Innovative recruitment strategies for a comprehensive worksite wellness initiative.

Recruiting for wellness initiatives is challenging. WorkWell KS, a statewide worksite wellness initiative, offers unique worksite recruitment strategies that may serve as lessons. From 2012 to 2018, WorkWell KS utilized champions, well-connected local leaders, to recruit worksites. A total of 784 worksites were recruited for at least one WorkWell KS workshop. A survey of champions requested identification of strategies, barriers and facilitators for successful recruitment and continued engagement. Forty-three champions reported on recruitment experiences. Sixty-three percent of respondents attributed recruitment success to having funding to complete their work. Face-to-face meetings was the most commonly reported successful strategy. Eighty-six percent of respondents reported that improving employee health was motivation for worksites to participate. Champions with a significant funding incentive for worksites commonly indicated that funding was a motivating factor. The most commonly selected factor for continued engagement was having a worksite staff member with wellness in their job description (67% of respondents). Forty-nine percent of respondents reported worksites' lack of time as a barrier to participation. The WorkWell KS initiative has implemented innovative recruitment methods that leverage well-connected leaders to recruit worksites to participate in a comprehensive worksite wellness initiative. Future worksite-based initiatives may benefit from adopting recruitment strategies presented here.

Salivary exRNA biomarkers to detect gingivitis and monitor disease regression.

AIM: This study tests the hypothesis that salivary extracellular RNA (exRNA) biomarkers can be developed for gingivitis detection and monitoring disease regression. MATERIALS AND METHODS: Salivary exRNA biomarker candidates were developed from a total of 100 gingivitis and non-gingivitis individuals using Affymetrix's expression microarrays. The top 10 differentially expressed exRNAs were tested in a clinical cohort to determine whether the discovered salivary exRNA markers for gingivitis were associated with clinical gingivitis and disease regression. For this purpose, unstimulated saliva was collected from 30 randomly selected gingivitis subjects, the gingival and plaque indexes scores were taken at baseline, 3 and 6 weeks and salivary exRNAs were assayed by means of reverse transcription quantitative polymerase chain reaction. RESULTS: Eight salivary exRNA biomarkers developed for gingivitis were statistically significantly changed over time, consistent with disease regression. A panel of four salivary exRNAs [SPRR1A, lnc-TET3-2:1, FAM25A, CRCT1] can detect gingivitis with a clinical performance of 0.91 area under the curve, with 71% sensitivity and 100% specificity. CONCLUSIONS: The clinical values of the developed salivary exRNA biomarkers are associated with gingivitis regression. They offer strong potential to be advanced for definitive validation and clinical laboratory development test.

Label-free quantitative proteomics reveals differentially regulated proteins in experimental gingivitis.

We investigated the sequential protein expression in gingival crevicular fluid samples during the induction (I) and resolution (R) of experimental gingivitis. Periodontally and systemically healthy volunteers (n = 20) participated in a three-week experimental gingivitis protocol, followed by debridement and two weeks of regular plaque control. Gingival crevicular fluid (GCF) samples were collected at baseline, Day 7, 14, and 21 (induction; I-phase), and at Day 21, 25, 30, and 35 (resolution; R-phase). Liquid chromatography-tandem mass spectrometry (LC-MS/MS) for label-free quantitative proteomics was applied. A total of 287 proteins were identified including 254 human, 14 bacterial, 12 fungal, and 7 yeast proteins. Ontology analysis revealed proteins primarily involved in cytoskeletal rearrangements, immune response, antimicrobial function, protein degradation, and DNA binding. There was considerable variation in the number of proteins identified, both among subjects and within subjects across time points. After pooling of samples between subjects at each time point, the levels of 59 proteins in the I-phase and 73 proteins in the R-phase were quantified longitudinally. Our data demonstrate that LC-MS/MS label-free quantitative proteomics is valuable in the assessment of the protein content of the GCF and can facilitate a better understanding of the molecular mechanisms involved in the induction and resolution of plaque-induced gingival inflammation in humans.

Dentin tubule occlusion and erosion protection effects of dentifrice containing bioadhesive PVM/MA copolymers.

OBJECTIVES: To study the effectiveness of a dentifrice containing polyvinylmethyl ether-maleic acid (PVM/MA) copolymer in occluding dentin tubules and investigate the interaction between PVM/MA and type I collagen using surface plasmon resonance (SPR). MATERIALS AND METHODS: Fifteen volunteers brushed dentin discs in situ using dentifrices with and without PVM/MA copolymer in a cross-over design. Dentin tubule occlusion was evaluated after brushing, after overnight saliva challenge in vivo for 12 h and after drinking 250 ml of orange juice. Dentin tubule occlusion and tubule size were compared between the two groups using repeated ANOVA and before and after erosive challenges using paired t tests. SPR using type I collagen as ligand and PVM/MA as analyte was performed to evaluate the binding of the two macromolecules. RESULTS: A median of 91% of dentin tubules were occluded after a single brushing in the PVM/MA group, as compared to 9% in the controls. After overnight saliva challenge and 10 min of erosion by orange juice, a median of 73% of the dentin tubules remained fully occluded in the PVM/MA group as compared to zero in the controls. Dentin tubule size increased after orange juice erosion in the controls but not in the PVM/MA group. SPR study showed that PVM/MA bound readily to collagen molecules in a 4 to 1 ratio. CONCLUSIONS: Dentifrice containing PVM/MA could effectively occlude dentin tubules and prevent dentin erosion. PVM/MA may improve adhesive retention of intra-tubular dentifrice plugs through binding to dentin surface collagen. CLINICAL RELEVANCE: Brushing with dentifrice containing adhesive polymers has preventive effect against dentin erosion and dentin sensitivity.

Metabolic perturbance in autism spectrum disorders: a metabolomics study.

Autism spectrum disorders (ASD) are a group of biological disorders with associated metabolic derangement. This study aimed to identify a pattern of metabolic perturbance in ASD using metabolomics in urinary specimens from 48 children with ASD and 53 age matched controls. Using a combination of liquid- and gas-chromatography-based mass spectrometry, we detected the levels of 82 metabolites (53 of which were increased) that were significantly altered between the ASD and the control groups using osmolality normalized data. Pattern analysis showed that the levels of several amino acids such as glycine, serine, threonine, alanine, histidine, glutamyl amino acids and the organic acid, taurine were significantly (p≤0.05) lower in ASD children. The levels of antioxidants such as carnosine were also reduced in ASD (p=0.054). Furthermore, several gut bacterial metabolites were significantly altered in ASD children who had gastrointestinal dysfunction. Overall, this study detected abnormal amino acid metabolism, increased oxidative stress, and altered gut microbiomes in ASD. The relationship of altered gut microbial co-metabolism and the disrupted metabolisms requires further investigation.

Evaluation of the antiplaque efficacy of two cetylpyridinium chloride-containing mouthwashes.

OBJECTIVE: The purpose of this clinical study was to evaluate the efficacy in reducing dental plaque regrowth of two mouthwashes containing 0.075% cetylpyridinium chloride (CPC), one with 6% alcohol and one alcohol-free, as compared to a negative control mouthwash without CPC, using the Modified Gingival Margin Plaque Index (MGMPI). METHODS: The study was a double-blind, randomized, three-way crossover, controlled design. Following a washout period, subjects reported to the dental clinic where they were instructed to brush their teeth, used their assigned mouthwash, and were scored by the examining dentist for plaque using the MGMPI method. Subjects were instructed to refrain from all oral hygiene for the next 24 hours, except for rinsing with their assigned mouthwash 12 hours post-brushing. After this 24-hour period, subjects returned to the dental clinic and were once again scored for plaque. This sequence of washout followed by mouthwash use and plaque scoring was repeated until each subject had used all three mouthwashes. An ANOVA was conducted to assess between-group differences. RESULTS: The two test mouthwashes significantly reduced plaque regrowth over a 24-hour period (p < 0.05) as compared to the negative control mouthwash. The difference between the CPC-containing mouthwashes was not significant (p = 0.4868). CONCLUSION: Two mouthwashes containing 0.075% CPC, one with 6% alcohol and the other alcohol-free, were found to be safe and effective in reducing plaque accumulation when compared a negative control mouthwash without CPC. In short-term studies, the MGMPI appears useful for evaluating the antiplaque efficacy of mouthwash products.

Comparison of the short-term antiplaque/antibacterial efficacy of two commercial dentifrices.

OBJECTIVE: The objective of these three clinical trials was to compare the impact of two commercial products, Colgate Total and Crest Pro-Health, on the formation of dental plaque over a 24-hour period of time. The studies utilized the Modified Gingival Margin Plaque Index (MGMPI), a validated and reliable clinical method for assessing the efficacy of products in reducing plaque build-up. METHODS: Colgate Total and Crest Pro-Health were the test products for all three clinical trials. Colgate Great Regular Flavor (CR) was used as the universal washout product. Colgate Total, as the only toothpaste approved by the FDA under an NDA for antiplaque, antigingivitis, and anticaries benefits, contains 0.3% triclosan/2.0% PVM/MA copolymer for antigingivitis and antiplaque, as well as 0.243% sodium fluoride (NaF) for anticaries. Crest Pro-Health contains 0.454% stannous fluoride (SnF2) as both a monographed anticaries agent and a monographed antigingivitis agent, along with sodium hexametaphosphate and zinc lactate. Twenty-five healthy subjects meeting all study criteria were included into each of the double-blind studies. Product assignment was randomized and a crossover design was implemented. Informed consent was obtained from all subjects prior to commencement of each of the studies. The studies followed published MGMPI procedures, which require subjects to receive a dental scaling/prophylaxis followed by a one-week washout period prior to use of test products. A baseline MGMPI score was calculated following use of the test products in the dental clinic. Subjects refrained from all oral hygiene for 24 hours following use of each test product, and returned to the clinic for a 24-hour MGMPI score. Following a washout period, subjects repeated the procedure with the other test product as per the crossover design. The differences (delta) between baseline plaque scores and 24-hour plaque scores were independently calculated for each study, and the delta values were compared for the two test products in each of the studies. RESULTS: In all three clinical trials, Colgate Total significantly reduced plaque regrowth over a 24-hour time period (p < or = 0.05) compared to Crest Pro-Health. Existing differences were determined via a paired t-test, which confirmed that Colgate Total was statistically significantly different from Crest Pro-Health. CONCLUSION: These in vivo data support the antiplaque benefit of the 0.3% triclosan/2.0% PVM/MA copolymer/0.243% sodium fluoride dentifrice. Additionally, the results support that Colgate Total provides superior efficacy in inhibiting the formation of dental plaque compared to Crest Pro-Health.

The use of the Modified Gingival Margin Plaque Index (MGMPI) method to investigate the inhibitory effect of various toothpastes on dental plaque formation.

OBJECTIVE: Colgate Total (CTT) is the only FDA-approved toothpaste for antiplaque and antigingivitis benefits. The objective of this study was to compare the impact of Colgate Total Pharma (CTP), a new variant of Colgate Total, with Colgate Regular Toothpaste (CRT) on plaque formation over a 24-hour period following a single use of the dentifrice. METHODS: CTP and CRT were the two test products. CRT was used for a washout product as well. Fifteen male/female subjects who met the inclusion/exclusion criteria were included into this single-blind (preliminary phase) and double-blind (randomized phase) crossover study. Ethical approval and written informed consent were obtained. Preliminary phase: After a one-week washout with CRT, subjects brushed in the dental clinic with CRT before a one-minute use of a test dentifrice. A baseline Modified Gingival Margin Plaque Index (MGMPI) score was calculated. Subjects refrained from oral hygiene for 24 hours, and returned to the clinic for their 24-hour MGMPI score. Subjects entered the second washout phase to repeat as per the crossover design. The above procedures were conducted three times by three independent examiners. Randomized phase: Subjects were randomized to the groups according to a computer-generated randomization schedule. The procedure was carried out as in the preliminary phase, except the washout period between the two products was at least one week and the products (CTP or CRT) were used in a randomized double-blind manner. Plaque scores were recorded as above. RESULTS: CTP provided a significant (p = 0.01) antiplaque effect versus CRT. The results are consistent with previously reported data for CTT. All three examiners demonstrated a strong correlation for this clinical study utilizing the MGMPI methodology. CONCLUSION: This clinical investigation examined the efficacy of a new variant of a commercial dentifrice, historically shown to provide antiplaque and antigingivitis efficacy. It is important to confirm the continued efficacy of new products to consumers and to the profession. Additionally, this clinical trial demonstrated the usefulness of the clinical methodology with respect to consistency in results by three independent clinical examiners. Because this methodology is often employed to document antiplaque benefits of new and existing technologies, it is important to periodically evaluate and confirm its reliability and reproducibility.

Assessing fluoride treatment and resistance of dental enamel to soft drink erosion in vitro: applications of focus variation 3D scanning microscopy and stylus profilometry.

OBJECTIVES: This study assesses the application of the focus variation 3D microscopy for the evaluation of dental erosion and fluoride treatment for prevention of enamel erosion in vitro. METHODS: Human dental enamel disks were treated with Prevident 5000 (PV, n=15) for 1 week and compared with a reference group (PN, n=15) after orange juice erosion in vitro. A focus variation 3D scanning microscope (IFM) and a stylus type profilometer (SSP) were used to evaluate the erosion depths on enamel. 3D topographic images were taken with vertical resolutions of 0.1 and 0.02 microm. Scratch marks depths from SSP were measured on IFM images. Measurements were compared between the SSP and IFM and between the two study groups. RESULTS: The SSP and IFM measurements of eroded enamel surfaces showed similar trends between the two methods and between the two study groups. The SSP and the IFM measurements were statistically significantly different but correlated with each other. PV group showed consistently lower erosion depth than PN in all profile measures using both SSP and IFM. The stylus tip created scratch marks that were significantly different in depths between the eroded and the reference surfaces in both groups. CONCLUSIONS: The focus variation 3D microscopy is a powerful tool in evaluating surface topography associated with enamel erosion and in assessing the treatment effects of anti-erosive therapies. Topical treatment with Prevident 5000 significantly increased enamel resistance to erosion by orange juice and should be considered as a treatment choice in patients susceptible to acidic dental erosion.

The salivary microbiome of diabetic and non-diabetic adults with periodontal disease.

BACKGROUND: A comparison of the salivary microbiome of non-diabetic and diabetic cohorts having periodontal health, gingivitis and periodontitis could reveal microbial signatures unique to each group that will increase understanding of the role of oral microbiota in the pathogenesis of disease, and assist with diagnosis and risk assessment for both periodontal disease and diabetes. METHODS: A group of individuals diagnosed with type 2 diabetes (T2D) was compared with a group without T2D. For both the diabetic and non-diabetic cohorts, three subgroups were established: periodontal health, gingivitis, and periodontitis. Salivary DNA was extracted (n = 146), polymerase chain reaction was performed to amplify 16S rRNA hypervariable region V3-V4, and constructed libraries were sequenced and subjected to bioinformatic and statistical analyses. RESULTS: Microbiome analysis resulted in 88 different genus level operational taxonomic units (OTUs) for differential abundance testing. Results were largely described by two trends. Trend 1 showed OTUs that increased in abundance with increasing periodontal disease, and in diabetics relative to non-diabetics. Trend 1 OTUs comprised a mix of primarily anaerobic commensals and potential periodontopathogens. Trend 2 was driven primarily by genera that decreased in abundance in those with diabetes relative to those without diabetes, which included other anaerobes associated with periodontal disease. Overall, oral microbial diversity decreased in diabetics and increased with progression of periodontal disease compared with periodontally healthy controls. CONCLUSION: Although select microbiota increased in both diabetes and periodontal disease progression, these genera decreased in co-existing diabetes and periodontal disease. These findings suggest that the genera abundance continues to change with additional stress imposed by co-existing conditions.

Clinical investigation of the antiplaque efficacy of a new variant of a commercially available triclosan/copolymer/fluoride dentifrice.

OBJECTIVE: The objective of two single-blind, three-treatment, crossover design, clinical studies was to evaluate the antiplaque efficacy using the Modified Gingival Margin Plaque Index (MGMPI) scores of three dentifrices: 1) a dentifrice containing 0.3% triclosan/2.0% polyvinylmethyl ether/maleic acid (PVM/MA) copolymer/sodium fluoride in a 17% dual silica base (Colgate Total Advanced Toothpaste-Test Dentifrice); 2) a commercially available dentifrice containing 0.3% triclosan/2.0% PVM/MA copolymer/sodium fluoride in a 10% high-cleaning silica base (Colgate Total Toothpaste-Positive Control Dentifrice); and 3) a commercially available dentifrice containing 0.243% sodium fluoride in a regular silica base (Colgate Winterfresh Gel-Negative Control Dentifrice). METHODS: In each study, subjects reported to the clinical facility, and those who met the inclusion/exclusion criteria were given a complete oral prophylaxis, a soft-bristled toothbrush, and a commercially available dentifrice (Colgate Cavity Protection Fluoride Toothpaste). They were instructed to use these products exclusively for seven days (washout period), after which time they reported back to the clinical facility and were randomized into three treatment groups. All subjects then brushed their teeth for one minute with a full ribbon (approximately 1.5 gm) of Colgate Cavity Protection Fluoride Toothpaste, and immediately followed with a one-minute brushing using a full ribbon of one of the three study dentifrices. Subjects then rinsed with a red disclosing solution (Butler Red-Cote) and had their teeth and gums examined to assess their plaque content. They returned to the clinical facility after 24 hours of no oral hygiene to again have their teeth and gums examined to assess their plaque content. As per the crossover clinical design, the same methods and materials were used until all subjects used all three study treatments. RESULTS: Seventeen subjects in the first study and 16 subjects in the second study complied with the protocol and completed all phases of the study. Two-way ANOVA results from both studies showed that there was no difference in mean delta MGMPI scores between the groups using the Test Dentifrice and the Positive Control Dentifrice. Results also showed that there was a statistically significant difference (p < 0.05) in delta MGMPI scores between both the Test Dentifrice treatment and the Positive Control Dentifrice treatment when compared to the Negative Control Dentifrice. CONCLUSION: A new improved dentifrice containing 0.2% triclosan/3.0% PVM/MA copolymer/sodium fluoride in a 17% dual silica base is comparable in controlling dental plaque when compared to a Positive Control Dentifrice containing 0.3% triclosan/2.0% PVM/MA copolymer/sodium fluoride in a 10% high-cleaning silica base, and is statistically significantly better in controlling dental plaque when compared to a Negative Control Dentifrice containing 0.243% sodium fluoride in a silica base.

Comparison of two clinical methods for evaluating the anti-plaque efficacy of a dentifrice.

OBJECTIVE: The objective of this research was to assess two different published methods of plaque level evaluation on human subjects, and to determine whether both methods can produce similar findings to the point that the methods can be used interchangeably. METHODOLOGY: Healthy human volunteers entered into a number of double-blind, cross-over clinical trials. Two plaque scoring methods were used: The Modified Gingival Margin Plaque Index (MGMPI) and the Turesky Modified Quigley-Hein (TMQH). With the MGMPI, plaque was evaluated 24 hours after a single product use. With the TMQH, plaque was scored after four days of product use. Three dentifrices were studied: Colgate Total, Colgate Total plus Whitening, and Colgate Regular Dental Cream. Additionally, two mouthrinses were evaluated: PerioGard and Fluorigard. In all studies conducted, there was a one-week wash-out period between each product use. RESULTS: There were no side effects observed or reported in any study. In all studies, both the plaque indices used found that the active products Colgate Total, Colgate Total plus Whitening and PerioGard produced significantly lower mean plaque scores compared to Colgate Regular Dental Cream and Fluorigard (p < 0.05). CONCLUSION: The results of this investigation indicate that the two plaque evaluation methods continue to demonstrate that an active product is significantly more efficacious than a control product. Therefore, either method can be used to investigate the anti-plaque efficacy of a product. Additionally, the MGMPI method can be used 24 hours after product use, which is a clear advantage over a four-day product use and will yield the same results.

Clinical evaluation of the anti-plaque effect of a commercial chewing gum.

OBJECTIVE: The objective of this research was to evaluate the dental plaque control effect of a chewing gum versus brushing with a dentifrice via four clinical studies. METHODOLOGY: Study 1 compared a commercial chewing gum (Colgate Dental Gum, CDG) with a water control after 24 hours post-brushing; Studies 2 and 3 compared CDG to two different brands of commercially available fluoride dentifrices after 24 hours post-brushing; Study 4 examined the anti-plaque effect of CDG plus a regular fluoride dentifrice (Colgate Winterfresh Gel, CWG) versus brushing with CWG alone for five days. The 24-hour clinical tests employed the Modified Gingival Margin Plaque Index (MGMPI), while the Quigley-Hein Plaque Index (QHPI) was used for the five-day study. All studies utilized a randomized, crossover design with a one-week washout period, and were single-blinded to the clinical evaluator. RESULTS: In Study 1, the mean MGMPI score for CDG was significantly lower (p < 0.05) compared to the water control. In Studies 2 and 3, while brushing with regular fluoride dentifrices provided improved plaque control compared to CDG, the chewing gum alone with no tooth brushing delivered a plaque reduction 60% as effective as brushing with a fluoride dentifrice. In Study 4, the group using the combination of chewing with CDG and brushing with CWG provided a significantly lower (p < 0.05) mean QHPI score compared to the group using the dentifrice only, particularly on the hard-to-brush lingual surfaces. CONCLUSIONS: Four clinical studies demonstrated that CDG provides a plaque control benefit. The results suggest that chewing gum may serve as an effective oral hygiene device when brushing may not be possible and, additionally, that chewing gum may serve as an effective adjunct to brushing for enhanced oral health.

Clinical evaluations of sustained calculus control by Colgate Simply White dentifrice using an in-situ appliance.

OBJECTIVE: Two clinical studies were conducted to evaluate the dental calculus control efficacy of Colgate Simply White dentifrice versus a positive and a negative control dentifrice, using a published intra-oral appliance and monitoring the prevention of calcium deposition, an indicator of early dental calculus formation. METHODOLOGY: Healthy human volunteers entered into the two double-blind, cross-over studies. An intra-oral appliance was custom-made for each subject. After brushing with an assigned dentifrice, each subject wore his or her appliance for four daytime hours (study 1) or 12 overnight hours (study 2). When the appliance was removed, it was washed, suspended in 0.1 M HCl to release Ca++ from deposits, and analyzed by Inductively Coupled Plasma (ICP) for deposited calcium. The three dentifrices studied were Colgate Simply White (CSW), Colgate Regular dentifrice (CR), and Colgate Tartar Control Whitening (CTW). There was a one-week wash-out period between each product use. RESULTS: There were no side effects observed or reported in either study. In both the four- and 12-hour studies, CSW and CTW had significantly lower calcium uptake compared to CR (p < 0.05). There was no statistical difference between CSW and CTW in efficacy. CONCLUSION: The results of this research demonstrate that Colgate Simply White dentifrice provides four- and 12-hour calculus control efficacy, superior to a standard dentifrice and comparable to a commercial anti-tartar dentifrice.

Analysis of the antibacterial activity and plaque control benefit of colgate total dentifrice via clinical evaluation and real-time polymerase chain reaction.

OBJECTIVE: This study analyzed, from a combined clinical and molecular biologic perspective, the antibacterial and antiplaque efficacy of Colgate Total dentifrice (CTD). METHODOLOGY: A single-blind crossover study design utilized 11 healthy human subjects. After a one-week washout period, subjects donated dental plaque, received a dental prophylaxis, and subsequently brushed with a test product. Twenty-four hours postbrushing, dental plaque was collected and a clinical plaque score determined. Dental plaque was submitted for Real-time Polymerase Chain Reaction (Real-time PCR) analysis. The same procedure was repeated in accordance with a crossover design for the use of the second test product. Following a one-week washout, a plaque donation, prophylaxis, and brushing with the test product ensued for each subject. Twenty-four hours post-brushing, the subjects returned for a plaque score and plaque donation. RESULTS: Twenty-four hours after brushing, dental plaque coverage increased 17.88% +/- 8.27% with CTD, compared to 30.42% +/- 9.97% with Colgate Cavity Protection (CCP; p = 0.005). Real-time PCR found plaque collected 24 hours after brushing with CTD exhibited, on average, fewer representative periodontal pathogens (Fusobacterium nucleatum, Actinobacillus actinomycetemcomitans, Tannerella forsythensis, and Porphyromonas gingivalis) and fewer early colonizers (Actinomyces naeslundii) than plaque collected before brushing, whereas CCP showed a moderate effect on oral bacteria. CONCLUSION: The study provides clinical and molecular biological evidence to substantiate the antibacterial and plaque control benefits of Colgate Total, and suggests the value of combining a molecular biological method with clinical research to corroborate clinical benefits.

Effectiveness of a triclosan/copolymer dentifrice on microbiological and inflammatory parameters.

According to the US Surgeon General's report, "Oral Health in America," published in 2000, most adults in the United States show some degree of periodontal pathology, with severe periodontal diseases affecting about 14% of middle-aged adults. Periodontal diseases are polymicrobial-induced inflammatory diseases, and they vary from mild gingival inflammation to severe deterioration of the periodontium, ie, loss of periodontal supportive tissues and, ultimately, tooth loss. New evidence shows that periodontal diseases may impact systemic health. For this reason, the maintenance of a healthy mouth is becoming increasingly important for the overall health of the body. This article summarizes laboratory research conducted during the development of a novel, multibenefit, oral-care technology based on triclosan--a broad-spectrum antibacterial agent--and a polyvinylmethylether/maleic acid copolymer. This unique combination of agents is found in Colgate Total, a clinically proven efficacious dentifrice for control of dental plaque and gingivitis. Data are presented that demonstrate the unique antibacterial properties of this dentifrice: (1) a broad-spectrum antimicrobial profile; (2) the long-lasting retention of triclosan on hydroxyapatite and epithelial cells; and (3) molecular evidence of antibacterial activity against specific pathogens in clinical dental plaque. In addition, data are presented that demonstrate the anti-inflammatory effects of triclosan on specific cytokines, the interruption of inflammatory pathways, and the inhibition of bone resorption. Overall, these data support the multibenefit clinical effects of Colgate Total and suggest a plurality of mechanisms of action.

Safety profile of a new liquid whitening gel.

Colgate Simply White Clear Whitening Gel, an at-home tooth-whitening product purchased over the counter, contains 18% carbamide peroxide (equivalent to 6.5% hydrogen peroxide) as the active ingredient in a brush-applied liquid gel. The excipients include ingredients commonly used in dentifrices. The potential for effects on the tooth pulp, oral soft tissue irritation, enamel damage, and tooth sensitivity with this peroxide-containing product have been evaluated. An in vitro study demonstrated that pulpal chamber hydrogen peroxide levels are well below those considered to cause an effect on pulpal tissue. An exaggerated-use (4 applications per day for 3 weeks) clinical study showed that no oral irritation occurred during 3 weeks of use. A study measuring peroxide salivary concentration after use of Colgate Simply White Clear Whitening Gel showed that the concentration of peroxide in the saliva after use of the product was extremely low, further supporting the position that this product has a low potential for causing oral irritation. Additional studies demonstrate that Colgate Simply White Clear Whitening Gel does not harm the enamel surface or produce demineralization after exposure equivalent to 3 weeks of normal use and over 6 weeks of exaggerated use. Colgate Simply White Clear Whitening Gel has not produced oral irritation (hard and soft tissues) or tooth hypersensitivity in a clinical subject population of 141 individuals using varying treatment regimens. These studies prove that Colgate Simply White Clear Whitening Gel is safe for daily use as directed.

The development of a new dental probe and a new plaque index.

OBJECTIVE: A curved periodontal probe has been developed to measure the length of newly formed plaque along the gingival margin of a tooth and the length of the entire gingival margin of the tooth. Plaque is expressed as a percent of the tooth's gingival margin, and is defined as the Modified Gingival Margin Plaque Index (MGMPI). The purpose of this research was to evaluate the efficacy of three marketed antiplaque products using the MGMPI. METHODOLOGY: A series of three clinical studies, involving five separate trials, was conducted. Three marketed antiplaque products were tested; PerioGuard mouthrinse, Colgate Total dentifrice and Colgate Total Plus Whitening dentifrice. Using a cross-over design, the efficacy of these test products on plaque formation was compared to Colgate Regular dentifrice. Plaque was evaluated before, and 24 hours after a single use of the above products using the MGMPI. RESULTS: In all studies conducted, plaque formation, as measured by the MGMPI, significantly increased over a 24-hour period. There were no significant differences in 24-hour scores between the test and control products evaluated. When the change from baseline to 24 hours was analyzed, the test products resulted in a consistently and significantly (p < 0.05) lower MGMPI mean score than the Colgate Regular dentifrice control. CONCLUSION: A new method has been developed that can measure plaque formation along the gingival margin.

New laboratory methods to study tooth surface coverage and interproximal plaque control by dentifrice products.

OBJECTIVE: To develop and test an in vitro tooth model for use in conjunction with laboratory methods to study interproximal effects and efficacy of dentifrices. The application of the model should offer visual evaluation of dentifrice coverage of the tooth surface, and measure dental plaque control at posterior interdental spaces with a dentifrice. METHODOLOGY: The dentifrice products tested with the model were: Colgate Total 2 in 1 Toothpaste and Mouthwash (CTTM), Colgate Total dentifrice (CTD), and Colgate Regular dentifrice (CRD). Extracted human posterior teeth were disinfected, cleaned, aligned, and mounted in denture acrylic. In the area coverage method, tooth surface coverage and penetration of two different forms of dentifrice products (CTTM and CRD) were compared using digital photography. In the interproximal plaque control method, the teeth were coated with human saliva and incubated anaerobically with a mixture of representative oral bacteria for six hours at 37 degrees C. In vitro dental plaque was assessed after brushing the facial surface with one of the three dentifrice products using a clinical plaque scoring index. RESULTS: The area coverage method demonstrated that both dentifrice products tested covered approximately 70% of the facial tooth surface; the CTTM dentifrice coverage on the lingual tooth surface was significantly higher than the coverage for the CRD dentifrice. With the interproximal plaque control method, in the presence of an active ingredient, the CTTM dentifrice had equivalent efficacy to the CTD dentifrice. Both CTTM and CTD were significantly superior to the CRD for interproximal dental plaque control. CONCLUSION: Using the developed tooth model, two assessment methods have been shown to have the potential to demonstrate tooth surface coverage, and to assess the potential efficacy of a dentifrice for the control of interproximal dental plaque. This process can indicate potential clinical evaluation of an oral care product, and support clinical findings with controlled evidence.

Global metabolomic analysis of human saliva and plasma from healthy and diabetic subjects, with and without periodontal disease.

Recent studies suggest that periodontal disease and type 2 diabetes mellitus are bi-directionally associated. Identification of a molecular signature for periodontitis using unbiased metabolic profiling could allow identification of biomarkers to assist in the diagnosis and monitoring of both diabetes and periodontal disease. This cross-sectional study identified plasma and salivary metabolic products associated with periodontitis and/or diabetes in order to discover biomarkers that may differentiate or demonstrate an interaction of these diseases. Saliva and plasma samples were analyzed from 161 diabetic and non-diabetic human subjects with a healthy periodontium, gingivitis and periodontitis. Metabolite profiling was performed using Metabolon's platform technology. A total of 772 metabolites were found in plasma and 475 in saliva. Diabetics had significantly higher levels of glucose and α-hydroxybutyrate, the established markers of diabetes, for all periodontal groups of subjects. Comparison of healthy, gingivitis and periodontitis saliva samples within the non-diabetic group confirmed findings from previous studies that included increased levels of markers of cellular energetic stress, increased purine degradation and glutathione metabolism through increased levels of oxidized glutathione and cysteine-glutathione disulfide, markers of oxidative stress, including increased purine degradation metabolites (e.g. guanosine and inosine), increased amino acid levels suggesting protein degradation, and increased ω-3 (docosapentaenoate) and ω-6 fatty acid (linoleate and arachidonate) signatures. Differences in saliva between diabetic and non-diabetic cohorts showed altered signatures of carbohydrate, lipid and oxidative stress exist in the diabetic samples. Global untargeted metabolic profiling of human saliva in diabetics replicated the metabolite signature of periodontal disease progression in non-diabetic patients and revealed unique metabolic signatures associated with periodontal disease in diabetics. The metabolites identified in this study that discriminated the periodontal groups may be useful for developing diagnostics and therapeutics tailored to the diabetic population.