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A 3-year clinical trial into the effect of fluoride content and toothpaste abrasivity on the caries inhibitory properties of a dentifrice.

The effect of reducing the abrasivity of toothpaste on dental caries was observed in a 3-year clinical trial involving 1106 11-13-year-old Berkshire schoolchildren were divided into three groups; Group 1 were allocated a low abrasivity paste containing 0.8% sodium monofluorophosphate, Group 2 a paste of conventional abrasivity also containing 0.8% sodium monofluorophosphate and Group 3 a low abrasivity non-fluoride paste. After 3 years the net DMFS increments (clinical and radiographic scores combined) were 4.22 in Group 1, 4.72 in Group 2 and 6.43 in Group 3. The differences between Groups 1 and 3 and between Groups 2 and 3 were highly significant (P less than 0.001). The mean increment in Group 1 was lower than in Group 2 but did not reach statistical significance. Reducing the abrasivity of the toothpaste had no meaningful effect on the standard of oral hygiene and prevalence of gingivitis as measured by the Gingival and Plaque Indices.

Adolescent↗

Fluoride ingestion from toothpaste: conclusions of European Union-funded multicentre project.

An important challenge encountered in this multicentred project was the need to take account of the different cultural and legal differences between the seven sites when agreeing the protocol. Examples such as access to registers of births and subject consent dictated that there were some differences in the methods used in the different sites. The data presented showed that it was possible to train and calibrate a number of examiners in a standardized photographic method for recording enamel fluorosis. This method has a number of important advantages for the objective monitoring of enamel fluorosis over time. There were considerable differences between the seven sites in the formulations of the toothpaste used and in the pattern of their use. The results indicate that it is possible to agree and adopt a standardized method for measuring fluoride ingestion from toothpaste. The aesthetic impact of enamel fluorosis seemed low in the populations included in this project, but further work is required on this issue.

Cariostatic Agents↗

Sensitivity to cinnamic aldehyde in a toothpaste. 2. Further studies.

The authors carried out further studies to assess the significance of the findings of patients sensitive to cinnamic aldehyde in a toothpaste. Selected groups of patients in whom sensitivity to this might have been overlooked were patch-tested. With the exception of three patients, two with cosmetic sensitivity and one with hand eczema, the results were negative. The frequency of use of the original toothpaste was assessed among patients attending the clinic and this was followed by a circular letter to general practitioners and dentists inviting referral of patients with oral symptoms. As a result, five further cases, four of whom gave positive patch test reactions to cinnamic aldehyde, were discovered. The authors emphasize the importance of attempting to obtain accurate information as quickly as possible when 'new' or hitherto unsuspected allergens are implicated.

Acrolein↗

Contamination of toothpaste and toothbrush by Streptococcus mutans.

Toothbrushes and toothpaste tubes used by persons infected with S. mutans were examined for the presence of this microorganism. Fifteen minutes after brushing greater than 10(6) S. mutans were isolated from the toothbrushes and after ordinary storage for 24 h 10(4) were recovered. From two out of 10 toothpaste tubes S. mutans was isolated from the orifice of the tube. The implications of these findings for the spread of the microorganism are discussed.

Dentifrices↗

Plaque inhibition and improved gingival condition by use of a stannous fluoride toothpaste.

The present study contains data from a 4-week clinical study where the effect of an experimental toothpaste containing 0.4% SnF2 on plaque and gingivitis was tested in a group of teenagers. The study was performed according to a double-blind, cross-over design. It was shown that the SnF2 containing toothpaste reduced both plaque and gingivitis significantly compared to a placebo paste which contained no fluoride or stannous ions.

Adolescent↗

The influence of toothpastes and prophylaxis pastes on fluorescence measurements for caries detection in vitro.

The aim of this study was to test the influence of toothpaste and prophylaxis paste remnants as well as powder remnants on DIAGNOdent readings. A total of 68 sites on the occlusal surface of human molars were used for this study. After a cleaning procedure, saliva was spread on the tooth surface, dried for 3 s, and DIAGNOdent (DD) values were measured. After these measurements were performed, 500 mg of the toothpaste or prophylaxis paste was taken and the occlusal surface was cleaned for 3 s with a slow rotating contra-angle handpiece. The paste was then rinsed off with the 3-in-1 syringe for 3 s using water with air. The DD measurements were taken again and the rinsing for 3 s and fluorescence measurements were repeated. The procedure with the powder using the PROPHYflex 2 was, in principle, the same. Whereas only small differences could be detected on sound surfaces, there was a distinct influence on decayed surfaces. It could be concluded that when the DIAGNOdent device is used in practice and special care in rinsing after cleaning is not taken, it is possible that false readings are registered.

Air↗

Prevention of early childhood caries--results of a fluoride toothpaste demonstration trial on Chinese preschool children after three years.

OBJECTIVES: This field demonstration trial evaluates the long-term effects of introducing daily toothbrushing with fluoride toothpaste in a Chinese kindergarten (test group) compared to caries development in children who had no organized preventive program (control group). METHODS: In the test group teacher-supervised toothbrushing was initiated with 1,000 ppm MFP toothpaste in addition to oral health education activities. Test and control children were examined at baseline (n = 289, aged 3 years) and annually thereafter. RESULTS: After three years, 251 children (87%) were still in the trial. Caries development (dmfs) calculation included only those children who were present at both baseline and subsequent annual examinations. At baseline the mean dmfs was 4.8 in the test group and 6.5 in the control group (NS). After three years the caries increment was 6.2 and 8.4 in the test group and the control group, respectively (P < .05). Adjusting for reversals, the net caries increment was 3.6 and 6.3, respectively (P < .01). Additionally, multiple linear regression analysis indicated that both baseline dmfs, the program and plaque level had a significant effect on the net caries increment. The use of hierarchical caries severity zones was useful for the identification of those children most at risk for further caries development. CONCLUSIONS: We conclude that a daily toothbrushing with limited involvement of professional staff was feasible in a Chinese kindergarten and that caries development was significantly slowed in the test children. Caries severity zones may possibly assist in determining levels of intervention.

Cariostatic Agents↗

An investigation of methods proposed for the analysis of the various forms of fluoride in toothpaste.

Analytical methods for the determination of soluble fluoride, soluble fluorine and total fluorine derivatives in toothpaste were investigated. Potentiometric determinations of soluble fluoride in TISAB-toothpaste slurries were shown to be inaccurate. Based on recovery measurements, analyses for soluble fluoride and soluble fluorine derivatives in the supernatant liquid were found to be reliable provided the slurrying time was standardized. A gas chromatography method for the analysis of total fluorine, using the silane derivative fluoride, was compared with methods involving ashing and distillation prior to colorimetric or potentiometric analysis.

Chromatography, Gas↗

Abrasion of human enamel and dentine caused by toothpastes of differing abrasivity determined using an in situ wear model.

OBJECTIVES: To determine the rates of enamel and dentine wear in situ during tooth brushing with a range of five toothpastes of differing RDA and REA values. METHODS: Enamel/dentine inserts were placed in the buccal aspects of full upper dentures of human volunteers. Enamel wear was determined by change in Knoop indent length and dentine wear was determined from the enamel-dentine step height, measured using optical profilometry. RESULTS: Significant differences between the test products were found for both enamel and dentine (p < 0.05). However for the conventional toothpastes the rate of wear was similar and differences between the products were not generally statistically significant for either enamel or dentine, despite the fact that their RDA values differed by more than a factor of two. The rate of wear was found to decrease throughout the duration of the study. CONCLUSIONS: The study demonstrated that the methodology used is capable of assessing enamel and dentine wear in situ within a relatively short period of time. The data suggest that whilst in vitro tests have value in understanding differences in abrasivity between products, they cannot be used to predict in vivo effects.

Adult↗

Role of fluoride toothpastes in a caries-preventive strategy.

While the clinical relevance of fluoride toothpastes per se is firmly established, the multifactorial processes involved in causation and prevention of caries render it difficult to define their exact role in an overall caries-preventive strategy. Therefore, an indirect pragmatic approach was chosen: the interpretation of secular trends in caries prevalence and other parameters is used to estimate the relative importance of this method of topical fluoride administration and to compare it with the contributions by other methods of prevention. All methods of caries prevention, with the exception of population-administered measures such as fluoridation of drinking water or domestic salt, can only work when applied regularly and conscientiously. For this reason behavioural aspects such as compliance and the chances for widespread (if not universal) application have to be considered. There is indirect evidence that toothbrushing with fluoride toothpastes is a highly probable explanation for the decline of caries prevalence in developed countries since the 70s; moreover, toothbrushing, and the use of therapeutic dentifrices, is considered to meet spreading compliance because a 'healthy mouth' becomes more and more socially desirable in growing numbers of subpopulations.

Attitude to Health↗

Controlled trial of the action of a toothpaste containing nicomethanol hydrofluoride in the treatment of dentine hypersensitivity.

A double-blind clinical trial was performed on 76 patients with dentine hypersensitivity. For four weeks the patients used either a toothpaste containing nicomethanol hydrofluoride or one containing potassium nitrate and sodium monofluorophosphate. After one, two and four weeks the pain responses of the teeth to three types of stimuli were assessed. In normal conditions of oral hygiene, the nicomethanol hydrofluoride toothpaste was found at least as effective as the potassium nitrate/sodium monofluorophosphate preparation.

Adult↗

The benefits of toothpaste--real or imagined? Review of its role in tooth whitening.

The market for whitening toothpastes in the UK is burgeoning at present, but little has been published about the modes of action or efficacy of such pastes. Much is known about how the individual ingredients work, but toothpaste formulations are complex and there is potential for interaction. Studies have been undertaken to compare the efficacy of various test products, but these have used different types of trial design and consequently direct comparisons are difficult, not least because there are several ways of measuring 'whiteness', and there is no consensus of opinion between workers in this field as to the best way to record it.

Anti-Infective Agents, Local↗

'Calcium fluoride-like' material formed in partially demineralized human enamel in vivo owing to the action of fluoridated toothpastes.

In this paper are presented the results of a chemical analysis of partially demineralized enamel lesions positioned under plaque in vivo for 3 weeks. During the experimental period the samples were brushed with fluoridated or non-fluoridated toothpaste systems. After the experiment the fluoride and protein uptake was determined. Furthermore, KOH extractions of the lesions were carried out and the solutions analyzed for calcium, fluoride, and phosphate. The results show that 'CaF2-like' material is most likely formed inside lesions during the in vivo period. This in indicated from chemical analysis, Raman spectroscopy, and SEM observations. The amount of CaF2-like material is on the order of 0.1 wt% if we consider its formation all over the enamel lesions, or 1 wt% if we assume its formation in interprismatic regions of the enamel only. About 40% of the fluoride taken up from toothpaste systems is in the form of CaF2-like material. In vivo there is a substantial influx of proteins (approximately 0.3%) and also a very large influx of phosphate ions. The effect of CaF2-like material is most likely strongly dependent on conditions in the lesion, such as pH change.

Calcium↗

Dentin permeability after toothbrushing with different toothpastes.

PURPOSE: To evaluate the interaction of smear layer produced during brushing and dentifrice particles. MATERIALS AND METHODS: Dentin disks were obtained from extracted human third molars. Dentin permeability was evaluated using a hydraulic pressure apparatus working at 1 psi of pressure. After preparation, each sample was connected to the hydraulic pressure apparatus to evaluate the permeability of dentin with the smear layer produced during specimen preparation. After 5 min of measurements dentin was etched with 37% phosphoric acid gel for 2 min, washed and gently dried with cotton to measure the permeability after smear layer removal. This was done to measure the maximum permeability of each specimen (expressed as 100%). Then a second smear layer was produced using a #400 carbide paper under water for 1 min. Dentin permeability of the smear layer covered dentin was then measured, and expressed as a percent of the maximum permeability of that specimen, permitting each specimen to serve as its own control. The three toothpastes used (Merfluan powder, Merfluan paste and Fluorigard) were applied on dentin surfaces using a small sponge to completely cover the dentin surface. After 5 s, each sample was connected to a mechanical device and brushed under water for 3 min with constant pressure of 250 gr using a Colgate medium toothbrush. After this treatment, each sample was gently washed with tap water, gently air dried for 3-5 s and connected with the pressure apparatus to remeasure the permeability after brushing. For SEM examination of dentin before and after treatment with toothpaste and brushing, each dentin and enamel sample was fixed in 2% buffered glutaraldehyde. RESULTS: Dentin permeability proved unaffected by dentifrice treatments. SEM observations demonstrated the presence of dentifrice particles on dentin surface and inside dentin tubules. Smear plugs produced during dentin brushing were not removed by dentifrices.

Dentin↗

Dental caries and fluorosis prevalence study in a nonfluoridated Brazilian community: trend analysis and toothpaste association.

The main purpose of this study is to compare data from previous surveys to current prevalence rates of dental caries and dental fluorosis in eleven- and twelve-year-olds in a non-fluoridated Brazilian community (< 0.2 ppm F). This study also assesses the possible association between use of fluoride toothpaste and the prevalence of dental caries and dental fluorosis. The sample subjects are randomly selected schoolchildren who were examined with a dental probe and buccal mirror under natural light. The intra-examiner error was calculated, using Kappa statistics (K tau 0.85). The results showed that between 1991 and 1997 there was a 56.7 percent decrease in the prevalence of dental caries and an 80.1 percent increase in dental fluorosis. Children with dental fluorosis were 1.75 times more likely to be free of caries (OR = 1.75-CI:0.43, 6.68). Children who started using fluoride toothpaste before the age of three were 4.43 times more likely to have dental fluorosis than those who started using it after the age of three (OR = 4.43-CI:0.51, 99.61). The results of the cross-sectional surveys conducted with schoolchildren in 1991, 1995, and 1997 suggest a continuing decrease in the prevalence of dental caries and an increase in the prevalence of dental fluorosis in this nonfluoridated Brazilian town.

Age Factors↗

[Determination of glycyrrhetic acid in toothpaste by reversed-phase high performance liquid chromatography (RP-HPLC)].

A method for determining glycyrrhetic acid in toothpaste by RP-HPLC is described. The operating conditions were YWG-C18 column (4.0 mm i.d. x 250 mm, 10 microns) at room temperature, V(methanol):V(0.01 mol/L KH2PO4) = 85:15 (pH 3.0) as mobile phase with flow rate of 1.0 mL/min and UV detection at 254 nm. Glycyrrhetic acid in toothpaste samples were extracted with methanol. The average recoveries of glycyrrhetic acid were 99.61%-101.67%. The relative standard deviations were 1.85%-3.16%. The method is simple, rapid and accurate.

Administration, Topical↗

[Clinical analysis of the sodium-fluoride and sodium-monofluorophosphate content of Colgate toothpaste].

After six weeks use of Colgate toothpaste (1000 ppm MFP and 450 ppm NaF) in case of 50 individuals (25 test and 25 control persons) both the Plaque Index of Silness and Löe and the modified Sulcus Bleeding Index--"bleeding on probing" (Mühlemann and Son) mean values showed a significant decrease. According to the results of cytological testing the effect of toothpaste containing MFP and NaF proved favourable. The investigation of the ionisable plaque fluoride content produced statistically significant rise in plaque fluoride content.

Adult↗