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PubMed1990

Pharmacokinetics of fluoride in man and its clinical relevance.

A large number of parameters will influence and mediate the activity and the pharmacological response of dental fluoride products after systemic or topical treatment. This report reviews some aspects of the pharmacokinetics of fluoride in man, fluoride bio-availability, plasma kinetics, and kinetics of fluoride in saliva and plaque fluid. Pharmacokinetic studies in growing dogs show that 90% of a single injected fluoride dose is retained shortly after birth, but at maturity it decreases to about 50%. The degree of fluoride accumulating in calcifying tissues seems to be strongly related to age. The bio-availability of fluoride from swallowed fluoride toothpaste is shown to be decreased if the toothpaste is ingested close to a meal. Several studies show that fluoride exerts its cariostatic effects through the liquid phase surrounding the enamel. The importance of fluoride in the fluid environment of the teeth and the kinetics of fluoride in saliva are discussed. Clinical studies using different slow-release fluoride systems indicate that they are promising cariostatic agents--in particular intra-oral slow-release devices and lozenges. A new micro-analytical method to study the kinetics of fluoride in plaque fluid collected from single tooth sites has been developed. Preliminary studies show that the clearance of fluoride from plaque fluid is slowest in the upper incisor region, followed by the molar region, and faster in the lower incisor region. A site-by-site study of the concentration of fluoride in plaque fluid after topical fluoride administration could be extremely beneficial in optimization of the methods and recommended safety regimens for fluoride therapy.

Biological Availability↗
PubMed1992

The changing patterns of systemic fluoride intake.

Fluorosis prevalence has increased in North America since the 1930's-1940's. It may also have increased since 1970, though the evidence for that is less clear. Continued monitoring will help determine whether increased fluorosis prevalence in children in the United States is a cohort effect from the 1970's. This review considers the evidence for an increase in fluoride ingestion from all sources since the 1970's. If an increase has occurred, the most likely sources are fluoride dietary supplements, inadvertent swallowing of fluoride toothpastes, and increased fluoride in food and beverages. For adults, there is no evidence from dietary surveys to show that fluoride intake has increased over the last generation. Dietary surveys for children aged six months to two years are similarly inconclusive, though the great variation in fluoride content of various infant foods might be obscuring real effects. The data on fluoride intake by children from food and beverages, infant foods included, are not strong enough to conclude that an increase in fluoride ingestion has occurred since the 1970's. However, the suggested upper limit of fluoride intake is substantially being reached in many children by ingestion of fluoride from food and drink (0.2-0.3 mg per day) and from fluoride toothpaste (0.2-0.3 mg per day). Two public health issues that arise from this review are: (a) the need for a downward revision in the schedule for fluoride supplementation, and (b) education on the potential for high fluoride concentration of soft drinks and processed fruit juices.

Adult↗
PubMed1995

The diffusion and enzymic hydrolysis of monofluorophosphate in dental plaque.

Although the ability of dental plaque to hydrolyze sodium monofluorophosphate (MFP) has been known for some time, its effect on the F- concentration at the plaque-enamel interface is undefined. We have determined enzyme kinetic values for MFP hydrolysis and diffusion coefficients so that the penetration and degradation of MFP in plaque can be modeled by computer. The KM and Vmax values for natural human plaque were 1.77 mmol/L and 41.4 nmol/min/mg protein, respectively, at pH 8.0. At pH 6.0, the Vmax was lower, 15.6 nmol/min/mg, but KM was not significantly different. Competitive inhibition by orthophosphate gave a Ki of 4.55 mmol/L. The diffusion coefficient for MFP in artificial plaque was 1.91 x 10(-6) cm2/sec. When these data were used for mathematical modeling of the effects of rinsing with MFP and F- solutions, compared with an equivalent NaF application, the concentration of F- from MFP was lower at the inner surface of plaque, and the peak occurred later. Both pH and plaque thickness had a marked effect on the amount of MFP that could penetrate: At pH 8.0, almost none reached the inner surface of a 1-mm-thick plaque intact. At pH 6.0, however, more MFP was able to penetrate, due to lower MFPase activity. While MFP diffusion is inherently slower than that of F-, enzymic degradation increases the gradient for inward diffusion. If the conventional view that MFP in toothpaste acts as a source of F- is true, then MFP toothpaste should be formulated to optimize MFPase activity in dental plaque.

Adult↗
PubMed2001

Anticalculus efficacy of an antiseptic mouthrinse containing zinc chloride.

BACKGROUND: The authors undertook a controlled clinical study to determine the efficacy of a tartar-control antiseptic mouthrinse in inhibiting the development of supragingival dental calculus. METHODS: After undergoing a dental prophylaxis, 334 subjects with a moderate rate of calculus formation were stratified and randomly assigned to one of three groups: positive control (using a tartar-control toothpaste and an antiseptic rinse), negative control (using a regular toothpaste and an antiseptic mouthrinse) or experimental (using a regular dentifrice and a tartar-control mouthrinse). Subjects brushed and rinsed twice daily, unsupervised, for four months. The researchers assessed subjects' calculus levels using the Volpe-Manhold Index, or VMI, after 16 weeks. RESULTS: Using analysis of covariance, the authors found that both the experimental group (which used a tartar-control rinse containing zinc chloride) and the positive control group (which used a tartar-control dentifrice containing pyrophosphate) demonstrated statistically significantly lower VMI scores (P = .001) than the negative control group (which used a regular dentifrice and an antiseptic rinse). Both anticalculus agents provided a clinically relevant 21 percent reduction in calculus formation. CONCLUSION: An antiseptic mouthrinse containing 0.09 percent zinc chloride as the anticalculus agent provides a clinically relevant reduction in calculus formation in people with a moderate rate of such formation. CLINICAL IMPLICATIONS: A tartar-control mouthrinse with zinc chloride as the tartar-control ingredient is clinically effective in reducing the formation of calculus.

Adolescent↗
PubMed1986

Effects of chlorhexidine gel in a group of maintenance-care patients with poor oral hygiene.

An intraindividual double-blind crossover study was designed in order to see if a 1% chlorhexidine gel used twice a day could substitute for ordinary toothpaste in group of maintenance-care patients with poor oral hygiene. Twenty patients from a student clinic participated, each with a long history of maintenance-care problems. A 4-week test period with chlorhexidine gel or placebo gel was followed by an intermediate period with ordinary toothpaste, and then by another 4-week test period. Plaque-covered surfaces (%), bleeding sites (%) and extraneous staining (color slides) were recorded at each sitting. The results demonstrated that brushing with chlorhexidine gel significantly influenced both the oral hygiene level and the gingival inflammation. The only adverse effect observed was a marked increase in the amount of brown staining, especially on the facial surfaces of the nonsmokers. In this short-term study, the staining was not considered cosmetically unacceptable by the patients. The total amount of staining was always greater in smokers than in nonsmokers.

Adult↗
PubMed2003

Permeability and morphology of dentin after erosion induced by acidic drinks.

BACKGROUND: The aims of this study were to evaluate 1) the alterations of dentin permeability after single exposure of dentin to several acidic soft drinks with different acid composition; 2) the effectiveness of smear layer on dentin surface to prevent erosion of sound dentin; and 3) the role of brushing procedures. METHODS: Dentin discs from human third molars were prepared. Each disc was treated with 0.5 M neutral EDTA for 5 minutes to remove the smear layer and to calculate the maximum fluid flow rate for each disc (to which an arbitrary value of 100% was assigned) using a pressure apparatus working at 1.0 psi. An homogeneous thin smear layer was then recreated with an abrasive paper under water. The following acidic drinks were applied for 5 minutes onto dentin surface: cola drink (phosphoric acid), orange fruit juice (ascorbic + citric acid), white wine (tartaric acid), vinegar (acetic acid), and mucolytic syrup (benzoic and tartaric acid). Each sample was then brushed for 3 minutes. Finally, each sample was brushed with a toothpaste and, as the final step, etched with phosphoric acid for 1 minute. Permeability was measured after each step. RESULTS: All acidic drinks were able to statistically increase dentin permeability and to open dentinal tubules by removing the smear layer. CONCLUSIONS: The study demonstrated that acidic drinks increased dentin permeability by removing and dissolving the smear layer and smear plugs. The erosion of peritubular dentin and smear plug removal is the main agent responsible for the increase in dentin permeability and probably for clinical dentin hypersensitivity. Brushing procedures reduced dentin permeability, creating a new fine and thin smear layer. Toothpaste may play a protective role in preventing complete smear layer removal and reducing dentin hypersensitivity by producing a new artificial smear layer and deposit inside tubules. The use and the abuse of acidic drinks may damage dentin and increase the risk for dentin hypersensitivity.

Acids↗
PubMed1987

Surface characteristics of posterior composites after polishing and toothbrushing.

The surface characteristics of eight posterior and two anterior composite resins were studied by SEM and profilometric tracings. The materials included both chemically cured and light-cured resin systems. Two posterior materials were microfilled composites; the others were conventional or hybrid types. The anterior composites were of conventional and hybrid types. At various steps in the procedures the following polishing/brushing treatments were evaluated: 1) dry polishing with Sof-lex discs followed by brushing with toothpaste; and 2) wet polishing with diamond pastes of increasing fineness, followed by brushing with toothpaste. The base line before the polishing/brushing procedures was obtained by wet polishing on silicon-carbide paper (4000 grit). All materials could be polished to a comparable smoothness by the Sof-lex discs, but this polishing procedure was associated with the development of an amorphous surface layer. Polishing with diamond pastes gave various results, with a 20-fold difference in surface roughness values from the smoothest to the roughest material. Toothbrushing after polishing with the Sof-lex system increased the surface roughness for all materials, but to various degrees. The two microfilled and four of the conventional posterior composites showed comparable surface roughness values, whereas two remaining posterior and the two anterior materials showed two to three times higher surface roughness values after toothbrushing.

Composite Resins↗
PubMed1996

Effects of oral hygiene products containing lactoperoxidase, lysozyme, and lactoferrin on the composition of whole saliva and on subjective oral symptoms in patients with xerostomia.

This study evaluates the effects of two oral hygiene products containing nonimmunoglobulin antimicrobial agents on whole saliva and on subjective oral symptoms in patients with xerostomia. Twenty patients used a lactoperoxidase-system-containing toothpaste (Biotene) combined with the use of a mouthrinse (Biotene), comprising also lysozyme and lactoferrin, for 4 weeks. Saliva samples were collected at base line, after 4 weeks' use of the products, and at the end of a 4-week washout period. Samples were analyzed for selected biochemical and microbiologic factors. The effects on subjective oral symptoms were also recorded. A 4-week daily use of toothpaste and mouthrinse relieved the symptoms of oral dryness in 16 patients. The levels of salivary hypothiocyanite, lysozyme, lactoferrin, or myeloperoxidase activity did not change, but there was a significant decrease in salivary pH (P < 0.05), total peroxidase activity (P < 0.05), and total protein content (P = 0.01). In patients with the lowest salivary flow rates (n = 5) a significant (P > or = 0.04) increase was detected in salivary hypothiocyanite concentrations. No major changes occurred in salivary microflora. The products relieved subjective oral symptoms in most xerostomic patients, but this was not necessarily related to the presence of antimicrobial agents.

Adult↗
PubMed2006

Oral hygiene practices and risk of oral leukoplakia.

OBJECTIVE: To determine the influence of oral hygiene habits and practices on the risk of developing oral leukoplakia. DESIGN: Case control study. SETTING: Githongo sublocation in Meru District. SUBJECTS: Eighty five cases and 141 controls identified in a house-to-house screening. RESULTS: The relative risk (RR) of oral leukoplakia increased gradually across the various brushing frequencies from the reference RR of 1.0 in those who brushed three times a day, to 7.6 in the "don't brush" group. The trend of increase was statistically significant (X2 for Trend : p = 0.001). The use of chewing stick as compared to conventional tooth brush had no significant influence on RR of oral leukoplakia. Non-users of toothpastes had a significantly higher risk of oral leukoplakia than users (RR = 1.8; 95% confidence levels (CI) = 1.4-2.5). Among tobacco smokers, the RR increased from 4.6 in those who brushed to 7.3 in those who did not brush. Among non-smokers, the RR of oral leukoplakia in those who did not brush (1.8) compared to those who brushed was also statistically significant (95% CL = 1.6-3.8). CONCLUSION: Failure to brush teeth and none use of toothpastes are significantly associated with the development of oral leukoplakia, while the choice of brushing tools between conventional toothbrush and chewing stick is not. In addition, failure to brush teeth appeared to potentiate the effect of smoking tobacco in the development of oral leukoplakia. RECOMMENDATIONS: Oral health education, instruction and motivation for the improvement of oral hygiene habits and practices; and therefore oral hygiene status, should be among the strategies used in oral leukoplakia preventive and control programmes.

Adolescent↗
PubMed1998

[Fluoride dentifrices].

The introduction of fluoride-containing dentifrices is held responsible for the important decrease in caries prevalence that was seen in the past decades. Fluoride in toothpaste is available in different formulations and combinations. Differences exist between dentifrices regarding the concentration of fluoride in the paste. Optimal results are obtained at levels of 1000 ppm fluoride. The efficiency of low-dose products is still a matter of further investigation. More research is necessary to determine the amount of toothpaste that should be used and the optimal frequency of use.

Cariostatic Agents↗
PubMed1998

The effects of dentifrice systems on oral malodor.

Chronic oral malodor is a serious concern for about one-fifth of the North American population, and a field of emerging research interest. The present three studies, one involving gas chromatography and two employing odor judge assessment, examined the efficacy of baking soda and other toothpastes in reducing breath odor. The most common cause of oral malodor is elevated levels of volatile sulfur compounds (VSC's), primarily hydrogen sulfide (H2S) and methyl mercaptan (CH3SH), in the breath. Gas chromatography, an accurate means of measuring breath VSC, was employed to evaluate the breath levels of VSC in 11 men after brushing with baking soda-containing dentifrices with or without the addition of Zn++. Dentifrices with either Zn++ or a concentration of baking soda 20% or greater significantly reduced VSC levels. The addition of Zn++ to baking soda dentifrices enhanced the anti-odor effects. In the first organoleptic study, dentifrices containing 20% baking soda and 30% baking soda demonstrated significantly greater ability to reduce breath odor than a standard sodium fluoride/silica dentifrice. The subjects' baseline mouth odor evaluations, initially rated as strong, declined after brushing with the baking soda toothpastes to a barely detectable level at one hour, then rising to a faint level at two hours and moderate levels at three hours. In the second organoleptic study, a dentifrice containing 65% baking soda demonstrated significantly greater ability to reduce breath odor than a standard sodium fluoride/silica tartar control dentifrice, but did not differ significantly from a standard dentifrice containing 0.76% sodium monofluorophosphate in a dicalcium phosphate dihydrate base. The results of these studies indicate that dentifrices containing 20% or more baking soda can confer a significant odor-reducing benefit for time periods up to three hours.

Adult↗
PubMed2001

Final report on the safety assessment of Mentha Piperita (Peppermint) Oil, Mentha Piperita (Peppermint) Leaf Extract, Mentha Piperita (Peppermint) Leaf, and Mentha Piperita (Peppermint) Leaf Water.

Mentha Piperita (Peppermint) Oil, Mentha Piperita (Peppermint) Leaf Extract, Mentha Piperita (Peppermint) Leaf, Mentha Piperita (Peppermint) Leaf Water are obtained from the Mentha piperita plant. The oil is currently used in cosmetic formulations as a fragrance component, but previously had been also described as a denaturant. The extract and leaves are described as biological additives, but only the extract is reported to be used. Peppermint Water is described as a flavoring agent or fragrance component, but is not currently in use. Peppermint Oil is used at a concentration of < or = 3% in rinse-off formulations and < or = 0.2% in leave-on formulations. Peppermint Oil is composed primarily of menthol and menthone. Other possible constituents include pulegone, menthofuran, and limone. Most of the safety test data concern Peppermint Oil. The oil is considered to present the "worst case scenario" because of its many constituents, so data on the oil were considered relevant to the entire group of ingredients. Peppermint Oil was minimally toxic in acute oral studies. Short-term and sub-chronic oral studies reported cystlike lesions in the cerebellum in rats that were given doses of Peppermint Oil containing pulegone, pulegone alone, or large amounts (>200 mg/kg/day) of menthone. Pulegone is also a recognized hepatotoxin. Repeated intradermal dosing with Peppermint Oil produced moderate and severe reactions in rabbits, although Peppermint Oil did not appear to be phototoxic. Peppermint Oil was negative in the Ames test and a mouse lymphoma mutagenesis assay but gave equivocal results in a Chinese hamster fibroblast cell chromosome aberration assay. In a carcinogenicity study of toothpaste and its components, no apparent differences were noted between mice treated with Peppermint Oil and those treated with the toothpaste base. Isolated clinical cases of irritation and/or sensitization to Peppermint Oil and/or its constituents have been reported, but Peppermint Oil (8%) was not a sensitizer when tested using a maximization protocol. It was expected that dermal absorption of Peppermint Oil would be rapid, following that of menthol, a major component, but in no case would be greater than absorption through the gastrointestinal tract. Because of the toxicity of pulegone, the safe concentration of this constituent was limited to < or = 1%. This concentration was achievable both by controlling the time of harvest and processing technique. There is evidence that menthol can enhance penetration of other agents. Formulators were cautioned that this enhanced penetration can affect the use of other ingredients whose safety assessment was based on their lack of absorption. With the limitation that the concentration of pulegone in these ingredients should not exceed 1%, it was concluded that Mentha Piperita (Peppermint) Oil, Mentha Piperita (Peppermint) Extract, Mentha Piperita (Peppermint) Leaves, Mentha Piperita (Peppermint) Water are safe as used in cosmetic formulations.

Animals↗
PubMed2000

A new desensitizing dentifrice--an 8-week clinical investigation.

An 8-week, double-blind, three-way clinical trial compared the dentinal hypersensitivity-reducing effectiveness of a new dentifrice containing 5.0% potassium nitrate and 0.454% stannous fluoride in a silica base (Colgate Sensitive Maximum Strength Toothpaste, Colgate-Palmolive Co.) with a commercially available desensitizing dentifrice containing 5.0% potassium nitrate and 0.243% sodium fluoride in a silica base (Sensodyne Fresh Mint Toothpaste, Block Drug Company, Inc.) and a nondesensitizing dentifrice containing 0.243% sodium fluoride in a silica base (Colgate Winterfresh Gel, Colgate-Palmolive Co.). One hundred nine subjects were stratified into three balanced groups according to gender, age, mean baseline tactile (Yeaple Probe), and thermal (air blast) scores. The test products were randomly assigned to each group with instructions to brush twice daily. Oral examinations with tactile and thermal assessments were repeated after 4 and 8 weeks. The new dentifrice group demonstrated statistically significant improvements in tactile and thermal sensitivity over the two control groups.

Adult↗
PubMed2000

Clinical study to compare extrinsic stain formation in subjects using three dentifrice formulations.

The purpose of this study was to compare the degree of extrinsic dental stain formed with the use of three dentifrices: (1) a new dentifrice formulation containing 5.0% potassium nitrate and 0.454% stannous fluoride in a silica base (Colgate Sensitive Maximum Strength Toothpaste, Colgate-Palmolive Co.); (2) a commercially available dentifrice containing 5.0% potassium nitrate and 0.243% sodium fluoride in a silica base (Sensodyne Fresh Mint Toothpaste, Block Drug Company, Inc.); and (3) a dentifrice containing 0.243% sodium fluoride in a silica base (Colgate Winterfresh Gel, Colgate-Palmolive Co.). A total of 121 participants were entered into the study and stratified into 3 balanced groups according to baseline mean Lobene Stain Index scores. A thorough dental prophylaxis was completed on each participant after completion of the baseline examination. The three groups were randomly assigned to use one of the three dentifrices. The groups were well balanced with regard to mean baseline stain index scores, gender, and tobacco habits. Participants were instructed to brush their teeth twice daily (morning and evening) for 1 minute with their assigned dentifrice and a commercially available soft-bristled toothbrush. Extrinsic dental stain examinations, which measured dental stain area and dental stain intensity, were conducted at baseline and 4 and 8 weeks. Examinations were conducted by the same dental examiner at each examination. After 4 and 8 weeks' use of the test dentifrices, there was no statistically significant difference regarding extrinsic stain formation with the use of any of the dentifrices. Thus, it can be concluded from this study that the use of a new formulation dentifrice containing 5.0% potassium nitrate and 0.454% stannous fluoride in a silica base will not result in a greater formation of extrinsic dental staining than that which is formed by two commercially available dentifrices not known to cause extrinsic dental stain.

Adolescent↗
PubMed2000

A randomized clinical trial of the desensitizing efficacy of three dentifrices.

The effect on dentinal hypersensitivity from the use of a new dentifrice containing 5.0% potassium nitrate and 0.454% stannous fluoride in a silica base (Colgate Sensitive Maximum Strength Toothpaste, Colgate-Palmolive Co.) over an 8-week period was compared to a commercially available dentifrice containing 5.0% potassium nitrate and 0.243% sodium fluoride in a silica base (positive control [Sensodyne Fresh Mint Toothpaste, Block Drug Company, Inc.]) and to a commercially available nondesensitizing dentifrice containing 0.243% sodium fluoride in a silica base (negative control [Colgate Winterfresh Gel, Colgate-Palmolive Co.]). A total of 120 participants were stratified into 3 balanced groups according to baseline mean air blast (thermal) and tactile (Yeaple Probe) sensitivity scores, gender, and age. Participants brushed their teeth twice daily (morning and evening) for 1 minute. Dentinal hypersensitivity examinations were conducted at baseline, 4 weeks, and 8 weeks by the same dental examiner. After 4- and 8-weeks' use of their assigned products, participants in the new dentifrice group demonstrated statistically significant improvements (p < 0.05) in tactile and air blast sensitivity, as compared to those using the positive and negative control dentifrices.

Adult↗
PubMed2000

Comparative efficacy of a new battery-powered toothbrush and an electric toothbrush on plaque removal.

This single-use, examiner-blind clinical study evaluated the plaque-removal efficacy of a new, battery-powered toothbrush (Colgate Actibrush) compared to a commercially available electric toothbrush (Braun Oral-B Plaque Remover) after 24 hours of no oral hygiene. Adult men and women reported to the clinical facility having refrained from oral hygiene procedures for 24 hours, and were stratified into 2 balanced groups according to plaque (prebrushing) scores. Participants then brushed their teeth for 1 minute, under supervision, with their assigned toothbrush and a commercially available toothpaste (Colgate Cavity Protection Great Regular Flavor Fluoride Toothpaste) and again were evaluated for supragingival plaque (postbrushing). The same dental examiner conducted the prebrushing and postbrushing plaque examinations. The study found no statistically significant difference in plaque removal between the group using the battery-powered toothbrush and the group using the electric toothbrush. Both power toothbrushes were found clinically to be equally effective with regard to the removal of 24-hour plaque accumulation.

Adolescent↗
PubMed2000

Comparative efficacy of Colgate Actibrush battery-powered toothbrush and Colgate Plus (manual) toothbrush on established plaque and gingivitis: a 30-day clinical study in New Jersey.

The objective of this 30-day clinical study, conducted in harmony with American Dental Association guidelines, was to evaluate the efficacy of a new battery-powered toothbrush (Colgate Actibrush) relative to a manual toothbrush (Colgate Plus Diamond Head Toothbrush, Full Head, Soft Bristle) in the control of supragingival plaque and gingivitis. A total of 110 adult men and women from the Northern New Jersey area were entered into the study and stratified into 2 balanced groups according to baseline plaque and gingivitis scores. Participants were instructed to brush twice daily (morning and evening) for 1 minute with their assigned toothbrush and a commercially available toothpaste (Colgate Cavity Protection Great Regular Flavor Fluoride Toothpaste). Examinations for plaque and gingivitis were conducted by the same dental examiner at baseline, after 15 days, and again after 30 days of product use. All 110 participants complied with the protocol and completed the 30-day clinical study. At the 30-day examinations, the group using the Colgate Actibrush battery-powered toothbrush exhibited a statistically significant greater reduction in plaque (26.7%) and in gingivitis (25.8%) than did the group who used the Colgate Plus Diamond Head Toothbrush. The results of this 30-day clinical study support the conclusion that the Colgate Actibrush battery-powered toothbrush provides a clinically superior level of efficacy for the control of supragingival plaque and for the control of gingivitis when compared with a manual toothbrush.

Adolescent↗
PubMed1997

Clinical efficacy of an optimized stannous fluoride dentifrice, Part 5: A 3-month study of extrinsic tooth staining, northeast USA.

The objective of this 3-month, double-blind clinical study was to investigate the level of tooth staining associated with the use of Colgate Optimized Stannous Fluoride (COSF) dentifrice compared to the tooth staining associated with two commercially available dentifrices. The results of this clinical study support the conclusion that the intensity and extent of extrinsic tooth stain associated with the use of the COSF dentifrice are significantly lower than that associated with Crest Gum Care Toothpaste. Further, this study provided no indication that the use of the COSF dentifrice is associated with a greater level of stain than that associated with the use of Crest Regular Toothpaste, a standard 0.243% sodium fluoride/silica dentifrice.

Adult↗