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The comparative plaque removal efficacy of two advanced manual toothbrush designs in two independent clinical studies.

Two independent studies were conducted to evaluate and compare the clinical performance of two commercially available manual toothbrushes (Colgate Total Professional and the Oral-B Cross Action). Study I was a short-term, examiner-blind crossover clinical trial (N = 30) designed to measure the removal of 24-hour plaque build-up. All subjects refrained from brushing for 24 hours and were screened for dental plaque on the facial and lingual surfaces of all natural teeth using the Rustogi Modified Navy Plaque Index. Patients then received one of the two study toothbrushes and brushed their teeth for a timed one minute. They were then re-assessed for plaque. The data showed that the Colgate Total Professional toothbrush performed better than the Oral-B Cross Action toothbrush in reducing whole-mouth plaque scores (p < 0.001). Study II was a definitive six-week, single-blind clinical trial (N = 55), conducted in harmony with American Dental Association guidelines, to assess the ability of the two toothbrushes to reduce supragingival plaque and gingivitis. In this study, the subjects were stratified into two balanced groups based on their baseline plaque and gingivitis scores. Subjects were then instructed to continue with their normal brushing technique twice daily for one minute with their assigned toothbrush and a commercially available dentifrice. Examinations for plaque (Rustogi Modified Navy Plaque Index), and gingivitis (Loe-Silness Gingival Index) were conducted by the same examiner at baseline, after three weeks, and again after six weeks. The data from this long-term clinical trial showed that the Colgate Total Professional toothbrush exhibited statistically significantly lower plaque and gingivitis scores than did the Oral-B Cross Action toothbrush. The magnitudes of these differences were 29.5% for plaque and 31.1% for gingivitis. These reductions are adequate to support the claim that the Colgate Total Professional toothbrush provides clinically superior control of supragingival plaque and gingivitis, when studied in accordance with the criteria provided by the 1999 Guidelines of the American Dental Association for determining superiority.

Adolescent↗

Thomas Lea Buckingham, MD, DDS, (1816-1883).

Miller, farmer, mechanic, dry goods merchant, dentist, author, physician, teacher, inventor, and fourteenth president of the American Dental Association, take your pick, for Thomas Lea Buckingham without feigning, embraced that menu to the brim--the verge beyond which, only a pittance of dentists might succeed. Nevertheless, the facts lie untouched--a testament to one of dentistry's most brilliant, unassuming, and dedicated disciples. Loved by his students and respected by his peers, Thomas Lea Buckingham reached new heights in garnishing respect from his colleagues. Sharing his knowledge, Dr. Buckingham profusely wrote about his findings, being affirmed by at least 25 dental periodicals (many with multiple contributions), over a period of thirty-four years, from 1850 to 1884. His principal writings appeared in Dental Cosmos, Johnston's Dental Miscellany, New York Odontologic Society Transcripts, Odontologic Society of Pennsylvania, American Dental Association Transactions, Dental Items of Interest, Pennsylvania Journal of Dental Science, Dental News, Dental Jairus, Missouri Dental Journal, Dental Registrar, New England Journal of Dentistry, and the British Journal of Dental Science. Upon Buckingham's death, noted dentists of his era spoke with love and respect of this exceptional dentist. This paper highlights the maturation of a minimally educated miller, who, with determination and purpose, rose to the pinnacle of his selected professions and garnered the love and respect of his fellow men.

History, 19th Century↗

Effective control of dental chair unit waterline biofilm and marked reduction of bacterial contamination of output water using two peroxide-based disinfectants.

Bacterial biofilm in dental unit waterlines (DUWs) is a widespread problem, and poses a potentially significant risk of infection to dental staff and patients, particularly those who are medically compromised or immunocompromised. The purpose of the present study was to investigate the level of bacterial contamination of dental chair unit output water in the Dublin Dental Hospital, and to investigate the efficacy of two hydrogen peroxide-based disinfectants in reducing bacterial loads to < or =200 cfu/mL as recommended by the American Dental Association. The chemical quality of dental chair unit input and output water was well within the limits recommended for potable water. Water supplied to the units yielded an average aerobic heterotrophic bacterial cell density of 184 cfu/mL. However, the corresponding density in output water was considerably higher; the average cell density in water from the three-in-one air/water syringes and cup fillers in 12 chairs was 8200 and 4300 cfu/mL, respectively. Dental unit water obtained from 18 separate reservoir-supplied units in general practices in the Dublin area yielded an average of 66000 cfu/mL. The bacterial species found were predominantly environmental organisms, which were also present at low levels in the input water. Some of the species identified (e.g., Burkholderia cepacia and Pseudomonas fluorescens) are known opportunistic pathogens. The capacity of two disinfectants, Sterilex Ultra and Sanosil, to reduce bacterial contamination to safe levels was compared. In a controlled study, once weekly overnight (15 h) disinfection using either agent reduced the bacterial density to below the American Dental Association recommended level of 200 cfu/mL. However, once disinfection ceased the bacterial loads increased to unacceptably high levels within three weeks. Electron microscopic analysis showed that both disinfectants markedly reduced biofilm in the DUWs, but the biofilm rapidly became extensive again when once weekly disinfection ceased. While both disinfectants were equally effective in lowering the bacterial counts to acceptable levels, Sterilex Ultra was associated with clogging of DUWs in some dental chair units after repeated usage, suggesting that Sanosil is a more suitable agent for routine use.

Biofilms↗

The clinical efficacy of Colgate Total Plus Whitening Toothpaste containing a special grade of silica and Colgate Total Toothpaste for controlling breath odor twelve hours after toothbrushing: a single-use clinical study.

The objective of this double-blind clinical study, conducted in harmony with American Dental Association guidelines, was to compare a new dentifrice formulation variant of Colgate Total Toothpaste containing a special grade of silica (Colgate Total Plus Whitening Toothpaste) to the commercially available, ADA-Accepted and clinically proven Colgate Total Toothpaste for controlling breath odor twelve hours after brushing the teeth. Breath odor was evaluated by a panel of three examiners using a nine-point hedonic scale. Following a baseline evaluation of breath odor, prospective study subjects who scored above the threshold value for unpleasant breath odor were stratified by score and randomized into two treatment groups. Subjects were provided with a soft-bristled toothbrush, and brushed their teeth thoroughly in their regular and customary manner with their assigned dentifrice. Subjects refrained from dental hygiene, breath mints or mounthrinses for the next twelve hours, after which they were again evaluated for breath odor. Eighty-three (83) adult male and female subjects from the Mississauga, Ontario, Canada area participated in the study. At twelve hours after brushing their teeth, subjects in both dentifrice treatment groups presented mean breath odor scores which were statistically significantly lower than the mean scores observed at baseline. Importantly, there was no statistical difference between the two dentifrices of the mean twelve-hour breath odor scores. The mean twelve-hour breath scores for the Colgate Total Plus Whitening Toothpaste group and the Colgate Total Toothpaste group were 4.89 and 4.67, respectively, which are within the range of values corresponding to pleasant breath odor. Thus, the results of this double-blind clinical study, conducted according to a protocol which had been approved by the Council on Scientific Affairs of the American Dental Association, support the conclusion that Colgate Total Plus Whitening Toothpaste and Colgate Total Toothpaste provide effective control of breath odor at twelve hours after toothbrushing.

Adolescent↗

The clinical efficacy of Colgate Total Plus Whitening Toothpaste containing a special grade of silica and Colgate Total Fresh Stripe Toothpaste in the control of plaque and gingivitis: a six-month clinical study.

The objective of this six-month, placebo-controlled, double-blind clinical study, conducted in harmony with American Dental Association guidelines, was to provide an assessment of the effectiveness of a new dentifrice formulation of Colgate Total Toothpaste containing a special grade of silica (Colgate Total Plus Whitening Toothpaste), vs. Colgate Total Fresh Stripe Toothpaste as a control, and a placebo dentifrice without triclosan and the copolymer, for the control of supragingival dental plaque and gingivitis. Adult male and female subjects from the state of New Jersey were entered into the study, and stratified into three treatment groups which were balanced for baseline Quigley-Hein Plaque Index scores and baseline Löe-Silness Gingival Index scores. Subjects received an oral prophylaxis, and were instructed to brush their teeth twice daily (morning and evening) for one minute with their assigned dentifrice, using a soft-bristled toothbrush. Examinations for supragingival plaque and gingivitis were conducted after three-months' and again after six-months' participation in the study. One-hundred ten (110) subjects complied with the protocol and completed the entire six-month clinical study. At both the three- and six-month study examinations, the Colgate Total Plus Whitening Toothpaste group and the Colgate Total Fresh Stripe Toothpaste group exhibited statistically significantly less supragingival plaque and gingivitis than did the placebo toothpaste group. At the six-month examination, the magnitude of these differences exceeded 23.0% for all four parameters measured in the Colgate Total Plus Whitening Toothpaste group (29.9% for Plaque Index, 59.2% for Plaque Severity Index, 23.2% for Gingival Index, and 75.1% for Gingivitis Severity Index). Also, at the six-month examination, the magnitude of these differences exceeded 21.0% for each of the four parameters measured in the Colgate Total Fresh Stripe Toothpaste group (27.9% for Plaque Index, 54.9% for Plaque Severity Index, 21.4% for Gingival Index and 69.2% for Gingivitis Severity Index). The results of this six-month clinical study support the conclusion that Colgate Total Plus Whitening Toothpaste and Colgate Total Fresh Stripe Toothpaste provided a statistically significant, clinically relevant level of efficacy for the control of supragingival plaque and gingivitis, in accordance with the criteria provided by current American Dental Association guidelines.

Adult↗

The enhanced anticaries efficacy of a sodium fluoride and dicalcium phosphate dihydrate dentifrice in a dual-chambered tube. A 2-year caries clinical study on children in Brazil.

PURPOSE: To clinically evaluate and compare a dentifrice system in a dual-chambered tube, wherein one chamber contained sodium fluoride in a silica base and the other chamber contained dicalcium phosphate dihydrate (Test Dentifrice delivering 0.243% sodium fluoride), to a dentifrice containing 0.243% sodium fluoride in a silica base (Positive Control Dentifrice). MATERIALS AND METHODS: This study was conducted in harmony with the published 1988 American Dental Association guidelines for studies geared toward the comparison of fluoride dentifrices. This 2-yr caries clinical study employed a double-blind, parallel-group design, and involved 6-10 yr-old children from the metropolitan area of Maceio, Alagoas, Brazil. Qualifying subjects were stratified according to age and sex, and were randomly assigned to the two treatment groups, with multiple subjects in the same household all assigned to the dentifrice randomly allocated to the first among them. Caries examinations were conducted in accordance with U.S. Food and Drug Administration guidelines for the clinical evaluation of drugs to prevent dental caries. One calibrated examiner performed all the measurements. After treatment assignment, study participants were instructed to brush their teeth at home with their assigned dentifrice at least twice daily. Brushing instructions were reinforced by indoctrination in proper oral hygiene techniques by dental professionals, supplemented by pamphlets supplied by the sponsor and yearly mailings to participants, emphasizing good oral hygiene and the need to enforce compliance with the study. Post-baseline examinations were performed after 1 yr of product use, and again after 2 yrs of product use. RESULTS: Two thousand four hundred thirty-two (2,432) subjects completed this 2-yr study. For these subjects, the mean caries scores (DMFS, decayed, missing and filled tooth surfaces) at baseline were 3.84 for the Test Dentifrice group, and 4.06 for the Positive Control Dentifrice group. For caries increments after 1 yr, the respective means were 2.02 for the Test Dentifrice group and 2.12 for the Positive Control Dentifrice group. Finally, after 2 yrs, the mean caries increments were 4.30 for the Test Dentifrice group, and 4.83 for the Positive Control Dentifrice group. No statistically significant difference was indicated between the treatment groups at baseline or between the 1-yr caries increment scores. However, there was a statistically significant difference in the 2-yr caries increment scores between the treatment groups. Relative to the Positive Control Dentifrice group, the Test Dentifrice group presented a 10.97% reduction in caries increment scores at 2 yrs. In accordance with the procedures and standards provided by the published guidelines of the American Dental Association for the comparison of the anticaries efficacy of fluoride dentifrices, the results of this study support the conclusion that the dentifrice system in a dual-chambered tube, wherein one chamber contained sodium fluoride in a silica base and the other chamber contained dicalcium phosphate dihydrate, delivering 0.243% sodium fluoride, provided a superior level of anticaries efficacy than did the dentifrice containing 0.243% sodium fluoride in a silica base.

Brazil↗

The enhanced anticaries efficacy of a sodium fluoride and dicalcium phosphate dihydrate dentifrice in a dual-chambered tube. A 2-year caries clinical study on children in the United States of America.

PURPOSE: To clinically evaluate and compare a dentifrice system in a dual-chambered tube, wherein one chamber contained sodium fluoride in a silica base and the other chamber contained dicalcium phosphate dihydrate (Test Dentifrice delivering 0.243% sodium fluoride), to a dentifrice containing 0.243% sodium fluoride in a silica base (Positive Control Dentifrice). MATERIALS AND METHODS: This study was conducted in harmony with the published 1988 American Dental Association guidelines for studies geared toward the comparison of fluoride dentifrices. This 2-yr caries clinical study employed a double-blind, parallel-group design, and involved 5-17 yr-old children from the Central and South areas of Florida and from the Lares area of Puerto Rico. Qualifying subjects were stratified according to age and sex, and were randomly assigned to the two treatment groups, with multiple subjects in the same household all assigned to the dentifrice randomly allocated to the first among them. Caries examinations were conducted in accordance with U.S. Food and Drug Administration guidelines for the clinical evaluation of drugs to prevent dental caries. Two calibrated examiners performed all the measurements. After treatment assignment, study participants were instructed to brush their teeth at home with their assigned dentifrice at least twice daily. Brushing instructions were reinforced by indoctrination in proper oral hygiene techniques by dental professionals, supplemented by pamphlets supplied by the sponsor and yearly mailings to participants, emphasizing good oral hygiene and the need to enforce compliance with the study. Post-baseline examinations were performed after 1 yr of product use, and again after 2 yrs of product use. RESULTS: Two thousand five hundred six (2,506) subjects completed this 2-yr study. For these subjects, the mean caries scores (DMFS, decayed, missing and filled tooth surfaces) at baseline were 2.29 for the Test Dentifrice group, and 2.47 for the Positive Control Dentifrice group. For caries increments after 1 yr, the respective means were 0.69 for the Test Dentifrice group and 0.81 for the Positive Control Dentifrice group. Finally, after 2 yrs, the mean caries increments were 1.25 for the Test Dentifrice group, and 1.46 for the Positive Control Dentifrice group. No statistically significant difference was indicated between the treatment groups at baseline or between the 1-yr caries increment scores. However, there was a statistically significant difference in the 2-yr caries increment scores between the treatment groups. Relative to the Positive Control Dentifrice group, the Test Dentifrice group presented a 14.38% reduction in caries increment scores at 2 yrs. In accordance with the procedures and standards provided by the published guidelines of the American Dental Association for the comparison of the anticaries efficacy of fluoride dentifrices, the results of this study support the conclusion that the dentifrice system in a dual-chambered tube, wherein one chamber contained sodium fluoride in a silica base and the other chamber contained dicalcium phosphate dihydrate, delivering 0.243% sodium fluoride, provided a superior level of anticaries efficacy than did the dentifrice containing 0.243% sodium fluoride in a silica base.

Adolescent↗