Tobacco and oral health.
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Carcinoma, Squamous Cell↗
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Results for “TOOTH DISCOLORATION”
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Be prepared for patients' questions on tooth whiteners.
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Humans↗
The development of a new power toothbrush designed for improved tooth whitening through extrinsic stain removal.
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Dental Plaque↗
Relative extrinsic stain removal effectiveness of a new battery-powered toothbrush and a flat trim manual toothbrush.
PURPOSE: To evaluate the stain removal efficacy of two different toothbrush designs using a laboratory stained pellicle test with seven different dentifrices. METHODS: The toothbrushes were a prototype powered toothbrush (Crest SpinBrush Pro Whitening) and an ADA reference manual toothbrush, as a control. The dentifrices used in the study were: Crest Dual Action Whitening (Cool Mint), Crest Extra Whitening with Tartar Control (Clean Mint), Crest MultiCare Whitening (Fresh Mint), Colgate Total, Colgate Total Plus Whitening, Arm & Hammer Advance White with Tartar Control and Rembrandt Plus with Active Dental Peroxide. This was a randomized, parallel group study that examined stain removal with a novel toothbrushing configuration adapted for powered and manual toothbrushes. Stain was scored before and after brushing for two consecutive, 1-minute periods using digital image analysis. The mean change in L* was statistically compared between toothbrushes with ANCOVA. Labial enamel specimens were obtained from bovine permanent incisors and these specimens were subjected to a laboratory staining process until the L* values for the samples were in the range of 35-45. Digital images for CIE L*a*b* analysis were captured using a high-resolution digital camera under standard polarized lighting conditions. Based on the L* values, the enamel specimens were divided into 14 groups of nine specimens each. RESULTS: Baseline L* values ranged from 40.62 to 41.38 for the 14 toothbrush/dentifrice combinations. The change in L* (post-brushing minus baseline), denoted as deltaL*, was calculated for each specimen and the resulting data were subjected to a two-way ANCOVA. Toothbrush type and dentifrice type were the two terms in the model, and baseline L* was the covariate. Pairwise tests were performed on the adjusted means in order to compare the stain removal efficacy of the two toothbrushes for each of the seven dentifrices evaluated. The powered toothbrush resulted in statistically significantly greater deltaL* values (all P < or = 0.006) than the manual toothbrush for every dentifrice tested. The deltaL* values for dentifrices used with the powered toothbrush were from 66.0-164.2% higher than for the same dentifrice used with the manual toothbrush.
Analysis of Variance↗
Tooth whitening through the removal of extrinsic stain with a power toothbrush: results of four randomized, examiner blind, positive controlled clinical studies.
PURPOSE: To assess the "whitening" through stain removal benefit delivered by a prototype power toothbrush and a positive control power toothbrush over a 2-week period. METHODS: Four independent studies with identical protocols were conducted to examine tooth whitening through the removal of extrinsic stain with power toothbrushes. These were randomized, positive-controlled, two treatment, parallel group, examiner-blind, 2-week studies involving approximately 20 healthy adults with longstanding visible extrinsic stain on the facial surfaces of the 12 anterior teeth. Approximately 10 subjects per group were enrolled into the study for each of the two treatment groups; a prototype-powered toothbrush group (Crest SpinBrush Pro Whitening) and a positive control powered toothbrush group (Sonicare Personal 4100). RESULTS: In these four studies, the positive control sonic power toothbrush statistically significantly (P < 0.05) reduced stain scores by 84%, 77%, 44% and 49% following 2 weeks of brushing. Importantly, the prototype whitening power toothbrush statistically significantly (P < 0.05) reduced stain scores by 88%, 65%, 59% and 57% following 2 weeks of brushing. In both the individual studies and a combined analysis involving all four studies, the adjusted mean changes between treatment groups did not differ significantly between the two treatment groups. In the combined analysis, a one-sided upper 95% confidence bound on the difference in stain reduction scores between the two toothbrushes (positive control minus prototype) was found to be 8.3% of the prototype toothbrush adjusted mean change. This supports that the prototype power toothbrush removed extrinsic stain at least as well as the positive control toothbrush across these four studies.
Adult↗
Tooth whitening effects of an experimental power whitening toothbrush relative to an 8.7% hydrogen peroxide paint-on gel control.
PURPOSE: To assess the whitening efficacy of a new whitening power toothbrush, designed specifically for the removal of extrinsic stains, relative to an 8.7% hydrogen peroxide paint-on gel control. METHODS: This study was a randomized, single center, two-treatment, parallel design, 4-week, controlled study (n = 27) conducted to measure the whitening ability of an experimental power toothbrush relative to a peroxide paint-on gel control used in conjunction with a manual toothbrush. Subjects were randomized to the experimental battery-powered toothbrush group (twice a day brushing with Crest Cavity Protection dentifrice for 2 minutes each time) or the peroxide paint-on gel control group who applied Colgate Simply White Night per manufacturer's instructions once a day prior to bedtime for the first 14 days of the study as well as brushed twice a day with Crest Cavity Protection dentifrice for 2 minutes using the ADA manual reference toothbrush over the 4-week study period. Study evaluations included objective digital image analysis (L* a* b*) and oral soft tissue examinations at baseline, Week 2 and Week 4. In addition, a pilot, single center, 1-week study (n = 9) was conducted to measure the absolute whitening ability of the experimental power toothbrush as measured by digital imaging analysis in a high stain population, induced by 1 week of rinsing with tea. Study evaluations included digital image analysis (L*a*b*) and oral soft tissue examinations at baseline and Week 1 following brushing with the experimental power toothbrush. RESULTS: In the comparative study, the average baseline L*, b*, and W* values were well-balanced across treatment groups. At the Week 2 visit, adjusted (via ANCOVA) mean deltaL*, delta(a)*, delta(b)* and deltaW* values of 0.08, -0.41, -0.08, and -0.28, respectively, were observed in the peroxide paint-on control group, relative to adjusted mean deltaL*, delta(a)*, delta(b)* and deltaW* values of 0.16, -0.19, -0.38, and -0.33, respectively, in the experimental power toothbrush group. No statistically significant differences were observed between the two treatment groups for any of the endpoints. However, delta(b)* and deltaW* values for the experimental power toothbrush group were statistically significantly improved relative to baseline. At the Week 4 visit, adjusted (via ANCOVA) mean deltaL*, delta(a)*, delta(b)* and deltaW* values of -0.15, -0.24, -0.14, and -0.04, respectively, were observed in the peroxide paint-on control group, relative to adjusted mean deltaL*, delta(a)*, delta(b)* and deltaW* values of 0.02, -0.12, -0.22, and -0.15, respectively, in the experimental power toothbrush group. No statistically significant differences were observed between the two treatments groups for any color endpoints of deltaL*, delta(a)*, delta(b)*, or deltaW*. In the induced stain study, the average baseline L*, a*, b*, and W* values were 71.21, 8.28, 19.01, and 35.52, respectively. At the Week 1 visit, the mean deltaL*, delta(a)*, delta(b)*, and deltaW* values were 0.55, -0.27, 0.00, and -0.51 respectively. The deltaL* and deltaW* were statistically significantly improved (P < 0.05) relative to baseline.
Adult↗
Tooth color correction. First things first.
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Adolescent↗
Composite resin veneers: a new technique.
A new technique for the fabrication of composite resin direct veneers is presented. In this technique, a transparent acrylic resin matrix is fabricated before preparation of the facial surface of the tooth, to allow the adequate reproduction of contour, shape, and surface texture originally exhibited by the tooth. Advantages, as well as limitations, of the procedure are also presented.
Acrylic Resins↗
Vital tooth bleaching: review and current status.
Vital tooth bleaching refers to the clinical application of a chemical solution to a tooth surface in order to achieve a lightening effect. This article reviews the available literature to address the following questions: What are the methods of vital bleaching? How does vital bleaching work and is it effective? What effects are there on the teeth, dental restorative materials, soft tissues and systemic health? The techniques used in the application of dentist-applied and patient-applied bleaching systems are described. Generally, vital tooth bleaching has been found to be effective, however, relapse does occur. The literature suggests that bleaching agents may have transient effects on the tooth itself, and may affect some dental materials. Soft tissues exposed to hydrogen peroxide for prolonged periods show changes consistent with inflammation or hyperplasia. Hydrogen peroxide may also potentiate the carcinogenic effect of known carcinogens. However, more clinically relevant studies are needed. Until long-term safety data becomes available, the dental practitioner should approach the use of in-home bleaches with caution. The U.S. Food and Drug Administration (FDA) recently classified these products as "new drug." However, dentist-applied bleaching gel systems are a viable alternative and deserve further consideration. They are simple to use, require little armamentarium, and limit the exposure of the bleaching agent to the teeth only. Vital tooth bleaching refers to the clinical application of a chemical solution to a tooth surface in order to achieve a lightening effect. There was a resurgence of interest in vital bleaching with the recent introduction of the in-home bleaching technique.(ABSTRACT TRUNCATED AT 250 WORDS)
Carbamide Peroxide↗
Body dysmorphic disorder: diagnosis and treatment.
Our society constantly sees images of athletes and models in movies and magazines and on television. These people often are presented as representing the ideals of the human body. These images can have a significant effect on people who already are predisposed to being preoccupied with their appearance, those who suffer from body dysmorphic disorder (BDD). People who have this disorder are preoccupied with certain aspects of their bodies and often seek to remedy their perceived flaws with cosmetic treatment. A general dentist may be the first health care worker who has an opportunity to intervene and assist these people in getting treatment. Patients may have unrealistic expectations for certain procedures, so assessing their psychological status is an important part of treatment planning and diagnosis. Patient expectations should be determined and the ability to provide care that meets those expectations should be discussed.
Adult↗
Delivery, substantivity and clinical response of a direct application percarbonate tooth whitening film.
PURPOSE: A novel overnight bleaching system containing 19% sodium percarbonate and silicone film forming agents (Crest Night Effects) is described, along with research supporting the substantivity of the product on tooth surfaces and its resulting whitening efficacy. METHODS: Nine adult volunteers were enrolled in a study to determine overnight retention (substantivity) of the product. A non-reactive blue pigment was added to the product to aid in evaluating retention. The participants applied the product to their anterior dentition at night and then had digital images taken. After 7 hours of sleep, the patients were awakened and re-imaged. The percent coverage with blue pigment on the surfaces of the 12 anterior teeth was calculated from the digital images after application and after awakening. The product was also evaluated in a 2-week efficacy study with 16 adult volunteers. Each night the participants brushed their teeth before going to bed as they normally would, dried their teeth with a towel, and then applied the product to their six maxillary and mandibular anterior teeth. The product was left on the teeth overnight and then removed in the morning via toothbrushing. Color (baseline and after 2 weeks of product usage) was determined using digital imaging and the standard L*a*b* measurement scale. RESULTS: In the substantivity study, 84.7% of the subject teeth surfaces were covered on average with the blue pigment-containing film immediately after application. Following overnight use, excellent retention was demonstrated as 77.4% of the initially covered surfaces still had pigment-containing film on them. These means did not differ significantly (P > 0.44). In the clinical efficacy study, there was significant (P < 0.0001) color improvement versus baseline after 2 weeks of treatment as measured by a mean (SD) delta b* of -1.71 (0.85) and mean (SD) delta L* of 1.62 (0.68). The product was well-tolerated, with the primary adverse events being oral irritation (13%) and tooth sensitivity (6%). No participants discontinued product use because of a product-related adverse event.
Administration, Topical↗
Placebo-controlled clinical trial of a 19% sodium percarbonate whitening film: initial and sustained whitening.
PURPOSE: To evaluate in a randomized, double-blind, placebo-controlled clinical trial the initial, cumulative and sustained whitening with a brush-applied, peroxide-based, overnight tooth whitener. METHODS: 50 adults were randomized to Crest Night Effects, a 19% sodium percarbonate gel that dries to form an adherent film, or a placebo gel without any peroxide source. The treatments were brush-applied at night, and removed the next morning with normal toothbrushing. Subjects were evaluated biweekly during the 6-week treatment period to evaluate initial and cumulative color change, and again, 4 weeks after completion of treatment to evaluate color relapse. Efficacy was determined by evaluating reduction in tooth yellowness (delta b*), increase in tooth brightness (delta L*) and overall change relative to white (delta W*) from standardized digital images. Tolerability was assessed by examination and interview conducted at treatment and post-treatment visits. RESULTS: Relative to baseline, the 19% sodium percarbonate film group had significantly (P < or = 0.013) whiter teeth after 2 weeks overnight use. For maxillary teeth, delta b* and delta L* means (SD) were: -1.35 (0.858) and 1.06 (0.886), respectively. For mandibular teeth, delta b* and delta L* means (SD) were: -1.27 (0.903) and 0.56 (0.790), respectively. Relative to placebo, the 19% sodium percarbonate group was significantly (P < 0.005) better than placebo for delta b*, delta L*, and delta W*. There was a cumulative benefit with additional treatment, as evidenced by significant (P < 0.0001) improvement in mean delta b* after the initial 2 weeks of treatment. Approximately 90% of the 6-week cumulative color improvement was still evident after 4 weeks post-treatment. Tooth sensitivity (20% of the peroxide group) represented the only adverse event with increased occurrence over placebo, and these events were mild and fully resolved during/after treatment.
Administration, Topical↗
Randomized clinical trial comparing overnight use of two self-directed peroxide tooth whiteners.
PURPOSE: To directly compare tooth color change and spatial uniformity of two brush-applied, peroxide-based overnight tooth whiteners in a 2-week randomized clinical trial. METHODS: 57 adult volunteers were randomly assigned to Crest Night Effects, a 19% sodium percarbonate system packaged in unit dose sachets that when applied, dries to form an adherent film, or Colgate Simply White Night, a paint-on liquid in an applicator bottle at a concentration of 8.7% hydrogen peroxide. Both groups applied their assigned gel on the facial surfaces of the six maxillary anterior teeth for 14 nights. Efficacy was measured objectively as change in L*a*b* tooth color from standard digital images of maxillary teeth, while safety was evaluated by clinical examination and interview. RESULTS: After 14 nights treatment, adjusted mean (SE) change in yellowness (delta b*) was -0.95 (0.092) for the 19% sodium percarbonate film and -0.17 (0.096) for the 8.7% hydrogen peroxide gel, with these groups differing statistically (P < 0.0001). Other individual and composite color parameters also demonstrated significantly greater whitening for the 19% sodium percarbonate film compared to the 8.7% hydrogen peroxide gel after 14 nights use. Only the 19% sodium percarbonate film exhibited significant (P< 0.0001) proximal color improvement (delta b*) after 2 weeks, approximately 98% of that seen on the body of the tooth, providing evidence of proximal bleaching and uniform spatial whitening following use of this barrier-free system. Both products were well-tolerated, with no subjects discontinuing treatment early due to a causal adverse event.
Administration, Topical↗
Teeth.
Common environmental chemicals, drugs, or physical agents can adversely affect human teeth during their embryonic development and after their eruption into the oral cavity. One of the more common elemental toxicants is lead. Teeth are known to accumulate lead during their development. Both animal and human studies have shown that teeth with high lead levels are generally more susceptible to dental caries. Similarly, although inorganic fluorides have long been recognized for their potential to prevent dental caries, exposure to excessive amounts of fluoride when enamel is forming often leads to a type of enamel hypoplasia referred to as dental fluorosis or mottled enamel. Teratogenic agents, such as tetracyclines, a class of antibiotic drugs commonly administered to infants and children, will often result in the discoloration of tooth enamel when prescribed during tooth development. It has recently been suggested that childhood exposure to passive smoking increases the risk for dental caries. Environmental tobacco smoke has previously been linked to periodontal disease in adults. However, this is the first report of an association between passive tobacco smoke and increased susceptibility to dental caries. Last, an often-overlooked source of damage to teeth among all age groups after their eruption into the oral cavity is physical trauma from a variety of sources, especially sports-related injuries. Epidemiologic data suggest that up to one third of all dental injuries are sports related.
Child↗
Bleaching--the facts and the myths. Interview by Aisling O'Mahony.
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Carbamide Peroxide↗
Efficacy and safety assessment of a new liquid tooth whitening gel containing 5.9% hydrogen peroxide.
PURPOSE: To evaluate the efficacy and safety of a new 5.9% hydrogen peroxide liquid, invisible gel, (Colgate Simply-White Whitening Gel). METHODS: A total of 30 subjects were enrolled into the study and divided into two treatment groups (Colgate vs. placebo gel). Efficacy was assessed using VITA shade scores and safety evaluations were performed including the examination of plaque index (PI), bleeding index (BOP), gingival recession and dentin hypersensitivity. Statistical analysis was performed to determine the mean change from baseline. RESULTS: The new whitening gel containing 5.9% hydrogen peroxide was significantly effective in lightening tooth shade. After only 2 weeks, patients enrolled in the study exhibited an overall mean 4.48-shade improvement from baseline, which was significantly greater than placebo group and far exceeded the ADA minimum requirements to claim "clinical efficacy". In the new Colgate Simply White Clear Whitening Gel group, periodontal health (PI and BOP) improved with time overall. Moreover, dentin hypersensitivity did not significantly increase, and all treatments were generally well tolerated. CLINICAL SIGNIFICANCE: The new Colgate Simply White whitening gel containing 5.9% hydrogen peroxide allowed consistent bleaching using minimal contact time, without adversely impacting overall tolerability.
Adult↗
Cleaning power and abrasivity of a new toothpaste based on ion-exchange resins.
PURPOSE: To compare the stain removal efficacy and enamel abrasivity of a new experimental dentifrice based on an ion-exchange resin mixture that releases calcium, fluoride, phosphate and zinc ions (named NMTD1), to four commercially available dentifrices: Crest Extra-whitening toothpaste, Crest Tartar Protection toothpaste, Crest Cavity Protection toothpaste and Colgate Fluoride Cavity Protection toothpaste. Calcium pyrophosphate was used as a control for the efficacy of the staining removal experiment. METHODS: Cleaning power evaluation was made following the method developed by Stookey et al. The abrasion of the toothpastes was determined by means of a brushing machine, using 2000, 4000 and 8000 strokes and a 250g toothbrush load. Bovine specimens were prepared and abrasion was measured by a surface profilometer system. RESULTS: The new experimental dentifrice did not remove stains whereas Crest Extra-whitening and Crest Cavity Protection dentifrices produced statistically significant stain removal when compared with the calcium pyrophosphate control. Abrasion studies demonstrated that abrasion was linearly correlated to the number of strokes and the abrasion rates proved to be non significant for Colgate and the new experimental dentifrices, but significant for Crest Extra-whitening, Crest Tartar Protection and Crest Cavity Protection. CLINICAL SIGNIFICANCE: This study demonstrated that the use of a dentifrice based on an ion-exchange mixture was not effective at removing stains and abrasion was most insignificant when compared to other commercially available toothpastes.
Animals↗
Staining of non-carious human coronal dentin by caries dyes.
This study tested the hypothesis that commercially available caries dyes stain non-carious human coronal dentin in freshly extracted teeth. Multiple sections were cut from 10 non-carious and two control carious teeth using a water-cooled saw. Each section was stained with one of five caries dyes. The location of staining, if any, was noted and the staining intensity was scored on a four-point scale. One of the sections from each tooth was subsequently decalcified and processed for observation under a light microscope using four histologic staining techniques to evaluate morphology, collagen distribution and bacterial content. The association between the stain intensity scores on the undecalcified sections and the five dyes was evaluated using the Kruskal-Wallis One-Way ANOVA by Ranks test. Outer carious dentin in the control specimens stained intensely with each of the five dyes. In the undecalcified, non-carious sections, all had at least one area of staining. However, this staining could be differentiated from the intensity of dye staining in the carious controls, except in two instances. The association between stain intensity scores and the five dyes was not statistically significant. In the histologic sections, numerous bacteria were seen within the dentinal tubules of carious lesions of the two control specimens; however, no bacteria were found in any of the sections from non-carious specimens. Histologically, no differences were observed in the morphology or staining pattern within mantle or circumpulpal dentin in areas stained with caries dye, and in only one unique instance within the main body of the dentin. These results suggest that the five dyes evaluated in this study can stain non-carious dentin, however, this stain can be differentiated from the staining of outer carious dentin in vitro.
Analysis of Variance↗