Can Desensitizing Toothpastes Also Have an Effect on Gingival Inflammation? A Double-Blind, Three-Treatment Crossover Clinical Trial

Dental Erosion in Competitive Swimmers and Preventive Treatments: An In Vitro Study

The aim of this in vitro study was to evaluate the effectiveness of highly concentrated fluoride products and remineralizing products (F-APC) in preventing erosive dental lesions in competitive swimming patients. A total of 48 teeth were extracted, preserved in saline solution and divided into three groups. In G1 (control group), each tooth was half-immersed in chlorinated pool water; in G2 (fluoride-treated group), after being totally immersed in chlorinated water, each tooth had half of its surface treated with a highly concentrated fluoride product once a week; in G3 (remineralization product-treated group), each tooth was totally immersed in chlorinated water and half of its surface was treated with a remineralizing product after each immersion. The study was conducted over a 4-week period, immersing the teeth for 4 h per day. In G1, statistically significant differences were observed in submerged versus non-submerged tooth surfaces at week 3 (T3) (p = 0.019) and week 4 (T4) (p = 0.0007), with four and eight surfaces showing erosive tooth wear (ETW), respectively. In G2, a difference was observed between fluoride-treated and non-fluoride-treated surfaces at T4 (p = 0.039), with three surfaces with ETW among the non-treated ones. In G3, the difference was observed between portions treated with F-APC and those not treated at T4 (p = 0.019), with four surfaces with ETW among the untreated ones. Chlorinated pool water is a potential erosive agent for teeth if water pH values reach a critical value. Treating the teeth surface with highly concentrated fluoride products, once a week for 5 min, and F-APC are effective in protecting teeth against tooth erosion.

Epidemiological evaluation of patient compliance regarding oral health and hygiene during the COVID-19 period

This work aimed to report values on oral hygiene habits at home during the pandemic and compare the differences between previous oral hygiene habits. A total of 1,136 questionnaires were filled in via a link sent through email to the patients. The answers show that although they had more time during the pandemic, they spent less time on dental and tongue hygiene. Dental and tongue hygiene are key to maintaining systemic health. The questionnaire was sent by e-mail to 1,136 male and female patients throughout Italy. Demonstrate and understand whether patients during the pandemic cleaned and spent time cleaning and maintaining their teeth and tongue hygiene. The questionnaire testifies to the fact that it is not the time but the patient's compliance and motivation that makes the difference.

OBJECTIVE

This work aimed to report values regarding oral hygiene habits at home during the pandemic and compare the difference with previous oral hygiene habits.

METHODS

This study was performed anonymously and had patients answer an online questionnaire. The questionnaire consisted of 11 closed-answer questions (except 1) concerning oral hygiene habits at home at the time of COVID-19 and participant characteristics, including gender and age. A total of 1,136 questionnaires were filled in via a link sent by email to the patients.

RESULTS

Among the 1,136 patients examined, 32.4% (372) were male and 67.6% (775) were female, and almost half (47.9%) of the patients who answered the questionnaire were aged 18-40 years. Patients who participated in our survey were asked questions related to dental and tongue hygiene. The answers showed that although they had more time during the pandemic, they brushed their teeth less and did not brush their tongues regularly.

CONCLUSION

Patients with periodontal problems usually have less time for brushing and do not have good plaque control. The questionnaire showed the opposite, such that the patient's compliance and motivation matters more than time. Thus, dentists and dental hygienists must encourage and make patients understand the importance of oral hygiene at home.

Improving Oral Health with Fluoride-Free Calcium-Phosphate-Based Biomimetic Toothpastes: An Update of the Clinical Evidence

As the demand for clinically effective fluoride-free oral care products for consumers increases, it is important to document which types of toothpastes have been shown in clinical studies to be effective in improving oral health. In this review, we included different indications, i.e., caries prevention, improving periodontal health, reducing dentin hypersensitivity, protecting against dental erosion, and safely improving tooth whitening in defining what constitutes improvement in oral health. While there are several professional and consumer fluoride-containing formulations fortified with calcium-phosphate-based ingredients, this review focuses on fluoride-free toothpastes containing biomimetic calcium-phosphate-based molecules as the primary active ingredients. Several databases were searched, and only clinical trials in human subjects were included; in vitro and animal studies were excluded. There were 62 oral health clinical trials on biomimetic hydroxyapatite (HAP), 57 on casein phosphopeptide-amorphous calcium phosphate (CPP-ACP), 26 on calcium sodium phosphosilicate (CSPS, or so called Bioglass), and 2 on β-tricalcium phosphate (β-TCP). HAP formulations were tested the most in clinical trials for benefits in preventing caries, dentin hypersensitivity, improving periodontal health, and tooth whitening. Based on the current clinical evidence to date, fluoride-free HAP toothpaste formulations are the most versatile of the calcium phosphate active ingredients in toothpastes for improving oral health.

Antigingivitis, Desensitizing, and Antiplaque Effects of Alkaline Toothpastes: A Randomized Clinical Trial

Gingivitis is a widespread disease commonly associated with dentin hypersensitivity, that, in turn, may complicate routine dental care, leading to plaque accumulation. We aimed to assess the antigingivitis, desensitizing, and antiplaque effects of a fluoride-containing (TWF) alkaline toothpaste and a fluoride-free (TW) alkaline toothpaste. Eighty-four consenting patients aged 20-25 years with diagnosed gingivitis and dentin hypersensitivity (DH) were recruited in this double-blind, parallel-group study and randomly divided into two groups (each n = 42). Eighty-two patients completed the entire study protocol. The outcomes were assessed after 4 weeks of intervention. A significant improvement in gingival condition was found according to the modified gingival index, with effect sizes of 0.99 [CI95%: 0.52-1.46] and 1.71 [CI95%: 1.18-2.24], and the gingival bleeding index, with effect sizes of 3.17 [CI95%: 2.39-3.94] and 2.64 [CI95%: 1.96-3.32] in the TW and TWF groups, respectively. DH also decreased in both groups, with a significantly greater reduction in the TWF group (effect sizes of 3.28 [CI95%: 2.51-4.04] and 3.10 [CI95%: 2.40-3.80] according to the visual analog scale and Schiff scale, respectively). No side effects were registered. In conclusion, the use of alkaline toothpaste provided a significant reduction in gingival inflammation and bleeding, DH, and oral hygiene after 4 weeks of daily use in young adults. Trial Registration: NCT0562376. Funding: none.

A randomized clinical trial for comparing the efficacy of desensitizing toothpastes on the relief of dentin hypersensitivity

The 4-week double-blind clinical trial to manage dentin hypersensitivity (DH) using different desensitizing toothpastes was conducted. 53 participants with DH were enrolled in this trial. The participants were randomized into 3 groups: Group N; no active ingredient-containing toothpaste (Pleasia fluoride-free), Group SC; a toothpaste containing strontium chloride (Sensodyne Original), and Group TP; a toothpaste containing tricalcium phosphate (Vussen S). They were instructed to brush their teeth manually for 3 min, 3 times per day for 4 weeks with the allocated toothpastes, and were assessed at baseline (0), 2, and 4 weeks, respectively. Schiff sensitivity score was recorded to 3 different stimuli (air-blast, cold, and acid) at each assessment. Overall DH was also assessed using a visual analog scale (VAS). The longer participants used the toothpastes, the greater reduction in DH in all groups to the three stimuli. Group TP demonstrated significant reduction of DH compared to group N for air-blast and cold stimuli. Group TP showed significantly lower VAS than group N and SC. Tricalcium phosphate containing toothpaste used in this trial was most useful to reduce DH. It can be one of the treatment options that alleviate DH.

Preparation and In Vitro Characterization of Gels Based on Bromelain, Whey and Quince Extract

The growing interest in the appearance and color of teeth has led to the emergence of a wide range of teeth whitening methods, both in dental offices and in patients' homes. Concerns about the possible side effects or toxic effects of peroxide-based whitening gels leads to the identification of alternative whitening methods, based on natural compounds with mild action on tooth enamel and remineralizing effect. In this context, this study describes the preparation and in vitro analysis of whitening gels based on natural active agents-bromelain, quince and whey-using organic (polyacrylate, polyethylene glycol) and/or inorganic (silicate) excipients. Five natural products gels were prepared, containing bromelain extract, quince extract and whey, in various proportions. Two supplementary gels, one containing Lubrizol and another containing SiO2, were prepared. All gels were submitted for multiple in vitro analysis such as: SDS-PAGE analysis, UV-vis and FTIR spectroscopy, SEM microscopy, antibacterial activity on Streptococcus mutans ATCC 25175, Porphyromonas gingivalis ATCC 33277, Enterococcus faecalis ATCC 29212, Escherichia coli ATCC 25922 and Staphylococcus aureus ATCC 25923. The quince extract sample was the only one which completely discolored the blue dye on SDS-PAGE analysis. On the UV-vis spectra, the 303 nm band is assigned to an in situ modified form of bromelain. SEM images of gels containing SiO2 particles show evident marks of these particles, while the rest of the gels containing Lubrizol or whey are more uniform. Regarding antibacterial tests, the SiO2 gel samples did not show inhibition in any strains, but the other tested samples varied in the size of the inhibition diameter depending on the amicrobial strain tested; the protease activity of bromelain modulates the composition of the added whey proteins. Bromelain added as a nanoencapsulated assembly better preserves its integrity. The prepared gels showed antibacterial properties.