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PubMed2001

Sensitivity of titanium brackets to the corrosive influence of fluoride-containing toothpaste and tea.

Titanium brackets are used in orthodontic patients with an allergy to nickel and other specific substances. In recent studies, the corrosive properties of fluoride-containing toothpastes with different pH values were investigated. The present in vivo study tested how the surfaces of titanium brackets react to the corrosive influence of acidic fluoride-containing toothpaste during orthodontic treatment. Molar bands were placed on 18 orthodontic patients. In these same patients, titanium brackets were bonded on the left quadrants and stainless steel brackets on the right quadrants of the upper and lower arches. Fifteen patients used Gel Kam containing soluble tin fluoride (pH 3.2), whereas 3 used fluoride-free toothpaste. The brackets were removed for evaluation by light microscopy and scanning microscopy 5.5 to 7.0 months and 7.5 to 17 months after bonding. The quality and quantity of elements present were measured by scanning microscopy. Macroscopic evaluation showed the matte gray color of titanium brackets dominating over the silver gleam of the steel brackets. The plaque accumulation on titanium brackets is high because of the very rough surface. Pitting and crevices were observed in only 3 of the 165 brackets tested. The present in vivo investigation confirms the results of in vitro studies, but the changes are so minor that titanium brackets can safely be used for up to 18 months. Wing surfaces should be improved by modifying the manufacturing process.

Adult↗

PubMed2002

Dentine hypersensitivity: the effects of brushing toothpaste on etched and unetched dentine in vitro.

Although many people have exposed dentine, only a percentage exhibit symptoms of dentine hypersensitivity. This has been ascribed to opening and closing of the dentinal tubules by for example, smear layer changes or tubular occlusion. The aims of this study were to examine the surface morphological changes of etched and unetched dentine in vitro, attributed to the effects of toothbrushing with and without toothpastes designed for the alleviation of dentine hypersensitivity. A total of 96 etched and 96 unetched human dentine specimens were brushed with various toothpastes and water for 1, 2, 5 or 10-min periods in a toothbrushing machine and subsequently examined under scanning electron microscopy for surface changes. Analyses of brushed etched specimens demonstrated that time and treatment were significant variables (P < 0.05) for tubule occlusion. Further, the interaction between time and treatment was significant (P < 0.05). The artificial silica based paste was significantly better for all time intervals at occluding the dentine tubules. All toothpastes investigated caused dynamic changes to the smear layer of the unetched dentine, opening tubules. However, the artificial silica based paste resulted in occluded rather than patent tubules. All of the pastes evaluated had the capacity to remove the smear layer but some could then occlude tubules through the contained abrasives.

Acid Etching, Dental↗

PubMed2001

Cheilitis caused by contact urticaria to mint flavoured toothpaste.

A 26-year-old woman presented with a 12-month history of persistent dermatitis of the lips. She had failed to respond to cosmetic avoidance and therapeutic measures. Patch testing was negative, including her toothpaste and toothpaste flavours. She defied diagnosis until an acute flare followed immediately after dental treatment with a mint flavoured tooth cleaning powder. This led us to prick test her to mint leaves and this was positive. Her cheilitis settled after changing from her mint-flavoured toothpaste. A diagnosis of contact urticaria should be considered in cases of cheilitis of unknown cause.

Adult↗

PubMed2005

Prevalence of dental fluorosis in children from non-water-fluoridated Halmstad, Sweden: fluoride toothpaste use in infancy.

OBJECTIVES: To determine the prevalence and severity of dental fluorosis in children aged 7-9 years from non-water-fluoridated Halmstad, Sweden, and to relate the results to their reported fluoride exposure history during infancy. MATERIAL AND METHODS: In Spring 2002, a questionnaire distributed to a cluster random sample of 1039 parents enquired into their child's early oral health behaviors and included a "photographic toothpaste menu". The permanent upper anterior teeth (13-23) were examined clinically (+10% repeats) using a modified Thylstrup-Fejerskov Index. RESULTS: Complete data were available for 53% (n=548) of the sampled children. The prevalence offluorosis at any level was 49% (95% CI: 45-54%), and of fluorosis with esthetic concern (TF score > or =3) 4% (95% CI: 3-6%). Based on repeat observations, reliability was good (kappa = 0.82). There was no statistically significant increased risk of dental fluorosis prevalence associated with any of the fluoride exposure risk factors examined, including reported usage of (1000 ppm) fluoride toothpaste from time of first deciduous tooth eruption. CONCLUSIONS: While there were low levels of dental fluorosis of esthetic concern, half the children had some degree of dental fluorosis. The prevalence of dental fluorosis was not explained by the risk factors, including fluoride toothpaste usage as explored in this study.

Age Factors↗

PubMed2004

Development of methods to enhance extrinsic tooth discoloration for comparison of toothpastes. 1. Studies in vitro.

BACKGROUND: The interaction of chlorhexidine with dietary chromogens to cause extrinsic dental staining has been exploited in vitro and in vivo to study tooth discoloration and its control. These studies in vitro investigated factors that might enhance stain formation, and evaluated formulations to inhibit the stain with the primary aim of devising a protocol for use in vivo. METHOD: The standard method cycled acrylic specimens through saliva, 0.2% chlorhexidine and tea on the hour 8 times per day and stain was measured using a spectrophotometer. Test interventions were 3 "whitening" toothpastes (A, P, R), a fluoride toothpaste (C) and water. In studies 1 and 3 interventions were at 09:00 and 16:00, and in studies 2 and 4 at 09:00 and 13:00. Between cycles, specimens remained dry in studies 1 and 2 and were maintained in water day and night in studies 3 and 4. Studies 5-7 determined the influence of tea temperature, exposure time and concentration, and chlorhexidine temperature and exposure time on stain development. Studies 8-10 modified the standard procedure using tea at triple strength and 50 degrees C, and assessed stain inhibition by toothpastes and water using optical density, colorimetric and visual assessment recordings. RESULTS: In studies 1-4, there were highly significant differences between interventions. Overall, the experimental whitening paste (P) produced the most stain inhibition, and water or the proprietary whitening paste (R), produced the least stain inhibition. More stain inhibition was seen with interventions at 09:00 and 16:00. Both tea concentration and temperature significantly influenced staining. Chlorhexidine temperature did not influence staining. Exposure time to tea and chlorhexidine had a small effect on staining. In studies 8 and 9, interventions at 09:00 and 16:00 were more effective; the most stain inhibition was with paste P and the least with water, paste R being intermediate. In study 10, P was the most effective and R the least effective interventions. CONCLUSIONS: These studies in vitro suggest that the chlorhexidine tea stain model can be manipulated to enhance stain and thereby should improve discrimination between stain inhibition formulations. The timing of interventions in the model appears to be important. These studies in vitro were used to plan a clinical protocol.

Acrylic Resins↗

PubMed1992

Effect of supervised use of a fluoride toothpaste on caries incidence in pre-school children.

Caries prevalence of children living in Helsinki is low and little further reduction has been seen during recent years. The aim of the study was to investigate whether a supervised daily brushing at school with a fluoride toothpaste containing 1.2% sodium monofluorophosphate reduced caries incidence in a well-controlled group of nursery-school children with low caries prevalence. A total of 87 children from two nursery schools formed the test group. A group of children matched for age, baseline dfs and follow-up time, who had attended the same nursery schools just before starting this prospective study and who had brushed their teeth daily at school without toothpaste, formed a retrospective control group. After the follow-up time (mean 1.4 years), the total number of new carious surfaces was 23 in the test group (mean 0.3) and 83 in the control group (mean 0.9); the difference was significant. In the test group 72% and in the control group 62% of children were caries-free after the follow-up period. The results suggest that the use of a fluoride toothpaste as an extra daily prophylaxis reduces caries incidence in pre-school children.

Chi-Square Distribution↗

PubMed2006

Cheilitis caused by contact allergy to anethole in spearmint flavoured toothpaste.

A 63-year-old woman presented with a 6-year history of persistent cheilitis. Minimal improvement was achieved with therapeutic measures. Patch testing was positive to anethole, a flavouring used in her toothpaste. Her cheilitis resolved after cessation of the flavoured toothpaste. This case demonstrates the importance of considering contact allergy to toothpaste flavours in patients with cheilitis.

Allergens↗

PubMed1989

The effect of a cetylpyridinium chloride (CPC) detergent foam compared to a conventional toothpaste on plaque and gingivitis. A single blind crossover study.

A CPC-detergent formulation in a foam vehicle, was compared with a fluoride toothpaste for its ability to prevent plaque and gingivitis over a period of 12 days. Whilst refraining from all other oral hygiene procedures, the foam or toothpaste was applied to the teeth in fluoride application trays, in a group of 14 volunteers. At days 8 and 12 of this crossover study, the following assessments were made: gingival crevicular fluid; gingival index; bleeding on probing; plaque index; plaque area. Except for plaque area at day 8 of the study, there were no significant differences between the 2 products at either day 8 or day 12. It is therefore concluded that the CPC-detergent formulation, in its present form, does not inhibit plaque and gingivitis more effectively than a conventional fluoride toothpaste.

Adolescent↗

PubMed1993

The effects of a chlorhexidine toothpaste on the development of plaque, gingivitis and tooth staining.

Chlorhexidine has found many uses in clinical dentistry as an antiplaque agent. To date, effective chlorhexidine-containing toothpastes have not been made available. This study was the first phase in the evaluation of a 1% chlorhexidine toothpaste, formulated to ensure a high availability of the contained antiseptic. The study was a 19-day, randomised double-blind placebo-controlled, crossover experiment al gingivitis clinical trial employing 14 healthy human volunteers. From a zero plaque and low gingivitis baseline, the development of plaque, gingivitis and dental staining was measured on days 12 and 19 of the 2 study periods. The toothpaste was used 2x a day as a slurry rinse with no other form of oral hygiene. The washout period was 21 days. The development of plaque and gingivitis was statistically and clinically highly significantly reduced during the use of the active compared to the placebo product. Conversely, dental staining was statistically and clinically significantly increased. The product deserves further evaluation for potential clinical use.

Adult↗

PubMed1996

Oral mucosal desquamation of pre- and post-menopausal women. A comparison of response to sodium lauryl sulphate in toothpastes.

The aim of the present study was to investigate whether a difference in susceptibility to chemically induced irritation of the oral mucosa in 14 pre- and 14 post-menopausal women exists, following local exposure to sodium lauryl sulphate (SLS) in toothpastes. 4 different pastes differing only in detergent concentration present, or not, were used. The participants applied 1 cm of the different test toothpastes to a cap splint covering the teeth and the oral mucosa of the upper jaw 2 x daily for 2 min during a period of 4 days. 42 desquamative reactions of the oral mucosa (in 20 subjects) were observed, 29 and 13 in the pre- and the post-menopausal group, respectively. Desquamation was only experienced following exposure to SLS-containing toothpastes, not succeeding SLS-free paste. The results demonstrated that oral mucosa of pre-menopausal women was significantly more sensitive to SLS than oral mucosa of post-menopausal women. The difference in mucosal irritation between the 2 groups increased with increasing concentration of SLS.

Adult↗

PubMed2004

A methodology using subjective and objective measures to compare plaque inhibition by toothpastes.

OBJECTIVES: Plaque scoring usually employs subjective indices. The aim was to compare plaque inhibition of three toothpastes using two objective and one subjective measures of plaque. MATERIAL AND METHODS: Formulations were: (1) an experimental anti-plaque paste (test); (2) an experimental paste (minus active or negative control); and (3) a proprietary anti-plaque toothpaste product (positive control). The study was a blind, randomised crossover design using a 4-day, no tooth brushing, plaque regrowth model and involving 22 healthy subjects. After baseline plaque removal, subjects rinsed twice a day with slurries of the allocated paste. On day 5, plaque was scored by index, wet weight and optical density of extracted disclosing solution from the plaque (stain intensity). RESULTS: All data showed the same pattern. There were highly significant subject and treatment effects but not period effects. The positive control was highly significantly more effective in plaque control than the test and minus active experimental formulations, which in turn were not significantly different from each other. There were strong and significant correlations between pairs of scoring methods particularly wet weight and stain intensity. CONCLUSION: The use of objective methods of plaque alongside conventional subjective indices provided convincing evidence for increased discriminatory power in a study comparing plaque inhibition by toothpastes.

Adult↗

PubMed1978

Effect of socioeconomic factors on the observed caries reduction after fluoride tablet and fluoride toothpaste consumption.

The caries experience of 123 fluoride users (F-tablets and/or F-toothpaste) was compared with that of a group of 226 non-users. Fluoride users appeared to have a 15% lower DFS score (16.2) than non-users (19.0). After a matching procedure had been used to correct for some intervening variables (socioeconomic status, toothbrushing habit, sweet consumption) no difference was found between the groups of F-tablet and F-toothpaste users and the respective groups of matched non-users. The difference in caries experience of 15% between users and non-users remained in only one group after the matching procedure, that in which the children used both F-tablets and F-toothpaste.

Child↗

PubMed1994

Caries development after substitution of supervised fluoride rinses and toothbrushings by unsupervised use of fluoride toothpaste.

In a nonfluoridated community of Finland, where fortnightly fluoride rinsing with 0.2% sodium fluoride has been used for nearly two decades, a total of 313 children 7-8 yr old were recruited and randomly divided into two groups. 206 children completed the 3-yr trial. The control group (n = 94) participated in the rinsing program which included supervised toothbrushings, while the test group (n = 112) received a new fluoride toothpaste tube (0.15% F) for home use every second month. Annual dental recordings, treatment plannings and the treatment itself were all carried out by one clinician. At the end of the study the number of caries-free children of the toothpaste group was lower (P < 0.01) and the caries increment higher (P < 0.05) than that of the mouthrinse group. Out of the mean of four dental visits per child and year some 1.5 were prophylactic by nature. No differences were found between the number of treatment visits, time or prophylactic care of the two groups. Unsupervised use of fluoride toothpaste may not be a sufficient substitute for the school-based fortnightly fluoride rinses and supervised toothbrushings in caries prevention of children with erupting permanent teeth.

Child↗

PubMed2004

Fluoride ingestion from toothpaste: background to European Union-funded multicentre project.

As in most other established market economies throughout the world the prevalence of dental caries has declined in most Member States of the European Union (EU). There is evidence that the increased use of fluoride toothpaste has been a major factor in this improvement. Recently there has been increasing debate on the alleged link between increased use of fluoride toothpaste, particularly by infants and young children, and increased levels of enamel fluorosis. Central to these discussions are two issues, namely measurement of the amount of fluoride ingested by infants and young children and measurement of enamel opacities including fluorosis. The aims of the project described in this special issue addressed these two measurement issues. Seven EU Partners participated. Standardized methods for recording the amount of fluoride ingested when using fluoride toothpaste were developed and used in the seven sites. Similarly a standardized photographic method for recording enamel opacities, including fluorosis, was developed.

Cariogenic Agents↗

PubMed1978

Oral use of chlorhexidine gluconate toothpaste in epileptic children.

The purpose of this clinical study was to evaluate the effect of a 3-min daily toothbrushing with 1% chlorhexidine gluconate toothpaste on dental plaque, gingivitis and gingival hyperplasia in 30 mentally retarded epileptic children treated with phenytoin. A double-blind cross-over technique was used. Brushing once daily for 2 months with 1% chlorhexidine gluconate toothpaste resulted in significantly lower Pl I and G I values. Gingival hyperplasia was not significantly reduced by the use of the chlorhexidine toothpaste.

Administration, Oral↗

PubMed1980

Minor and trace inorganic components of toothpastes.

Elements present in minor or trace quantities in various toothpastes available in Scandinavia have been quantitatively assayed by means of emission spectrography and neutron activation analysis. The elements antimony, arsenic, mercury or selenium were observed at levels less than 2 parts/10(6). Boron, gallium, iron, magnesium, manganese and titanium occurred at levels between 0.001 and 1%. Cadmium, copper, lead, nickel and tin could not be identified. The detection limit for these elements amounted to 10 parts/10(6). The amounts of any of these elements which could be transferred to the body after swallowing toothpaste during brushing, have been compared with daily intake of similar elements through food and drinks, and found to be small compared to the diet intake except in the case of titanium. The intake of titanium from toothpaste could exceed the diet intake five times.

Dentifrices↗

PubMed1993

Experiments with a toothpaste containing polydimethylsiloxan/triclosan.

Polydimethylsiloxan (silicone oil) adsorbs to solid surfaces and to teeth because of its low surface tension, forming a thin, resistant layer. Triclosan is a lipid-soluble, antibacterial substance which is added to toothpastes and mouthwashes to inhibit plaque. Triclosan can be dissolved in silicone oil, conferring an antibacterial property on the layer of silicone oil which forms on solid surfaces. The aim of the present study was to determine whether a toothpaste containing triclosan/silicone oil has any effect on established gingivitis in a test panel of 33 teenagers. This toothpaste and a placebo paste were randomly distributed to the panel, and the number of gingival bleeding points was recorded. No instruction in oral hygiene was given. The panel was then examined 4 wk later and the number of bleeding points again recorded. It was found that the reduction in bleeding points was significantly higher in the group which had used the triclosan/silicone oil paste than in the placebo group. Deposition of a lipid-soluble, antibacterial agent in a layer of silicone oil which adsorbs to the tooth surfaces because of its physical properties represents a new and promising principle in preventive dentistry.

Adolescent↗

PubMed2006

The relative efficacy of fluoride toothpastes assessed with pH cycling.

This study addressed the dose response between fluoride toothpastes and in vitro de- and remineralization, to predict the efficacy of toothpastes and understand the mode of action in the range 0-3,000 ppm F. Enamel lesions were pH-cycled with calcium uptake and loss being assessed daily. Both 'shallow' (about 50 microm deep) and 'deep' (about 200 microm deep) lesions were studied. F treatments were given in 30 (w/v)% toothpaste dilutions for up to 5 min daily. Calcium loss during the demineralization periods showed a dose response, resulting in 72% reduction for 3,000 ppm F compared to 0 ppm F. Calcium uptake during remineralization was increased in the F compared to non-F groups, with F concentration being less important than its mere presence. Significant differences were observed in F response between shallow and deep lesions, suggesting that this parameter should be included when testing caries-preventive products. Microradiographic analysis showed that lesion depth and severity had increased significantly in the non-F groups. In the F groups, the original lesion was partly remineralized, while a new lesion had formed beyond the original lesion front. Mineral loss of this second lesion correlated inversely with the F concentration of the treatments. These data revealed that fluoride can drive demineralization further into enamel by making the surface tissue less soluble, hence by not neutralizing acids penetrating into the tissue. It is also concluded that depth analysis of mineral uptake and loss is important to understand the mode of action of different F products.

Analysis of Variance↗