Pharmacodynamic and pharmacokinetic effects in gingival crevicular fluid from re-dosing during brushing.

The IntelliClean System from Sonicare and Crest combines a rechargeable sonic power toothbrush and a novel liquid toothpaste into one integrated system, providing the opportunity to re-dose with toothpaste during the brushing cycle. The purpose of this study was to investigate cleaning effects from in-mouth re-dosing with toothpaste during the brushing cycle vs conventional bolus dosing. This was a randomized, examiner-blind, six-period, crossover clinical study. Eighteen adult subjects used an experimental integrated system employing either a re-dosing regimen (2 doses at the start of brushing with 1 additional in-mouth dose during the last 30 seconds of brushing [2+1]) or a conventional regimen (2 doses at the start of brushing only [2+0]). Gingival crevicular fluid (GCF) was sampled at the final brushing quadrant from a preselected site in the gingival sulcus using filter strips at baseline and at 4, 15, and 120 minutes postbrushing. Mean change from baseline in the concentrations of total facultative anaerobes (TFAs) and gram-negative anaerobes (GNAs) in the GCF at 120 minutes posttreatment were modeled separately using general linear mixed models. Area under the curve of surfactant (sodium dodecyl sulfate [SDS]) in GCF over 2 hours postbrushing was calculated and modeled using an analysis of variance model. All hypotheses were tested 2-sided at the 5% significance level. Relative to the conventional regimen, the re-dosing (2+1) regimen produced a significantly greater reduction in log10 (TFA colony-forming units [CFU]/microL GCF) after brushing, 0.99+/-0.12 vs 0.65+/-0.12 (mean change +/- standard error), and a significantly greater reduction in log10 (GNA CFU/microL GCF) after brushing, 0.75 +/-0.14 vs 0.45 +/- 0.14. The re-dosing regimen led to significantly more SDS in GCF relative to the conventional regimen over the 2-hour time period. Re-dosing of liquid toothpaste during the brushing cycle with the IntelliClean System leads to a significantly increased cleaning effect, as defined by a reduced bacterial count in GCF, and significantly higher levels of surfactant in the GCF up to 2 hours after the brushing event.

Oral malodor reduction by a combination of chemotherapeutical and mechanical treatments.

Bacterial proliferation and plaque accumulation on the surface of the tongue are major factors contributing to oral malodor. In this research, we used subjective and objective methods to evaluate the breath benefit of a triclosan-containing dentifrice (Blend-a-Med Complete Night) with and without tongue brushing in a randomized, examiner-blinded, three-period crossover clinical trial. Twenty-nine adults (mean age 40.2 years) with morning malodor were randomly assigned to a treatment sequence: triclosan dentifrice, triclosan dentifrice plus tongue brushing, and a control dentifrice (Crest Cavity Protection). The subjects used each product four times in 27 h with a 2-day wash-out period between treatments. Halimeter measurements were taken at baseline and at 3, 24 and 27 h. Subject questionnaire data assessing the breath quality were collected at 24 and 27 h. Both triclosan regimens showed significant improvement in oral malodor (p < 0.03) relative to the control. Significant (p = 0.035) malodor benefit was observed when tooth brushing with triclosan dentifrice was supplemented with tongue brushing. The triclosan dentifrice was associated with significant improvement (p < 0.05) in morning mouth feel and feeling of clean and fresh breath during the day relative to the control. There were no adverse events reported. The triclosan dentifrice was effective against overnight and daytime oral malodor. Supplementing routine brushing with tongue brushing resulted in additional breath improvement and breath benefits of the triclosan dentifrice were first-person noticeable.