Stain removal, abrasion and anticaries properties of a novel low abrasion dentifrice containing micro-fibrillated cellulose: in vitro assessments

OBJECTIVES

This laboratory study assessed the performance of a novel fluoride dentifrice containing micro-fibrillated cellulose (MFC) and entrapped silica.

METHODS

Removal of extrinsic stains was assessed using the pellicle cleaning ratio (PCR) method, and radioactive dentin abrasivity (RDA) was measured, to calculate a cleaning efficiency index (CEI). Fluoride efficacy was evaluated using widely used remineralization and fluoride uptake methods. The test product (Protegera™) was compared to common dentifrices (Crest - Cavity Protection™ and ProHealth™, Sensodyne Pronamel™, Arm & Hammer™ Advanced Whitening, Crest ProHealth™, and Colgate Optic White™).

RESULTS

The PCR for the MFC dentifrice (141) was comparable to three known marketed stain-removing dentifrices (Arm & Hammer™ Advanced Whitening, Crest ProHealth™, and Colgate Optic White™) but it had a significantly lower RDA (88 ± 6) than 5 other products. This gave it the highest CEI of the tested products (2.0). In a 10-day pH cycling study, the fluoride efficacy of the MFC product was comparable to Sensodyne Pronamel and Crest Cavity Protection. The MFC dentifrice was superior for promoting fluoride uptake into incipient enamel lesions compared to the USP reference dentifrice.

CONCLUSION

The MFC dentifrice has low abrasion, but despite this, it is highly effective in removing stained pellicle. It also is an efficacious fluoride source when compared to relevant commercially available fluoride dentifrices with high dentin abrasivity.

CLINICAL SIGNIFICANCE

The addition of micro-fibrillated cellulose to a fluoride dentifrice gives a low abrasive product that can effectively remove external stains, and serve as an effective fluoride source. This combination of benefits seems well suited to enamel protection and caries prevention.

Is the whitening effect of charcoal-based dentifrices related to their abrasive potential or the ability of charcoal to adsorb dyes?

OBJECTIVES

To evaluate if tooth color alteration of activated charcoal-based dentifrices may be attributed to the dye adsorption potential of charcoal (chemical action - C - slurry only) or to the association of dye adsorption with abrasion (chemo-mechanical action - CM- slurry/toothbrushing). Potential adverse effects in surface roughness, gloss, and wear were also assessed.

METHODS

Bovine enamel/dentin specimens were randomly allocated into the groups according to treatments and test model (n = 15): deionized water (negative control- NC); Colgate Maximum Anticaries Protection (conventional toothpaste- positive control- PC); Colgate Luminous White Activated Charcoal (LW); Oral-B 3D White Therapy Charcoal (WT); Curaprox Black is White (BW); Dermavita Whitemax (Activated charcoal powder- WP). Specimens were exposed to the C or CM models, in 28-day staining-treatment cycling. Color change (ΔE00), whiteness index (ΔWID), percentage of alteration of surface roughness (%Raalt), and gloss (%GUalt) were calculated. Additional specimens (n = 9) were indented with a Knoop diamond and subjected to 100,000 abrasion cycles. Enamel wear was determined by calculating the decrease in indentations geometry. Data were analyzed by ANOVA/Tukey tests (α = 0.05).

RESULTS

The CM-model produced lower color change (staining) than C (p = 0.0001). PC, LW, WT, BW, and WP showed similar color results for both models, differing from NC (p < 0.05).%Ra and%GU did not differ among the C-model groups (p > 0.05) and WP exhibited the highest variation (%Ra and%GU) under CM-model. Enamel wear values were lowest in the NC and PC groups, intermediate for LW, WT, BW, and highest for the WP (p < 0.05).

CONCLUSION

Activated charcoal-based dentifrices have a similar ability to minimize tooth staining as the conventional toothpaste, with increased enamel wear potential in the long term (after 100,000 cycles). The activated charcoal powder damaged the enamel surface, showing a higher deleterious effect on enamel roughness, gloss, and wear.

CLINICAL SIGNIFICANCE

Dentifrices containing activated charcoal do not provide superior results to minimize tooth staining compared to conventional toothpaste. Charcoal powder should be used with caution because it promotes higher superficial alterations on the enamel surface.

Evaluation of Stain Removal Efficacy and Color Stability of Three Different Dentifrices on Artificially Stained Enamel Surface-An In Vitro Study

AIM

The aim of the present study was to assess the stain removal ability and color stability of three distinct dentifrices on artificially stained enamel surface.

MATERIALS AND METHODS

This study included 75 intact, healthy premolars free of dental caries that were extracted during orthodontic therapy. The samples were allowed to dry for 6 hours after being submerged in the prepared tea solution for roughly 18 hours every day. Then this procedure was repeated for seven successive days. All samples were randomly divided into three experimental groups with 25 samples in each group. Group I: control dentifrice, group II: dentifrice containing hydrogen peroxide, group III: dentifrice containing papain and bromelain. A specially designed toothbrushing simulator was used to brush every sample in the relevant group. Using a spectrophotometer and a measurement program, color measurement was evaluated after staining process after 4 weeks and 8 weeks of teeth cleaning. Using a profilometer, the surface roughness values (Ra) were assessed.

RESULTS

After 8 weeks of brushing of stained samples, the color stability was better in dentifrice containing hydrogen peroxide (1.14 ± 0.11) followed by dentifrice containing papain and bromelain (1.22 ± 0.08) and control group (1.30 ± 0.09). And after 8 weeks of brushing of stained samples, the surface roughness was more in dentifrice containing hydrogen peroxide (0.237 ± 0.02) followed by dentifrice containing papain and bromelain (0.229 ± 0.13) and control group (0.207 ± 0.05).

CONCLUSION

The present study concluded that the dentifrice containing hydrogen peroxide showed a superior whitening effect on the stained enamel surface than dentifrice containing papain and bromelain and control dentifrice.

CLINICAL SIGNIFICANCE

The development of various dentifrice products has been greatly aided by the increased demand for an improved esthetic appearance. Teeth's natural color and any external stains that could accumulate on the tooth surface combine to determine a tooth's color. Additionally, the use of whitening dental pastes to remove external stains has grown in favor. With the development of these whitening toothpastes, dentifrices' ability to lessen or eliminate extrinsic dental stains has increased. How to cite this article: Mishra D, Kamath DG, Alagla M, et al. Evaluation of Stain Removal Efficacy and Color Stability of Three Different Dentifrices on Artificially Stained Enamel Surface-An In Vitro Study. J Contemp Dent Pract 2024;25(1):68-71.

Toothpaste use in Peruvian children during COVID-19 pandemic: results from a National Demographic and Health Survey

PURPOSE

To determine the impact of COVID-19 pandemic on use of toothpaste in Peruvian children.

METHODS

A national database of Peruvian children from 0 to 11 years old was used to develop a cross-sectional study, with a final sample of 51, 013 subjects. Data were obtained of results of the Demographic and Family Health Survey (ENDES); the questionnaire was self-reported. The use of toothpaste and fluoride concentration in toothpaste were dependent variables, and for the independent variable, the year was considered; in addition, other covariates were included. The statistical analyses applied were descriptive, bivariate, and multivariate tests.

RESULTS

Use of toothpaste was 98.99% (n = 50,134), while fluoride toothpaste with < 1000 ppm was used by 77.29% (n = 27,366). For bivariate analysis, use of toothpaste was associated with place and area of residence, altitude, natural region, and age; for use of fluoride toothpaste with minimum 1000 ppm, there was an association with place and area of residence, natural region, wealth index, and age. In a multivariate manner, year only presented a positive association with use of fluoride toothpaste < 1000 ppm (RPa:1.04; 95%CI 1.01-1.07).

CONCLUSIONS

Year 2020 of COVID-19 pandemic had a positive impact on the use of < 1000 ppm fluoride toothpaste in Peruvian children.

Comparative Evaluation of Abrasiveness among Three Dentifrices: An In Vitro Study

Aim

A lot of herbal and medicated toothpastes having natural and antisensitivity properties are creating niches for themselves in the market. However, toothpaste containing high content of abrasives can be harmful to the teeth. The present in vitro study was conducted to assess the abrasiveness of three commercially available dentifrices on human-extracted anterior teeth on sound and demineralized enamel.

Materials and methods

A total of 42 freshly extracted teeth were mounted on acrylic resin and randomly divided into three groups (group I, Colgate; II, Glister; and III, Dant Kanti). Each group consisted of one test tooth (partially) and one control tooth (completely) covered with nail varnish. The study had two phases. Phase 1-baseline average roughness (Ra) value was assessed with a profilometer of all the samples. Phase 2-further, teeth were immersed in the demineralizing solution for 4 days to allow the formation of an artificial carious lesion. Tooth brushing was performed by a customized automated toothbrushing model on all the teeth for 28 days. Ra value was again evaluated with Profilometer.

Result

Data were analyzed, and a statistically significant result was observed with demineralized teeth in all three groups (p = 0.005). The intragroup comparison showed a significant difference with demineralized teeth of Colgate and Dant Kanti, (p =0.018) and (p =0.027), respectively. However, there was no significant difference in demineralized teeth of glister and sound teeth of all three groups.

Conclusion

Glister was found to be the least abrasive of all three toothpastes, followed by Dant Kanti and Colgate.

Clinical relevance

The particle size of the ingredients used in manufacturing toothpaste can lead to abrasion of the teeth.This, in combination with the hard bristles, can cause more harm to the teeth than good. The current study has compared the abrasive potential of three commercially available kinds of toothpaste. Hence daily use of these commercially available dental products should be used cautiously.

How to cite this article

Priyam S, Sankeshwari R, Jalihal S, et al. Comparative Evaluation of Abrasiveness among Three Dentifrices: An In Vitro Study. Int J Clin Pediatr Dent 2023;16(2):264-269.

USE OF MOUTHWASH AND DENTIFRICE CONTAINING AN ANTIMICROBIAL PHTHALOCYANINE DERIVATIVE FOR THE REDUCTION OF CLINICAL SYMPTOMS OF COVID-19: A RANDOMIZED TRIPLE-BLIND CLINICAL TRIAL

PURPOSE

This clinical trial aimed to evaluate the use of mouthwash and dentifrice containing an antimicrobial phthalocyanine derivative (APD) to reduce the clinical symptoms in patients with COVID-19.

METHODS

This randomized, triple-blind clinical trial enrolled 134 patients aged 18 years or older who underwent COVID-19 testing through the use of nasopharyngeal swab RT-qPCR in a reference center for the diagnosis of COVID-19, had no clinical contraindications to mouthwash and gargle, and had access to cell phones with communication applications. According to the use of a mouthwash and dentifrice containing antimicrobial phthalocyanine derivatives (APD), patients were randomly assigned (1:1) to the APD or non-APD (control) group. All participants were instructed to floss twice a day, brush teeth for 2 minutes 3 times a day, and gargle/rinse (5 mL) for 1 min/3 times a day for 7 days. An online questionnaire was sent to collect data on the clinical symptoms of COVID-19 3 times: T0 (baseline before using the oral hygiene products), T3 (3 days after), and T7 (7 days after). The investigators, patients, and outcome assessors were blinded to group assignment. The Mann-Whitney, Chi-Square, Fisher's exact, and Cochran's tests were used according to the nature of the variables studied, with the level of significance set at P < .05.

RESULTS

No statistically significant difference was found in the prevalence of symptoms between groups at baseline. A statistically significant reduction in clinical symptoms was found in the control group (fatigue, shortness of breath, hoarse voice, sore throat, nasal congestion, and chest pain) and APD group (cough, fatigue, shortness of breath, hyposmia/anosmia, dysgeusia, hoarse voice, sore throat, nasal congestion, chest pain, diarrhea, and irritability/confusion) during the follow-up period. There were statistically significant differences, with a higher prevalence of symptoms in the control group at T3 and T7. Dysgeusia, sore throat, and irritability/confusion were less prevalent in the APD group at T3, and shortness of breath, hyposmia/anosmia, dysgeusia, hoarse voice, sore throat, diarrhea, and irritability/confusion were more prevalent in the control group at T7.

CONCLUSIONS

Based on this methodology, the results demonstrated that the regular use of mouthwash and dentifrice-containing APD had a positive impact on the clinical symptoms, as reported by patients with COVID-19.

The effect of toothpaste with reduced concentration of fluoride-containing sodium trimetaphosphate and polyols on initial enamel erosion

OBJECTIVES

This in vitro study evaluated the efficacy of toothpaste containing fluoride (F), sodium trimetaphosphate (TMP), and xylitol and erythritol (XE) to inhibit or repair initial enamel erosion lesions.

MATERIALS AND METHODS

Bovine enamel blocks (n = 120) were selected according to surface hardness (SH) and randomly divided into 5 experimental groups (n = 24 blocks/group): Placebo (no F, TMP, XE); 1100 ppm F; 16% xylitol + 4% erythritol (XE); 200 ppm F + 0.2% TMP (200 ppm F/TMP); and 200 ppm F + 0.2% TMP + 16% xylitol + 4% erythritol (200 ppm F/TMP/XE). The sound and softened blocks were immersed in toothpaste slurry in human saliva for 2 min. The blocks were then submitted to 4 erosive challenges in citric acid (0.75%, pH 3.5), each challenge for 1 min, with stirring. The SH of the blocks was determined after treatment (t) and after the 4 erosive challenges. In addition, the precipitates were analyzed by scanning electron microscopy (SEM). Variables were submitted to a two-way repeated-measures analysis of variance followed by a Student-Newman-Keuls test (p < 0.05).

RESULTS

Toothpaste containing 200 ppm F/TMP/XE led to the highest protective and repair effect compared to the other groups (p < 0.001). The protective and repair effect was XE > 200 ppm F/TMP > 1100 ppm F > placebo (p < 0.001). All groups produced precipitates with a thicker layer for XE and TMP groups.

CONCLUSIONS

Toothpaste containing 200 ppm F, TMP, and polyols demonstrated a superior protective and repair effect in initial enamel erosive lesions in vitro.

CLINICAL RELEVANCE

Toothpaste containing F and polyols could be an advantage in patients affected by dental erosion, due to its higher preventive potential, mainly in individuals who frequently drink acidic beverages. However, future studies are needed to confirm these results.

Nocturnal Salivary Fluoride Bioavailability After Brushing with a High-fluoride Dentifrice

The use of fluoridated dentifrices is recognized as the main reason for the decline of dental caries and its effect is associated with the bioavailability of fluoride (F) in the oral cavity. High-fluoride dentifrice has been indicated for patients at high risk of caries and management of root lesions. This study aimed to evaluate the bioavailability of F in saliva after the use of high-fluoride dentifrice during the nocturnal period. Fifteen healthy adults participated in this is in vivo and crossover study in which the concentration of F in their saliva was determined after brushing with the tested dentifrices: a conventional (1450 ppm F) or with high-fluoride concentration (5000 ppm F). Before brushing, the participants collected the non-stimulated saliva (baseline), immediately after brushing (time zero) and after 5min, 2h, 4h, and 8h, during the nocturnal period (between 10:00 pm and 06:00 am). The salivary F concentration was determined using a specific F ion electrode. Regarding statistical analysis, a paired t-test was used to compare dentifrices with p fixed at 5%. At baseline, there was no significant difference between groups (p>0.001). Immediately after brushing, both dentifrices increased the F salivary concentration, with the highest concentration reached in time zero; however, the use of 5000 ppm F dentifrice maintained the higher F salivary concentration at all times evaluated (p<0.001), remaining higher until 8 h after brushing. Furthermore, this treatment showed higher F bioavailability in relation to time, evaluated by the area under the curve (p<0.001). Thus, it can be concluded that the high-fluoride dentifrice increased the bioavailability of salivary F during the nocturnal period in comparison with conventional dentifrice.

Effect of tooth bleaching and application of different dentifrices on enamel properties under normal and hyposalivation conditions: an in situ study

OBJECTIVE

The purpose of this in situ study was to evaluate different dentifrices on enamel after bleaching under normal and hyposalivatory conditions.

MATERIALS AND METHODS

Twenty-four participants were assigned of which 12 had normal and 12 had low salivary flow. The study was conducted in 6 in situ experimental phases of 24 h duration: placebo, NaF, SnF₂, F/Sn/Chitosan, F/Arginine, and F/Bioactive Glass. The specimens were previously bleached in vitro. Microhardness (SMH), roughness (Ra), and color analyses (CIELAB and ΔE₀₀) were performed at baseline (T1), after bleaching (T2) and after in situ phase (T3). Scanning electron microscopy (SEM) and the elemental levels (wt%) of Ca, P, and Na and the proportion between Ca and P were determined using an energy-dispersive X-ray spectrometer (EDS) in T3. The SMH and Ra were analyzed by mixed models for repeated measures and Tukey Kramer. The color and Na% were analyzed by split-plot ANOVA and Tukey test. The EDS were analyzed by Mann's Whitney nonparametric, Friedman, and Nemenyi tests (p<0.05).

RESULTS

The dentifrices placebo and NaF in the low flow presented lower SMH and higher Ra in T3 and lower Ca% compared to the same dentifrices in normal flow. For normal flow, SnF₂ resulted in greater SMH. For low flow, SnF₂, F/Sn/Chitosan, and F/Bioactive Glass resulted in higher SMH in T3 and did not differ from T1. F/Bioactive Glass showed lower Ra among the dentifrices evaluated for both salivary flows, whereas SnF₂ showed the highest. F/Bioactive Glass showed a statistically significant difference from placebo for Ca%, P%, Na%. For ΔE^*_ab and ΔE₀₀ (T1×T3), no differences were found for the dentifrices and salivary flows.

CONCLUSION

The low salivary flow had less capacity for remineralization of bleached enamel compared to normal flow. Overall, the dentifrice with bioactive glass had the best performance in bleached enamel under low and normal salivary flow condition.

CLINICAL RELEVANCE

It is recommended to use a bioactive glass-based dentifrice after bleaching to promote tooth enamel recovery for patients with or without impaired salivary flow.

In situ evaluation of 200 ppm fluoride toothpaste content trimetaphosphate, xylitol and erythritol on enamel demineralization and dental biofilm

OBJECTIVE

To evaluate the effect of low-fluoride (F^-) toothpaste and sodium trimetaphosphate (TMP) associated with xylitol and erythritol (XE) on enamel demineralization and biofilm composition.

METHODS

This crossover double-blind in situ study consisted of five phases (seven days each), in which 14 volunteers wore oral appliances containing four enamel bovine blocks. The cariogenic challenge was performed by exposure to a 30% sucrose solution (6x/day). The toothpaste treatments (3x/day) were as follows: placebo (no F^-/TMP/XE); 200 ppm F^- (NaF) (200F); 1,100 ppm F^- (1100F); 16% Xylitol and 4% Erythritol (XE); and 200 ppm F^-, 0.2% TMP, 16% xylitol, and 4% erythritol (200F-TMP-XE). Percentage of surface hardness loss (%SH) and integrated loss of subsurface hardness (ΔKHN), and calcium (Ca²⁺), phosphate (PO₄^3-), and F^- on enamel and biofilm were determined; as well as insoluble extracellular polysaccharide (EPS).

RESULTS

XE and 1100F groups showed no significant difference for %SH and ΔKHN values (p = 0.220 and p = 0.886), and the 200F-TMP-XE group had the lowest mineral loss (p < 0.001). Ca²⁺ and PO₄^3- in the enamel showed the highest values (p < 0.001) for the 200F-TMP-XE group. Higher values of F^- in the enamel and biofilm were observed for the 1100F group (p < 0.001). There was no difference for Ca²⁺ (p = 1.00) and EPS (p =0.918) values between XE and 200-TMP-XE groups in the biofilm, but their values were higher and lower than the 1100F (p = 0.002 and p = 0.029), respectively.

CONCLUSIONS

200F-TMP-XE promoted a greater protective effect against enamel demineralization and significantly affected the composition of biofilm formed in situ compared to 1100F toothpaste.

CLINICAL SIGNIFICANCE

Low-F^- toothpaste containing TMP and polyols can be considered an effective and safe measure to improve the oral health of individuals, especially patients with high caries activity.

Randomised study of intra-oral kinetics of fluoride-containing toothpastes

OBJECTIVES

This randomised, controlled, analyst blind, crossover study aimed to evaluate and compare salivary fluoride and calcium ion concentration over 60 min following brushing with an assigned treatment and following an orange juice (OJ) or deionised (DI) water rinse 60 min post-brushing.

METHODS

Study treatments, both containing 1150 ppm fluoride as NaF and 5% w/w KNO₃, were the Test (including 1.2 % w/w cocamidopropyl betaine) and Comparator (including tetrasodium pyrophosphate and sodium lauryl sulphate) toothpastes. Twenty nine participants were randomised to treatment.

RESULTS

A sharp increase in salivary fluoride ion concentration immediately post-brushing with either toothpaste decreased over time. Fluoride concentration following Test toothpaste use was numerically higher than the Comparator at all timepoints, with a significant difference from 10 min post-brushing (p < .05). Following the 60 min rinse, there were no significant differences between the Test or Comparator + OJ groups in salivary fluoride concentration but the Test + DI water group was significantly lower than Test (p < .001) or Comparator (p < .001) + OJ groups. A reduction in salivary calcium ion concentration was seen immediately post-brushing and after the OJ rinse with both toothpastes. Significant differences were observed in favour of the Test toothpaste at all timepoints (p < .05) and for Test and Comparator + OJ group (p < .001) compared with Test + DI water rinse. Both treatments were generally well-tolerated.

CONCLUSIONS

This study demonstrated that toothpaste formulations with identical declared fluoride concentrations and the same fluoride source give rise to differing intraoral fluoride concentrations over time, which are potentially related to different formulation excipient effects.

CLINICAL SIGNIFICANCE

By understanding the interaction of toothpaste formulation excipients in the oral environment, formulations can be developed that maximise retention of fluoride in the oral environment.

Bioavailable gluconate chelated stannous fluoride toothpaste meta-analyses: Effects on dentine hypersensitivity and enamel erosion

OBJECTIVES

To compare the effect of bioavailable gluconate-chelated stannous fluoride (SnF₂) toothpaste with control toothpastes for treatment of dentine hypersensitivity (DH) and enamel erosion.

DATA AND SOURCES

A Procter & Gamble Oral Care archive of clinical studies was reviewed from 2000 to 2020. Eligible studies were Randomised Controlled Trials (RCTs) investigating bioavailable gluconate-chelated SnF₂ toothpaste efficacy compared to controls in adult participants measured following tactile (Yeaple force) and/or evaporative stimuli (Schiff score) in-vivo, duration <2 months (DH); or by erosive toothwear (profilometry) from in-situ samples, duration 10-15 days. Two authors independently assessed eligibility and resolved disagreements by discussion. A meta-analysis was undertaken and Risk of Bias (RoB) assessed using the Cochrane collaboration RoB tool for randomized parallel-group and cross-over trials.

RESULTS

Fourteen RCTs (1287 participants) assessed DH relief and Six RCTs (184 participants) enamel erosion protection. For DH SnF₂ toothpastes provided a 57 % (evaporative air) and 142 % (tactile) benefit versus negative controls (sodium fluoride/monofluorophosphate, 8 studies; p < 0.001). Compared to positive controls (potassium nitrate or arginine, 6 studies), a 22 % advantage (p = 0.036) was seen for evaporative air. In erosion studies, SnF₂ toothpastes provided an 83 % benefit versus control toothpastes (arginine or sodium fluoride; p < 0.001) with a change (95 %CI) in average surface profilometry level (μm) of -2.02(-2.85, -1.20).

CONCLUSIONS

The use of these bioavailable SnF₂ toothpastes, as part of a daily oral hygiene regimen, will provide patients with enamel erosion protection, combined with alleviation of DH pain when present, improving quality of life.

Effect of toothbrush/dentifrice abrasion on weight variation, surface roughness, surface morphology and hardness of conventional and CAD/CAM denture base materials

We evaluated the effect of toothbrush/dentifrice brushing on the weight variation and surface properties of different denture bases. Four denture base materials (conventional heat cure, high impact, CAD/CAM, and polyamide resins) were subjected to toothbrushing abrasion (50,000 strokes). The weight value, surface roughness, and topography of each group were determined before and after toothbrushing. The hardness was measured by the Vickers hardness test. Data were analyzed using ANOVA and Bonferroni tests. After toothbrushing, the weight of the polyamide resin had significantly increased; significant weight losses were observed for conventional heat cure and high impact resins, but none for the CAD/CAM resin. The surface roughness of each group increased significantly owing to the wear caused by toothbrushing. The weight variation and surface roughness were not affected by the hardness. Our results suggested that denture base materials deteriorate after brushing with toothpaste, in which the polyamide resin exhibited lower levels of abrasion.

Hydraulic conductance of dentin after treatment with fluoride toothpaste containing sodium trimetaphosphate microparticles or nanoparticles

OBJECTIVES

To evaluate the hydraulic conductance of dentin after treatment with fluoride toothpastes containing sodium trimetaphosphate microparticles (TMPmicro) or nanoparticles (TMPnano).

MATERIALS AND METHODS

The dentinal tubules of bovine dentin blocks (4 × 4 × 1 mm) were unobstructed for determination of the maximum hydraulic conductance of the dentin. The dentin blocks were randomized into four groups (n = 15/group) of toothpastes (placebo, 1100 ppm F, and 1100 with 3% TMPmicro or 3% TMPnano) which were applied for 7 days (2×/day) using a brushing machine. The dentin surface (5/group) was analyzed by scanning electron microscopy. The hydraulic conductance post-treatment was measured in the other ten blocks. Thereafter, the same blocks were immersed in citric acid (pH 3.2) for 1 min, and the conductance was determined again. The data were submitted to 2-way ANOVA repeated measures, followed by the Student-Newman-Keuls test (p < 0.05).

RESULTS

The percentage conductance reduction post-treatment for the groups were placebo = 1100 ppm F < 1100 TMPnano < 1100 TMPmicro (p < 0.001). After acid attack, the percentage reduction was placebo < 1100 ppm F < 1100 TMPnano < 1100 TMPmicro (p < 0.001). The toothpastes containing TMP showed the highest obliteration of dentinal tubules.

CONCLUSIONS

The addition of TMPmicro to fluoride toothpaste produced a greater reduction in hydraulic conductance when compared with 1100 ppm F toothpaste.

CLINICAL RELEVANCE

The increased capacity of toothpastes containing TMP to reduce hydraulic conductance indicates their potential to reduce symptoms of dentinal hypersensitivity.

Efficacy of nano-carbonate apatite dentifrice in relief from dentine hypersensitivity following non-surgical periodontal therapy: a randomized controlled trial

Background

Dentine hypersensitivity (DH) could occur or intensify after non-surgical periodontal therapy because of the exposure of dentine tubules, but currently no gold standard exists to treat DH. It has been demonstrated that nano-sized particles presented potential for dentine tubules blocking and remineralization. This randomized controlled trial aimed to investigate the efficacy of dentifrice containing nano-carbonate apatite (n-CAP) in reducing dentine hypersensitivity (DH) after non-surgical periodontal therapy.

Methods

48 periodontitis patients with DH were included in this clinical trial. After non-surgical periodontal therapy, patients included were randomized to test and control group and the respective dentifrices were applied at chairside, after which they were instructed to brush teeth with the allocated dentifrices twice a day at home. Periodontal parameters were recorded at baseline and the last follow-up. DH was measured by air-blast test and recorded by visual analogue scale (VAS) and Schiff sensitivity scale at baseline, after polishing (0 week) and 2/4/6 weeks.

Results

45 participants completed the follow-up. Periodontal parameters were improved and comparable between groups. Significant reduction in DH was observed in both groups at all time-points compared to baseline in terms of VAS and Schiff score. The test group achieved significantly greater relief from hypersensitivity compared with the control group after 4-week at-home use (for change of VAS, test group: 2.27 ± 2.47 versus control group: 1.68 ± 2.24, p = 0.036; for change of Schiff, test group: 0.94 ± 0.92 versus control group: 0.61 ± 0.83, p < 0.001). The 6-week results showed borderline significance between groups in terms of change of Schiff (p = 0.027) and no significance in terms of change of VAS (p = 0.256).

Conclusions

Home-use of n-CAP based dentifrice had some benefit on alleviation of DH following non-surgical periodontal therapy after 4 weeks compared to the control product.

Trial registration

Chinese Clinical Trials Registry (No. ChiCTR-IPR-17011678, http://www.chictr.org.cn/, registered 16 June, 2017).

Amount of Dentifrice and Fluoride Concentration Influence Salivary Fluoride Concentrations and Fluoride Intake by Toddlers

The present study evaluated fluoride (F) concentrations in saliva of toddlers after brushing with dentifrices containing different F concentrations, applied in different quantities, and estimated F intake from toothbrushing. The study comprised a double-blind, crossover protocol, in which toddlers (n = 18, 2-3 years old) were randomly assigned into six groups, according to possible combinations of dentifrices (0/550/1,100 ppm F, as NaF) and amounts (rice grain, pea size, and transverse technique). Volunteers used a F-free dentifrice during 1 week. On the 7th day, saliva samples were collected before (baseline), and at 5/15/30/60 min after toothbrushing. All dentifrice expectorated after brushing was collected. F concentrations (saliva and expectorate) were determined with an ion-specific electrode. Data were submitted to ANOVA or Kruskal-Wallis test, followed by Fisher's LSD or Student-Newman-Keuls' tests (p <0.05). Brushing with 550 ppm F dentifrice (pea size or transversal technique) increased the area under the curve (AUC) at similar levels compared to 1,100 ppm F (rice grain). The highest AUC and salivary F at 5 min after brushing were achieved by 1,100 ppm F (pea size), followed by 550 ppm F (transversal technique). Regarding F intake, the highest values were observed for 550 ppm F (transversal technique), followed by 1,100 ppm F (pea size). It is possible to conclude that the amount of dentifrice and F concentration in the product significantly affected both salivary F concentrations and F intake during toothbrushing.

Effectiveness of herbal oral care products in reducing dental plaque & gingivitis - a systematic review and meta-analysis

Background

Despite the large number of trials conducted using herbal oral care products for the reduction of dental plaque or gingivitis, results are conflicting and inconclusive.

Objective

To assess the effectiveness of herbal oral care products compared to conventional products in reducing dental plaque and gingivitis adults.

Methods

We searched the following databases for Randomised controlled trials (RCTs): MEDLINE Ovid, EMBASE Ovid etc. which yielded 493 trails. Of which 24 RCTs comparing herbal toothpaste or mouth rinse with over the counter toothpaste or mouth rinse in adults aged 18 to 65 years were included. Two authors extracted information and assessed the methodological quality of the included studies using Risk of Bias. Meta-analyses using the random-effects model were conducted for four outcomes for tooth paste and mouth rinse respectively. Mean difference (MD) or standardized mean difference (SMD) were used to estimate the effect, with 95% confidence intervals.

Results

A total of 1597 adults participated in 24 RCT studies. These were classified as herbal toothpaste (HTP) (15 trials, 899 participants) and herbal mouth rinse (HMR) (9 trials, 698 participants) compared with non-herbal toothpaste (NHTP) or non-herbal mouth rinse (NHMR). We found that HTP was superior over NHTP (SMD 1.95, 95% CI (0.97–2.93)) in plaque reduction. The long-term use of NHMR was superior in reduction of dental plaque over HMR (SMD -2.61, 95% (CI 4.42–0.80)). From subgroup analysis it showed that HTP was not superior over fluoride toothpaste (SMD 0.99, 95% CI (0.14–2.13)) in reducing dental plaque. However, HTP was favoured over non-fluoride toothpaste (SMD 4.64, 95% CI (2.23–7.05)).

Conclusion

For short-term reduction in dental plaque, current evidence suggests that HTP is as effective as compared to NHTP; however, evidence is from low quality studies.

Effect of high-fluoride dentifrice and bracket bonding composite material on enamel demineralization in situ

OBJECTIVE

This in situ study evaluated the effect of high-fluoride dentifrice (5000 μg F^-/g) and fluoride-containing bonding composite resin on enamel demineralization adjacent to orthodontic brackets.

METHODS

Ten volunteers wore palatal appliances containing bovine enamel blocks with metallic brackets bonded with fluoride-free or fluoride-containing composite resin. During three phases of 14 days each, three dentifrices with different fluoride concentrations (0, 1100, and 5000 μg F^-/g) were tested. The cariogenic challenge consisted of 20% sucrose solution dripped 8x/day onto the dental blocks. At the end of each phase, biofilm formed was collected for fluoride analysis. Cross section hardness was performed in enamel blocks, and the lesion area was calculated. Data were analyzed by two-way ANOVA followed by Tukey post hoc test (α = 5%).

RESULTS

The only signicant factor for all the variables under study was the dentifrice. Smaller lesion area and higher fluoride concentration on biofilm were found in 5000 μg F^-/g group, irrespective of bonding composite resin (p < 0.001). Neither bracket-bonding composite resin nor the interaction between the factors was statistically significant (p > 0.05) for all the variables.

CONCLUSION

High-fluoride dentifrice is effective in reducing demineralization on enamel adjacent to orthodontic brackets, while the fluoride-containing bonding composite resin does not influence it.

CLINICAL SIGNIFICANCE

Since high-fluoride dentifrice was able to reduce demineralization adjacent to brackets, it can be an option to caries management in orthodontics patients.

Fluoride in Saliva and Oral Mucosa after Brushing with 1,450 or 5,000 ppm Fluoride Toothpaste

The aim was to measure and compare fluoride concentrations in oral mucosa and saliva following a single brushing with either 1,450 or 5,000 ppm fluoride toothpaste. Fourteen healthy participants provided saliva and oral mucosa samples in the morning before tooth brushing. Then participants brushed their teeth with 1,450 ppm fluoride toothpaste, and saliva and mucosa samples were collected after 1, 2, 4, and 6 h. The experiment was repeated 3-7 days later with 5,000 ppm fluoride toothpaste. All samples were analyzed for fluoride using an ion-selective electrode adapted for microanalysis. Pre-brushing fluoride concentrations were higher in mucosa (mean1,450 0.26 ppm and mean5,000 0.20 ppm) than in saliva (mean1,450 0.08 ppm and mean5,000 0.07 ppm). The mean fluoride concentrations increased in both mucosa and saliva following a single brushing with both 1,450 ppm (meanmuc1,450 (1 h) 1.15 ppm, meansal1,450 (1 h) 0.33 ppm) and 5,000 ppm fluoride toothpaste (meanmuc5,000 (1 h) 3.21 ppm and meansal5,000 (1 h) 0.90 ppm). At 6 h, the fluoride concentrations had returned to pre-brushing levels. Across the 6-h sampling period the fluoride concentration in saliva was statistically significantly 1.4 times higher following brushing with 5,000 ppm compared with 1,450 ppm fluoride toothpaste. For mucosa, this ratio was only 1.1 and not statistically significant. In conclusion, the fluoride level in oral buccal mucosa is higher than in saliva and follows the same fluoride clearance pattern as in saliva. Over the initial 6-h period following a single tooth brushing, the ratio of the fluoride concentration in mucosa to that in saliva is independent of the fluoride concentrations in the toothpastes used.

Gastrointestinal Absorption and Renal Excretion of Fluoride After Ingestion of a High-Fluoride Dentifrice

This study aimed to evaluate the gastrointestinal absorption and renal excretion of fluoride after the ingestion of high-fluoride dentifrice. Twelve volunteers participated in this in vivo, crossover, and blinded study. In three experimental phases, the volunteers were randomly assigned to one of three treatment groups, who ingested either the following: distilled and deionized water (control), conventional dentifrice (1100 μg/g), or high-fluoride dentifrice (5000 μg/g). Both dentifrices contained fluoride in the form of NaF/SiO₂. To determine the rate of fluoride absorption, non-stimulated saliva was collected for up to 120 min after ingestion and the area under the curve of the salivary fluoride concentration was plotted as a function of time and the maximum concentration determined. All urine produced during the 24 h before and after ingestion was collected, and urinary excretion was calculated from the difference between the urinary fluoride concentrations in the two periods. A specific ion electrode coupled to an ion analyzer was used to measure fluoride concentrations. Statistical analysis was performed by ANOVA followed by Tukey's test with p set at 5%. All measured parameters were highest after the ingestion of the dentifrice with 5000 μg/g (p < 0.001), confirming that this has an increased level of bioavailable fluoride compared with the conventional dentifrice. The high-fluoride dentifrice increases the concentration of salivary fluoride, which may explain its greater anticaries effect. However, it poses a potential risk of causing dental fluorosis and so should not be used by children.

Protocols to Study Dental Caries In Vitro: pH Cycling Models

As laboratory models are bridges to in vivo caries studies, they must mirror clinical conditions, where demineralization and remineralization alternate constantly (i.e., pH cycling) and are only interrupted during the very short period of application of investigational products, such as toothpaste or mouth rinse. In view of this, models have been developed, based on pH cycling, to study the anticaries or caries remineralizing effects of substances. The pH cycling models have long been accepted and utilized by the scientific community and the toothpaste industry as an appropriate alternative to animal caries testing, particularly for ionic fluoride-based dentifrices. Several pH cycling models have been developed and described in the literature over the years. However, in this chapter, we crudely categorize them into two types: according to what the investigational product is tailored to achieve, i.e., prevention of caries development (net demineralization) or remineralization of early caries (net remineralization). Thus the models are termed "demineralization" or "remineralization" models and are described in details here together with their disadvantages and applications.

In situ anticaries efficacy of dentifrices with different formulations - A pooled analysis of results from three randomized clinical trials

OBJECTIVES

Data generated from three similar in situ caries crossover studies presented the opportunity to conduct a pooled analysis to investigate how dentifrice formulations with different fluoride salts and combinations at concentrations of 1400-1450 ppm F, different abrasive systems and in some cases, carbomer (Carb), affect enamel caries lesion remineralization and fluoridation.

METHODS

Subjects continuously wore modified partial dentures holding two gauze-covered partially-demineralized human enamel specimens for 14 days and brushed 2×/day with their assigned dentifrice: Study 1: sodium fluoride (NaF)/Carb/silica, NaF/silica, NaF + monofluorophosphate (MFP)/chalk; Study 2: NaF/Carb/silica, NaF + MFP/dical, amine fluoride (AmF)/silica; Study 3: NaF/Carb/silica, NaF + stannous fluoride (SnF₂)/silica/hexametaphosphate (HMP). All studies included Placebo (0 ppm F) and/or dose-response controls (675 ppm F as NaF [675F-NaF]) ±Carb. Specimens were evaluated for percentage surface microhardness recovery (SMHR) and enamel fluoride uptake (EFU).

RESULTS

All 1400-1450 ppm F dentifrices except NaF + SnF₂/silica/HMP provided significantly greater lesion remineralization than Placebo (p < 0.0001): differences in SMHR ranged from 17.46% (NaF + MFP/dical) to 26.66% (AmF/silica). For EFU (back-transformed log EFU), all 1400-1450 ppm F dentifrices gave significant fluoride uptake compared to Placebo (p < 0.0001): increases in EFU ranged from 4.95 μg F/cm² (NaF + SnF₂/silica/HMP) to 16.32 μg F/cm² (NaF/carb/silica). Dentifrices containing NaF or AmF as sole fluoride source provided the greatest remineralization and fluoridation; Carb addition did not alter fluoride efficacy; some excipients appeared to interfere with the cariostatic action of fluoride. Treatments were generally well-tolerated with ≤4 treatment-related adverse events per study.

CONCLUSION

Commercially available fluoride dentifrices varied greatly in their ability to remineralize and fluoridate early caries lesions.

CLINICAL SIGNIFICANCE

Fluoride dentifrices are the most impactful anticaries modality worldwide. While clinical caries trials have not consistently shown the superiority of one formulation over another, these findings using a sensitive in situ caries model indicated that dentifrices containing NaF or AmF as the sole fluoride source provided the greatest remineralization and fluoridation benefits.

A Nitrous-Oxide Pioneer Peddles His Own Dentifrice: "Dr Colton's Vegetable Dentonic"

During the latter half of the six-year long "Panic of 1873," nitrous-oxide pioneer G.Q. Colton developed, advertised, and sold his dentifrice, "Dr Colton's Vegetable Dentonic" to supplement his dental anesthetic enterprise.

In Vitro Evaluation of Resilient Liner after Brushing with Conventional and Experimental Ricinus communis-Based Dentifrices

PURPOSE

To evaluate the effect of experimental (Ricinus communis) and commercial dentifrices used for denture cleaning on abrasiveness (gravimetric method; roughness), hardness, and color stability of a resilient relining material.

MATERIALS AND METHODS

Sixty circular (15 × 3 mm) specimens were distributed into four groups: C (control; brushing with water); CO (brushing with Colgate - for natural teeth); CB (brushing with Corega Brite - for complete dentures); RC (brushing with experimental dentifrice). Brushing was performed in a toothbrushing machine with a soft brush and a dentifrice suspension for 50 minutes, calculated to correspond to 1 year of regular brushing. Variables were measured initially and after the trial period. For the gravimetric method, the difference in mass was considered. The surface roughness was measured by a rugosimeter, and the hardness test was performed by a Shore A durometer. Color changes (ΔE; CIE L*a*b* and NBS systems) were measured by a portable spectrophotometer. Results were analyzed by ANOVA/Tukey's test (α = 0.05).

RESULTS

The largest mass variation (μg; p < 0.0001) occurred in C (-6.21 ± 3.18). Concerning roughness, CB (0.26 ± 0.04) showed the lowest value, followed by RC (0.29 ± 0.08) and CO (0.34 ± 0.24) (p < 0.0001). Group C produced the greatest surface roughness (0.72 ± 0.25). Hardness values decreased after brushing with water (p = 0.014). No significant differences were found among RC (50.31 ± 1.03), CO (49.11 ± 1.31), CB (49.17 ± 1.23), and C (48.02 ± 1.26). Color stability was similar in all groups (p = 0.135; C: 2.3 ± 0.77; CO: 2.6 ± 0.54; CB: 2.2 ± 0.44; RC: 2.9 ± 1.56).

CONCLUSIONS

The use of experimental dentifrice could be indicated, as it showed similar results to the specific dentifrice, keeping the resilient material properties within acceptable values.

Comparison of Antimicrobial Activity of Child Formula Dentifrices at different Concentrations: An in vitro Study

Aim

The aim of the present in vitro study is to evaluate and compare antimicrobial efficacy of commercially available child’s dental formulas in reduced concentrations containing different forms of fluoride against Streptococcus mutans activity.

Materials and methods

The selected dentifrices were prepared in dilutions of 1:1, 1:2, 1:4, 1:8, and 1:16 using sterile pyrogen-free distilled water. Various dilutions of the selected toothpaste slurries were incubated in the agar plate containing pure strains of S. mutans, and antimicrobial activity of each was assessed by measuring the diameter of zones of inhibition (in mm). Agar well plate diffusion method and minimum inhibitory concentration (MIC) determination were the methods used in this study. The inhibitory circle of each dentifrice was measured and MIC was achieved by considering the value of diameter of the circle.

Results

The results of the study showed that even at a lower concentration of fluoride, inhibition halos were obtained for all the formulations at different dilutions.

Conclusion

The kid’s formulations having lower fluoride concentration show antimicrobial activity even after dilutions. Thus, commercially, the fluoride concentrations can be further lowered down in the dentifrices, thereby reducing the risk associated with fluoride.

How to cite this article

Malhotra R, Singla S, Shashikiran ND. Comparison ofAntimicrobial Activity of Child Formula Dentifrices at different Concentrations: An in vitro Study. Int J Clin Pediatr Dent 2017;10(2):131-135.

Comparative Evaluation of Efficacy of Three Different Herbal Toothpastes on Salivary Alkaline Phosphatase and Salivary Acid Phosphatase - A Randomized Controlled Trial

INTRODUCTION

Very few researches in the past have tried to evaluate the effect of herbal toothpaste on saliva and salivary constituents like alkaline phosphatase and acid phosphatase which play an important role in maintaining oral health.

AIM

To evaluate and compare the effect of three different herbal toothpastes on Salivary Alkaline Phosphatase (ALP) and salivary Acid Phosphatase (ACP).

MATERIAL AND METHODS

The present study was a preliminary study conducted among 45 dental students (15 subjects in each group) in the age group of 19-21 years. Subjects in each group were randomly intervened with three different herbal toothpastes respectively (Group A - Patanjali Dant Kanti, Group B - Himalaya Complete Care and Group C - Vicco Vajradanti). Unstimulated saliva sample were collected before and after brushing and salivary ACP and salivary ALP levels were assessed at an interval of one week each for a period of four weeks starting from day one. Compiled data was analyzed using chi square test, paired t-test and ANOVA based on the nature of the obtained data.

RESULTS

All the three toothpastes showed significant (p<0.001) reduction in ACP and ALP levels at each interval. For patanjali toothpaste, the mean reduction was in the range of 2.55 - 2.62 IU/L for ACP and 2.94 - 2.99 IU/L for ALP. For Himalaya toothpaste, the mean reduction was in the range of 1.39 - 1.47 IU/L for ACP and 1.55 - 1.61 IU/L for ALP. For Vicco toothpaste, the mean reduction was in the range of 2.46 - 2.50 IU/L for ACP and 2.64 - 2.77 IU/L for ALP. Patanjali and Vicco toothpaste were significantly effective in reducing the levels of salivary ACP and ALP more than Himalaya toothpaste (p<0.05).

CONCLUSION

Herbal toothpastes, especially Dant Kanti and Vicco Vajradanti, showed significant reduction in levels of ACP and ALP resulting in overall improvement towards the oral health.

Comparative Evaluation of Remineralizing Potential of Three Pediatric Dentifrices

Introduction

Dentifrices are available in different formulations and more commonly a single dentifrice is used by whole family; be it an adult or child. However, concerns over high fluoride in pediatric formulations coupled with inability of the children to spit have led to recommendations to minimize fluoride ingestion during toothbrushing by using a small amount of toothpaste by children and incorporating minimal quantity of fluoride in the toothpastes. Literature is scarce on the remineralization potential of popularly known Indian pediatric dentifrices; hence, pediatric dentifrices containing lesser concentration of fluoride have been marketed relatively recently for the benefit of children without posing a threat of chronic fluoride toxicity at the same time.

Aim and objectives

The present study was undertaken to evaluate and compare the remineralization potential of three commercially available Indian pediatric dentifrices with different compositions on artificially induced carious lesions in vitro through scanning electron microscopy (SEM).

Materials and methods

The present in vitro study was conducted on 45 sound extracted primary molar surfaces divided into three groups (15 each). Artificial demineralization was carried out, followed by remineralization using dentifrice slurry as per the group allocation. All the samples were studied for remineralization using SEM and the results statistically compared.

Results

All three dentifrices tested showed remineralization; although insignificantly different from each other but significantly higher compared to the demineralizing surface.

Conclusion

One can use pediatric dentifrices for preventing dental caries and decelerating lesion progression with an added advantage of lower fluoride toxicity risk.

How to cite this article

Kapoor A, Indushekar KR, Saraf BG, Sheoran N, Sardana D. Comparative Evaluation of Remineralizing Potential of Three Pediatric Dentifrices. Int J Clin Pediatr Dent 2016;9(3):186-191.

Plaque removal efficacy of Colgate 360 toothbrush: A clinical study

Aim:

The aim of this clinical study was to confirm the plaque removal efficacy of the Colgate 360 Whole Mouth Clean Toothbrush.

Study Design:

This was a single-center, monadic, case–controlled study with the 7 days duration.

Materials and Methods:

A total of eighty participants (56 male and 24 female) aged between 18 and 45 years with a minimum of 20 permanent teeth (excluding the third molars) without any prosthetic crowns and an initial plaque score of minimum 1.5 as determined by Modified Quigley-Hein Plaque Index (1970) participated in the study. There were two dropouts during the study duration, one male and one female. The participants were instructed to brush for 1 min, after which plaque index was recorded again. They were then instructed to brush their teeth twice a day for 1 min with the assigned toothbrush (Colgate 360 Whole Mouth Clean Toothbrush) and a commercially available fluoride toothpaste for the next 7 days. On the 7^th day, all the participants were recalled for follow-up and plaque examination. The plaque index scores (pre- and post-brushing) were recorded, tabulated, and analyzed statistically.

Results:

The mean plaque indices reduced after brushing both on day 1 and day 7. There was also a reduction in mean plaque indices from day 1 to day 7. All these reductions were statistically significant (P < 0.001). The reduction in plaque scores was independent of the gender of the participants however female participants showed lower scores as compared to male participants (P < 0.001).

Conclusion:

The present study demonstrated a significant reduction in plaque scores with the use of Colgate 360 Whole Mouth Clean Soft Toothbrush throughout the study period. Continued use resulted in a further significant reduction in plaque scores irrespective of the gender of participants.

Dentifrices for children differentially affect cell viability in vitro

Objectives

Child dentifrices vary in their composition, with possible differential impacts on cells in the oral soft tissue. While cytotoxicity studies have been performed on adult dentifrices, no respective studies have thus far been reported on child dentifrices.

Material and methods

Seventeen commercial dentifrices for children up to 12 years of age were evaluated with respect to their in vitro cytotoxicity on gingival fibroblasts, oral squamous cell carcinoma HSC-2 cells, and L929 mouse fibroblasts. Proliferation was analyzed and live-dead staining was performed.

Results

Ten child dentifrices greatly reduced cell viability with LC50 values below 5 %. Four dentifrices showed a moderate cytotoxicity with LC50 values between 5 and 20 %. Three child dentifrices showed almost no cytotoxicity with LC50 values above 95 %. The results of the assays for proliferation and live-dead staining supported these findings.

Conclusions

The different composition of the child dentifrices translated into a broad spectrum of in vitro cytotoxicity on cells of the oral cavity.

Clinical relevance

The in vitro data provide the scientific foundation for further in vivo research testing the clinical relevance of the present findings.

Salivary fluoride levels after toothbrushing with dentifrices containing different concentrations of fluoride

OBJECTIVE

To determine the salivary fluoride levels after toothbrushing with dentifrices containing 458 ppm and 1000 ppm of fluoride and to compare salivary fluoride levels of two dentifrices at different intervals of time.

MATERIALS AND METHODS

In total, 50 children in the age group of 6-12 years were selected. The individuals were randomly divided into two groups using either 458 ppm or 1000 ppm fluoride dentifrice, respectively. Whole saliva samples were collected prior to brushing, immediately after brushing, and at subsequent intervals after brushing into sterile test tubes.

RESULTS

Data collected were evaluated using unpaired t-test. Salivary fluoride level following the use of 458 ppm fluoride dentifrice was significantly lower than the level found following the use of 1000 ppm dentifrice, but the levels were above the baseline values even after 1 h.

CONCLUSION

There was considerable salivary fluoride retention after brushing with fluoride dentifrices.

Mechanisms of action of fluoridated acidic liquid dentifrices against dental caries

OBJECTIVE

This study attempted to clarify the mechanisms of action of fluoridated acidic liquid dentifrices against dental caries.

DESIGN

In the in vitro leg, enamel specimens were submitted to a pH-cycling model, treated with distinct dentifrices (0, 550 μgF/g pH 4.5 and pH 7.0, 1100 or 5000 μgF/g pH 7.0) and analyzed using hardness. Alkali-soluble fluoride (F) deposition was quantified on pre-demineralized specimens treated with the dentifrices. In the clinical leg, 2-to-4-year-old children who had been using liquid dentifrices for 6 months (550 μgF/g pH 4.5 or pH 7.0 or 1100 μgF/g pH 7.0) had their plaque samples collected 5 and 60 min after the last brushing. Fluoride uptake in whole plaque was evaluated.

RESULTS

The reduction of the pH had a partial preventive effect on subsurface hardness loss only. [F] had a significant influence on the deposition of fluoride, surface and subsurface hardness loss. In vivo, the reduction of the pH was able to significantly increase plaque F uptake, leading to similar levels as those found for the neutral dentifrice containing twice [F].

CONCLUSION

The results obtained from in vitro studies whose design does not include the presence of dental plaque should be interpreted with caution.

Short term comparative evaluation of antimicrobial efficacy of tooth paste containing lactoferrin, lysozyme, lactoperoxidase in children with severe early childhood caries: a clinical study

BACKGROUND AND OBJECTIVES

The present study is conducted to compare the anti-microbial efficacy of tooth paste containing lactoferrin, lysozyme, lactoperoxidase (BioXtra ®), a 500ppm fluoride tooth paste, and a non fluoridated tooth paste in children with Severe Early Childhood Caries (S-ECC).

MATERIALS AND METHODS

Study group included 30 children with S-ECC aged 3-5 years. Subjects were randomly selected & divided into three groups of ten each. Group I: Non-fluoride tooth paste, Group II: 500 ppm fluoride tooth paste, Group III: tooth paste containing lactoferrin, lysozyme & lactoperoxidase. Estimation of salivary S. mutans and L. acidophilus levels was accomplished by collecting salivary samples and inoculated on Mitis Salivarius Bacitracin agar (MSB) and Rogosa SL media. Colony Forming Units (CFUs) were counted and the results were tabulated and subjected to statistical analysis.

RESULTS

Brushing with tooth paste containing lysozyme, lactoferrin and lactoperoxidase after a week showed highly significant reduction in the CFU counts of both salivary S. mutans and L. acidophilus (p<0.001), whereas 500ppm fluoride tooth paste showed a highly significant reduction in the S. mutans levels (p<0.001), but a significant reduction in L. acidophilus count (p<0.01). Non-fluoride tooth paste showed a highly significant reduction in S. mutans (p<0.001) only, but reduction in the L. acidophilus levels was insignificant (p<0.05).

CONCLUSION

The present study revealed that tooth paste containing lactoferrin, lysozyme, and lactoperoxidase was highly significant in reducing the salivary levels of mutans Streptococci and L. acidophilus in children with S-ECC.

Effect of oral health education and fluoridated dentifrices on the oral health status of visually impaired children

Visually impaired children are challenged everyday in their everyday skills. Oral hygiene practices among visually impaired children require a special approach with time and patience. The purpose of this study was to evaluate the effect of oral health education and fluoridated dentifrices on the oral health status of visually impaired children.

MATERIALS AND METHODS

Fifty visually impaired children between 8 and 12 years of age formed the study group. Oral health education and motivation was done with the help of Braille. Modified Bass method of brushing was taught to the children and the required dental treatment was done. Subjects were randomly divided into two equal groups fluoridated and non-fluoridated. Oral hygiene index -simplified, DMFT, deft index, and Streptococcus mutans and Lactobacillus count were assessed at baseline, immediately after the treatment and at 3, 6, and 12 month intervals. The oral health awareness was assessed using a questionnaire at the beginning and end of the study.

RESULTS

At baseline, the mean OHI-S, DMFT and deft scores were 2.72, 0.47, and 0.51 respectively. At the end of 12 months there was a significant decrease in OHI-S scores in the fluoridated group. No significant difference was seen in DMFT and deft between the fluoridated and non-fluoridated groups at the different time interval. After the oral health education and comprehensive treatment there was a reduction in Streptococcus mutans and Lactobacillus counts in both groups; however, at the end of 3, 6, 12 months there was a significant decrease in fluoridated group as compared to the non-fluoridated. The oral health awareness increased significantly at the end of the study.

CONCLUSION

The oral health education and motivation formulated for the visually impaired children was effective in improving their oral health status. Fluoridated dentifrices decreased the Streptococcus mutans and Lactobacillus counts and improved the oral hygiene status.

An Unusual Plasma Cell Gingivitis Case Related to Use of Herbal Toothpowder

INTRODUCTION

Plasma cell gingivitis (PCG) is a rare benign condition of gingiva marked by dense infiltration of plasma cells into the subepithelial gingival tissue. Considered to be a true hypersensitivity reaction, it leads to edematous enlargement of gingiva extending up to the mucogingival junction. Identification and removal of the allergen leads to remission of the lesion. This case describes an unusual case of PCG.

CASE PRESENTATION

The patient did not respond well to conventional periodontal therapy. Discontinuation of herbal toothpowder with surgical periodontal therapy led to remission of gingival enlargement. Massive enlargement responded well to removal of allergen and surgical periodontal therapy. There was no evidence of recurrence at the 18 month follow-up.

CONCLUSION

Clinicians should be aware of the adverse effects of herbal agents used in dentifrices, and caution should be exercised against excessive use of such products.