Impact of toothpaste on abrasion of sound and eroded enamel: An in vitro white light interferometer study.

PURPOSE: To evaluate the influence of brushing using toothpastes marketed under different categories on abrasion of sound and eroded enamel in vitro at nanometer scale using a white light interferometer (WLI). METHODS: Enamel surface of resin-embedded bovine incisors were fine polished with diamond slurry and divided into testing area (approximately 2 mm x 4 mm) and reference area using a nail varnish. The enamel specimens were randomly assigned to 10 groups (n = 10 each); six of which were subjected to erosive challenge. The testing area in these eroded groups was exposed to 10 ml of Coca-Cola for 90 seconds and then rinsed for 10 seconds in deionized water (DW). Enamel specimens, except for those in one eroded group, were brushed by an automatic brushing machine with 120 linear motion strokes in 60 seconds under load of 250 g with/without toothpaste slurry. After the toothbrushing abrasion, each specimen was rinsed for 10 seconds with DW followed by immersion in artificial saliva for 2 hours. Toothpaste slurries were prepared containing one of the four toothpastes used and DW in a ratio of 1:2. The erosion-abrasion cycle was repeated three times. Then, the nail varnish was removed and enamel surface loss (SL) was measured by the WLI. Data were statistically analyzed by one-way ANOVA followed by Bonferroni's correction at significance level of 0.05. RESULTS: For eroded specimens, the mean SL values of groups not brushed and brushed with no toothpaste were not significantly different, but were significantly lower than those of whitening, anti-erosion and anti-caries toothpaste groups (P < 0.001). The whitening toothpaste group showed significantly higher SL than all other groups (P < 0.001). For sound enamel specimens, SL was not measured except for the whitening toothpaste group.

Enhancement of plaque removal by baking soda toothpastes from less accessible areas in the dentition.

OBJECTIVE: To determine if baking soda toothpastes are relatively more effective than non-baking soda toothpastes in promoting plaque removal from less accessible sites in the dentition. METHODS: Several single-brushing comparisons of baking soda and non-baking soda toothpastes for their overall ability to remove plaque have been published. In this study, individual comparisons of these published data, comparing the plaque removal performance of baking soda and non-baking soda toothpastes at various sites in the dentition, were examined to see if there were any site-dependant performance trends. The site-specific single-brushing data were then combined and analyzed in two ways. Meta-analyses of the clinical studies were performed to compare baking soda's relative plaque removal advantage at various sites in the mouth using paired t-testing at p <0.05. Also, plaque index reductions at various sites due to brushing with baking soda toothpastes were graphically compared with plaque index reductions due to brushing with non-baking soda dentifrices. The percent relative plaque removal advantage for baking soda toothpastes at various sites were plotted against the reduction in plaque index due to brushing with non-baking soda toothpastes. RESULTS: Individual comparisons showed that brushing with the toothpastes containing baking soda generally removed significantly more plaque from each site than brushing with toothpastes without baking soda. The relative efficacy advantage for baking soda toothpastes was consistently higher at sites where the non-baking soda toothpastes removed less plaque. Meta-analytical comparisons confirmed baking soda toothpastes to be relatively more effective in enhancing plaque removal from sites where less plaque was removed compared to brushing with non-baking soda toothpastes (p < 0.05). Graphically, the baking soda toothpastes' relative plaque removal advantage could be seen to increase hyperbolically with decreasing plaque removal by the non-baking soda toothpastes with which they were compared. We presuppose that the reason less plaque is removed by non-baking soda toothpastes at some sites than others is that these sites are less accessible to the toothbrush. CONCLUSION: These results show that baking soda toothpastes are relatively more effective in enhancing plaque removal from harder-to-reach areas of the dentition (p <0.05), i.e., from lingual than facial surfaces, from posterior than anterior areas, and from proximal than mid-surface sites.

[Toothpastes: ingredients, brands, categories and their utilization].

Toothpaste is one of the most widely used dental products, with the largest sales. Its use is one of the most popular oral hygiene behaviors in developed countries. In the last 30 years there has been a large variety of changes in toothpaste composition. One of the main changes is utilizing the toothpaste as a delivery system for therapeutic agents to the oral cavity. A large variety of toothpastes can be found on the market, for different purposes: caries prevention, gingivitis prevention, anti calculus formation, dentine hypersensitivity prevention and for teeth whitening. Toothpastes have a wide range of ingredients: abrasives, humectants, preservatives, thickening or binding agents, detergents, flavoring agents and therapeutic agents. This review provides details on the ingredients of dentifrices, the evidence about the different brands and categories, and questions about their utilization.

Fluoride content in children's dentifrices marketed in Lima, Peru.

The aim of the present study was to determine the concentration of total fluoride (TF) and total soluble fluoride (TSF) in children's dentifrices marketed in the city of Lima, Peru. Three samples of 23 dentifrices (4 without fluoride and 19 with fluoride) were purchased in different pharmacies in Lima, Peru. The TF and TSF concentrations found in the dentifrices were determined by ion-selective electrode, expressed in ppm F (µg F/g of dentifrice). The TF concentration in the majority of the fluoride toothpastes matched that shown on the label, except for one declared as 1450 ppm F by the manufacturer, whereas only 515.1 ppm F was found. The concentration of TSF found in the fluoride toothpastes ranged from 457.5 to 1134.8 ppm F. All the dentifrices were formulated with silica, but one also presented calcium carbonate. In conclusion, 83% of the children's dentifrices marketed in Lima, Peru, were fluoridated, but only 53% contained a TSF concentration greater than 1000 ppm F, the minimum concentration required to provide an anticaries effect.

Prevalence of dental fluorosis and associated risk factors in 11-15 year old school children of Kanyakumari District, Tamilnadu, India: a cross sectional survey.

OBJECTIVES: This study presents data on the prevalence and severity of dental fluorosis in 11-15-years-old school children of Kanyakumari district, TamilNadu, India, and also the relationships between prevalence of dental fluorosis and selected risk factors. MATERIALS AND METHODS: A total of 1800 children, from all the nine blocks of Kanyakumari district, studying in classes 6-10 were examined using type III examination. The assessment form designed specifically for this study was used while examining each student. RESULTS: Dental fluorosis was present in 15.8% (285 children) of the study population and the community fluorosis index was calculated to be 0.27. The prevalence of dental fluorosis varied from as low as 1.4% in some blocks to as high as 29.4% in some others. There was a significant difference in the level of dental fluorosis between rural and urban residents ( P < 0.001). The prevalence of dental fluorosis was higher in children who consumed pipe water as compared to children who consumed ground water. 65% of the children with dental fluorosis had no caries, indicating the positive effects of fluoride. CONCLUSIONS: The prevalence of dental fluorosis can be attributed to the level of fluoride in the drinking water as it exhibited a step-wise increase when the water fluoride levels increased from 1.5-1.7 ppm. Measures for defluoridation of drinking water before distribution has to be taken in the high prevalence blocks to lower the burden of dental fluorosis in this community.

Effects of toothbrush size and dentifrice type/brand on pea-sized and larger amounts of dentifrice.

PURPOSE: To assess the effects of toothbrush size and dentifrice type/brand on amounts of dentifrice being placed when trying to replicate pictures with different amounts of dentifrice, including a pea-sized amount. METHODS: This laboratory trial used one researcher to repeatedly dispense five dentifrice products on three different child-sized toothbrushes using a standard procedure. Two sets of drawings, depicting the recommended pea-sized and larger amounts, were used as guides in an effort to place the same amount each time. Data were analysed using ANOVA. RESULTS: Amounts of dentifrice placed on the two larger toothbrushes were significantly greater than those placed on the smallest toothbrush (p < 0.0001). The amounts placed on the two larger toothbrushes with similar brushing areas but different shapes were not significantly different from each other. The effect of dentifrice type/brand varied in each analysis. For pea-sized amounts, one of 10 pairwise comparisons was significant. For amounts larger than pea-sized, another pair of the 10 pairwise comparisons was significant. However, there was no significant effect of dentifrice type/brand when considering both pea-sized and larger amounts together in the same analysis. CONCLUSIONS: Toothbrush size significantly affected the amount of dentifrice placed for both pea-sized and larger amounts. The amounts placed on larger size toothbrushes were greater than on the smaller size toothbrush. No consistent effects of selected dentifrices were found.

Chemical and physical factors of desensitizing and/or anti-erosive toothpastes associated with lower erosive tooth wear.

Toothpastes have a complex formulation and their different chemical and physical factors will influence their effectiveness against erosive tooth wear (ETW). We, therefore, investigated the effect of different desensitizing and/or anti-erosive toothpastes on initial enamel erosion and abrasion, and analysed how the interplay of their chemical and physical factors influences ETW. Human enamel specimens were submitted to 5 erosion-abrasion cycles using 9 different toothpastes and an artificial saliva group, and enamel surface loss (SL) was calculated. Chemical and physical factors (pH; presence of tin; calcium, phosphate and fluoride concentrations; % weight of solid particles; wettability; and particle size) of the toothpaste slurries were then analysed and associated with the amount of SL in a multivariate model. We observed that all desensitizing and/or anti-erosive toothpastes presented different degrees of SL. Besides pH and fluoride, all other chemical and physical factors were associated with SL. The results of this experiment indicate that enamel SL occurs independent of whether the toothpastes have a desensitizing or anti-erosive claim, and that lower SL is associated with the presence of tin, higher concentration of calcium and phosphate, higher % weight of solid particles, smaller particle size, and lower wettability.

Dentin morphology and permeability after brushing with different toothpastes in the presence and absence of smear layer.

BACKGROUND: The purpose of this study was to evaluate the morphology and permeability of dentin after brushing with different toothpastes in the presence and absence of smear layers. METHODS: Dentin discs were prepared from extracted third molars. Dentin permeability was measured using a hydraulic pressure apparatus working at 70 cm H2O pressure. Dentin was treated with 0.5 M EDTA for 5 minutes and washed to remove a smear layer and to establish the maximum permeability of each dentin disc, which was expressed as 100%. A new smear layer was then created on the upper surface using a #400 carbide paper under water for 30 seconds. Dentin permeability of the smear layer-covered dentin was measured and expressed as a percentage of the maximum permeability of that specimen, permitting each specimen to serve as its own control. Each sample was then brushed by a mechanical device under water for 3 minutes with constant pressure of 250 g using a medium toothbrush and permeability remeasured. Finally, 1 of 5 different toothpastes was applied on the dentin and brushed for 3 minutes. In another group, the same procedures were performed with the exception of the smear layer production, so it was possible to calculate changes in the permeability of dentin with open tubules following brushing. Scanning electron microscopic (SEM) examination of dentin was obtained before and after treatments with brushing and toothpastes. RESULTS: Dentin permeability was reduced by brushing procedures when the smear layer was absent, but it was increased when the smear layer was present. Toothpaste application reduced dentin permeability when no smear layer was present on the top of the surface, but modified and increased permeability of samples with smear layers. SEM observations demonstrated the presence of dentifrice particles on dentin surfaces and inside dentinal tubules, and this may be responsible for the observed reductions in permeability. Smear plugs produced during dentin brushing were not removed by the dentifrices. CONCLUSIONS: Dentin permeability and morphology are significantly affected by toothbrushing and by the type of dentifrice used. The presence of smear plugs in the dentin may decrease severity.

Oral health status and access to care in a rural area of India.

A study was carried out in two villages in a rural area of Andhra Pradesh, India, 150 kilometres south of the state capital, Hyderabad. Ninety-eight women and sixty-two men, age range 15-70 years, were interviewed and examined. Information gathered included socio-economic data, distance travelled outside the village and previous access to health care. Data were recorded on periodontal status using CPITN and full periodontal charting. Comparisons were made between male and female subjects for travel outwith the village, attendance at medical and dental health facilities, tooth cleaning methods and materials and prevalence of periodontal disease. There was a high prevalence of chronic inflammatory periodontal disease in this population, and most of this was untreated. In view of the difficulties in access to health care, it would be prudent to offer good preventive oral health care within the rural community.

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

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

The technology behind Colgate Simply White Toothpaste.

Colgate Simply White Toothpaste is a new advanced tooth whitening dentifrice that can be used every day. The synergy of abrasive stain removal with activated hydrogen peroxide delivers excellent performance in the removal of extrinsic and intrinsic tooth stain. Colgate Simply White Toothpaste provides other oral health benefits that have become the cost-of-entry into the toothpaste market: caries protection, tartar control, fresh breath, and a preferred flavor.

Marketing strategies and warning labels on children's toothpaste.

PURPOSE: The overconsumption of toothpaste has negative consequences, particularly for children. This study's objectives were to describe misleading marketing strategies used in selling children's fluoridated toothpaste and identify warning label characteristics. Two researchers independently coded the packaging from 26 over-the-counter toothpastes that are specifically marketed for children. Aggressive marketing strategies targeting children were identified: every toothpaste in this sample displayed at least 1 children's animated character, 50% had at least 1 picture of a food item, 92.3% stated they were flavored and 26.9% depicted a full swirl of toothpaste, directly contradicting dentist recommendations for young children. Further, on most toothpaste tubes, warnings regarding fluoride overconsumption for young children were only listed on the back and in very small font. Misleading marketing strategies are regularly used in selling children's toothpaste as if it is a food product, while warnings regarding overconsumption among youth are minimized. Dental hygienists are in an important position to help parents of young children implement safe oral care practices.

Fluoride content in children's dentifrices marketed in Lima, Peru

Abstract The aim of the present study was to determine the concentration of total fluoride (TF) and total soluble fluoride (TSF) in children's dentifrices marketed in the city of Lima, Peru. Three samples of 23 dentifrices (4 without fluoride and 19 with fluoride) were purchased in different pharmacies in Lima, Peru. The TF and TSF concentrations found in the dentifrices were determined by ion-selective electrode, expressed in ppm F (μg F/g of dentifrice). The TF concentration in the majority of the fluoride toothpastes matched that shown on the label, except for one declared as 1450 ppm F by the manufacturer, whereas only 515.1 ppm F was found. The concentration of TSF found in the fluoride toothpastes ranged from 457.5 to 1134.8 ppm F. All the dentifrices were formulated with silica, but one also presented calcium carbonate. In conclusion, 83% of the children's dentifrices marketed in Lima, Peru, were fluoridated, but only 53% contained a TSF concentration greater than 1000 ppm F, the minimum concentration required to provide an anticaries effect.

Evidence based toothpaste classification, according to certain characteristics of their chemical composition.

Toothpastes are daily oral care products, the chemical composition of which is constantly changing due to manufacturer's competition. It becomes more and more difficult for dentists to recommend the best toothpaste and for patients to choose one. The objective of this paper was to draw out recommendations based on the best evidence available and to propose a new classification of toothpastes. Publications were searched in PubMed database (published between 1991-2011, limited to English language articles in dental journals). Recommendations for toothpaste choice and usage were developed from the best evidence available.

[Dentifrices:an evaluation based on the current literature]. / Dentifrices: évaluation sur base de la littérature actuelle.

Toothpastes remain a frequently used auxilary in oral hygiene. Although some new components have been introduced, the base composition does not differ much between toothpaste types. Concerning toothpastes there is a thin border between cosmetics and drugs and it becomes more and more difficult for oral health care workers to prescribe the right toothpaste for the right patient. Production companies are frequently using commercial advertisements to promote their product. In this way, it's getting more and more difficult for the dentist (and patient) to find the suitable product. This literature review aims to search for scientific evidence for toothpaste components and their clinical use. In this way the review can be used as a compendium for health care workers to make the right choice in prescribing toothpastes. Furthermore all available toothpastes on the Belgian market are listed, following their composition.

Unconventional dentistry: Part IV. Unconventional dental practices and products.

This is the fourth in a series of 5 articles providing a contemporary overview and introduction to unconventional dentistry (UD) and its correlation to unconventional medicine (UM). Several common UD and UM practices are described to familiarize practitioners with a variety of theories, practices, products and treatments that specifically apply to dentistry. This brief review is not intended as an in-depth resource.

An in situ model to study the toothpaste abrasion of enamel.

OBJECTIVES: In order to understand the clinical relevance of dentifrice abrasivity on the dentition in vivo, an in situ enamel wear model has been developed. MATERIALS AND METHODS: Polished human enamel blocks were indented with a Knoop diamond, attached to dentures and worn by adult volunteers for 24 h per day. The blocks were brushed for 30 s, twice per day with dentifrices of known relative dentine abrasivity (RDA) and relative enamel abrasivity (REA). The dentifrices used were either dentifrice A (RDA=85, REA=3.4), dentifrice B (RDA=189, REA=2.0) or dentifrice C (RDA=132, REA=42.7). After 28 days, the blocks were removed and the geometry of each Knoop indent was remeasured. From the baseline and post-treatment values of indent length, the amount of enamel wear was calculated from the change in the indent depth. RESULTS: The median values for enamel wear of dentifrices A, B and C were -0.02, 0.01 and -0.48 microm, respectively. The differences between dentifrice C and dentifrices A and B were of statistical significance. CONCLUSION: This study has demonstrated the usefulness of an in situ technique for investigating the relationship between the abrasivity of a dentifrice in vitro and the wear of enamel in situ.

[Dietary and hygienic aspects of fluoride exposure in pregnant women]. / Ekspozycja na fluorki kobiet ciezarnych w aspekcie diety i nawyków higienicznych.

The study was undertaken to assess the exposure of pregnant women to fluoride on the basis of diet preferences and hygienic habits revealed with a questionnaire. The group included 59 women aged 22-39, living in a large urban agglomeration. Questions concerned sources of fluoride such as diet (tap water, tea, fish, poultry), use of fluoride-containing preparations for oral hygiene and substances containing fluoride for additional prophylaxis. The oral health status was clinically examined and caries intensity was assessed with the mean DMF-t index. According to the clinical examination, the mean DMF-t index was 13.64 and ranged from 1 to 23. Consumption of tap water averaged 0.73 L (max. 2.5 L), including 0.55 L (max. 2.5 L) of tea. Poultry was a regular part of the diet in only 14 of the respondents (24%) and only 3 (5%) sporadically (once a week) ate ocean fish. All the respondents used toothpaste containing fluoride, but only 15.3% applied professional prophylaxis with fluoride preparations. As far as the diet is concerned, individual differences in the intake of fluorides were significant. Interestingly, despite the declared everyday use of fluorine-containing toothpaste, the caries intensity index was rather high, suggesting the need for special dental care in this group of patients.