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PubMedDate not supplied

Remineralisation of enamel lesions with daily applications of a high-concentration fluoride gel and a fluoridated toothpaste: an in situ study.

The inhibition of enamel demineralisation and the enhancement of remineralisation are positively but not linearly related to the concentration of fluoride, especially when high fluoride concentrations are used. The aim of this in situ experiment was to determine the maximum amount of enamel remineralisation that can be achieved with daily applications of very high concentrations of fluoride. For this purpose we compared the efficacy of a daily application of fluoridated topical gel (12500 ppm F, partly as NaF, Olafluor and Dectafluor, pH 4.5) in combination with a fluoridated toothpaste (1450 ppm F as NaF), with fluoridated toothpaste alone. Participants (n = 26, with partial dentures) were fitted with a demineralised enamel specimen (mean mineral loss of 1674 vol%.micro m) and were instructed to use one of the two fluoride treatments. After 4 weeks of treatment, the specimens were retrieved, a section was cut and analysed with microradiography. The remainder of each of the specimens was used for analysis of the 'loosely bound' and 'bound' fluoride. Fluoride was measured with gas-liquid chromatography. After 4 weeks in the mouth, the original lesion was reduced in size by 54% in the toothpaste + gel group (n = 14) and by 44% in the toothpaste-only group (n = 12), but the difference between the groups was not statistically significant. The mineral content profiles showed remineralisation of the lesions throughout the depth of the lesion. The enhancement of remineralisation by the high amounts of fluoride was most pronounced in the surface layer. For both the 'loosely bound' and 'bound' fluoride, a statistically significant increase in fluoride concentration could be found in the toothpaste + gel group. In the 4-week in situ period the use of high amounts of fluoride resulted in a maximum remineralisation rate. This is illustrated by an increase in remineralisation and higher fluoride concentrations in the toothpaste + gel group compared to the toothpaste-only group.

Dental Enamel↗

PubMedDate not supplied

Total and free fluoride in toothpastes from some non-established market economy countries.

In 101 fluoride toothpastes, bought in local shops in Burkina Faso (n = 3), China (n = 5), Myanmar (n = 22), Nepal (n = 19), Philippines (n = 13), Syria (n = 22), Togo (n = 7) and Vietnam (n = 10), the total and free ionisable fluoride concentrations were established. The total fluoride concentration of the toothpastes was determined by gas liquid chromatography. The amount of soluble fluoride was measured after dilution in artificial saliva and treatment of the supernatants with acidic phosphatase. The free fluoride concentration in this mixture was measured with a fluoride electrode. Twenty-five percent of all toothpastes contained less than 738 ppm total fluoride, and another 25% contained between 738 and 977 ppm fluoride. Regarding free ionisable fluoride the 25th, 50th, and 75th percentile contained < or =275, 780 and 990 ppm fluoride, respectively. Of the 61 toothpastes with declared fluoride concentration, 75% contained a total F concentration of > or =89% of the declared concentration. In 25% of these toothpastes the free ionisable fluoride was < or =55% of the declared fluoride, and in another 25% of the pastes the free ionisable fluoride concentration was > or =89% of the declared fluoride. In conclusion, deficiencies were found regarding the total as well as the free ionisable fluoride concentration of toothpastes bought in non-established market economy countries. Unclear labelling concerning the type and concentration of fluoride was often encountered. A need for quality control of fluoride toothpastes is recommended.

Africa↗

PubMed2001

Caries inhibition in rats by a sodium fluoride, tripolyphosphate toothpaste with whitening and anti-tartar properties.

The anti-caries properties of a silica-based, sodium fluoride (NaF) toothpaste containing sodium tripolyphosphate (NaTPP) with tooth whitening and anti-tartar properties (Aquafresh Whitening), in specific pathogen-free Osborne-Mendel rats, were assessed in this study. A silica-based, fluoride-free placebo containing NaTPP, and a NaF-containing silica-based USP reference standard toothpaste were used as negative and positive control toothpastes, respectively. 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, packaged in coded tubes, was applied to the dentitions of the rats' teeth for one minute, twice daily on weekdays, and once daily on weekends and holidays. Both the NaF/NaTPP-containing and the NaF-containing USP standard toothpaste groups had lower total enamel caries scores (41 to 45%) than the group treated with the fluoride-free NaTPP-containing placebo. 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. It is thus apparent that Aquafresh Whitening has the anticaries benefit of a USP reference standard NaF toothpaste.

Analysis of Variance↗

PubMed2003

Effects of a betaine-containing toothpaste on subjective symptoms of dry mouth: a randomized clinical trial.

Our aim was to study the effects of mildly flavoured sodium lauryl sulphate (SLS)-containing and detergent-free toothpastes with and without betaine (BET) on subjective symptoms of dry mouth in a randomised clinical trial. BET is an osmoprotectant that reacts with molecules to supply the surface with a water coating that protects cells from surfactants. Twenty-seven xerostomic patients and 18 healthy controls took part in the randomised, double-blind clinical trial with a crossover design. Three mildly flavoured toothpastes: (1) 4% BET, (2) 1% SLS and 4% BET, and (3) 1% SLS were used for six weeks each. The reference or washout paste contained neither SLS nor BET. The subjects' dental appointments were at the beginning of the trial and before and after the use of each toothpaste. At each appointment, the subjects were interviewed about subjective sensations of dry mouth (Visual Assessment Scoring (VAS) Index). The subjects did not report any adverse effects in connection with the use of the toothpastes. The VAS scores for lip dryness and eating difficulties were significantly lower for the BET paste (lip dryness: BET<BET+SLS; p < 0.005 and eating difficulties: BET<BET+SLS; p = 0.02; BET<reference; p = 0.003). The BET paste relieved dry mouth symptoms in 44% of the xerostomic patients, the corresponding figures for the other pastes being BET+SLS 22% (p = 0.002 as compared with BET), SLS 18% (p = 0.022), and reference 7% (p = 0.000). In conclusion, all the mildly flavoured toothpastes used in this study were well accepted by the xerostomic subjects. Thus, other toothpaste components may be more mucosa-irritating than just SLS, or else they enhance the effect of SLS. The detergent-free, BET-containing toothpaste appeared to be associated with relief of some symptoms of dry mouth.

Analysis of Variance↗

PubMed2004

Enamel mineralization by calcium-containing-bicarbonate toothpastes: assessment by various techniques.

Surface defects such as scratching, acidic erosion, and natural dimpling of the tooth enamel can significantly affect its cosmetic appearance. There are many analytical techniques that can be used to view the surface of enamel and to assess the effect of surface treatments. Light microscopy, scanning electron microscopy (SEM), profilometry, and atomic force microscopy (AFM) can usefully be applied to viewing mineral surfaces and obtaining information about surface morphology and smoothness. Energy-dispersive x-ray fluorescence and other surface-ionizing techniques can give information about surface chemistry. Microhardness instrumentation can be used to determine surface hardness, while gloss meters and reflectometry can provide measurements of gloss and whiteness. In this study, four sets of in vitro experiments were performed, which illustrate the value of three of these techniques. Specially formulated calcium-containing toothpastes, designed to fill in surface defects in tooth enamel, were evaluated in four experiments for their ability to effect cosmetic improvements in etched tooth enamel: (1) two calcium-containing, sodium-bicarbonate-based toothpaste formulations were shown by SEM to smooth tooth enamel without introducing new scratches. In contrast, a commercial whitening toothpaste removed similar scratches but also created new ones; (2) calcium-containing dentifrices were shown by SEM and hardness measurements to put mineral onto the surface of enamel and to harden it. The effects of uneven dispensing of the two-phase, bicarbonate-based, calcium-containing formulation were shown to be small; (3) a number of different calcium-containing toothpastes were shown by SEM to deliver mineral onto the etched enamel surfaces, whereas a conventional fluoride toothpaste did not; and (4) AFM was used to follow the smoothing of an etched enamel surface after serial treatments with a calcium-containing, bicarbonate-based toothpaste. After 15 in vitro cycles, surface roughness was reduced by more than 50% and peak height was reduced by about two thirds. The results illustrate the effectiveness of the three analytical techniques and show that the calcium-containing toothpastes can deposit mineral into enamel surface deformities under a wide variety of conditions and from a wide variety of formulas.

Bicarbonates↗

PubMed1989

[Comparison of Czechoslovak and foreign toothpastes].

The authors made a nation-wide investigation focused on the consumption of foreign toothpastes and their evaluation, as compared with locally produced ones. They also assessed the properties of selected foreign toothpastes according to the Czechoslovak norm by laboratory tests. The investigation related that foreign toothpastes are purchased by one quarter of the subjects where enquiries were made. The main reason for selection of a foreign toothpaste was better taste and a better sensation of fragrance. People appreciate also the attractivity packing and adequate information on the properties and composition of the toothpaste. As compared with local toothpastes, the better taste of foreign ones is emphasized. Laboratory tests of the properties of foreign tooth pastes, as compared with local revealed that from the physico-chemical and microbiological aspect local toothpastes compare favourably with foreign ones. However, the organoleptic properties, packing and information are not comparable.

Czechoslovakia↗

PubMed2001

Polishing and whitening properties of toothpaste containing hydroxyapatite.

Toothpastes containing hydroxyapatite (HA-toothpaste) have demonstrated efficacy in preventing caries, treating hypersensitivity and curing periodontal diseases, however, their effects on whitening teeth have not been investigated. In this study, the polishing and whitening properties of hydroxyapatite contained toothpastes were evaluated in a combined experimental and clinical study. The polishing properties were evaluated in artificial teeth by polishing with different toothpastes, while the brightening and whitening properties were examined in volunteers using two colorimeters with two specially made fiberscopes. The results revealed that the addition of hydroxyapatite to toothpaste did not alter its polishing properties, while it did result in a marked increase in tooth-whiting. It was also found that the brightening and whitening properties increased as the amount of hydroxyapatite in the toothpaste increased. It is concluded that toothpaste containing hydroxyapatite are effective at whitening tooth and that whitening was not due to their polishing effect on tooth surface.

Journal Article↗

PubMed2003

[Influence of the buffer capacity of amine fluoride-containing toothpastes and gels in enamel erosion].

The aim of the study was to evaluate the abrasion resistance of eroded enamel brushed with experimental toothpastes and fluoride gels of varying buffering capacities. 50 Specimens were prepared from extracted human molars and cycled through three alternating de- and remineralizations including brushing abrasion in a brushing machine. Demineralization was accomplished by immersing the samples in 1% citric acid (5 min), remineralization occurred during immersing the samples in artificial saliva (1 min). Groups of ten samples were brushed with either one of the toothpaste (A-C) or one of the fluoridated gels (D-E). Toothpastes and gels were produced on the basis of elmex toothpaste or elmex-gelée (GABA International AG, Switzerland). Amount of titrable acid was defined as amount (mg) of 1 N KOH needed for neutralization of 1 g toothpaste or gel (A: 6 mg, B: 12 mg, C: 24 mg, D: 3.1 mg, E: 10 mg KOH). The following abrasion values (mean + S.D. [micron]) were obtained profilometrically: A: 6.76 +/- 2.05, B: 6.84 +/- 1.19, C: 8.28 +/- 2.89, D: 4.19 +/- 1.09 and E: 0.83 +/- 0.61. No significant difference in abrasion between the toothpastes was found. The fluoride gel with the higher buffering capacity (E) exhibited significantly less abrasion than the gel with the lower buffering capacity (D). It is concluded that in eroded enamel buffering capacity of the tested fluoridated toothpastes has no effect on abrasion, whereas use of fluoride gel with a higher buffering capacity leads to reduced abrasion values.

Amines↗

PubMed2004

One topical fluoride (toothpastes, or mouthrinses, or gels, or varnishes) versus another for preventing dental caries in children and adolescents.

BACKGROUND: Topical fluorides in the form of toothpaste, mouthrinse, varnish and gel are effective caries preventive measures. However, there is uncertainty about the relative value of these interventions. OBJECTIVES: To compare the effectiveness of one form of topical fluoride intervention with another when used for the prevention of dental caries in children. SEARCH STRATEGY: We searched the Cochrane Oral Health Group's Trials Register (May 2000), the Cochrane Central Register of Controlled Trials (CENTRAL) (The Cochrane Library Issue 2, 2000), MEDLINE (1966 to January 2000), plus several other databases. We handsearched journals, reference lists of articles and contacted selected authors and manufacturers. SELECTION CRITERIA: Randomized or quasi-randomized controlled trials with blind outcome assessment, comparing fluoride varnish, gel, mouthrinse, or toothpaste with each other in children up to 16 years during at least 1 year. The main outcome was caries increment measured by the change in decayed, missing and filled tooth surfaces (D(M)FS). DATA COLLECTION AND ANALYSIS: Inclusion decisions, quality assessment and data extraction were duplicated in a random sample of one third of studies, and consensus achieved by discussion or a third party. Authors were contacted for missing data. The primary measure of effect was the prevented fraction (PF) that is the difference in mean caries increments between the 'experimental' and 'control' groups expressed as a percentage of the mean increment in the control group. Random effects meta-analyses were performed where data could be pooled. MAIN RESULTS: There were 17 studies included, and 15 contributed data for the meta-analyses. Fluoride toothpaste was not significantly different from mouthrinse (pooled DMFS PF 0%; 95% CI, -18% to 19%; p = 0.94), or gel (pooled DMFS PF 0%; 95% CI, -21% to 21%; p = 1), or both gel and mouthrinse (pooled DMFS PF 1%; 95% CI, -13% to 14%; p = 0.94); heterogeneity was substantial. Results from the single trial comparing toothpaste with varnish (in deciduous teeth) were inconclusive (dfs PF 5%; CI not obtainable). The pooled results from the comparisons of fluoride varnish with mouthrinse was a non-significant difference favouring varnish (DMFS PF 10%; 95% CI, -12% to 32%; p = 0.40), but this result was not robust to sensitivity analysis performed, and heterogeneity was considerable. Results from the single trial comparing varnish with gel (14%, 95% CI, -12% to 40%; p = 0.30) and the single trial comparing gel with mouthrinse (-14% DMFS PF; 95% CI, -40% to 12%; p = 0.30) were inconclusive (favoured varnish and mouthrinse respectively). REVIEWER'S CONCLUSIONS: Fluoride toothpastes in comparison to mouthrinses or gels appear to have a similar degree of effectiveness for the prevention of dental caries in children. There is no clear suggestion that fluoride varnish is more effective than mouthrinses and the evidence for the comparative effectiveness of fluoride varnishes and gels, and mouthrinses and gels is inconclusive. No conclusions about adverse effects could be reached, because no data were reported on in the trials. Acceptance is likely to be greater for fluoride toothpaste.

Adolescent↗

PubMed1989

Analytical methods for the determination of various forms of fluoride in toothpastes.

Fluoride (F) toothpastes, properly formulated and tested to show chemical activity, stability and clinical efficacy, are the most important components of caries prevention programmes. Analytical methods, based on the use of a F- -specific electrode, for the determination of various F species (ionic, soluble and total F) in toothpastes were investigated. The methods involved analysis of F species in the supernatants, suspensions and precipitates (residues) of 20 per cent aqueous slurry of toothpastes as well as in the pastes themselves. The ionic F (F-) concentration was determined by the addition of acetate buffer (7.5 M, pH 5.2; containing a metal-chelating agent) to the supernatant of slurried toothpastes. The soluble F (F- plus F of hydrolysed PO3F2-) in the supernatants was determined by direct acid hydrolysis in 0.8 M HCl, at room temperature (23 + 1 degree C), for 3, 12 or 24 h and in 2.3 M HCl, at 50 degrees, for 10, 20 or 40 min. The total F concentration in the suspensions (slurries) and in the pastes was determined using acid-hexamethyldisiloxane (HMDS) diffusion; a method which hydrolysed PO3F2- and separated F as well. Inaccuracy was encountered in the determination of ionic and soluble F in the suspensions of slurried toothpastes. There was a good agreement (r = 0.997) between the soluble and total F concentrations in the supernatants of monofluorophosphate (Na2PO3F; MFP) toothpastes, suggesting that the two methods, i.e. direct acid hydrolysis and acid-HMDS diffusion, can interchangeably be used.(ABSTRACT TRUNCATED AT 250 WORDS)

Dentifrices↗

PubMed2002

Do powered toothbrushes contaminate toothpaste with metals?

Replaceable brush units of powered toothbrushes (PTBs) can contain metal parts made of nickel and chromium bearing alloy. These alloy ingredients have allergenic potential, and may contaminate toothpaste and the mouth during use. Here I quantify metals abraded from PTBs. A leading brand of PTB was used in a simulated intraoral environment with three leading brand toothpastes, and post-brushing samples were analysed for iron, chromium, nickel, molybdenum, and manganese by certified laboratories using standard methods. Results showed tartar control toothpaste abraded most metal, and caused discolouration of toothpaste slurry. Discolouration of toothpaste slurry, as a useful indicator of metal abrasion, was limited to one toothpaste brand, and not useful across brands.

Color↗

PubMed1999

Effect of cyclodextrins and polymers on triclosan availability and substantivity in toothpastes in vivo.

The aqueous solubility of triclosan is only about 10 microg/mL. This very low solubility can hamper its biological activity in the oral cavity, which could explain the mixed clinical results obtained from triclosan toothpaste trials. Triclosan availability in a silica-based toothpaste was improved through cyclodextrin solubilization. The triclosan in vivo availability was optimized through a series of phase-solubility studies and triclosan release studies. It was found that in toothpastes, natural beta-cyclodextrin (betaCD) was just as good a solubilizer as the more water-soluble betaCD derivatives. Furthermore, the amount of cyclodextrin could be reduced by as much as 60% through the addition of a small amount of carboxymethylcellulose (CMC), without affecting triclosan release from the toothpaste. Optimally, cyclodextrins resulted in an almost 3-fold enhancement of triclosan availability compared to an identical toothpaste containing no cyclodextrin. In vivo studies in humans showed that replacing triclosan with triclosan/betaCD in the toothpaste resulted in only moderate improvement in triclosan substantivity. However, replacing triclosan with triclosan/betaCD/CMC complex resulted in significant improvement in triclosan substantivity. Furthermore, the in vivo studies showed that replacing free triclosan with triclosan/betaCD/CMC complex resulted in an almost 3-fold increase in initial triclosan concentration in saliva after brushing and about 2-fold increase in duration of activity.

Adult↗

PubMed2000

Studies in vitro of abrasion by different manual toothbrush heads and a standard toothpaste.

BACKGROUND: Loss of dentine at the buccal cervical region of teeth has a multifactorial aetiology. However, a considerable amount of circumstantial evidence, supported by laboratory experiments, implicates toothbrushing with toothpaste as a consistent factor. Most interest has centred around the abrasivity of toothpastes, particularly since a toothbrush alone has negligible effects on dentine. The influence of filament stiffness on toothpaste abrasion was the subject of some studies, mostly at least 2 decades ago, and produced conflicting conclusions. Numerous changes to toothbrush design and construction have taken place in recent years. AIMS: The aim of this study was to measure the abrasion of a standard substrate, acrylic, by a standard toothpaste carried on modern brands of toothbrushes classified by manufacturers as hard (3 brands), medium (3 brands) and soft (6 brands). METHOD: The substrate was brushed for 20,000 strokes with at least 6 heads from each brand. Measurements of substrate loss were made at 5000 stroke increments by profilometry. RESULTS: Substrate loss for all brushes showed a pattern of abrasion which was to a first approximation linear. Overall, hard brushes caused least abrasion and soft brushes the most, with differences between groups being significant. Within-group differences between brands reached significance for soft and medium brushes but not hard brushes. CONCLUSIONS: The results could be explained by increased retention of toothpaste by smaller diameter filaments and denser tufts on soft brushes and the greater flexion of filaments increasing the area of contact with the surface. Calculations on the clinical outcome of these data in vitro indicate that toothbrushing with toothpaste alone would produce minimal damage to dentine even over many years. Differences between brushes therefore are probably of little clinical significance. Certainly, the data do not support the use of hard brushes, particularly in view of the potential detrimental effects to gingival tissues.

Hardness↗

PubMed2001

A study to assess the plaque inhibitory action of a new zinc citrate toothpaste formulation.

BACKGROUND, AIMS: Zinc-citrate-containing toothpastes have previously been suggested to be of value at inhibiting plaque and gingival inflammation. Present formulations have included triclosan which is thought to contribute major antibacterial/antiplaque effects. Alternative antimicrobial agents and other ingredients such as oils could help to produce equally effective formulations. The aim of this study was to determine whether zinc citrate toothpastes containing bromochlorophene and a triglyceride oil (1% and 8%) could inhibit de novo plaque formation. METHODS: Toothpaste slurry rinses were used over a 96-h period by 24 volunteers, whilst omitting all other oral hygiene procedures. For comparative purposes, a conventional commercial fluoride control toothpaste was also used in this triple cross-over double blind study. RESULTS: After 24 and 48 h, there were no statistically significant differences in plaque between the 2 test pastes and the control paste, whether assessed using a plaque index or plaque area. After 96 h, however, a significant reduction in plaque score of 10.6% and 24.2%) in plaque area (both p < 0.001) was found for the zinc citrate/1% oil toothpaste compared to the control paste. In addition, at 96 h, the 8% oil toothpaste significantly reduced plaque score compared to the control paste by 4.3% (p = 0.029). CONCLUSIONS: These findings would appear to warrant further investigation into the potential value of the zinc citrate/bromochlorophene/triglyceride formulation at inhibiting both plaque and gingival inflammation.

Adult↗

PubMed2003

Effect of toothpaste on the plaque inhibitory properties of a cetylpyridinium chloride mouth rinse.

BACKGROUND AND AIMS: Cetylpyridinium chloride (CPC) mouth rinses have moderate plaque inhibitory activity when used alone but rarely have shown adjunctive benefits to tooth brushing with toothpaste. Several explanations for this apparent anomaly can be proferred, including loss of antiseptic activity due to interactions with toothpaste ingredients. The aim of this study was to measure the effect of toothpaste on the plaque inhibitory properties of a CPC mouth rinse using paired rinses of CPC, toothpaste slurry (TP) and water (W). METHODS: The study was a single blind, randomised, seven-treatment, cross over design balanced for residual effects, involving 21 healthy, dentate subjects. The paired rinses were: W-CPC, CPC-W, TP-CPC, CPC-TP, W-TP, TP-W and W-W. Rinsing with solutions or slurries was done for 60 s twice per day. On day 1, subjects were rendered plaque free, suspended tooth cleaning and commenced the allocated rinse regimen. On day 5, plaque was scored by index. A 2(1/2) day wash out of normal oral hygiene was allowed between each regimen. RESULTS: The order from lowest to highest plaque scores was as follows: W-CPC = CPC-W < CPC-TP < TP-CPC < or = W-TP < TP-W < W-W. Several differences in pairs of treatments were statistically significant, the most relevant of which were significantly less plaque with W-CPC compared to TP-CPC, TP-W and W-TP, and significantly more plaque with W-W compared to all other regimens except TP-W. CONCLUSIONS: Toothpaste, whilst possessing some plaque inhibitory activity, when used immediately before a CPC mouth rinse adversely affected the plaque inhibitory action of this antiseptic. This in part may explain the reported lack of adjunctive benefits of CPC rinses to normal oral hygiene practices and supports the suggestion, made for chlorhexidine rinses, that their use should follow toothpaste by at least 60 min.

Adult↗

PubMed2000

Multicentre study of allergic contact cheilitis from toothpastes.

The present work reports the results of a multicentre study of toothpaste allergic contact cheilitis (TACC) conducted by GIRDCA (Gruppo Italiano Ricerca Dermatiti da Contatto e Ambientali). The study examined 54 patients with eczematous lesions on the lips, the possible cause of which was suspected to be the use of toothpastes. Patch tests were conducted with a standard series, a specially-targeted series (toothpaste cheilitis series, TCS), and with suspected toothpaste(s). A stop-restart test (SRT) was carried out with these, together with a use test to identify possible alternative products. The TCS produced 17 positive reactions in 13 patients, the most frequent being to spearmint oil. Of the 54 patients, 5 displayed positive reactions only to the TCS. The patch tests with toothpaste produced positive reactions in 11/32 patients, the SRT a positive response in 10/12 cases. The diagnosis of TACC was confirmed in 15/54 patients. Alternative products were identified for 5 patients. In conclusion, the allergens most frequently responsible for TACC were the flavourings, and the additional series proved to be useful in many cases (together with patch tests with toothpastes and the SRT) for correct diagnosis and to initiate effective prevention.

Adolescent↗

PubMed2000

The chemical stain removal properties of 'whitening' toothpaste products: studies in vitro.

BACKGROUND: A considerable number of toothpastes are available as tooth whitening products. Most appear to contain ingredients that might remove extrinsic stains rather than change natural tooth colour. Extrinsic stain removal could be achieved by physical or chemical means. AIM: The purpose of this study was to measure the chemical stain removal properties of a range of whitening toothpaste products and experimental formulations using a standardised method in vitro. MATERIALS AND METHOD: 5 separate studies were conducted involving a total of 39 agents of which 28 were whitening products, 7 were experimental formulations, 2 were oxidising mouthrinses used as positive controls, 1 was a popular fluoride toothpaste product as a benchmark control, and 1 was water as the negative control. The formulations and controls varied in each study. The stain model was saliva/chlorhexidine/tea stain developed on optically clear acrylic to an optical density of at least 2.0. Groups of stained specimens were exposed to standard slurries or solutions of each test agent for 1 minute periods up to 5 minutes. Optical density readings were taken at each 1 minute time point. Analyses were based on per cent stain remaining after 5 minutes and time to 75% stain remaining. RESULTS: 3 toothpaste products achieved 100% stain removal by 5 minutes; 2 of these in 3 out of 4 studies in which they were used. 4 experimental formulations also achieved 100% stain removal. In general agents with high total stain removal also had short times to 75% stain remaining. The majority of agents tested had low total chemical stain removal and prolonged times to 75% stain remaining. A few agents were little different from water and several similar in effect to the conventional fluoride toothpaste. This method in vitro tests agents under the best case scenario conditions for chemical stain removal. CONCLUSION: Only a small number of the whitening toothpaste products have good chemical stain removal potential; the majority are unlikely to achieve their claimed benefits through chemical stain removal. There is clearly a need for further data on the actual effects of such products using both methods in vitro and particularly in vivo or in situ.

Acrylic Resins↗

PubMed2002

General dental practitioner advice regarding the use of fluoride toothpaste in two areas with a school-based milk fluoridation programme and one without such a programme.

OBJECTIVE: To describe the knowledge and practice of general denta practitioners (GDPs) working in Liverpool (where there is no milk fluoridation programme) and St Helens and Knowsley, and the Wirral (where children have fluoridated milk in schools and pre-schools) relating to the advice given for child patients regarding the use of fluoridated toothpaste. DESIGN: Data were collected via a postal questionnaire sent to all 329 GDPs working within the three areas. GDPs working in more than one of the areas and those working in specialist orthodontic or oral surgery practices were excluded. RESULTS: Two hundred and thirty-four (71%) questionnaires were completed and returned. Only 3% of dentists said that no-one in their practice gave advice on the concentration of fluoride toothpaste to be used. For caries free children under 7 years of age only 64% of GDPs gave advice concerning the concentration of toothpaste which coincided with the available clinical guidelines. Twenty eight per cent of GDPs also contradicted the guidelines by advising children under 7 with high caries to use a low fluoride toothpaste. Although 59% of GDPs in the fluoridated milk areas asked the child whether they had fluoridated milk at school, they did not appear to alter the advice given regarding the use of fluoridated toothpaste. CONCLUSION: The study showed that a significant number of GDPs did not adhere to clinical guidelines relating to the use of fluoride toothpaste when giving advice to their child patients. For evidence-based dentistry to become a reality in this area, ways must be found to disseminate the available guidelines more fully and increase their acceptance and use by practitioners.

Animals↗