communities where there is widespread use of fluoride toothpastes, is likely to manifest itself in an increased dental fluorosis prevalence. In this paper, recent data from Ireland which are similar to those recorded in many developed countries are used to answer these questions in part. It is concluded that water fluoridation continues to be an effective and cost-effective strategy for caries prevention in areas where the overall caries level has declined and where the cost of water fluoridation implementation has increased. Also, there is no evidence of excessive fluoride intake in fluoridated communities where fluoride toothpastes are widely used.

Adolescent↗
PubMed1992

The effect of study design on in situ treatment of carious enamel lesions.

The aim of this exploratory study was to investigate the influence of several factors on changes in the mineral content of carious enamel lesions treated in situ. The study involved 36 adult volunteers who used either a non-fluoride toothpaste or one of two fluoride toothpastes (1000 or 1500 ppm F). Human enamel specimens were prepared and attached to partial dentures as described previously (Schäfer, 1989) and treated in situ for between three and six weeks. The mineral content of lesions was determined by microradiography and computerized densitometry. The factors investigated in this study included study length, frequency of treatment, trial design, patient compliance, patient diet, and previous caries experience of the patient. The effects observed were small, relative to that of the treatment, and not statistically significant (p greater than 0.05). However, the trends in the data were all as would be intuitively predicted. Study duration correlated positively with observed lesion mineral content. Lesions worn by panelists using a fluoride toothpaste for six weeks contained greater levels of mineral with respect to placebo than did those in panelists on a three-week study. The residual variations in the three phases of the study were found to be similar, suggesting that there is no advantage in these studies having a cross-over design. Brushing frequency also correlated positively with observed lesion mineral content, with panelists brushing three times per day with a fluoridated dentifrice having lesions with greater levels of mineral, with respect to placebo, than those brushing twice per day. Overall, no clear relationship between reported diet and changes in lesion mineral levels was apparent.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1993

The plaque removal effects of single rinsings and brushings.

Chemical plaque removal is one mechanism whereby an agent could improve oral hygiene and gingival health. As with toothpastes most agents, when delivered as rinses, would be considered adjunctive to mechanical tooth cleaning procedures. The aim of this study was to determine whether selected commercial rinses exhibited clinically significant plaque removal properties alone or when combined with toothbrushing with water or a toothpaste. A group of 12 volunteers took part in this single blind, randomized placebo-controlled, 12 cell cross-over study, employing 6 rinses. During each regimen subjects accumulated plaque from a zero baseline over 72 hours. Plaque removal was then measured by index and area after first a single rinse of product and second a subsequent brushing with water or toothpaste. Prebrushing rinsing removed less than 5% of the plaque with little difference between agents. No rinse was more adjunctive than water to postrinse brushings. Most statistically significant differences arose with the chlorhexidine rinse being apparently less effective. However, the possibility of a disclosing dye interaction cannot be discounted as explaining this anomalous result. This study could not support any claim of a direct prebrushing rinse benefit greater than that provided by water to mechanical plaque removal by any of the products tested.

Adult↗
PubMed1978

Plaque-inhibiting effect of dentifrices containing stannous fluoride.

The present study showed that the plaque inhibiting effect of aqueous solutions of stannous fluoride can be maintained in toothpastes. A commercial toothpaste containing 0.4 per cent of water soluble tin was effective whereas one containing 0.03 per cent showed no effect. The plaque inhibiting effect was shown in one study where the toothpastes were applied in cap splints and the plaque was scored after four days by the Plaque Index of Löe, and in another where the effect of locally applied pastes was monitored 24 hours later by the Gingival margin Plaque Index of Harrap. The present investigation supports the view that the stannous ion is essential in the plaque inhibition caused by stannous fluoride preparation. The exact mechanism is unknown but it is speculated that a change in the surface potential of oral bacteria through interaction with the stannous ion may be important.

Chlorhexidine↗
PubMedDate not supplied

Effectiveness of bromochlorophene on gingival health.

The effect of a commercial toothpaste containing 0.2% bromochlorophene (BCP) on established plaque and gingivitis was compared with placebo. The two toothpastes were similar in packaging, taste, consistency, and color. Thirty-two patients with chronic gingivitis were enrolled in this randomized, double-blind comparison and were asked to brush twice a day with the given toothpaste without changing their oral hygiene habits. Plaque index, gingival index, gingival crevicular fluid, and papillary bleeding index were recorded at baseline and after 3 weeks. Significant decreases in gingival and papillary bleeding indices were noted in the BCP group, as compared with the placebo group. Plaque index significantly decreased in both groups. No significant change was noted in the volume of gingival crevicular fluid.

Alkaloids↗
PubMed2000

The effect of salt-containing dentifrices on gingival inflammation.

OBJECTIVE: This study examined the effect of an alkaline, salt-containing toothpaste, a toothgel of similar contents, and a conventional toothpaste on gingival inflammation. METHOD AND MATERIALS: One hundred fifteen patients suffering from mild to moderate chronic gingivitis were enrolled in a double-blind clinical study. All subjects had at least 20 teeth, probing depths of less than 6 mm, and a sulcular bleeding index of 50% or more. At the beginning of the study period, the subjects were randomly assigned to 3 study groups. The baseline examination recorded the number of decayed, missing, and filled teeth, an approximal plaque index, a sulcular bleeding index, and the gingival index. RESULTS: After an 8-week study period, statistically significant reductions in the plaque and bleeding indexes were observed in all 3 groups. There were no significant differences among the 3 dentifrices examined. CONCLUSION: The effectiveness of salt-containing dentifrices in patients with gingivitis was comparable to that of a conventional toothpaste.

Adult↗
PubMed2001

[Effects of mouthwashes on the structural characteristics of human mixed saliva].

Effects of TANA hygienic liquids on the structural characteristics of mixed saliva were studied in 9 subjects aged 15-20 years after tooth cleaning with Colgate and Pepsodent toothpastes. Tooth cleaning with Colgate paste led to structural changes in the saliva, but gargling with hygienic liquids "Soft Fluoride Gargling" and "Tartar Control" helped preserve its structure. Structural characteristics of the oral fluid were retained after tooth cleaning with Pepsodent toothpaste. Gargling with the above hygienic liquids after tooth cleaning with Pepsodent led to structural changes in the saliva or created conditions for such changes. "Fluoride Gargling for Children" used after tooth cleaning with both toothpastes promoted alkalization of the oral fluid, which can lead to lithogenesis in the oral cavity.

Adolescent↗
PubMed2005

Clinical evaluation of dentinal hypersensitivity treatment with 5% potassium nitrate dentifrice.

AIM: To evaluate the desensitizing effect of a Bulgarian-made dentifrice containing 5% potassium nitrate in a double-blind experiment. MATERIAL AND METHODS: The study included 40 clinically healthy individuals aged 23 to 60 years, who complained of increased sensitivity to thermal, chemical and mechanical stimuli in 462 teeth. The recruited patients were allocated into two groups: 20 patients were treated with the Sensi I dentifrice, and the other 20--the Sensi II dentifrice. The outcome of treatment was evaluated by any alteration in pain sensitiveness in response to different stimuli and changes in the threshold of electrical excitability. RESULTS: The Sensi I toothpaste (containing 5% potassium nitrate) was found to have a better desensitizing effect than the Sensi II placebo toothpaste (P < 0.01). The Sensi I dentifrice caused a rise in the threshold of electrical excitability of sensitive teeth with clinically intact enamel (P < 0.01), teeth with erosions (P < 0.05) and teeth with exposed root surfaces (P < 0.001). CONCLUSION: The Sensi toothpaste, containing 5% potassium nitrate, demonstrated a pronounced anesthetizing effect; it can be used successfully for treatment of dentinal hypersensitivity of teeth with clinically intact enamel, erosions and exposed root surfaces due to gingival recessions.

Adult↗
PubMed2006

Dental self-care and dietary characteristics of remote-living Indigenous children.

INTRODUCTION: Indigenous children in remote communities carry a disproportionate amount of the dental disease burden among Australian 4-12 year-olds. However, there have been no reports of dental service use, dental self-care or dietary characteristics among remote-living Indigenous children. This information may provide insight into behaviours linked with the high levels of dental disease observed. The purpose of this study was to examine such behaviours among Indigenous children in three remote communities in the Top End of the Northern Territory of Australia. The study is part of a wider investigation involving the implementation and monitoring of water fluoridation plants in two of the communities, and the collection of clinical dental data from children in these three and other remote communities. METHODS: In 2003, small-scale fluoridation plants were installed in two remote communities (Communities A and B) in the Top End of the Northern Territory with naturally low fluoride levels in the water and with a high prevalence of child dental disease. Another community (Community C) was selected as a comparison site (natural levels of water fluoride low). A convenience sample of carers of children from all communities completed a questionnaire that sought information on carer education and their children's age, sex, use of dental services, dental self-care behaviours, dietary characteristics, household water source and water consumption. The questionnaires were administered by a project worker and community residents once consent had been obtained. Data were analysed using SPSS version vers.13.0 (SPSS Inc; Chicago, IL, USA). RESULTS: Some 214 carers completed the questionnaire for 409 children aged 4-12 years; 131 (32.0%) from Community A, 158 (38.6%) from Community B and 120 (29.3%) from Community C. The response rates for the child survey based on Census data (generally regarded as an undercount) was 55% across the three communities. Approximately one-third of carers had had no secondary schooling or could not recall their level of educational attainment. Child age was reasonably spread over the target age-range and there were no significant differences between communities by sex. Approximately one-third of children were reported to have had their teeth checked every year by a dental therapist and most children were reported to use a toothbrush. While most children were also reported to use toothpaste, only 20% of such children reportedly used it every day. Time of toothpaste use was evenly distributed between morning and evening, with a small proportion of children reportedly using it twice a day. The most common age that toothpaste use began was 4 years and most children had never taken fluoride supplements. Over three-quarters of children who reportedly consumed softdrinks, cordial, milk or flavoured milk in the evenings drank such beverages at least a few evenings each week. Over 90% of children across the three communities who reportedly drank tea, and approximately three-quarters of those who consumed sweet snacks, did so at least a few evenings each week. Almost all houses were connected to the community water supply. Most children sourced their drinking water from a tap and approximately two-thirds were reported to drink more than 4 cups of water a day. CONCLUSIONS: Our study showed there were low levels of preventive dental care, irregular use of dentrifices, negligible implementation of alternative fluoride sources, high consumption of sweetened snacks and drinks in the evenings, and almost universal connection of houses to the public water supply among remote-dwelling Indigenous children. The findings provide some insights into factors contributing to the poor and declining state of such children's dental health, and should aid in the planning and implementation of oral health promotion initiatives.

Adolescent↗
PubMed1991

An assessment of Plax pre-brushing dental rinse used according to directions with supervised toothbrushing.

This study assessed the use of a pre-brushing rinse followed with toothbrushing with toothpaste in compliance with label directions. The treatment pre-brushing rinse was compared to a placebo pre-brushing rinse in a cross-over design. The study was started with 20 subjects. One subject developed a throat infection after the first session and was administered an antibiotic prescription and the data was not included in the analyses. No side effects or reactions to the solutions were observed or reported during or following the study. At baseline, the two groups were found to have similar plaque area scores on buccal, lingual, and total tooth surfaces. After rinsing with the pre-brushing solution (Plax) and brushing with an American Dental Association-approved toothbrush and a commercially-available fluoride toothpaste, there was significantly less plaque area when compared to the same regimen with the placebo pre-brushing rinse. For both buccal and lingual plaque area scores the differences were statistically significant at the p less than .05 level favoring Plax. On all surfaces the subjects removed significant amounts of plaque area following rinsing and brushing with toothpaste compared to their baseline scores.

Adolescent↗
PubMed1990

Antiplaque effects of dentifrices containing triclosan/copolymer/NaF system versus triclosan dentifrices without the copolymer.

A dentifrice containing triclosan/PVM/MA, Colgate Gum Protection Formula Toothpaste (GPF), was found to be highly effective against oral bacteria with minimal inhibitory concentration ranging from 0.3 to 5.35 micrograms/ml. A variety of in vitro model systems simulating oral environment were used to compare dentifrices containing triclosan/PVM/MA versus the dentifrices containing triclosan without PVM/MA, such as Crest Gum Health Toothpaste (CGH) and Neo-Mentadent P Toothpaste (N-MP). The uptake of triclosan on saliva-coated hydroxyapatite (HA) disks and buccal epithelial cells was significantly higher from the GPF versus the other dentifrices. Uptake on HA disks was 132 micrograms/disk versus 11 micrograms/disk from CGH; on buccal epithelial cells the uptake was 59 micrograms/2 x 10(5) cells with GPF versus 30.0 micrograms with CGH per same number of cells. The retained triclosan on the surfaces provided a sustained and higher antibacterial effect up to 4 hours post-treatment with GPF, but not with N-MP and CGH. In dynamic plaque model systems such as the chemostat or the controlled saliva flow system, GPF was significantly (P = 0.05) more effective than N-MP or CGH in reducing plaque thickness, protein and carbohydrate contents of plaque films. Collectively, the results of these microbiological and biochemical investigations indicate that the GPF has the potential to provide superior clinical efficacy versus the dentifrices without the copolymer.

Dental Plaque↗
PubMedDate not supplied

[Current and future prospects concerning the prevention of dental caries].

Caries is a disease which on the basis of numerous epidemiological data it should be possible to control. The preventive interventions which have proved to have the greatest effect on the diffusion of this disease are essentially: fluoroprophylaxis, oral hygiene, food hygiene and periodic dental examination. The common denominator, which has the greatest effect on success, is a good level of health education of the populations affected by the programme, with specific reference to the teeth. The importance of the diet as a possible element predisposing to caries is an ascertained fact by now, and in fact it is well known that the greatest cariogenic effect is achieved after eating foods containing large quantities of fermentable sugars at irregular intervals throughout the day, especially in the form of products of high density and viscosity. The proposal to replace sugar with substitutive sweeteners such as: xilitol, sorbitol, licasin, talin, palatinit and, more recently, aspartame does not completely solve the problem; and apart from this the clearcut reduction of caries achieved in different European and non-European countries does not appear to be directly connected with a drop in sugar consumption, while more and more importance is ascribed to individual food choices. Oral hygiene procedures aim not only at the cleaning of teeth but also, to some extent, controlling the bacterial plaque. For this reason these are sometimes included among anticaries interventions; however opinions differ in this regard, with a clear prevalence of negative views. The question changes radically if we combine with mechanical procedures alone the use of fluoride-based toothpastes, which are recognised, in combination with other interventions, as playing a fundamental role in the rapid decline of caries in industralised countries. Toothpaste is considered as an excellent vehicle for the topical application of fluoride since it comes into contact with the teeth is slight concentrations only (of about 20 p.p.m.) but at high frequency, the latter constituting a decisive factor for the success of prevention. Furthermore, especially in the case of small children, it acts not only topically but also at systemic level, since in fact part of the toothpaste is swallowed, with consequent passing of the fluoride into the circulation. Undoubtedly the most valid anticaries prophylaxis is fluoroprophylaxis which may be achieved following different methods. Fluoration of water is the most widespread form of administration of fluoride systemically and also the most appropriate since it supplies small but continuous doses of fluoride.(ABSTRACT TRUNCATED AT 400 WORDS)

Adult↗