The effects of a novel herbal toothpaste on salivary lactate dehydrogenase as a measure of cellular integrity.

OBJECTIVE: Lactate dehydrogenase (LDH) is a critical intracellular enzyme responsible for anaerobic respiration in pyruvate metabolism which becomes detectable in extracellular spaces after cellular breakdown. This clinical investigation examined the effects of brushing with a test toothpaste containing natural ingredients, i.e., clove (Syzygium aromaticum), aloe vera (Aloe barbadensis), amla (Emblica officinalis), neem (Azadirachta indica), tulsi (Ocimum basillicum), and honey (from Apis mellifera), and 0.96% zinc (zinc oxide, zinc citrate) and 0.76% SMFP (1000 ppm F) in a calcium carbonate base formulated with natural ingredients (Ved Shakti, Colgate Palmolive India) and a fluoride toothpaste containing 0.76% SMFP (1000 ppm F) in a calcium carbonate base (Colgate Cavity Protection, Colgate Palmolive; henceforth control) on salivary LDH in conjunction with the assessments of dental plaque and gingivitis representing oral hygiene parameters. MATERIALS AND METHODS: This double-blind, two-cell study enrolled 70 adults (age range 20-59 years). Subjects completed a washout and provided baseline saliva samples for LDH analysis and clinical assessments of dental plaque and gingivitis using the Turesky Modification of Quigley-Hein and Loe-Silness methods respectively. Subjects were randomly assigned to brush their teeth with either the test or control. Post-treatment sample collection and clinical evaluations were conducted after 3 weeks, 6 weeks, and 12 week sof brushing with all assessments conducted 12 h after hygiene. Statistical analyses were conducted independently for each parameter by t-test for within treatment evaluation and analysis of covariance (ANCOVA) for between treatment comparisons. RESULTS: At baseline, treatment groups demonstrated no significant differences for LDH or dental plaque and gingival index scores. Brushing with the test demonstrated progressive reductions in salivary LDH, plaque and gingival index scores over the study duration in comparison to the control. The test demonstrated reductions in LDH of 9.5-15.4% over the study period in comparison to the control representing statistically significant effects (p < 0.05). The test also demonstrated reductions in dental plaque that ranged between 6.4 and 16.2% over the study period and gingivitis reductions that ranged between 8.2 and 23.8% representing statistically significant results (p < 0.05). CONCLUSIONS: Brushing with a novel herbal toothpaste demonstrated significant reductions in salivary LDH representing improvements in cellular integrity with concurrent reductions in dental plaque and gingivitis as compared to the control dentifrice. CLINICAL RELEVANCE: Salivary LDH measurements offer a non-invasive and objective measurement of mucosal cellular integrity complementing other evaluations and clinical assessments such as plaque and gingival index scores.

Reductions in clinical inflammation and oral neutrophils with improving oral hygiene.

OBJECTIVE: This study compared the effects of oral hygiene with a toothpaste formulated with zinc (test) to a fluoride dentifrice (control) for effects on oral polymorphonuclear leukocyte (PMN) as a measure of whole mouth inflammation along with effects on clinical parameters of dental plaque and gingivitis. MATERIALS AND METHODS: Adults (age range 18-60 years, n = 212) completed this double-blind, parallel design study. After washout, a baseline oral rinse sample was evaluated for PMN prior to clinical assessments for gingivitis and dental plaque. Subjects were randomly assigned to brush twice daily with either the test or the control toothpaste. Post-treatment evaluations repeated all baseline assessments after 4-week, 6-week and 12-week use of dentifrice with all assessments conducted 12 hours after brushing. RESULTS: PMN reductions in the test were 16.8%, 18.7% and 42.5% at the 4-week, 6-week and 12-week evaluations respectively and significantly different from the control (p < 0.05). The test toothpaste also demonstrated progressively increasing reductions in gingivitis and dental plaque that ranged from 7.6 to 33.3% and 2.3 to 9.1% respectively versus the control (p < 0.05). CONCLUSIONS: The test dentifrice demonstrated progressive reductions in oral PMN representing whole mouth inflammation in conjunction with improvements in oral hygiene as compared to the control toothpaste. CLINICAL RELEVANCE: A hallmark of oral inflammation includes the accumulations of PMN in the afflicted gingival regions to reduce the influences of proliferating microorganisms. Brushing with a zinc dentifrice demonstrated progressive reductions in oral PMN and improvements in oral hygiene as evidenced by progressively lower dental plaque and gingival indices.

A randomized clinical study to examine the oral hygiene efficacy of a novel herbal toothpaste with zinc over a 6-month period.

OBJECTIVES: This clinical investigation examined the effects of brushing with a test toothpaste containing natural ingredients, that is, clove (Syzgium Aromaticum), aloe vera (Aloe Barbadensis), amla (Emblica Officinalis), neem (Azadirachta Indica), tulsi (Ocimum Basillicum) and honey (from Apis Mellifera) along with zinc salts and fluoride in comparison with a dentifrice formulated with fluoride alone on dental plaque and gingivitis over a 6-month period. MATERIALS AND METHOD: One hundred and eighty (180) subjects with mean plaque index scores greater than 1.5 (Turesky Modified Quigley Hein Plaque Index) and gingival index scores >1.0 (Loe and Silness gingival index) in good general health and who met other study criteria were enrolled in the clinical study. Subjects were evaluated for plaque and gingival index scores and were randomly assigned to perform twice-daily oral hygiene with either the test or the control toothpaste for the next 6 months. One hundred and fifty (150) subjects [test toothpaste (n = 72) and control toothpaste (n = 78)] completed the 6-month clinical study with evaluable data. Post-treatment assessments identical to baseline were conducted after 3-month and 6-month use of an assigned product after subjects refrained from oral hygiene for 12 h prior to each evaluation. Comparisons of the treatment groups with respect to baseline-adjusted gingival, plaque, and bleeding index scores at the follow-up examinations were performed using analyses of covariance (ANCOVA). All statistical tests of hypotheses were two-sided and employed a level of significance of p < 0.05. RESULTS: No significant intergroup differences were noted between treatment groups for age and gender by two-sample t-test and chi-square analyses, respectively (p > 0.05). Furthermore, the treatment groups demonstrated no differences at baseline for plaque, gingival and bleeding index scores by a two-sample t-test (p > 0.05). At 3-month and 6-month examination, the test toothpaste exhibited progressive reductions in plaque, gingival and bleeding scores as compared to control toothpaste as showed by ANCOVA (p < 0.001). In comparison with the control, the test demonstrated reductions in 23.5%, 25.6%, and 73.3% for dental plaque, gingival index and bleeding index outcomes, respectively, at the final visit. Reductions in the frequencies of sites with higher clinical scores were noted over the study with more sites registering improvements in the test group than in the control group. CONCLUSIONS: Routine oral hygiene with the test toothpaste formulated with herbal ingredients and zinc demonstrated a clinical adjunctive improvement in oral hygiene and parameters of gingival health as compared to brushing with a fluoride toothpaste.

The Effects of Two New Dual Zinc plus Arginine Dentifrices in Reducing Oral Bacteria in Multiple Locations in the Mouth: 12-Hour Whole Mouth Antibacterial Protection for Whole Mouth Health.

OBJECTIVES: To compare the effects of two new fluoride toothpastes with Dual Zinc plus Arginine to the effects of a fluoride control toothpaste in reducing bacteria in oral biofilm on teeth and in multiple soft tissue locations, as well as in saliva, 12 hours after 14 and 29 days of product use. METHODS: A randomized, single-center, three-cell, double-blind, parallel-group design was employed. The study protocol was approved by an Institutional Review Board. One hundred eighty adult subjects who met inclusion and exclusion criteria and signed an informed consent form were enrolled in the study. Subjects were randomly assigned to one of the three study products: 1) 0.96% zinc (zinc oxide, zinc citrate), 1.5% L-arginine and 1450 ppm fluoride as sodium fluoride in a silica base, Test 1; 2) 0.96% zinc (zinc oxide, zinc citrate), 1.5% L-arginine and 1000 ppm fluoride as sodium fluoride in a silica base, Test 2; and 3) 1450 ppm fluoride as sodium fluoride in a silica base, Control, for twice-daily use during tooth brushing. Oral samples were collected from the teeth, tongue, oral buccal mucosa, gingiva, and saliva at baseline and 12 hours after 14 and 29 days of assigned product use and were processed, serially diluted, plated, incubated, and scored for viable bacteria. Statistical analyses were performed separately for each sample site using ANOVA and ANCOVA for within- and between-treatment comparisons, respectively. RESULTS: One hundred seventy-three subjects completed the study. Relative to subjects in the Control group, subjects in the two Test groups exhibited statistically significant reductions of 29-41% in numbers of bacteria in each of the five sample areas, 12 hours after 29 days of product use. Similar results were seen after 14 days of product use, but some differences were not statistically significant, indicating that the effects of these zinc-based toothpastes build over time with continued use. The two Test toothpastes were shown to be clinically equivalent using the Fieller's confidence interval test. CONCLUSIONS: Toothpastes containing 0.96% zinc (zinc oxide, zinc citrate), 1.5% L-arginine and either 1450 ppm or 1000 ppm fluoride as sodium fluoride in a silica base provide statistically significant reductions in oral bacteria on the teeth, tongue, cheeks, and gums, as well as in saliva, compared to toothpaste with fluoride alone, 12 hours after 29 days of twice-daily tooth brushing. The results demonstrate that regular and continued twice-daily use of these new toothpastes provide 12-hour whole mouth antibacterial protection for whole mouth health.

Reduction in bacteremia after brushing with a triclosan/copolymer dentifrice-A randomized clinical study.

AIM: The aims of this study were to; 1) test susceptibility to bacteremia in subjects with moderate gingivitis, and 2) compare the effects of brushing with a fluoride toothpaste (control) as compared to a triclosan/copolymer toothpaste (test) on those susceptible to repeated bacteremia. MATERIALS AND METHODS: One hundred and seven adult subjects were tested for repeated bacteremia after eating a hard apple. Twenty-nine bacteremia positive subjects were enrolled in a double-blind cross-over study designed to analyse the effects of a test toothpaste. After random toothpaste assignment, subjects brushed for 21 days. Following a wash-out period, subjects completed the study with the alternate toothpaste. Statistical analysis compared bacteremia between groups by analysis of covariance (ANCOVA). RESULTS: Twenty-six adult subjects completed the cross-over study. No statistically significant differences for bacteremia were seen at baseline. Mean bacterial counts at baseline and post-treatment visits were 45.5 and 10.8 counts versus 48.5 and 38.0 counts, respectively (test vs. control group; significant at p < .05). Significant reductions in blood borne bacteria were seen in the test versus control groups in both cultural and DNA data (p < .05). CONCLUSIONS: Thirty percentage of subjects showed repeated bacteremia. Brushing with a triclosan/copolymer dentifrice demonstrated significant reductions in bacteremia as compared to the control toothpaste.

Antibacterial and anti-biofilm activity of mouthrinses containing cetylpyridinium chloride and sodium fluoride.

BACKGROUND: Cetylpyridinium chloride (CPC) and sodium fluoride augment oral hygiene by inactivating bacteria and inhibiting enamel demineralisation, respectively. However, there are few reports in the literature documenting the antibacterial efficacy of their combined use in mouthrinses. We have used six experimental systems to compare the antibacterial effects of mouthrinses containing 0.075% CPC (test rinse, TR) or 0.075% CPC with sodium fluoride (test fluoride rinse, TFR). RESULTS: Effects against planktonic bacteria were determined using viable counting (for Streptococcus mutans and salivary bacteria), a redox dye (for Actinomyces viscosus and salivary bacteria) and viable counting (for ex vivo oral rinses). Effects against saliva-derived biofilms were quantified using confocal microscopy and differential viable counting. Inhibition of biofilm formation was evaluated by pre-treating hydroxyapatite coupons with mouthrinses prior to inoculation. Otherwise-identical controls without CPC (control rinse and control fluoride rinse, CR and CFR, respectively), were included throughout. Compared to the controls, TFR and TR demonstrated significant antimicrobial effects in the redox assays, by viable counts (>3 log reductions) and in oral rinse samples (>1.25 log reductions, p < 0.05). TFR and TR also significantly reduced the viability of oral biofilms. Pre-treatment of hydroxyapatite with TFR and TR significantly inhibited biofilm formation (>3 log difference, p < 0.05). Overall, there were no consistent differences in the activities of TR and TFR. CONCLUSIONS: Sodium fluoride did not influence the antibacterial and anti-biofilm potency of CPC-containing formulations, supporting the combined use of CPC and sodium fluoride in mouthrinses to control oral bacteria and protect tooth enamel.

Antibacterial efficacy of a cetylpyridinium chloride-based mouthrinse against Fusobacterium nucleatum and in vitro plaques.

PURPOSE: To assess the antimicrobial effects of a fluoride-free and alcohol-free mouthrinse containing 0.075% CPC (test rinse, TR) compared with an otherwise-identical CPC-free control rinse (CR). METHODS: Activity against laboratory cultures of Fusobacterium nucleatum, a bacterium associated with gingival disease, was determined using viable counting following 30-second exposures to TR and CR. Effects against intact saliva-derived plaque biofilms were quantified using confocal microscopy coupled with three-dimensional image analyses (viability profiling). RESULTS: Short exposures to TR caused significant inactivation of F. nucleatum, as determined by viable counting (c. 3 log reduction compared to the control rinse, P < 0.05). Confocal microscopy revealed extensive inactivation of complex oral biofilms following treatment with TR; biofilms were significantly less viable than those exposed to CR and three-dimensional images revealed extensive zones of dead bacteria even within plaque depths. In conclusion, this investigation demonstrates that the CPC-containing mouthrinse has significant antibacterial efficacy against oral bacteria associated with gingival disease and significantly inactivated plaque biofilm in comparison to a relevant control.

Bacteriological effects of dentifrices with and without active ingredients of natural origin.

Compounds of natural origin are increasingly used as adjuncts to oral hygiene. We have adopted four distinct approaches to assess the antibacterial activity of dentifrices containing natural active ingredients against oral bacteria in several test systems. Corsodyl Daily (CD), Kingfisher Mint (KM), and Parodontax fluoride (PF) were compared to a dentifrice containing fluoride (Colgate Cavity Protection [CCP]) and one containing triclosan (Colgate Total [CT]). The growth inhibitory and bactericidal potency of the formulations were determined for 10 isolated oral bacteria. Effects of single exposures of simulated supragingival plaques were then determined by epifluorescence and confocal microscopy, while the effects of repeated exposures were quantified by viable counting. Additionally, dense plaques, maintained in continuous culture, were repeatedly dosed, and the outcome was assessed by viable counting and eubacterial DNA profiling. The test dentifrices exhibited variable specificity and potency against oral bacteria in axenic culture. Of the herbal formulations, KM caused the largest viability reductions in simulated supragingival plaques, with CT causing the greatest reductions overall. Following single exposures, CD caused moderate reductions, while PF had no effect. After multiple dosing, all formulations significantly reduced numbers of total, facultative, and Gram-negative anaerobes, but only KM and CT caused greater reductions than the fluoride control. KM also reduced counts of streptococci (rank order of effectiveness: CT > KM > CCP > PF > CD). Marked changes in eubacterial DNA profiles were not detected for any herbal formulation in dense plaques, although KM markedly reduced viable counts of streptococci, in agreement with supragingival data. While both nonherbal comparators displayed antibacterial activity, the triclosan-containing formulation caused greater viability reductions than the herbal and nonherbal formulations.

Community-level assessment of dental plaque bacteria susceptibility to triclosan over 19 years.

BACKGROUND: Triclosan is a broad-spectrum antimicrobial agent used in toothpaste to reduce dental plaque, gingivitis and oral malodor. This community-level assessment evaluated the susceptibility of dental plaque bacteria to triclosan in samples collected over 19 years. METHODS: A total of 155 dental plaque samples were collected at eleven different times over 19 years from 58 adults using 0.3% triclosan, 2% copolymer, 0.243% sodium fluoride toothpaste and from 97 adults using toothpaste without triclosan. These included samples from 21 subjects who used triclosan toothpaste for at least five years and samples from 20 control subjects. The samples were cultured on media containing 0, 7.5 or 25 µg/ml triclosan. Descriptive statistics and p values were computed and a linear regression model and the runs test were used to examine susceptibility over time. RESULTS: Growth inhibition averaged 99.451% (91.209 - 99.830%) on media containing 7.5 µg/ml triclosan and 99.989% (99.670 - 100%) on media containing 25 µg/ml triclosan. There was no change in microbial susceptibility to triclosan over time discernible by regression analysis or the runs test in plaque samples taken over 19 years including samples from subjects using a triclosan-containing dentifrice for at least five years. CONCLUSIONS: This community-level assessment of microbial susceptibility to triclosan among supragingival plaque bacteria is consistent with the long-term safety of a 0.3% triclosan, 2% copolymer, 0.243% sodium fluoride dentifrice.

Modulation of Biofilm Formation and Permeability in Streptococcus mutans during Exposure To Zinc Acetate.

The penetration of biofilms by antimicrobials is a potential limiting factor in biofilm control. This is relevant to oral health, as compounds that are used to control microbial growth and activities could also affect the permeability of dental plaque biofilm with secondary effects on biofilm tolerance. We investigated the effects of zinc salts on the permeability of Streptococcus mutans biofilms. Biofilms were grown with low concentrations of zinc acetate (ZA), and a transwell transportation assay was applied to test biofilm permeability in an apical-basolateral direction. Crystal violet assays and total viable counts were used to quantify the biofilm formation and viability, respectively, and short time frame diffusion rates within microcolonies were determined using spatial intensity distribution analysis (SpIDA). While the diffusion rates within biofilm microcolonies were not significantly altered, exposure to ZA significantly increased the overall permeability of S. mutans biofilms (P < 0.05) through decreased biofilm formation, particularly at concentrations above 0.3 mg/mL. Transport was significantly lower through biofilms grown in high sucrose conditions. IMPORTANCE Zinc salts are added to dentifrices to improve oral hygiene through the control of dental plaque. We describe a method for determining biofilm permeability and show a moderate inhibitory effect of zinc acetate on biofilm formation, and that this inhibitory effect is associated with increases in overall biofilm permeability.

Whole mouth antimicrobial effects after oral hygiene: comparison of three dentifrice formulations.

AIMS: This study compared the antimicrobial effects of three commercial dentifrice formulations: sodium fluoride/triclosan/copolymer (TCN/C), stannous fluoride/sodium hexametaphosphate/zinc lactate (SnF(2)/SHMP) and sodium fluoride (NaF). MATERIALS AND METHODS: Thirty-five adults (15 men and 20 women; average age 33 years and pockets <5 mm) completed this double-blind, triple-crossover study. After washout, baseline samples from four sites, plaque, saliva, tongue and buccal mucosa, were collected and evaluated for six microbial types, anaerobes, Streptococci, Actinomyces, hydrogen-sulphide (H(2) S)-producing bacteria, Fusobacteria and Veillonella. A specific dentifrice was randomly assigned for twice-daily use for 13 days. On day 14, 12 h after brushing, samples were collected for microbiological evaluations. Alternate dentifrices followed this identical protocol. RESULTS: For all four oral sites and six organisms evaluated in each site, the TCN/C demonstrated significant reductions (49-83%) as compared with the other treatments (p < 0.01). The SnF(2)/SHMP group showed significant reductions of 14-43% for 14 of 24 outcomes as compared with the NaF group (p < 0.01), with no differences in 10 outcomes. CONCLUSIONS: The TCN/C dentifrice formulation consistently demonstrated significant reductions for a range of microorganisms in diverse oral sites in comparison with the NaF, or the SnF(2)/SHMP dentifrice formulations as seen 12 h after brushing.

Chlorhexidine Improves Hygiene Reducing Oral Polymorphonuclear Leukocytes with Antimicrobial Effects at Distinct Microenvironments amongst Subjects Stratified by Health Status.

Oral conditions such as gingivitis and oral malodor are commonly reported globally. Objective: This investigation clinically stratified subjects to healthy, malodor and gingivitis groups and enumerated oral polymorphonuclear leukocytes (PMN) as a measure of inflammation prior to and after rinsing with a chlorhexidine (CHX) mouthwash. The study also assessed clinical outcomes (dental plaque and gingival bleeding indices), malodor (halimeter scores, organoleptic and tongue coat index and microbiological parameters (anaerobic and malodor organisms of dental plaque, tongue surface and saliva) for a comprehensive assessment of the oral inflammatory burden. Methods: Consenting adults were stratified into control (n = 17), gingivitis (n = 19) and halitosis (n = 17) groups based on clinical criteria. At baseline, oral samples were examined for PMN in addition to microbiological analysis of dental plaque, saliva and tongue scrapings for anaerobic and malodor bacteria. Subjects were issued a commercially available fluoride toothpaste and a chlorhexidine mouthwash for two-week use prior to post-treatment assessments identical to baseline. Results: At baseline, PMN were lowest in the control that increased amongst the halitosis subjects, with the gingivitis group registering the highest levels (p < 0.05) with these outcomes corresponding with clinical parameters (p < 0.05). CHX use improved outcomes with a 56−61% reduction in PMN with significant differences between groups (p < 0.05). Dental plaque and bleeding indices were lower by 57−78% with oral malodor, demonstrating reductions of 33−59% (p < 0.05). Significant reductions in anaerobic and malodor organisms ranging from 78−96% and 76−94%, respectively, were noted after CHX use (p < 0.05). Conclusions: At study enrollment, PMN scores were lowest in healthy subjects, with increasing numbers amongst halitosis followed by gingivitis. Amongst all subject groups, CHX use significantly reduced oral PMN and corroborated with corresponding decreases in clinical, malodor and bacterial outcomes. Together, these results demonstrate the significant reductions in the oral inflammatory burden following CHX use.

Increase in the level of oral neutrophils with gingival inflammation - A population survey.

Objectives: Host responses to oral inflammation include a continuous and substantive response with the influx of polymorphonuclear leukocytes (PMN). PMN, referred to as first responders, migrate rapidly from the circulatory system through the connective tissue to mitigate stimuli and localize in the saliva. This study examined the relationship between the well-established clinical indices of gingivitis and dental plaque and the PMN level. Materials and Methods: This study enrolled adults aged 18-75 years, who provided voluntary informed consent. Oral rinse samples were collected from 159 participants to estimate the PMN levels prior to the full-mouth assessment for gingivitis and dental plaque using the respective clinical indices. Results: The gingival index and dental plaque index scores were in the range of 0.098-2.71 and 0.73-4.78, respectively. Regardless of the age and gender, higher number of PMN was observed with higher gingival index and dental plaque index scores. Our analyses indicated a significant correlation between the oral PMN level and gingival index with a correlation coefficient of 0.66 (p < 0.0001). Similarly, the correlation between the PMN level and dental plaque index was statistically significant with a correlation coefficient of 0.57 (p < 0.0001). Regression analysis identified a significant relationship between the PMN level and clinical indices (p < 0.0005). Conclusions: Increase in the PMN levels with increasing clinical scores (gingival and dental plaque indices) reflect the oral inflammatory burden, irrespective of age or gender. These observations warrant future studies on participants stratified by health status and research directed toward examining the effects of interventions.

The Utility of Salivary Heme to Stratify Healthy Volunteers from Individuals with Gingivitis and Periodontitis: a Pilot Study.

Gingival bleeding due to poor oral hygiene is reported globally. Assessment of blood in saliva may improve diagnostics, serve as an outcome measure in clinical trials and support patient education through point-of-care tests. This work analyzed salivary heme using a rapid test format and separately using a lateral flow immunoassay assay [LF] for chair-side implementation. Clinical examinations stratified adult subjects into healthy, gingivitis or periodontitis groups at baseline. Healthy subjects presented no periodontal pockets and whole mouth gingivitis scores of less than 1.0. Gingivitis subjects registered gingival index scores greater than 1.0. Included in the periodontal disease group were subjects with periodontal pockets greater than 4 mm. The rapid test is based on the peroxidase activity salivary heme converting a colourless probe to a coloured compound for spectrophotometric analysis. For the LF assay, saliva was placed in the test window of the device with reactions scored after room temperature incubation. Average salivary heme concentrations in the healthy, gingivitis and periodontal disease groups were 27, 201 and 326 nM respectively, by the rapid test, representing significant differences by analysis of variance and Tukey's-multiple comparison tests (p<0.05). Similarly, results in the LF assay demonstrated increasing band intensity from the healthy to the periodontal disease groups and was quantifiable by image analysis. This pilot study emphasizes the potential efficacy of rapid heme measurement in investigations of oral health.

A 6-month study of the effects of 0.3% triclosan/copolymer dentifrice on dental implants.

AIM: Supportive therapy to maintain dental implants is increasingly important. This study examined the effect of a 0.3% triclosan/2% copolymer dentifrice on oral biofilms and gingival inflammation (GI) on dental implants and peri-implant tissues. MATERIALS AND METHODS: One hundred and twenty adults with a dental implant and contra-lateral tooth were enrolled in this 6 month, double-blind, two-treatment, parallel group study. Sixty subjects were randomly assigned to a triclosan/copolymer dentifrice test group and 60 subjects to a fluoride dentifrice control group and instructed to brush twice daily for 6 months. At baseline, 3, and 6 months, a calibrated dentist assessed dental plaque, GI and collected supragingival dental plaque for microbiological analysis. RESULTS: Subjects in the triclosan/copolymer group demonstrated significantly lower levels of dental plaque, gingivitis, and bleeding on probing at 3 and 6 months at both the implant and contra-lateral tooth compared with the fluoride group (p<0.05). There were significantly fewer Gram-negative anaerobes in the triclosan/copolymer group (p<0.05) including >90% reductions in Aggregatibacter actinomycetemcomitans, Campylobacter rectus, Eubacterium saburreum, Fusobacterium nucleatum, Porphyromonas gingivalis, Prevotella melaninogenica, Solobacterium moorei, and Tannerella forsythia. CONCLUSIONS: Twice daily use of a triclosan/copolymer dentifrice may enhance dental implant maintenance by reducing dental plaque and GI.

Removal of dental plaque from different regions of the mouth after a 1-minute episode of mechanical oral hygiene.

PURPOSE: To assess dental plaque on different regions of the dentition prior to and immediately after toothbrushing. METHODS: Subjects refrained from oral hygiene for 22-26 hours prior to baseline whole mouth plaque assessments by the Turesky modification of the Quigley-Hein Index (TMQH). All subjects brushed with a marketed soft-bristled toothbrush and a fluoride dentifrice for 1 minute prior to post-brushing plaque assessments similar to baseline. One calibrated clinical examiner conducted all measurements. RESULTS: 30 subjects (mean age 23 years) completed the study. Irrespective of arch, posterior teeth harbored higher frequencies for scores of 3-5 than corresponding anterior teeth prior to brushing. In comparison to the pre-brushing examination, scores of 0-1 were more common in the post-brushing evaluation, however, greater frequencies of higher plaque were observed on posterior than on anterior regions. Irrespective of gender, subject or arch, anterior teeth harbored lower mean amounts of plaque than posterior teeth by ANOVA at both clinical examinations (P < 0.0001). Additionally, irrespective of arch, lower mean scores for plaque were observed on anterior teeth than from posterior teeth or the whole mouth at both examinations (P < 0.001). Lingual and molar surfaces consistently harbored large densities of plaque and represented areas with the least plaque removal after toothbrushing. Mid-vestibular sites represented the areas with the highest percent removal of plaque at 65% and harbored significantly lower levels of plaque than proximal sites during all phases of the study (P < 0.0059).

Increasing oral PMN during experimental gingivitis and its reversal by prophylaxis.

This investigation evaluated clinical parameters and the levels of polymorphonuclear leukocytes [PMN] collected in an oral rinse amongst subjects who refrained from dental hygiene for a period of 12 days. METHODS: Study enrolled consenting adults and assigned to a non-prophy group [n = 16] and a separate prophy group [n = 27]. Both groups underwent clinical evaluations and sampling for PMN at baseline and on days 3,6,9 and 12 of study initiation. The prophy group underwent supragingival prophylaxis at the conclusion of the no-hygiene phase and recalled for a final clinical evaluation and PMN assessment 1 week later. RESULTS: Progressive increases in oral PMN were noted due to abstinence from oral hygiene (p < 0.05). Subjects registered PMN increases ranging from 20% recorded three days following abstinence of hygiene to the highest value of 298% at the 12-day evaluation (p < 0.05). One week after prophylaxis, average PMN scores were 22% lower than baseline (p < 0.05). Abstinence from dental hygiene led to progressive increases in clinical parameters for dental plaque, gingival inflammation and bleeding. Dental plaque, gingival index and gingival bleeding scores recorded increases of 59%, 64% and 126% respectively at the conclusion of the no-hygiene phase. Prophylaxis resulted in marked reductions in all clinical parameters. CONCLUSIONS: Abstinence from dental hygiene corresponded with increasing scores for dental plaque, gingival inflammation and bleeding in conjunction with increasing oral PMN. These effects were irrespective of age or gender and were reversed by supragingival prophylaxis.

Antimicrobial effects in oral microenvironments by a novel herbal toothpaste.

OBJECTIVE: This clinical study compared the antibacterial effects after brushing with a novel herbal toothpaste incorporating zinc [test] to a control fluoride toothpaste on anaerobic organisms, gram-negative bacteria and malodor bacteria of dental plaque, tongue scrapings and cheek surfaces. METHODS: This double-blind, two-cell study enrolled 44 adults [age range 19-63 years]. Subjects completed a 1-week washout and provided baseline oral samples i.e. dental plaque, tongue and cheek scrapings for microbiological analysis. Diluted samples for microbiological analyses were plated on agar to enumerate anaerobic organisms, gram-negative bacteria and malodor bacteria representing functional groups of organisms. Subjects were randomized to brush their teeth with either the test or control with the first brushing conducted under supervision in the dental clinic. Post-treatment samples were collected 12 h after 21 day hygiene with assigned toothpaste. After providing these samples, subjects brushed in the dental clinic with additional samples collected 4 h after brushing. Statistical analyses were conducted separately for each organism collected from each oral niche by t-test for within-treatment assessments and analysis of covariance (ANCOVA) for between-treatment comparisons. RESULTS: Treatment groups demonstrated no significant differences at baseline for anaerobic organisms, gram-negative bacteria and malodor bacteria in any oral niche (p > 0.05). The test demonstrated reductions between 42 and 68% for anaerobic bacteria in oral niches, 12 h after brushing with reductions increasing to 46-80%, 4 h after brushing. Similarly, the test demonstrated reductions between 49 and 61% for gram-negative bacteria of oral niches that increased to 54-69% at the 4 h post-brushing evaluation. Reductions in malodor organisms of 22-42% were noted 12 h after brushing that increased to 60-72%, 4 h after brushing. CONCLUSIONS: In comparison to control, brushing with a novel herbal toothpaste demonstrated significant reductions in functional bacterial groups from distinct oral niches 12 h after brushing with additional microbial reductions 4 h after brushing.

The antimicrobial efficacy of commercial dentifrices.

This investigation compared the effects of a fluoride dentifrice and toothpastes formulated with antimicrobial ingredients (stannous fluoride and triclosan/copolymer) on oral micro-organisms, including those found in samples taken from the human oral cavity. Microbiological techniques determined the minimum inhibitory concentrations (MICs) of each dentifrice necessary to inhibit the growth of bacterial strains from the healthy oral cavity, as well as those found in dental caries, periodontal disease, and halitosis. Ex vivo studies utilized oral rinse samples and supragingival plaque from adults to determine antimicrobial effects on the entire microbial diversity of these samples, including biofilm-derived micro-organisms. The triclosan/copolymer dentifrice demonstrated the lowest MICs and significantly inhibited Gram-positive and Gram-negative bacteria (including the periodontal pathogens Aggregatibacter actinomycetemcomitans, Eikenella corrodens, and Fusobacterium nucleatum). In the ex vivo tests, the triclosan/copolymer dentifrice demonstrated substantial inhibition in the oral rinse samples over each treatment period (p > 0.0005) as compared to either the fluoride or stannous fluoride dentifrices. Similarly, the triclosan/copolymer dentifrice demonstrated the highest inhibition of micro-organisms in the supragingival plaque biofilm (p < 0.0005). No significant differences were observed between the fluoride and stannous fluoride dentifrices (p > 0.5).