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PubMed2004

Clinical study to compare the effectiveness of a test whitening toothpaste with a commercial whitening toothpaste at inhibiting dental stain.

AIMS: A single centre, randomised single-blind, three-way crossover study was performed, to compare the effect of an experimental test toothpaste with a commercially available whitening toothpaste and water control at inhibiting extrinsic stain promoted by repeated chlorhexidine/tea rinses. METHODS: This study used 23 subjects. During the week before the study the subjects received a prophylaxis to remove all staining, plaque and calculus deposits. On the Monday of the following week subjects returned to the clinic to receive their rinses and to check their dentition was stain free. Under direct supervision at both 09:00 and 13:00 hours they rinsed with either a toothpaste slurry or water control that was repeated daily up to and including the following Thursday. Additionally from the Monday to the Thursday each subject rinsed with a 0.2% chlorhexidine mouthrinse, immediately followed by a rinse with a warm black tea solution. This cycle was repeated hourly eight times throughout the day and on the following days until the Friday. Throughout this period volunteers omitted all other forms of oral hygiene except rinsing with the chlorhexidine mouthwash. On the Friday the level of stain on the teeth and dorsum of tongue was assessed using the Lobene stain index for both stain area and intensity. At the end of each trial period each subject received a thorough prophylaxis to remove all plaque, calculus and staining before starting the second and third period of the study. RESULTS: As expected appreciable amounts of extrinsic stain accumulated on the teeth over each study period. The amount of stain following use of the toothpastes and water control was least with the experimental toothpaste, followed by water control and lastly the commercial whitening paste. For all sites combined there was evidence that the experimental paste was significantly superior to both the commercial paste and water control at reducing stain area (p<0.001), a product of stain area and intensity (p<0.001 and 0.05, respectively) but not stain intensity (p>0.05). CONCLUSIONS: In this stain-prevention model the use of an experimental paste showed a significant reduction in stain accumulation on the teeth compared with a (placebo) negative water control and a commercially available whitening paste. As such the experimental paste would be expected to be of benefit in controlling extrinsic dental staining.

Adult↗
PubMed2005

A 0.05% cetyl pyridinium chloride/0.05% chlorhexidine mouth rinse during maintenance phase after initial periodontal therapy.

BACKGROUND: Chlorhexidine (CHX) mouth rinse/spray can still be considered the gold standard in the chemical prevention of plaque formation and development of gingivitis. The product unfortunately has some side effects, such as extrinsic tooth staining, poor taste, taste disturbance, sensitivity changes in tongue, pain and irritation because of the alcohol content. These side effects led to the search of new formulations. METHODS: In this double-blind, randomized, long-term, parallel study, 48 moderate periodontitis patients rinsed for 6 months (starting immediately after a "one-stage, full-mouth" disinfection) with one of the following products: CHX 0.2%+alcohol (Corsodyl), CHX 0.05%+ cetyl pyridinium chloride (CPC) 0.05% and no alcohol (Perio-Aid Maintenance, a new formulation), or the placebo of the latter. After 1, 3 and 6 months a series of clinical and microbiological parameters were recorded for the supra- and subgingival area as well as for saliva. RESULTS: Although there was a significant treatment impact (mechanical debridement) in all groups, both CHX solutions further decreased both plaque and gingivitis indices (p<0.001 and p<0.05, respectively), when compared with placebo. This was also reflected by additional reductions in the number of CFU/ml of aerobic and especially anaerobic species and by a suppression of Streptococcus mutans (versus an overgrowth for the placebo), in all niches. Differences between both CHX solutions were never encountered. The subjective ratings were slightly in favour of the new CHX-CPC formulation when compared with the other CHX-alcohol formulation, especially for taste of the product (p<0.05), but less impressive for the staining of teeth and tongue. CONCLUSIONS: The results of this study demonstrated the potential of a new CHX 0.05%+CPC 0.05% non-alcoholic formulation as an effective antiplaque agent for long-term use with reduced subjective side effects.

Anti-Infective Agents, Local↗
PubMed2005

The effect of a dentifrice and mouth rinse combination containing amine fluoride/stannous fluoride on plaque and gingivitis: a 6-month field study.

AIM: To examine the effect of amine fluoride/stannous fluoride (AmF/SnF(2))-containing dentifrice and mouth rinse on plaque formation and gingivitis as compared with habitual oral hygiene procedures with a regular sodium fluoride (NaF) dentifrice. MATERIAL AND METHODS: In total, 22 general practices participated in this research project. The participants (N=281) were randomly assigned into two groups: the test group received an AmF/SnF(2) dentifrice-mouth rinse combination and the control group received a NaF-containing dentifrice. The patients were requested to brush twice daily for approximately 2 min. The subjects of the test group had to rinse additionally in the evening for 30 s with 10 ml of the mouth rinse. RESULTS: Both groups started with comparable scores of plaque, bleeding and staining. At 6 months, the plaque scores were 0.95 for the AmF/SnF(2) group and 0.99 for the NaF group (decrease of 16% and 10%, respectively). Bleeding scores, although significantly different from baseline, did not show differences between the two regimes. At the end of the experimental period, the overall staining was more pronounced in the AmF/SnF(2) group (41%) than the NaF group (26%). Both plaque reduction and increase in staining seemed to be correlated to the amount of mouth rinse used in the test group. CONCLUSION: In instruction-resistant patients recruited from dental practices, the combined use of AmF/SnF(2) did not decrease gingivitis at a significant level in comparison with the regular regime of two times daily brushing with an NaF-containing dentifrice. However, the above-mentioned combination resulted in greater plaque reduction than that observed with the use of the conventional dentifrice. When used according to the manufacturer's instructions, this effect on plaque scores was more pronounced.

Adult↗
PubMed2006

A review of the effects of stannous fluoride on gingivitis.

AIM: To review the literature on the effects of stannous fluoride on gingivitis. MATERIAL AND METHODS: The Medline and cochrane central register of controlled trials were searched up to August 2005 to identify appropriate studies. The primary outcome measure was gingivitis. RESULTS: Independent screening of titles and abstracts of 542 papers resulted in 36 publications (inter-reviewer ê score of 0.76), out of which 15 papers finally fulfilled the criteria of eligibility. For SnF(2)dentifrices, a statistically significant reduction in gingivitis was noted in comparison with control (weighted mean difference (WMD) of 0.15 (gingival index) and 0.21 (gingivitis severity index) (test for heterogeneity p<0.00001, I(2)=91.1% and p=0.03, I(2)=80.1%, respectively)). With regard to plaque reduction inconsistent results existed. On using the plaque index no differences were found, whereas meta-analysis of the Turesky index provided a WMD of 0.31 (p=0.01, test for heterogeneity p<0.0001, I(2)=91.7%). Because of insufficient data, a meta-analysis for SnF(2)mouth rinse and dentifrice/mouthrinse formulations was not performed. CONCLUSIONS: The use of SnF(2) dentifrices results in gingivitis and plaque reduction when compared with a conventional dentifrice. The precise magnitude of this effect was difficult to assess because of a high level of heterogeneity in study outcomes.

Dental Plaque↗
PubMed2006

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

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

Adolescent↗
PubMed2006

Effect of two new chlorhexidine mouthrinses on the development of dental plaque, gingivitis, and discolouration. A randomized, investigator-blind, placebo-controlled, 3-week experimental gingivitis study.

OBJECTIVE: The aim of this experimental gingivitis study was to assess the efficacy and safety of two new chlorhexidine (CHX) mouthrinses. MATERIAL AND METHODS: Ninety volunteers participated in this investigator-blind, randomized, clinical-controlled trial in parallel groups. During the treatment period, no oral hygiene measures except rinsing with non-alcoholic 0.2% CHX or 0.2% CHX/0.055% sodium fluoride mouthrinses, a positive control, or a negative control were permitted. The primary parameter was the gingival index; the secondary parameters were plaque index, discolouration index, and bleeding on probing. Clinical examinations were conducted 14 days before the start of the study, at baseline, and after 7, 14, and 21 days. The two sample t-test, anova, and ancova were used for the statistical analysis. RESULTS: No difference in efficacy was found between the two new CHX formulations and the positive control. On day 21, statistically significantly less gingival inflammation and plaque accumulation compared with placebo were observed. Besides discolouration and taste irritations, no adverse events were recorded. CONCLUSION: The two new CHX mouthrinses were able to inhibit plaque re-growth and gingivitis. Neither the omission of alcohol nor the supplementation with sodium fluoride had weakened the clinical efficacy of CHX with respect to the analysed clinical parameters.

Adolescent↗
PubMed2006

Benefit of "one-stage full-mouth disinfection" is explained by disinfection and root planing within 24 hours: a randomized controlled trial.

OBJECTIVES: The beneficial effects of the one-stage, full-mouth disinfection remain controversial in the scientific literature. This might be due to the fact that an entire mouth disinfection with the use of antiseptics has been confused with a full-mouth scaling and root planing. This parallel, single blind RCT study aimed to compare several full-mouth treatment strategies with each other. MATERIAL AND METHODS: Seventy-one patients with moderate periodontitis were randomly allocated to one of the following treatment strategies: scaling and root planing, quadrant by quadrant, at two-week intervals (negative control, NC), full-mouth scaling and root planing within 2 consecutive days (FRP), or three one-stage, full-mouth disinfection (FM) protocols within 2 consecutive days applying antiseptics to all intra-oral niches for periopathogens using as antiseptics: chlorhexidine (FMCHX) for 2 months, amine fluoride/stannous fluoride for 2 months (FMF), or chlorhexidine for 2 months followed by amine fluoride/stannous fluoride for another 6 months (FMCHX+F). At baseline and after 2, 4, and 8 a series of periodontal parameters were recorded. RESULTS: All treatment strategies resulted in significant (p<0.05) improvements of all clinical parameters over the entire duration of the study. Inter-treatment differences were often encountered. The NC group nearly always showed significant smaller improvements than the two CHX groups. The differences between the FRP or FM groups, and the two CHX groups only sporadically reached a statistical significance. CONCLUSION: These observations indicate that the benefits of the "OSFMD" protocol are partially due to the use of the antiseptics and partially to the completion of the therapy in a short time.

Adult↗
PubMed2006

An efficacy and safety analysis of a chlorhexidine chewing gum in young orthodontic patients.

AIM: The objective of the present study was to investigate the impact of a chlorhexidine (CHX) chewing gum in teenage orthodontic patients on plaque levels, gingival bleeding tendency and tooth staining. MATERIALS AND METHODS: A randomized-controlled, double-blind, parallel study was conducted on 31 teenagers in fixed orthodontic therapy. Subjects of the CHX gum group were asked to continue their oral hygiene procedures in conjunction with chewing two pieces of a 5 mg CHX-containing chewing gum for 10 min. twice a day for 3 months. Subjects of the placebo gum group received the same instructions; however, using a CHX-free chewing gum. Plaque levels, gingival bleeding on probing and tooth staining were monitored at baseline and subsequently after 1-3 months. RESULTS: Plaque levels significantly decreased from baseline at lingual/palatal sites in the placebo gum group. In the CHX gum group, a similar, yet non-significant trend was observed. At buccal sites, plaque levels remained unaffected in both groups. Gingival bleeding tendency significantly decreased in both groups, predominantly at lingual/palatal sites. There were no significant between-group differences in any of the efficacy parameters at any time point. However, the increase in staining was nearly five times higher in the CHX gum group. CONCLUSIONS: There seems to be no indication for a CHX chewing gum in teenage orthodontic patients when used as an adjunct to normal oral hygiene practices.

Adolescent↗
PubMed1975

Tetracycline-stained teeth in Jerusalem preschool children.

The prevalence of tetracycline-stained teeth was studied in 965 5-year-olds attending compulsory kindergarten in West Jerusalem in 1971. In addition, demographic data were collected to determine the socioeconomic status of the children's families. The prevalence of children with stained teeth was 8.0%, males being affected twice as often as females. The prevalence of staining was significantly higher in children of lower socioeconomic status.

Child, Preschool↗
PubMed1976

Enamel mottling in a non-fluoride community in England.

In 1974--75 an assessment of mottling in incisor teeth was carried out on a random sample of 13- to 14-year-old children in Liverpool, England. The number of children examined was 463. All of these children were born and had lived in Liverpool when the fluoride content of the water supply had averaged 0.12 parts/10(6). The mouth prevalence of mottling was 42.5%. The tooth prevalence of mottling was 9.6%. There was no sex difference. The data obtained was compared with those of other authors and confirmed that a considerable proportion of mottling observed in fluoride and non-fluoride communities was caused by factors other than ingested fluoride.

Adolescent↗
PubMed1977

An epidemiologic study of factors affecting extrinsic staining of teeth in an English population.

A survey is described in which extrinsic staining of teeth was assessed by practising dentists during routine clinical examinations. Habits information was also supplied by patients. The results show that extrinsic staining is markedly influenced by smoking habits and age, and that males tend to have more staining than females. The effect of tea and coffee consumption was not pronounced. No effect attributable to the use of a stannous fluoride toothpaste was observed.

Adolescent↗
PubMed1977

A new index for measuring extrinsic stain in clinical trials.

A staining index has been proposed which is simple to use clinically and yet is sensitive enough to detect small changes in staining levels between different groups. Accurate scale drawings from An atlas of tooth form were reproduced. Outlines of the labial and lingual surfaces of all eight incisor teeth were enlarged to scale (magnification X 4) and each tooth face divided into 4-mm squares. All areas of extrinsic stain were drawn by the examiner on the grid system. This method has been tested in three clinical trials and the reproducibility investigated. In 161 duplicate examinations a total of 1,830 stained squares were scored by one examiner, compared with 1,853 squares by the second examiner; the reproducibility ratio was 0.155 and the coefficient of correlation was 0.956. The method proved sufficiently sensitive to record differences in staining levels in groups using two dentifrices; one was a normal commercial product with an abrasivity against dentin approximately two-thirds that of the other paste. The proposed Extrinsic Stain Index provides data which can be analyzed by appling parametric or nonparametric tests.

Adult↗
PubMed1986

Prevalence of enamel developmental defects in a group of 11- and 12-year-old children in South Wales.

The prevalence of enamel developmental defects was assessed in 579 children aged 11 and 12 yr using the DDE Index. The teeth were dried prior to the examination and a normal dental operating light was used for illumination. Teeth with some type of defective enamel were seen in 48.9% of children. White/single opacities were present in 26.4% of children and white/diffuse, patchy opacities in 9.9% of children. The enamel was abnormal in 5.74% of all teeth with white/single opacities and white/diffuse, patchy opacities occurring in 1.89% and 1.18% of teeth respectively. There was a significantly higher number of teeth affected by enamel defects in boys (P less than 0.01) and boys tended to have a higher prevalence of yellow opacities compared to girls.

Child↗
PubMed1988

Longitudinal survey of enamel defects in a cohort of New Zealand children.

Enamel defects are being used increasingly to monitor fluoride use. In New Zealand in 1982 a survey of the prevalence of enamel defects in 9-yr-old children was carried out. Children who had enamel defects on the labial surfaces of their maxillary incisors were re-examined after 3 yr together with an equal number of children without defects. The same examiner using the same examination methods and the DDE index carried out both examinations but at the second examination was unaware of the results for individual children at the first examination. There was little difference in the group prevalence of the main defect categories except for the tooth prevalence of hypoplasia. There was an increase in discolouration and hypoplasia occurring in combination with diffuse fluoride-related opacities. There was no evidence that defects had faded with time. This longitudinal survey showed that some increase in defect severity occurred over a relatively short time span in initially mild defects. In some children these changes were sufficient to cause a deterioration in tooth appearance. Age and tooth specific enamel defect data are necessary in surveys monitoring the public health use of fluoride since posteruptive changes can affect prevalence and severity.

Child↗
PubMed1993

Should the drinking water of Truro, Nova Scotia, be fluoridated? Water fluoridation in the 1990s.

An epidemiological assessment of differences in caries and fluorosis prevalences between children in Truro (< 0.1 ppm) and Kentville (fluoridated at 1.1 ppm in 1991), Nova Scotia, Canada, was completed in 1991. Out of a total of 429 children, in grades 5 and 6, in the two towns in 1991, 219 (51%) were examined. Parents answered a self-administered questionnaire investigating the sources of drinking water used by the children since birth, residence history, use of fluoride supplements, dentifrices, and other fluoride products during the first 6 yr of the life. The examination criteria differentiated between non-cavitated and cavitated carious lesions. Dental fluorosis was measured using the TSIF index. Examiner agreement was excellent. Of the children examined, 80 (36.5%) drank water (fluoridated or non-fluoridated) from municipal water systems during the first 6 yr of life. The children were assigned into five groups based upon residence history and exposure to fluoridated water during the first 6 yr of life. The percentage difference in mean DMFS scores between children in the fluoridated and non-fluoridated groups is 17% (delta DMFS1 = 0.7) when non-cavitated carious lesions are included and 39% (delta DMFS2 = 1.1) when they are excluded. The differences are not statistically significant. The significant risk factors associated with the DMFS1 and DMFS2 scores identified by a stepwise multiple regression analysis are: education level of the father, gender, and number of years of reported use of toothpaste during the first 6 yr of life. Dental fluorosis (mainly TSIF score of 1) was present in 41.5% and 69.2% of the children in the non-fluoridated and fluoridated groups, respectively.(ABSTRACT TRUNCATED AT 250 WORDS)

Child↗
PubMed1998

Association of salivary mutans streptococci with discoloured pits and fissures.

Experimental studies have demonstrated that mutans streptococci play a major role in caries etiology. Several previous epidemiologic studies found a positive association of salivary mutans streptococci with caries prevalence. The present epidemiologic study aimed at detecting a possible association of salivary mutans streptococci with brown discoloured pits and fissures, supposing that discolouration indicates caries. In the Canton of Zurich 1035 schoolchildren, aged 6.5-12.5, were examined with regard to caries prevalence and presence of discolourations in pits and fissures. A commercially available, semi-quantitative test was used to estimate the salivary level of mutans streptococci in each child. The salivary level (low/high) of mutans streptococci was significantly associated with the presence of slightly brown discoloured (C1), clearly brown discoloured (C2) and cavitated (C3) pits and fissures. The odds ratios were 1.5 (P<0.01) for C1, 2.5 (P<0.001) for C2 and 5.0 (P<0.001) for C3 pits and fissures. The findings are consistent with the hypothesis that brown discolouration indicates caries. Furthermore, the findings suggest that this type of discolouration at elementary school age indicates increased caries activity.

Age Factors↗