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Short-term effects of different toothpaste formulations on total salivary calcium: A randomized crossover study.

OBJECTIVES: Dental calculus formation can be inhibited by toothpastes containing pyrophosphate, which chelates calcium ions and prevents hydroxyapatite crystal formation. Although pyrophosphate may also influence salivary calcium availability, the short-term effects of commercially available toothpaste formulations on salivary calcium concentrations remain insufficiently characterized. This study investigated and compared the short-term effects of three fluoride toothpastes on salivary calcium concentration. METHODS: A randomized, three-treatment, three-period crossover trial was conducted in 48 healthy volunteers. The participants used three commercially available sodium fluoride toothpastes in randomized order: a formulation containing methyl vinyl ether/maleic acid copolymer, PVM/MA copolymer (Sensodyne), a formulation containing pyrophosphate and zinc (Dentalux), and a formulation containing sodium bicarbonate (Parodontax). Treatment periods were separated by a 2-day washout. Unstimulated saliva was collected at baseline (T0), immediately after brushing (T1), 30 min (T2), and 60 min (T3). Salivary calcium concentrations were quantified using a colorimetric assay. Data were analysed using linear mixed-effects models with toothpaste formulation, measurement time, treatment sequence, and the toothpaste-by-time interaction as fixed effects and participant as a random effect. RESULTS: Significant effects were observed for toothpaste formulation (F(2,103.35)=42.31, P&#x2009;<&#x2009;0.001), measurement time (F(3,141)=39.78, P&#x2009;<&#x2009;0.001), and the toothpaste-by-time interaction (F(6,141)=23.91, P&#x2009;<&#x2009;0.001), whereas treatment sequence had no significant effect (P&#x2009;=&#x2009;0.927). Compared with Dentalux&#xae; and Sensodyne&#xae;, Parodontax&#xae; resulted in significantly lower salivary calcium concentrations (both Bonferroni-adjusted P&#x2009;<&#x2009;0.001), immediately after brushing (T1). The differences decreased after 30 min and were no longer significant after 60 min. No significant differences were observed between Dentalux&#xae; and Sensodyne&#xae; at any time point. CONCLUSIONS: Commercially available fluoride toothpastes produced different short-term effects on the salivary calcium concentration, with the greatest differences occurring immediately after brushing. Because the products differed in terms of multiple formulation ingredients, the findings reflect product-level effects rather than ingredient-specific effects. Further multicentre studies are warranted to confirm these findings and evaluate their clinical relevance.

Humans↗

The effects of toothpastes on the residual microbial contamination of toothbrushes.

BACKGROUND: Contaminated toothbrushes have been shown to harbor and transmit viruses and bacteria. The authors conducted a study to evaluate the effect of a triclosan-containing toothpaste on the residual anaerobic microbial contamination of toothbrushes. METHODS: Twenty patients who had Type III or Type IV periodontitis participated in this study. One side of each of their mouths served as a control (no toothpaste). The teeth on the other side were brushed with a regular toothpaste or a triclosan-containing toothpaste. After the toothbrushes were allowed to dry in air for four hours, the authors placed the toothbrush heads in solution, dislodged the microbes from the brushes by vortexing and plated them in culture dishes. The authors anerobically incubated the culture dishes and determined the presence or absence of Prevotella species or Ps; Porphyromonas gingivalis, or Pg; and Actinobacillus actinomycetemcomitans, or Aa. RESULTS: The authors detected Aa and Pg on the control toothbrushes more frequently than they did Ps. This variation in isolation frequency was statistically significant by chi 2 analysis (P < .001). The authors compared the isolation frequency of the three test organisms between the control and regular-toothpaste groups, between the control and triclosan-containing--toothpaste groups, and between the triclosan-containing--toothpaste and regular-toothpaste groups. They found no significant intergroup differences in the isolation frequencies after using chi 2 analysis. CONCLUSIONS: Toothpaste use reduced the residual microbial contamination for two of three test organisms, but the lower isolation frequencies were not statistically significant. Further study in this area is indicated. CLINICAL IMPLICATIONS: Dental professionals should advise patients who have systemic, localized or oral inflammatory diseases to disinfect or frequently replace their toothbrushes.

Aggregatibacter actinomycetemcomitans↗

Verification of caries inhibition by a tartar control toothpaste.

OBJECTIVE: The anticaries properties of a silica-based, sodium fluoride (NaF) toothpaste containing tetrapotassium pyrophosphate (PPi) with anti-tartar properties (Aquafresh All Tartar Control) were assessed in specific pathogen-free Osborne-Mendel rats. METHODOLOGY: The dentifrice was compared to a silica-based, fluoride-free control toothpaste that contained PPi but no NaF, termed a "Placebo" (negative control), and a NaF-containing silica-based USP reference standard toothpaste which was used as a positive fluoride control toothpaste. Sixty weanling rats were randomly distributed into groups of 20; all were inoculated with S. mutans 10449S, ate cariogenic diet 2000, and drank demineralized water, ad libitum. Each toothpaste, contained in coded tubes, was applied to the dentitions of rats' teeth for one minute, twice daily on weekdays and once daily on weekends and holidays. There was no difference in weight gains or in recoveries of the S. mutans inoculant from tooth swabs among the groups at either the 24- or 38-day post-inoculation recovery date. After euthanasia at 42 days and defleshing, heads were randomly coded and scored blindly for carious lesions according to Keyes/Larson methods. Only after scoring was completed were the random codes broken to enable statistical analyses. Only after statistical analyses were completed and the data reported to sponsor were the identities of the test items revealed. RESULTS: Both the NaF/PPi-containing and the NaF-containing USP standard toothpaste groups had lower total enamel caries scores (29.8 to 30.6%, respectively) than the group treated with the fluoride-free PPi-containing control. Similar-dimensioned differences were evident both at smooth surface and sulcal enamel sites and in dentinal sites. All were statistically significant at p < 0.001. There were no statistically significant differences at any tooth surface category site between the two fluoride-containing toothpastes' effects. CONCLUSION: It is thus apparent that Aquafresh All Tartar Control, an anti-tartar NaF toothpaste, retains the anticaries benefit of a USP reference standard NaF toothpaste in vivo.

Animals↗

[The inhibitive effect of IgY toothpaste against oral Streptococcus mutans].

PURPOSE: To study the effect of the toothpaste containing IgY against oral Streptococcus mutans. METHODS: 140 subjects were divided into 2 groups randomly (test group and control group). Before the beginning of the test, every subject underwent a elution period in order to lessen the other interference factors, then used different toothpastes were used respectively and the test began. Streptococcus mutans values were determined with Dentocult SM Strip just before test, at 1, 3, 7, 30 days after toothpaste used and 14 days after stopping toothpaste used. RESULTS: (1) In test group,Streptococcus mutans values decreased at 1 day after toothpaste used. In control group Streptococcus mutans values decreased at 3 days after toothpaste used. (2) Streptococcus mutans values decreased gradually in each groups after toothpaste used. (3) In test group, 2 weeks after stopping toothpaste used, Streptococcus mutans values were still suppressed. CONCLUSION: The application of the toothpaste containing IgY may reduce oral Streptococcus mutans levels significantly.

Child↗

Toothpastes containing 0.3% and 0.5% triclosan. I. Effects on 4-day plaque regrowth.

Triclosan has been added to toothpaste formulations, alone or with zinc salts, to reduce plaque regrowth. The most encouraging results have been obtained with triclosan/zinc formulations particularly at the higher concentrations of one or both agents. Formulations containing 0.2% triclosan alone have shown less promise and the aim of this study was to measure plaque regrowth over 4-day periods with the use of 0.3% and 0.5% triclosan toothpastes with and without the addition of a copolymer, polyvinyl methyl ether maleic acid (PVM/MA) and to compare the findings with a conventional fluoride/anionic detergent based toothpaste and a 0.2% chlorhexidine mouthrinse. The method was a no oral hygiene randomized 6 times crossover study using the toothpaste slurry rinsing method. Plaque was recorded by a plaque index and by area. Three of the four triclosan toothpastes reduced plaque regrowth significantly compared with the placebo, with no significant differences among the triclosan toothpastes. Plaque scores were always significantly lower with the chlorhexidine mouthwash compared to all toothpastes. The results suggest that at 0.3% to 0.5% triclosan alone or with a copolymer toothpaste may be a benefit to oral hygiene, but whether this is sufficient to affect gingival health requires further clinical evaluation. Further research would also appear indicated to determine optimal levels for the copolymer concentrations in toothpastes.

Adult↗

The state of fluorides in toothpastes.

Formulating an effective toothpaste formula requires that fluoride (F) in toothpaste must be made available to the enamel microenvironment in reactive form (bioactive). The aims of this study were to evaluate the compatibility of F with the abrasives (cleaning and polishing agents) used in toothpaste formulations and to monitor the effect of ageing on availability of F in NaF/abrasive mixtures as well as in toothpaste formulations. There was a great variation in the rate and extent of loss of F in the NaF/abrasive mixtures and in the toothpaste formulas. Addition of NaF solution to aluminium- and calcium-containing abrasives resulted in losses of 60-90 per cent of the added F after 1 week's storage at room temperature. At 1 month of age, calcium phosphate dihydrate and aluminium silicate adsorb about four times more F than calcium carbonate. On the other hand, sodium bicarbonate and sodium metaphosphate inactivated 20-25 per cent of the added F after 9 months' storage. Silica was inert in binding and inactivating F of NaF and Na2PO3F (MFP). Calcium-containing abrasives were markedly more compatible with MFP than with NaF. After 12 months of storing the toothpastes, the soluble F (initial F- plus F of hydrolysed PO3F2-) in MFP-calcium carbonate/sodium silicate toothpaste was twice as much as MFP-calcium carbonate/aluminium silicate toothpaste.(ABSTRACT TRUNCATED AT 250 WORDS)

Chemical Phenomena↗

[Osteofluorosis caused by excess use of toothpaste].

BACKGROUND: Osteofluorosis is caused by chronic fluoride intoxication. Fluoride is used in toothpaste for the prevention of dental caries, and dental fluorosis has often been reported among children and attributed to ingestion of fluoride toothpaste. We report a case of chronic fluoride intoxication caused by excess use of toothpaste in an adult. CASE: A 45-year-old woman consulted a rheumatologist for painful swelling of the fingers, phalangeal rather than articular. She also had brown staining on her teeth. Radiography of the hands showed periosteal apposition on the phalanges. Further work-up ruled out tumoral or thyroid causes. Laboratory tests showed elevated fluoride levels in the blood (50.9 micromol/L, normal<1.5 micromol/L) and in the urine (721 micromol/L, normal<46 micromol/L). On questioning, we found only one cause for chronic fluoride intoxication: excess and unusual use of toothpaste. The patient brushed her teeth 18 times a day and swallowed the toothpaste, because she liked the taste. She consumed a tube of toothpaste every 2 days, thereby swallowing 68.5 mg of fluoride every day. Suspecting fluorosis from toothpaste, we asked the patient to use a toothpaste without fluoride. Sixteen weeks later, the pain had ceased, and laboratory tests showed massively reduced but still elevated fluoride levels in the blood (6.9 micromol/L) and urine (92.7 micromol/L). CONCLUSION: In this rare case of fluoride intoxication, misuse of a normally innocuous product caused osteofluorosis.

Bone Diseases↗

Investigation of erosion and abrasion on enamel and dentine: a model in situ using toothpastes of different abrasivity.

BACKGROUND: Studies in vitro suggest that abrasion and erosion may act synergistically to produce wear of enamel and dentine. Methods in situ are recently available to study separately erosion and abrasion of dental tissues. The aim of this study was to combine two in situ protocols to study the interplay between erosion and abrasion of enamel and dentine. METHOD: The study was a single-blind, randomised, five-treatment cross-over design involving 15 healthy volunteers. During each 10-day study period, subjects wore from 0900 to 1700 h an upper removable acrylic appliance holding one polished enamel and one polished dentine specimen. The specimen treatment regimens were: 1. Drinking water and brushing with toothpaste A. 2. Drinking water and brushing with toothpaste B. 3. Drinking orange juice. 4. Drinking orange juice and brushing with toothpaste A. 5. Drinking orange juice and brushing with toothpaste B. Drinking and brushing times were around 0900, 1100, 1300 and 1500 h. Drinks were consumed as 250 ml over 10 min and brushing ex vivo for 1 min to each specimen. Measurement of tissue loss was made on days 5 and 10 of each period using a profilometer. RESULTS: All treatments produced increasing tissue loss over time, which was considerably greater for dentine than enamel. For enamel, the data at days 5 and 10 showed a significant effect for erosion (i.e. orange juice was significantly more erosive than water), but no significant effect for abrasion (i.e. no significant difference between the two toothpaste treatments). The combined orange juice and toothpaste effects were directional for synergy but did not reach significance. For dentine at day 10, many specimens exceeded the 50 microm set limit of the profilometer and only day 5 data were considered. There were significant effects for erosion (orange juice produced significantly more erosion than water) and for abrasion (paste A was significantly more abrasive to dentine than paste B). The synergy effect could not be examined for dentine due to the truncation effect as the set limit of the profilometer was exceeded. CONCLUSIONS: Erosion increases the susceptibility of enamel to toothpaste abrasion. Dentine is considerably more susceptible than enamel to erosion and abrasion alone or combined. Dentine loss appears to correlate with toothpaste abrasivity (RDA value).

Adolescent↗

The rational use of fluoride toothpaste.

Well-formulated fluoride toothpastes are clinically proven to prevent and control dental caries. They may also be a risk factor in the aetiology of dental fluorosis. This review considers the available evidence to support the appropriate use of fluoride toothpaste to maximise the benefit and minimise the risk. Three factors have an important influence on the anticaries efficacy of fluoride toothpaste, namely concentration, frequency of brushing and post brushing rinsing behaviour. The evidence suggests that low-fluoride (<600 ppm F) toothpastes provide less caries protection than standard (1,000 ppm F) or high (1,500 ppm F) concentration formulations. However, low-fluoride toothpastes are appropriate for very young children (under 7 years) at low caries risk, particularly if living in fluoridated areas. For other young children, higher concentrations of fluoride should be used. Brushing should be recommended twice daily, whilst rinsing with large volumes of water should be discouraged. Small amounts of toothpaste are comparable in efficacy to large amounts. The risk of fluorosis is associated with the ingestion of high doses of fluoride during tooth development and consequently only young children are at risk. The variability in the dose of fluoride ingested is mainly a function of the amount used, less so its concentration. To minimise fluorosis risk, parents should be advised to use only a pea-sized amount of toothpaste and encourage spitting out of excess. It is concluded that by using fluoride toothpastes appropriately, the benefits can be maximised and the risks of fluorosis minimised.

Age Factors↗

Dentine hypersensitivity: the effects of brushing desensitizing toothpastes, their solid and liquid phases, and detergents on dentine and acrylic: studies in vitro.

Dentine exhibiting symptoms of dentine hypersensitivity has tubules open at the dentine surface and patent to the pulp. The mechanisms whereby dentinal tubules are exposed is ill understood but probably involves a variety of abrasive and/or erosive agents. This study in vitro examined the quantitative and qualitative effects of toothpastes, their solid and liquid phases and detergents on dentine and acrylic. Abrasion of dentine and acrylic were measured by surfometry. Morphological changes to dentine were assessed by scanning electron microscopy. Abrasion of dentine and acrylic by toothpastes increased with increasing brushstrokes with marked differences in the extent of abrasion between different pastes. Brushing dentine with water or detergents produced progressive abrasion but which appeared to plateau around 2 microm loss. Water and detergents produced minimal effects on acrylic. At 5000 strokes dentine abrasion by solid phases was less than the parent toothpastes but the ranking order of abrasivity was the same as the parent toothpastes. Loss of dentine produced by liquid phases was minimal and in the order of 1-2 microm. Observationally, all toothpastes removed at least the dentine smear layer to expose many tubules; with one desensitizing product leaving a particulate deposit occluding most tubules. The solid phases of the toothpaste produced identical morphological changes to the parent paste. The liquid phases and detergents all exposed dentinal tubules by 5000 strokes. Water had little or no effect on the dentine smear layer. It is concluded that toothpastes, solid phase, liquid phase and detergents have the potential to abrade or erode dentine to a variable degree and result in tubule exposure. The effects of the liquid phases and detergents appear limited to the removal of the smear layer. Such detrimental effects seen in vitro could have relevance to the aetiology and management of dentine hypersensitivity. Toothpaste formulations which despite exposing tubules have ingredients capable of occluding tubules may be an area of development for such products.

Acrylic Resins↗

In vitro antioxidant activities of antioxidant-enriched toothpastes.

Several forms of periodontal diseases (PD) are often associated with modified phagocytosing leukocytes and contemporary free radical production. Host antioxidant defenses could benefit from toothpastes used as adjuncts to counteract plaque-associated bacteria. The aim of the present study was to determine possible antioxidant activity (AA) of 12 differently antioxidant-enriched toothpastes, regardless of their efficacy as antimicrobial agents. Toothpastes were enriched alternatively with sodium ascorbyl phosphate, alpha-tocopherol acetate, pycnogenol, allantoin and methyl salycilate or a mixture of these. AA was tested in a cell-free system with a ABTS-decolorization assay improved by means of a flow injection analysis device. Comet assay, using NCTC 2544 keratinocytes, was performed to test if it was possible to identify any protection against in vitro DNA fragmentation provoked by a challenge with H(2)O(2) in cultures pre-incubated with toothpaste extracts. Only toothpastes containing sodium ascorbyl phosphate displayed clear AA with I(50) values ranging between 50 and 80 mg of toothpaste/ml water. COMET analysis of cells challenged with H(2)O(2) in presence of toothpaste extracts revealed a limited protection exerted by sodium ascorbyl phosphate. The results described herein indicate that toothpastes containing sodium ascorbyl phosphate possess AA. All the data were obtained in systems in vitro and the demonstration of in vivo AA is desirable. These findings could be useful in the treatment and maintenance of some forms of PD and should be considered when arranging new toothpaste formulations.

Antioxidants↗

Studies on the effect of toothpaste rinses on plaque regrowth. (I). Influence of surfactants on chlorhexidine efficacy.

A number of compounds have been added to toothpastes to inhibit plaque regrowth. The inclusion of cationic antiseptics, such as chlorhexidine, poses formulation difficulties because of interactions with other ingredients particularly anionic detergents. More recently, Triclosan/zinc citrate formulations have been shown effective plaque inhibitors. The aim of this study was to compare a commercially available 0.2% Triclosan/0.5% zinc citrate toothpaste with a number of experimental 0.5% chlorhexidine/detergent toothpastes for effects on plaque regrowth over 4 days. Subjects rendered plaque free at each baseline rinsed twice a day with toothpaste slurries and disclosed plaque was scored at the end of each period. All toothpastes significantly reduced plaque by comparison with a control toothpaste, but were significantly less effective than a 0.2% chlorhexidine rinse. Some significant differences in favour of one chlorhexidine toothpaste were noted but these were small in magnitude. Whether the plaque inhibition obtained with Triclosan/zinc citrate toothpaste was greater than would be expected from other commercially available preparations cannot be determined from this study and is the subject of a further investigation.

Adult↗

A comparison of triclosan and stannous fluoride toothpastes for inhibition of plaque regrowth. A crossover study designed to assess carry over.

Some triclosan and stannous fluoride toothpastes have been shown effective in reducing plaque and more particularly gingivitis in home use studies. There have been few comparisons of such products for their chemical plaque inhibitory action divorced from the indeterminate variable of toothbrushing. This study was a randomised, single-blind, cross-over comparison of 4 products, in a 4-day plaque regrowth design, balanced for residual effects and involving 12 healthy dentate subjects. The test agents were a stannous fluoride toothpaste, a triclosan/copolymer toothpaste, a triclosan/zinc citrate toothpaste and water. On day 1 of each study period, subjects were rendered plaque free. For the following 4 days, each subject suspended normal toothcleaning and rinsed 2 x daily with the allocated treatment for 60 s under supervision. On day 5, plaque was scored by index. Washout periods of 2 1/2 days brushing with water alone, followed each treatment period. Pseudo treatment periods of 4 days, involving 2 x daily rinsing with water in the absence of toothbrushing, followed the normal washouts after the stannous fluoride and triclosan/zinc citrate treatments, giving a total of 6 treatment periods. This design permitted analyses for 1st-order-carry-over. Intention to treat analyses revealed all toothpastes were more effective than water but that there were no differences between the active treatments. Per protocol analysis gave essentially similar findings except that the difference in plaque in favour of the triclosan/zinc citrate toothpaste over water did not reach significance. There was no evidence of 1st-order-carry-over effects for the stannous fluoride or triclosan/zinc citrate toothpastes. Consistent with other studies it appears that stannous fluoride and triclosan can be formulated into toothpaste vehicles to provide plaque inhibitory effects.

Adult↗

Fluorosis risk from early exposure to fluoride toothpaste.

UNLABELLED: Swallowed fluoride toothpaste in the early years of life has been postulated to be a risk factor for fluorosis, but the epidemiological evidence is weakened by the fact that most of the relevant studies were done in developed countries where an individual is exposed to multiple sources of fluoride. OBJECTIVES: To quantify the risk of fluorosis from fluoride toothpaste in a population whose only potential source of fluoride was fluoride toothpaste. METHODS: Case-control analyses were conducted to test the hypothesis that fluoride toothpaste use before the age of 6 years increased an individual's risk of fluorosis. Data came from a cross-sectional clinical dental examination of schoolchildren and a self-administered questionnaire to their parents. The study was conducted in Goa, India. The study group consisted of 1189 seventh grade children with a mean age of 12.2 years. RESULTS: The prevalence of fluorosis was 12.9% using the TF index. Results of the crude, stratified, and logistic regression analyses showed that use of fluoride toothpaste before the age of 6 years was a risk indicator for fluorosis (OR 1.83, 95% CI 1.05-3.15). Among children with fluorosis, beginning brushing before the age of 2 years increased the severity of fluorosis significantly (P<0.001). Other factors associated with the use of fluoride toothpaste, such as eating or swallowing fluoride toothpaste and higher frequency of use, did not show a statistically significant increased risk for prevalence or severity of fluorosis. CONCLUSIONS: Fluoride toothpaste use before the age of 6 years is a risk indicator for fluorosis in this study population.

Cariostatic Agents↗

An advocacy project to fluoridate toothpastes in Nepal.

AIMS: To describe a recent health promotion project undertaken by the United Mission to Nepal Oral Health Programme (UMN OHP) to increase the availability and consumption of affordable, fluoridated toothpaste in Nepal. METHOD: The process of advocating for the fluoridation of toothpastes in Nepal is based on Tearfund's advocacy cycle. RESULTS: The project achieved health promotion outcomes including healthy corporate and public policies and organisational practice and intermediate outcomes such as increased availability and consumption of affordable fluoridated toothpaste. Prior to implementation of the advocacy project in 1997, availability and consumption of fluoridated toothpaste was negligible. By March 2002 total market share of fluoridated toothpaste was approximately 90%. This represents an annual tonnage of 900 tons of fluoridated toothpaste. CONCLUSIONS: The health promotion activity of advocacy for the fluoridation of toothpastes in Nepal achieved measurable gains in health promotion outcomes and intermediate outcomes. Gains in health and social outcomes will take longer to evaluate but based on epidemiological evidence and the experience of other countries increased availability of affordable fluoridated toothpaste will have a significant and ongoing impact on the oral health of the people of Nepal.

Cariostatic Agents↗

Effect of a calcium carbonate-based toothpaste with 0.3% triclosan on pH changes in dental plaque in vivo.

The effects of a calcium carbonate-based toothpaste with added 0.3% triclosan on the pH of human dental plaque after a cariogenic challenge with 10% sucrose solution was investigated against a calcium carbonate-based toothpaste without triclosan and an alumina-based toothpaste. A silica-based toothpaste served as a control. Twenty adult volunteers were included in this study. The results showed that the plaque pH drop and the area under the curve for both calcium carbonate-based toothpastes, with and without 0.3% triclosan, were significantly less as compared with the alumina-based toothpaste, with both parameters being least for the toothpaste with added 0.3% triclosan. Calcium carbonate has been shown in previous studies to have a buffering effect on the plaque pH after an acidogenic challenge. The addition of 0.3% triclosan to the calcium carbonate-based toothpaste seemed to enhance this effect.

Adolescent↗

Efficacy of 'Gamadent' toothpaste on the healing of gingival tissues: a preliminary report.

The aim of this randomised, parallel, double-blind study, in which 28 adult patients diagnosed with chronic gingivitis or early stages of chronic periodontitis were recruited, was to evaluate the efficacy of 'Gamadent' toothpaste compared to a placebo toothpaste. 'Gamadent' toothpaste has all the basic constituents of a toothpaste with the addition of a sea cucumber extract (SCE) of the species Stichopus sp. 1 to improve the healing potential of tissues. The placebo has the same basic constituents minus the extract. Out of the 28 patients, 14 were placed in the test group who used the 'Gamadent' toothpaste, and 14 patients were placed in the control group (2 control subjects defaulted and were excluded), who brushed using the placebo toothpaste. The longitudinal study was carried out over a period of 3 months with assessments made at baseline, 1 month, 2 months and 3 months after conventional therapy at the baseline visit. The clinical parameters used during the trial were Plaque Index (PI), Gingival Index (GI), Papilla Bleeding Index (PBI) and Probing Pocket Depth (PPD). A predetermined number of sites on a molar, premolar, canine and an incisor were examined and evaluated in each quadrant. After the baseline assessment, the patients had full mouth scaling and debridement as well as oral hygiene instructions. Patients were instructed to brush their teeth twice a day with the toothbrush provided (Oral-B plus, size 35) and toothpaste (test or control), using the Bass technique. At the 1-month assessment, there were significant mean reductions to baseline mean values in PI (P < 0.005) and GI (P < 0.001) in the test group as compared to the control group. At the end of the 2-month interval, significant reductions were observed in PI, PBI and PPD (P < 0.001). By the end of 3 months, there were significant differences in the mean reduction of all the parameters i.e. PI, PBI, GI and PPD (P < 0.001), between the test and control sites. In conclusion, 'Gamadent' toothpaste provided noteworthy benefits, producing statistically significant improvement in all clinical parameters compared to the placebo during the healing phase after conventional initial therapy.

Adult↗

Skin reactions and irritation potential of four commercial toothpastes.

Skin reactions to 4 toothpastes were tested in 19 healthy dental students in a double-blind study. The hypothesis was that common toothpaste brands with and without sodium lauryl sulfate (SLS) and triclosan and with different additives/emulgators differ in irritation potential. An occlusion test system on human skin was used. The toothpastes tested were A) Zendium (non-ionic detergent), B) Solidox F (SLS/polyethylene glycol), C) Colgate Total (triclosan/copolymer/SLS/propylene glycol), and D) Solidox G (triclosan/zinc citrate/SLS/polyethylene glycol). Toothpaste C was the greatest irritant, causing skin erythema in 16 of the 19 subjects, whereas toothpaste D gave no reactions. Toothpaste B provoked three reactions (two severe), whereas toothpaste A caused only one mild reaction. Although this study was carried out on skin and hence not directly applicable to the oral cavity, these and previous results may indicate that a toothpaste without propylene glycol and SLS may be preferred by susceptible persons.

Adult↗