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Model for assessment of carious lesion remineralization, and remineralization by a novel toothpaste.

This study is of a novel toothpaste which induced remineralization of carious lesions in specific pathogen-free Osborne-Mendel rats. Randomly distributed weanlings in 7 groups (n = 10) each were initially induced to develop carious lesions as a result of a severe dietary and bacteriological challenge. Thus, all were inoculated with S. mutans 10449S, ate diet 2000CS (containing 56% cornstarch) ad libitum, and, upon weaning and for 10 additional days, drank demineralized water supplemented to 10% (w/v) with sucrose (SW) ad libitum. During these 10 days, 6 of the 7 groups of rats were topically treated with a slurried F(-)-free placebo toothpaste. On the 10th day after initial inoculation, two groups were sacrificed, one which had been treated with the placebo and the one which had been untreated. The remaining groups were then provided unsupplemented demineralized water (DW), fed diet 2000CS, and topically treated with either of 5 coded toothpastes: a slurry of the F(-)-free placebo, a similar slurry of a conventional sodium fluoride toothpaste (Crest Regular) containing about 383 ppm F-, or one of three prototype toothpastes formulated by Enamelon, Inc. containing soluble calcium and phosphate salts. Two of these contained 377 ppm F- after mixing their components, either as sodium monofluorophosphate (E-MFP) or as NaF (E-NaF). The third prototype contained 0 ppm F- (E-w/o F). Test items were applied to the dentition for one minute/day, five days/week. These 5 remaining groups were sacrificed 13 days after the DW provision. After defleshing, heads were coded randomly and scored blindly for carious lesions. The exchange of DW for SW was associated with highly significant reductions of 10449S recoveries (p < 0.001), but there were no differences in recoveries among the groups as a function of toothpaste type. Total mandibular and maxillary sulcal and smooth surface caries scores were statistically significantly lower for the E-NaF-treated group at 23 days than for the 23-day placebo-, E-w/o F(-)-, and conventional NaF toothpaste-treated group. Reductions were most impressive quantitatively on approximal tooth surfaces, where both the E-MFP and E-NaF groups had the lowest scores, but were also statistically significant at sulcal surfaces for the E-NaF group. Thus, this study model can be used to detect significant remineralization effects, as occurred with the prototype toothpaste E-NaF.

Administration, Topical↗

[A survey of cognition and utilization of fluoride toothpaste and associated factors].

OBJECTIVE: To survey the situation of cognition and utilization of fluoride toothpaste and associated factors amongst elementary and middle school students in Haidian district, Beijing. METHODS: Sample of students was recruited by a multistage, stratified, and probability proportional to size sampling procedure. Self-administered structured questionnaires were used to collect information concerning the knowledge of, attitudes to and utilization of fluoride toothpaste and associated factors. A total of 1 557 students completed the questionnaire effectively. RESULTS: The percent age of students who used fluoride toothpaste when brushing their teeth were 87.8%. More than 60% of students knew that fluoride toothpaste could prevent dental caries by strengthening the out layer of tooth surface. 41.6% of the students doubted about the harmless of fluoride toothpaste even to be used properly. Advertisement was the main source of information about the fluoride toothpaste. CONCLUSIONS: The percentage of students using fluoride toothpaste was high and the majority of them knew that fluoride toothpaste could prevent caries. The oral health education programme concerning the optimal use of fluoride in dental caries prevention is highly recommended.

Adolescent↗

Laboratory analysis of fluoride containing toothpaste available in South Africa.

Since the introduction of fluoridated toothpaste more than 30 years ago, it has become by far the most widespread source of fluoride in the world and after fluoridated water the most effective at reducing dental caries. Both the total soluble and the soluble ionic fluoride present in toothpaste are important in determining the effectiveness of the paste as it is important in remineralising demineralised lesions, a characteristic of fluoride which has proven to be the most important in preventing dental caries. The purpose of this study was to evaluate toothpaste currently available to the South African public regarding total soluble and soluble ionic fluoride. A variation of the method used by Grobler et al. (1983) and Du Preez et al. (1993) in previous studies conducted in South Africa was used in preparing the samples for fluoride analysis. Measurements of fluoride concentrations were done using an ionselective electrode. For all toothpaste studied (n=62), large variations occurred for the soluble ionic fluoride (mean = 318.44 microg F/g toothpaste; median = 139.69; standard deviation = 398.77). Correspondingly a mean total soluble fluoride of 848.84 microg F/g toothpaste was found (standard deviation = 189.35; median = 857.38). From this study it can be concluded that fluoride concentrations in toothpaste available to the South African public are in line with those found in the two previous South African studies. In the absence of artificially fluoridated water, toothpaste remains the most cost-effective strategy in the prevention of dental caries in South Africa.

Cariostatic Agents↗

[Czechoslovak toothpaste--present choice, consumption, quality].

The authors made a nation-wide survey focused on the choice, appreciation of different properties of toothpastes and the popularity of different brands. They also evaluated the quality of some toothpastes according to Czechoslovak standards. The results revealed that the attitude of the public as regards toothpastes is correct. The great majority of subjects consider fluorine and therapeutic substances an important part of toothpastes. The majority of subjects are satisfied with the supply, one third of the people complain that some types are in short supply. More than half the subjects ask for toothpastes with texts providing information. The majority of toothpastes met the demand defined by the Czechoslovak standards. Some shortcomings were revealed during organoleptic evaluation and in the technology of production. The authors discuss the small consumption of toothpastes which must be increased by the health educational activities of dental surgeons but also by increased attention of manufactures and the network of shops to the technology, distribution and propagation of toothpastes.

Consumer Behavior↗

Potassium nitrate toothpaste for dentine hypersensitivity.

BACKGROUND: Dentine hypersensitivity may be defined as the pain arising from exposed dentine, typically in response to external stimuli, and which cannot be explained by any other form of dental disease. Many treatment regimes have been recommended over the years, and in recent years particular attention has been focused on toothpastes containing potassium nitrate. OBJECTIVES: To compare the effectiveness of potassium nitrate containing toothpastes with placebo toothpastes in reducing dentine hypersensitivity. SEARCH STRATEGY: The following databases were cross searched via the database host DIALOG: MEDLINE, EMBASE, ELSEVIER BIOBASE, BIOSIS PREVIEWS, CAB HEALTH, SCI SEARCH, CURRENT CONTENTS until 1 April 2000. The specialised Cochrane Oral Health Group Trials Register was also searched. Bibliographies of clinical studies and reviews identified in the electronic search were checked for studies published outside the electronically searched journals. SELECTION CRITERIA: Randomised clinical trials (RCTs) in which the effect on dentine hypersensitivity of potassium nitrate toothpastes were tested against non-potassium nitrate containing placebo toothpastes. DATA COLLECTION AND ANALYSIS: Two of the reviewers independently recorded the results of the included trials using a specially designed chart. Sensitivity was assessed by using thermal, tactile, air blast, and subjective methods. The quality of all RCTs, that fulfilled the inclusion criteria, was acceptable with Jadad scores ranging from 3 to 4 (Jadad 1998). MAIN RESULTS: Out of the eight studies that initially fulfilled the criteria to be included in the review, four studies did not present mean and standard deviations and could thus not be included in the meta-analysis. Three of these did not show an effect on any of the measurements of dentine hypersensitivity, while one did. Four studies were included in the meta-analysis which showed statistically significant effect of potassium nitrate toothpaste on air blast and tactile sensitivity, e.g. the meta analysis of air blast sensitivity showed a standardized mean difference in sensitivity score of -1.51 (95% CI: -2.09 to -0.94) in favour of treatment. The subjective assessment failed to show a significant effect at the six to eight week assessment. REVIEWER'S CONCLUSIONS: No strong evidence is available supporting the efficacy of potassium nitrate toothpaste for dentine hypersensitivity.

Adult↗

Potassium containing toothpastes for dentine hypersensitivity.

BACKGROUND: Dentine hypersensitivity may be defined as the pain arising from exposed dentine, typically in response to external stimuli, and which cannot be explained by any other form of dental disease. Many treatment regimens have been recommended over the years, and in recent years particular attention has been focused on toothpastes containing various potassium salts. OBJECTIVES: To compare the effectiveness of potassium containing toothpastes with control toothpastes in reducing dentine hypersensitivity. SEARCH STRATEGY: The following databases were searched: Cochrane Oral Health Group Trials Register (searched until August 2005); CENTRAL (until August 2005); EMBASE/MEDLINE, PubMed, Web of Science (until September 2005). Bibliographies of clinical studies and reviews identified in the electronic search were checked for studies published outside the electronically searched journals. SELECTION CRITERIA: Randomised controlled trials (RCTs) in which the effect on dentine hypersensitivity of potassium containing toothpastes was tested against non-potassium containing control toothpastes. DATA COLLECTION AND ANALYSIS: Two of the review authors independently recorded the results of the included trials using a specially designed form. Sensitivity was assessed by using thermal, tactile, air blast, and subjective methods. MAIN RESULTS: Six studies were included in the meta-analysis which showed the statistically significant effect of potassium nitrate toothpaste on air blast and tactile sensitivity at the 6 to 8 weeks follow up, e.g. the meta-analysis of air blast sensitivity showed a standardized mean difference in sensitivity score of -1.25 (95% CI: -1.65 to -0.851) in favour of treatment. The subjective assessment failed to show a significant effect at the 6 to 8 week assessment. AUTHORS' CONCLUSIONS: The evidence generated by this review is based on a small number of individuals. Furthermore, the effect varies with the methods applied for assessing the sensitivity. Thus no clear evidence is available for the support of potassium containing toothpastes for dentine hypersensitivity.

Adult↗

An in vitro study of fluoride release from a resin-modified glass ionomer cement after exposure to toothpaste slurries of different pH.

The aim of the study was to evaluate the fluoride release from an aged resin-modified glass ionomer (Vitremer) after exposure to five toothpaste slurries with different pH values. Cylindrical specimens of the material were leached in de-ionized water for 3 months and then exposed for 30 min daily for 10 days to three dentifrice slurries (20 specimens/group) containing 0.05% fluoride with pH values of 2.6, 5.7 and 8.3 and two non-fluoridated slurries with pH values of 2.5 and 5.7. A neutral NaF solution (0.05% F) was used as a control. During the 30 min exposure time, the fluoride concentration was gradually decreased in order to imitate the clinical situation. Thereafter, specimens were immersed individually in de-ionized water and the fluoride release determined. After the first day of exposure, all groups except one without fluoride (pH 5.7) showed significantly (P < 0.05) increased fluoride release. After exposure to the fluoridated toothpaste slurry with pH 5.7, significantly (P < 0.05) more fluoride was released compared to the toothpaste slurry with pH 8.3. Low pH (2.5 or 2.6) of the slurry resulted in a significantly (P < 0.05) higher fluoride release, regardless of whether it was fluoridated or not. The total amount of fluoride released after exposure to the more acidic fluoride toothpaste slurry was greater than that released from the more acidic non-fluoride toothpaste and the less acidic fluoride toothpaste. Our data indicate that the fluoride release from the resin-modified glass ionomer studied may be increased after treatment with an acidified NaF-toothpaste.

Analysis of Variance↗

The effects of tartar-control toothpaste on the oral soft tissues.

Ninety-two dental and dental hygiene students completed a double-blind, controlled clinical trial. The purpose of the trial was to evaluate the effects of toothpastes, in varying concentrations of flavor and tartar-control agents. Four formulations of toothpastes were assessed: (A) control-low flavor with no tartar control; (B) medium flavoring with medium tartar control; (C) high flavoring with medium tartar control; and (D) medium flavoring with no tartar control. Soft tissue reactions were assessed objectively and independently by three examiners. Subjective perceptions about each toothpaste were gathered by a structured, open-ended questionnaire. The "tartar control" toothpastes, B and C, resulted in statistically significant (p less than 0.005) higher rates of mucosal reactions (e.g., ulceration, sloughing, erythema, migratory glossitis) than the "non-tartar control" toothpastes A and D. When the oral mucosal reaction rates were adjusted for multiple clinical observations within each subject at the same point in time there was no statistically significant (p greater than 0.05) difference between male (0.25) and female (0.28) subjects. In this study population, the order of preference was observed as toothpaste A greater than D greater than B greater than C. The major reasons for disfavor were burning sensation in toothpastes C (2.4%) and B (4%).

Adult↗

A study to assess the plaque inhibitory action of a newly formulated triclosan toothpaste.

BACKGROUND/AIMS: Triclosan containing toothpastes have been noted for their potential to inhibit plaque and gingival inflammation. The aim of this study was to determine whether a toothpaste containing triclosan and an enhanced fluoride system would inhibit de novo plaque formation beyond that of a non-triclosan, conventional fluoride toothpaste. METHODS: This study used a 4-day plaque regrowth model in which 24 volunteers used toothpaste rinses as the only form of oral hygiene. Following a prophylaxis and a single brushing with the toothpastes, 2x daily rinsing with toothpaste slurries was used over the following 96 h. RESULTS: After 24 h, there was no difference in plaque area between the triclosan paste and its control paste. After 96 h, a reduction in plaque score of 5% was noted for the test toothpaste compared to the control paste which was statistically significant (p=0.028). For plaque area this reduction was increased to 16%, which was also significant (p=0.006). CONCLUSIONS: These findings would appear to warrant further investigation into the potential value of the paste in inhibiting both plaque and gingivitis.

Adult↗

A modification to the experimental gingivitis protocol to compare the antiplaque properties of two toothpastes.

BACKGROUND AND AIMS: Randomised, blind, controlled experimental gingivitis and home-use study protocols are used to evaluate the efficacy of oral hygiene products. The present methodological study combined the two clinical trial designs to compare the preventive and therapeutic potentials of two toothpastes. MATERIAL AND METHODS: The study was a parallel group, randomised, double-blind design, initially involving 73 healthy dentate subjects. A 21-day experimental gingivitis protocol was combined with a 6-week (42 days) home-use protocol. At baseline, modified gingival index (MGI), gingival index (GI) and gingival bleeding (GB) were recorded. A dental prophylaxis was then performed. Subjects were allocated to either control fluoride or stannous fluoride toothpaste based on gender and GI. During the first 21-day period, subjects applied the allocated toothpaste, for 1 min twice a day, to a group of teeth in a plastic shield and brushed the remaining teeth with the same paste. From day 21 the shield was not placed, and subjects brushed all teeth with the toothpaste for 1 min twice per day up to day 42. MGI, GB and a plaque index (PI) were recorded on days 21 and 42. RESULTS: Sixty-nine and 67 subjects completed to days 21 and 42, respectively. For shielded teeth, PI, MGI and GB increased to day 21 and then after ceasing the use of the shield decreased to day 42. At day 21, PI favoured the stannous fluoride toothpaste, but differences did not achieve statistical significance for any parameter at days 21 or 42. For unshielded teeth, there were no significant differences between the toothpastes for any parameter at either time point. CONCLUSION: : The feasibility of combining two gingivitis clinical trial methodologies appears proven, and data on both the preventive and therapeutic chemical and mechanical efficacy of toothpastes can be obtained through such protocols. Specifically from the present study and consistent with some other reports, the plaque inhibitory properties of the stannous fluoride product are limited and do not always translate into an antiplaque/antigingivitis effect.

Adult↗

Protection of dentin by triclosan toothpaste in a bacterial demineralisation model.

The effect of the addition 0.3% triclosan to a non-fluoride and fluoride toothpaste was tested in an in vitro demineralisation model. This model comprised bovine dentin specimens overlaid with acidogenic Streptococcus mutans suspensions in agarose at two different concentrations of cells. Before the experiments, subsurface lesions were made in the dentin specimens in a methylcellulose gel system. In a first set of experiments, the toothpastes were diluted in the S. mutans suspensions at w/v dilutions of 1:100, 1:1,000, and 1:10,000, respectively. After 22 h of incubation at 37 degrees C, the suspensions were removed and assessed for calcium, lactate and pH. In this set of experiments, an additive protective effect of triclosan to the non-fluoride toothpaste was found at the lowest concentration of S. mutans cells and when the toothpaste was relatively undiluted (1:100 w/v). No additive effect was observed to the fluoride toothpaste. In the second set of experiments, the specimens were immersed daily for 3 min in 30% (w/v) slurries of the toothpastes before the 22-h incubations with the S. mutans suspensions. At the lowest concentration of S. mutans cells, triclosan had an additional protective effect to the non-fluoride and fluoride toothpaste. It is concluded that triclosan may contribute to the protection of dentin under a mild acid attack both when it is present in dental plaque and when it has been adsorbed to the dentin.

Adsorption↗

The effect of triclosan toothpaste on enamel demineralization in a bacterial demineralization model.

Triclosan has been incorporated into toothpaste to enhance inhibitory effects on bacterial metabolism in dental plaque. Many studies have confirmed these effects by showing a reduction of accumulation of dental plaque, gingivitis and calculus. However, there is no evidence for triclosan having an inhibitory effect on the dental plaque-induced demineralization of the dental hard tissues. Therefore, the effect of 0.3% triclosan added to non-fluoride and fluoride toothpaste was tested in an in vitro model, in which bovine enamel specimens were to be demineralized by acids produced in overlaying Streptococcus mutans suspensions. In a first set of experiments the toothpastes were added to the S. mutans suspensions at 1:100, 1:1000 and 1:10,000 (w/v) dilutions. After 22 h incubation at 37 degrees C the suspensions were removed and assessed for calcium and lactate content, and pH. In this set of experiments, triclosan had no additive protective effect to the non-fluoride or fluoride toothpaste. In a second set of experiments, the enamel specimens were immersed daily for 3 min in 30% (w/v) slurries of the toothpastes before the 22 h incubation with the S. mutans suspensions. Under these conditions, triclosan showed an additional protective effect compared with non-fluoride toothpaste at a low concentration of S. mutans cells (0.07 mg cells dry weight per 600 microL suspension). It is concluded that the enamel surface may act as a reservoir for triclosan, which may protect the enamel surface against a mild acid attack. In combination with fluoride, however, as in toothpaste, triclosan has no additional protective effect against demineralization.

Animals↗

Effect of glycyrrhizin-containing toothpaste on dental plaque reduction and gingival health in humans. A pilot study.

Glycyrrhizin, the main saponin of licorice, a surfactant producing aqueous gel, was tested for its effect on gingival health, as a supplemental agent in a toothpaste. 40 male and female volunteers brushed their teeth twice daily, with a toothpaste containing 0.25% and 0.50% glycyrrhizin, or a control toothpaste, respectively. All 3 toothpastes contained sodium lauryl sulfate as detergent. The subjects of the 3 groups were examined at days 0, 7, 14, 28, 35 and 42 for plaque, gingival and bleeding indices. The examiner was unaware of subject assignment. None of the brushing regimens with the experimental toothpastes induced significant changes in the examined indices, that were distinct from those observed with the control toothpaste. The decrease (insignificant) in the indices of the study period from 0 to 14 days may be considered as an increased oral hygiene awareness by the subjects examined. Possible explanations for the lack of efficiency in improvement of plaque, gingival and bleeding indices, may have been an insufficient glycyrrhizin concentration and/or chemical incompatibility in a toothpaste containing a mixture of an anionic detergent and an organic antibacterial surface agent.

Adult↗

The effect of toothpaste containing triclosan on oral mucosal desquamation. A model study.

SLS-containing toothpaste has previously been shown to cause oral mucosal desquamations when used in an experimental cap splint model. The aim of the present study was to examine the effect of toothpastes containing SLS in combination with triclosan on oral mucosal desquamation in a similar cap splint model system. It has previously been shown that the antibacterial agent triclosan also may have anti-inflammatory properties. The concentration of triclosan in the experimental toothpastes was 0.3%, while SLS varied from 1.5% to 3%. No oral mucosal desquamations were observed after use of a 1.5% SLS 0.3% triclosan containing toothpaste, contrary to the positive control toothpaste that contained 1.5% SLS without triclosan. Furthermore, a statistically significant reduction in severe desquamations was observed after use of a toothpaste containing 3% SLS-0.3% triclosan compared with the positive control. It may thus be suggested that triclosan exerts a moderating effect on desquamative reactions caused by SLS and that the effect is dependent on the relative amount of triclosan and SLS in the toothpastes.

Adult↗

An 18-week home-use study comparing the oral hygiene and gingival health benefits of triclosan and fluoride toothpastes.

Several triclosan and stannous fluoride toothpastes have been shown to have plaque inhibitory and more particularly gingival health benefits when compared to minus active controls. There have been relatively few studies to compare such products with conventional fluoride toothpastes in home use. The aim of this study was to compare the relative gingival health benefits of a triclosan/zinc citrate, triclosan/copolymer, stannous fluoride and conventional fluoride toothpastes in a home use study. The study was a double blind, parallel design with a total 143 healthy dentate volunteers (41 male, 102 female) who toothbrushed 2x daily with 1 of 4 toothpastes over an 18 week period. At the beginning of the trial, each volunteer was scored for plaque and gingivitis and then received a thorough prophylaxis. Each volunteer was allocated a toothpaste according to a predetermined randomisation scheme. The volunteers were then re-examined after 6, 12 and 18 weeks. No other oral hygiene products were used during this period. The results showed no statistically significant treatment differences between products for the gingival index throughout the 18 week-trial. No statistically significant treatment effects between products for plaque index were found at 6 or 18 weeks. However, a small but statistically significant treatment effect for plaque index was seen at 12 weeks in favour of the triclosan/copolymer toothpaste compared to the stannous fluoride and conventional fluoride toothpastes, this difference had disappeared by the 18 week examination. All volunteers oral hygiene and gingivitis scores improved after the baseline examination, and this improvement continued throughout the trial. This is a feature of nearly all toothbrushing studies and can be attributed to the initial prophylaxis and the Hawthorne phenomenon. Such phenomena, noted in home use clinical trials, may mask the efficacy of proven antiplaque formulations.

Adolescent↗

A study in vitro of the combined effects of soft drinks and tooth brushing with fluoride toothpaste on the wear of dentine.

The aim of this study was to measure loss of dentine produced by soft drinks alone and combined with tooth brushing with and without toothpastes. Groups of flat human dentine specimens were exposed for 10 min and then 30 min to orange juice (OJ), carbonated cola (CC) or modified blackcurrant (MB) drinks alone or after the exposures brushed with a fluoride toothpaste for 10 s. Further groups were exposed to OJ as before but brushed with water or non-fluoride toothpaste or placed in slurries of fluoride paste. Five cycles of each regimen were carried out. Tissue loss was determined by profilometry. Water immersion/brushing and brushing controls were included. OJ and CC produced similar erosion and significantly more than MB. Compared with drinks alone, dentine loss was reduced by fluoride toothpaste brushing but increased by water and non-fluoride toothpaste brushing. Fluoride toothpaste slurry had no significant effect on soft drink erosion. Very little abrasion with brushing alone was recorded over the time frame of these experiments. It is concluded that fluoride toothpaste could provide protection, albeit small, against erosion. The data again support the concept of brushing before meals.

Adolescent↗

The need for toothpastes with lower than conventional fluoride concentrations for preschool-aged children.

Since 1945, when community water fluoridation was first implemented in the United States, not only has the procedure grown to cover more than half of the US population, but the development and use of other fluoride methods have expanded greatly. A concomitant, dramatic decrease has occurred in the caries prevalence of US school-aged children. Recent studies indicate, however, that the prevalence and, to a lesser extent, the intensity of dental fluorosis have increased in schoolchildren in both fluoridated and fluoride-deficient areas. Several studies show that young children inadvertently ingest sizable proportions of toothpaste during toothbrushing. Although ingestion of fluoride toothpastes by preschool-aged children may not be the major contributor to the increase in fluorosis, the findings of at least four studies suggest that the use of fluoride toothpastes by young children is a risk factor. The direct dose-response relation between effectiveness and fluoride concentration of toothpastes is far from clear-cut and, at best, is weak. Thus, considering today's reduced risk of caries, it is timely to market fluoride toothpastes in the US with 400-500 ppm fluoride for preschool-aged children, who are still at risk for developing fluorosis, as has been done in several other countries. Dental public health authorities must work with toothpaste manufacturers, professional organizations, and regulatory agencies to facilitate the approval and marketing of such pediatric fluoride toothpastes.

Child, Preschool↗

In vitro efficacy of a whitening toothpaste containing calcium carbonate and perlite.

OBJECTIVES: The studies described in this paper aimed to assess the stain removal efficacy, fluoride efficacy and abrasivity to enamel and dentine of a new whitening toothpaste containing calcium carbonate and perlite, using appropriate in vitro models. METHODS: Stain removal efficacy was assessed using the pellicle cleaning ratio (PCR) method. Fluoride efficacy was assessed using remineralisation, demineralisation and fluoride-uptake methods. Abrasivity was assessed using an enamel and dentine wear method. RESULTS: The results showed that the new whitening toothpaste was able to remove extrinsic tooth stain more effectively than three commercially available toothpaste formulations. The fluoride efficacy was superior to a non-fluoridated control and was not significantly different to a clinically tested fluoride-containing toothpaste. The abrasivity data showed that the calcium carbonate/perlite toothpaste is no more abrasive to enamel or dentine than two other commercially available whitening toothpastes. CONCLUSIONS: The studies show that the new whitening toothpaste is effective in extrinsic stain removal, has an efficacious fluoride source and does not have an undue degree of abrasivity to enamel or dentine compared to other relevant commercially available products.

Aluminum Oxide↗