Over-the-counter products in tooth bleaching: A scoping review.

OBJECTIVE: To map and summarize the current scientific evidence concerning the active ingredients, effectiveness, and adverse effects of over-the-counter (OTC) bleaching products. DATA AND SOURCE: This study was conducted according to the PRISMA-ScR guidelines for scoping reviews and registered on the Open Science Framework platform. STUDY SELECTION: Database searches were conducted in PubMed/MEDLINE, Embase, and Scopus up to January 2024. All in vitro, in situ, and clinical studies evaluating the effectiveness and adverse effects of OTC bleaching products were included. A descriptive analysis of the included studies was performed. RESULTS: A total of 88 studies were included. Most of them were in vitro studies (n = 49), followed by randomized clinical trials (n = 28). The main OTC bleaching products identified were whitening or stain-removing toothpastes (n = 42), followed by whitening strips (n = 39). Most clinical studies indicate that whitening strips are effective in improving tooth color and providing whitening benefits. In contrast, the bleaching effectiveness of toothpastes, mouth rinses and whitening trays was mainly supported by in vitro studies. The main adverse effects associated with OTC bleaching agents were tooth sensitivity and gingival irritation. CONCLUSION: A wide variety of OTC bleaching products is available for consumer self-administered use. Clinical studies have mainly confirmed the bleaching effectiveness of whitening strips, while the validation for toothpastes, mouth rinses and whitening trays has mainly relied on in vitro studies. Nevertheless, the use of OTC bleaching products may result in adverse effects, including tooth sensitivity, gingival irritation, and enamel surface changes. CLINICAL SIGNIFICANCE: Some over-the-counter bleaching products may have whitening properties supported by clinical studies, particularly those containing hydrogen or carbamide peroxide. Nonetheless, clinicians must be aware of the potential risks associated with excessive self-administration of these products, which may result in adverse effects.

The in vitro Effect of Dentifrices With Activated Charcoal on Eroded Teeth.

AIM: The objective of this research was to compare the abrasive potential of dentifrices containing activated charcoal with those of a conventional dentifrice on the development of erosive tooth wear (ETW) in vitro. METHODS: Enamel and dentin samples were divided into toothpastes (n = 12): group (G)1-Colgate Triple Action (1450 ppm F) (positive control); G2-Colgate Natural Extracts (1450 ppm F); G3-Colgate Luminous White Activated Carbon (1450 ppm F); G4-Oral-B Whitening Therapy Charcoal (1100 ppm F); G5-Oral-B 3D White Mineral Clean (1100 ppm F); G6-Curaprox Black Is White (950 ppm F); and G7-erosion only (no abrasion, negative control). All samples were submitted to erosive pH cycles and G1 to G6 to abrasive challenges (15 seconds) using toothpastes' slurries plus 45 seconds of treatment for 7 days. The final profile was overlaid to the baseline one for the ETW calculation (µm). The data were subjected to analysis of variance/Tukey or Kruskal-Wallis/Dunn tests (P < .05). RESULTS: Oral-B 3D White (13.0 ± 1.0, 9.37 [1.36] µm), Oral-B Whitening Therapy (15.1 ± 1.2, 8.58 [1.71] µm), and Colgate Luminous White (13.6 ± 1.0, 7.46 [0.94] µm) toothpastes promoted the greatest enamel and dentin wear. On the other hand, Colgate Triple Action (12.2 ± 1.2, 5.30 [1.26] µm), Colgate Natural Extracts (10.8 ± 1.1, 4.16 [1.11] µm), and Curaprox Black Is White (11.5 ± 1.5, 4.06 [0.92] µm) toothpastes promoted lower wear values, similar to erosion only (4.16 [0.94] µm) in the case of dentin but not enamel (7.1 ± 0.8 µm). CONCLUSIONS: Toothpastes containing charcoal combined with pyrophosphate may have a high abrasive effect on eroded tooth surfaces. Many patients influenced by digital marketing use toothpastes containing activated charcoal with the aim of bleaching their teeth. However, care should be taken when using these products, as they may have a high abrasive effect.

Fluorose por ingestão voluntária de pasta fluoretada após os 5 anos de idade: relato de caso e discussão da importância da educação em saúde bucal na 1a infância / Fluorosis from voluntary ingestion of fluoride paste after 5 years of age: case report and discussion of the importance of health education in early childhood

Introdução: Preocupações com a ingestão de pasta fluoretada por crianças se limita à primeira infância devido ao risco de fluorose nos dentes permanentes anteriores, mas o processo educativo para garantir uma segurança para toda a dentição tem sido negligenciado. Objetivo: Relatar um caso de fluorose dentaria em dentes caninos, pré-molares e 2o molares por ingestão voluntária de pasta fluoretada Relato do caso: Paciente de 12 anos, 65 kg, procurou atendimento odontológico devido a insatisfação com a coloração dos dentes posteriores. Constatou-se que os dentes caninos, pré-molares e segundo molares, superiores e inferiores apresentavam opacidades tipo fluoróticas, estando os demais normais. Entre as possíveis causas, a principal recaiu sobre o modo que a criança passou a escovar os dentes após os 5 anos de idade. Foi relatado que ela voluntariamente escovava seus dentes 6x/dia sem cuspir. Foram feitas análises da concentração de fluoreto da água consumida pela paciente e nas pastas usadas. Também foi feito teste de excreção de fluoreto urinário pela paciente, solicitando para ela escovar os dentes cuspindo ou engolindo toda a pasta em uso. Resultados: Na água foi encontrado 0,74 mg F/L e nas pastas usadas 1.357 e 1.426 mg F solúvel/ kg. Na urina foi encontrado 0,90 e 1,35 mg F, respectivamente, cuspindo ou engolindo a pasta após as escovações. Foi estimado que a partir dos 5 anos de idade, a criança se submeteu à dose de 0,17 mg F/dia/kg de peso corpóreo, a qual é 2,4 vezes maior que o limite superior de risco de fluorose. Conclusão: O caso relatado sugere ser uma consequência de falha do processo de educação em saúde na 1a infância quanto ao uso racional de dentifrício fluoretado.

Introduction: Concerns about children's intake of fluoride toothpaste are limited to infancy due to the risk of fluorosis in the permanent anterior teeth, but the educational process to ensure safety for the entire dentition has been neglected. Objective: To report a case of dental fluorosis in canine, premolar and 2nd molar teeth caused by voluntary ingestion of fluoride toothpaste. Case report: A 12- year-old patient, 65 kg, search dental care due to dissatisfaction with the color of the posterior teeth. It was diagnosticated that the superior and inferior canine, premolar and second molar teeth had fluorotic opacities, and the other teeth are sound. Among the possible causes, the main one was the way the child started brushing their teeth after 5 years of age. It was reported that she voluntarily brushed her teeth 6x/day without spitting. Analyzes of the fluoride concentration in the water consumed by the patient and in the toothpastes used were performed. A urinary fluoride excretion test by the patient, requesting her to brush her teeth by spitting out or swallowing all the toothpaste in use, was made. Results: Fluoride concentration in the water was 0.74 mg F/L and 1,357 and 1,426 mg F/kg in the toothpastes pastes used. In urine test, 0.90 and 1.35 mg F were found, respectively, spitting or swallowing the toothpaste after brushing. It was estimated that from 5 years of age, the child was submitted a dose of 0.17 mg F/day/kg of body weight, which is 2.4 times the upper limit for an acceptable fluorosis. Conclusion: The reported case suggests that it is a consequence of the failure of the health education process in early childhood regarding the rational use of fluoride toothpaste.

Do commercial whitening dentifrices increase enamel erosive tooth wear?

OBJECTIVE: This in vitro study evaluated the effect of commercial whitening dentifrices on erosive tooth wear (ETW) of bovine enamel samples, in comparison with commercial regular dentifrices. METHODOLOGY: Sixty bovine crowns were embedded in acrylic resin, polished and then had their baseline profile determined. They were randomly assigned to 5 groups (n=12/group), according to the type of commercial dentifrice to be tested: GI - Crest Anti-cavity Regular; GII - Crest 3D White; GIII - Colgate Total 12 Clean Mint; GIV - Colgate Optic White; GV - Placebo (negative control, fluoride-free dentifrice). The samples were submitted to daily erosive and abrasive challenges for 3 days. The erosive challenges were performed 3 times a day by immersing the specimens in 0.1% citric acid solution (pH 2.5) for 90 s. Each day after the first and last erosive challenges, the specimens were subjected to the abrasive challenge for 15 s, using a toothbrushing machine (Biopdi, São Carlos, SP, Brazil), soft toothbrushes and slurry (1:3 g/ml) of the tested toothpastes (1.5 N). The specimens were kept in artificial saliva between the challenges. The final profile was obtained and the ETW (µm) was calculated. Data were analyzed by Kruskal-Wallis and Dunn's tests (p<0.05). RESULTS: All dentifrices tested significantly reduced the enamel wear in comparison with the Placebo, except GIII. The median (95% CI) ETW was 1.35 (1.25-1.46)bc for GI, 1.17 (1.01-1.34)cd for GII, 1.36 (1.28-1.45)ab for GIII, 1.08 (1.04-1.14)d for GIV and 2.28 (2.18-2.39)a for GV. CONCLUSION: When dentifrices from the same manufacturer were compared, the whitening dentifrices led to similar or less wear than the regular ones.

Do commercial whitening dentifrices increase enamel erosive tooth wear?

Abstract Objective This in vitro study evaluated the effect of commercial whitening dentifrices on erosive tooth wear (ETW) of bovine enamel samples, in comparison with commercial regular dentifrices. Methodology Sixty bovine crowns were embedded in acrylic resin, polished and then had their baseline profile determined. They were randomly assigned to 5 groups (n=12/group), according to the type of commercial dentifrice to be tested: GI - Crest Anti-cavity Regular; GII - Crest 3D White; GIII - Colgate Total 12 Clean Mint; GIV - Colgate Optic White; GV - Placebo (negative control, fluoride-free dentifrice). The samples were submitted to daily erosive and abrasive challenges for 3 days. The erosive challenges were performed 3 times a day by immersing the specimens in 0.1% citric acid solution (pH 2.5) for 90 s. Each day after the first and last erosive challenges, the specimens were subjected to the abrasive challenge for 15 s, using a toothbrushing machine (Biopdi, São Carlos, SP, Brazil), soft toothbrushes and slurry (1:3 g/ml) of the tested toothpastes (1.5 N). The specimens were kept in artificial saliva between the challenges. The final profile was obtained and the ETW (µm) was calculated. Data were analyzed by Kruskal-Wallis and Dunn's tests (p<0.05). Results All dentifrices tested significantly reduced the enamel wear in comparison with the Placebo, except GIII. The median (95% CI) ETW was 1.35 (1.25-1.46)bc for GI, 1.17 (1.01-1.34)cd for GII, 1.36 (1.28-1.45)ab for GIII, 1.08 (1.04-1.14)d for GIV and 2.28 (2.18-2.39)a for GV. Conclusion When dentifrices from the same manufacturer were compared, the whitening dentifrices led to similar or less wear than the regular ones.

Efecto de una Pasta Dental Comercial Conteniendo Xilitol Sobre el Recuento de Streptococcus Mutans en Saliva de Gestantes: Ensayo Clínico Controlado Aleatorizado / Effect of a Commercial Toothpaste Containing Xylitol on the Count of Streptococcus Mutans in Saliva of Pregnant Women: Randomized Controlled Clinical Trial

RESUMEN: El objetivo del presente trabajo fue determinar el efecto de una pasta dental comercial conteniendo xilitol sobre el recuento de Streptococcus mutans en saliva de gestantes. El presente fue un ensayo clínico, a doble ciego, que se realizó en el Centro de Salud "José Olaya" (Chiclayo Perú), en enero de 2017. Se trabajó con una población muestral de 50 gestantes en el segundo trimestre que cumplieron con los criterios establecidos, distribuyéndolas en dos grupos: 25 gestantes usaron pasta dental con 10 % de xilitol y 25 gestantes usaron pasta dental sin xilitol. Se les tomó y procesó microbiológicamente una muestra de saliva antes del inicio del estudio y 14 días después del uso de las respectivas pastas. Se realizó el recuento de unidades formadoras de colonias (UFC) de Streptococcus mutans en saliva con una confiabilidad altamente significativa mediante el Coeficiente de Correlación Intraclase, calibración intra e interexaminador (1,000 y 0,999, respectivamente). El análisis de los datos se realizó mediante la prueba U de Mann-Whitney, considerando un nivel de significancia del 5 %. No se encontró diferencia entre las gestantes que emplearon pasta dental con xilitol en comparación con las que utilizaron pasta sin xilitol (p=0,062). Se concluyó que el efecto de la pasta dental comercial conteniendo xilitol es similar a una pasta sin xilitol sobre el recuento de Streptococcus mutans en saliva de gestantes.

ABSTRACT: The objective of the present study was to determine the effect of a commercial toothpaste containing xylitol on the counts of Streptococcus mutans in saliva of pregnant women. The present was a double-blind clinical trial performed at the "José Olaya" health Centre (Chiclayo Peru) in January 2017. We worked with a sample population of 50 pregnant in the second trimester that met the established criteria, distributing in two groups: 25 pregnant women used toothpaste with 10 % xylitol and 25 pregnant used toothpaste without xylitol. They were taken and microbiologically processed a sample of saliva before the start of the study and 14 days after the use of the respective toothpastes. The Colony-forming units (CFU) of Streptococcus mutans in saliva were counted with a highly significant reliability through the intraclass correlation coefficient, Intra-and Interexaminer calibration (1.000 and 0.999, respectively). Data analysis was performed using the Mann-Whitney U test, considering a 5 % significance level. No difference was found among the pregnant women who used xylitol toothpaste compared to those who used toothpaste without xylitol (p = 0,062). It was concluded that the effect of xylitol containing commercial toothpaste is similar to a toothpaste without xylitol on the count of Streptococcus mutans in the saliva of pregnant women.

Ventajas y riesgos del uso de pastas dentales con nanotecnologías / Advantages and hazzards of the use of nanotechnology in toothpastes

El presente artículo de actualización analiza las ventajas y riesgos del uso de nanopartículas en pastas dentales. La nanotecnología puede mejorar sus propiedades ayudando al proceso de remineralización del diente, controlar el crecimiento bacteriano o proporcionar minerales para mejorar el control del pH. Con este fin se han agregado: nanohidroxiapatita, nanocalcio, fosfato de calcio, trimetafosfato de sodio, nanopartículas de plata, quitosán, entre otras. Por otro lado, se han descripto algunos efectos nocivos de estas nanotecnologías, lo que nos motiva a intensificar su estudio. CONCLUSIONES: La nano-odontología ha otorgado nuevas herramientas para la atención preventiva de la salud. La toxicidad oral para los nanodentífricos es baja, pero algunos pueden llegar al intestino, y a través de él a la circulación sanguínea y causar disturbios sistémicos. Es necesario profundizar las investigaciones en estos materiales, a fin de mejorar sus efectos beneficiosos, e identificar y eliminar sus riesgos para la salud. (AU)

The present update article analyzes advantages and risks of nanoparticles in relation to toothpastes. Nanotechnology can improve its properties by helping to remineralize the tooth, control bacterial growth or provide minerals to optimize pH control. For this purpose, anohydroxyapatite, nanocalcium, calcium phosphate, sodium trimetaphosphate, silver nanoparticles, chitosan, among others have been added. On the other hand, some harmful effects of these nanotechnologies have been described, which motivates us to intensify their study. CONCLUSIONS: Nano-dentistry has provided new tools for preventive health care. The oral toxicity for nanodentífricos is low, but some can reach the intestine, and through it to the blood circulation and cause systemic disturbances. It is necessary to deepen the investigations in these materials, in order to improve their beneficial effects, and identify and eliminate their health risks.

The abrasive effect of commercial whitening toothpastes on eroded enamel.

PURPOSE: To evaluate the in vitro abrasive effect of commercial whitening toothpastes on eroded bovine enamel samples in respect to erosive tooth wear. METHODS: 72 bovine crowns were embedded, polished and subjected to the baseline profile analysis. The samples were then protected in 2/3 of the enamel surface and were randomly assigned to six groups (n= 12/group): G1: Oral-B 3D White, G2: Close-up Diamond Attraction Power White, G3: Sorriso Xtreme White 4D, G4: Colgate Luminous White, G5: Crest (conventional toothpaste), G6:erosion only (control). All samples were submitted to an erosive pH cycling (4 x 90 seconds in 0.1% citric acid, pH 2.5, per day) and abrasive challenges (2 x 15 seconds, per day) for 7 days. After the first and the last daily cycles, the samples were subjected to abrasive challenges, using a toothbrushing machine, soft toothbrushes and slurry of the tested toothpastes (1.5 N). Between the challenges, the samples were immersed in artificial saliva. The final profile was obtained and overlaid to the baseline profile for the calculation of the erosive tooth wear (µm). The data were subjected to Kruskal-Wallis/Dunn tests (P< 0.05). RESULTS: G1 promoted the highest enamel wear (3.68±1.06 µm), similarly to G3 (3.17± 0.80 µm) and G4 (3.44± 1.29 µm). G3 and G4 performed similarly between them and compared with G5 (2.35± 1.44 µm). G2 (1.51± 0.95 µm) and G6 (0.85± 0.36 µm) showed the lowest enamel wear, which did not differ between them and from G5. Oral-B 3D White showed the highest abrasive potential while Close-up Diamond Attraction Power White showed the lowest abrasive potential on eroded enamel in vitro. CLINICAL SIGNIFICANCE: This study showed that some commercial whitening toothpastes, especially those containing pyrophosphate associated with hydrated silica, enhanced enamel erosive wear.

Independent and Additive Effects of Different Sources of Fluoride and Dental Fluorosis.

PURPOSE: To investigate the contribution of different sources of fluoride related to dental fluorosis. METHODS: This population-based, matched, case-control study (67 pairs) used a representative sample of 271 schoolchildren. Dental fluorosis was measured using Dean's index. Children's caregivers were interviewed about nine risk factors. Data were analyzed using conditional logistic regression. RESULTS: The prevalence of questionable cases was 18.8 percent, and the prevalence of very mild, mild, or moderate cases of dental fluorosis was 11.5 percent, with no severe case. Age of start of toothbrushing, drinking water from wells, frequency of toothbrushing, type of tooth-paste, standard/ children's mouthrinse usage, and fluoride supplements were not significant (P>0.15). Drinking water from wells and using supplements were underpowered (N less than six). Children who frequently ate toothpaste had an odds ratio of 5.56 (95% confidence interval (CI) 1.75 to 17.73) times more fluorosis; those applying toothpaste to cover the bristles had 5.55 times more fluorosis (95% CI 1.44 to 21.42); and those using an adult size toothbrush had 3.17 times more flurosis (95% CI 1.15 to 8.71). There was a significant additive interaction (P<0.01). CONCLUSION: In a community with water fluoridation, the factors associated with dental fluorosis are intentional toothpaste ingestion and tooth-paste applied on the whole toothbrush.

Relationship between toothpastes properties and patient-reported discomfort: crossover study.

OBJECTIVES: This study aims to correlate patient-reported reactions with in vitro analyses of the pH, abrasive quality, and cytotoxicity of four toothpastes. MATERIALS AND METHODS: One hundred twenty-one patients received non-identified samples of toothpaste to be used for 6 days and answered a questionnaire about their sensations. In vitro analysis: the pH of toothpastes was measured with a pH meter. The abrasivity of toothpastes was evaluated against composite resin specimens (n = 10). A toothbrushing machine was used to simulate wear, which was indirectly measured by mass loss using a scale. Cell culture media conditioned with toothpaste were used to assess the cytotoxicity. Confluent cells were kept in contact with the conditioned media or control for 24 h. The cell viability was measured using the 3-(bromide, 4,5-dimethylthiazol-2yl)-2,5-diphenyltetrazolium (MTT)-reduction assay. The obtained data on the pH, weight loss, and cell viability were compared by ANOVA/Tukey's tests (p < 0.05). RESULTS: With the exception of the bleaching effect paste, the Oral B® paste produced the highest frequencies of irritation reports, tooth sensitivity, taste discomfort, and texture discomfort in the clinical study; patients also reported rougher teeth, soft tissue peeling, dry mouth, thrush, tingling, and taste changes in response to this paste. The in vitro analysis demonstrated that Oral B® had the lowest pH, the highest abrasivity, and produced the lowest cell viability (p < 0.01). CONCLUSION: Results suggest that low pH toothpastes that are highly abrasive and cytotoxic may cause undesirable reactions in patients. CLINICAL RELEVANCE: Toothpaste's properties should be well known for indication to patient therefore minimizing discomfort reports.

Efetividade de dentifrícios clareadores sobre esmalte de dentes bovinos / Effectiveness of whitening dentifrices on bovine teeth enamel

Introdução: devido à insatisfação relatada pelos pacientes com a coloração dos dentes e a busca por procedimentos que envolvam estética do sorriso associado com o desenvolvimento de técnicas e materiais amplamente propagados na mídia, as empresas responderam com a oferta no mercado de uma variedade de opções de dentifrícios que propõem efeito clareador prático e rápido. Objetivo: avaliar a efetividade de dentífricos clareadores em diferentes formas de apresentação sobre esmalte de dentes bovinos. Material e Métodos: quinze dentes bovinos foram imersos diariamente por um período de 1 hora em refrigerante a base de cola e em seguida foram divididos equitativamente em três grupos, onde cada grupo foi escovado com um dentifrício especifico por 2 minutos. O grupo A foi escovado com dentifrício Colgate Luminous White (Colgate ­ Palmolive), em forma de pasta, o grupo B com dentifrício Closeup Diamond Attraction Delicate White (Unilever) em forma de gel e o grupo C com dentifrício Oral-B Complete (Procter & Gamble) em forma de pasta. Resultados: as diferentes formas de apresentação estudadas foram efetivas na remoção das manchas extrínsecas em dentes bovinos; O dentifrício Colgate Luminous White na forma de apresentação pasta clareador apresentou-se mais efetivo na remoção das manchas extrínsecas; O dentifrício Oral ­ B Complete na forma de pasta foi efetivo, porém em menor intensidade em comparação aos dentifrícios clareadores estudados. Conclusão: as diferentes formas de apresentação dos dentifrícios utilizados foram efetivas na remoção de manchas extrínsecas.

Introduction: due to dissatisfaction reported by patients with tooth staining and the search for procedures involving smile aesthetics associated with the development of techniques and materials widespread on social medias, companies responded by offering to the market a variety of toothpaste choices in order to provide practical and fast bleaching effects. However, these dentifrices appear to have a limited efficiency since they only contain abrasives for the removing of extrinsic tooth stain. Objective: his research aimed to assess the effectiveness of different forms of presentation of bleaching agents on bovine teeth enamel. Methods: daily, fifteen bovine teeth were immersed in cola soft drink for a period of 1 hour and then they were divided into three groups (each group containing five bovine teeth). Each group was brushed with a specific dentifrice for 2 minutes: the group A was brushed with Colgate Luminous White in paste form (Colgate ­ Palmolive); the Group B with Diamond Closeup Attraction Delicate White in gel form (Unilever), and the group C with Oral-B complete in paste form (Procter & Gamble). Results: color change was observed through photographs and analysis of the interpreted samples based on the theoretical background. Conclusion: the dentifrices used were able to remove extrinsic stains and the bleaching dentifrice Colgate Luminous White was more effective as a result in this connection.

Factors associated with dental fluorosis in school children in southern Brazil: a cross-sectional study.

This cross-sectional study assessed risk factors for dental fluorosis (DF) among 8- to 12-year-old children in southern Brazil. Children attending 20 schools were randomly selected (n=1,196). They were interviewed and their parents answered a questionnaire that was sent home. Prevalence of DF was 8.53% (modified Dean's criteria), and the prevalence of severe DF was 0.17%. The results of multiple logistic regression analyses indicated that DF was associated with a higher frequency of tooth brushing and with initial use of fluoride toothpaste at the emergence of the first tooth. DF does not constitute a public health problem in southern Brazil.

Enamel erosion and prevention efficacy characterized by confocal laser scanning microscope.

The aim of this study was to evaluate the erosion-inhibiting effect of two toothpastes on the development of erosion-like lesions, by a confocal laser scanning microscope (CLSM). Forty human enamel blocks were divided into five groups (n = 8), in accordance to evaluate the GC MI Paste Plus and Oral B with stannous fluoride, applied as slurries and associated with toothbrush. Specimens were submitted to an erosion challenge from citric acid (0.5%, pH = 2.8), for 5 min, six times a day, alternating in artificial saliva immersions. Reference group was not exposed to treatment. Part of specimens (Groups 02 and 03) was exposed twice daily just to slurries, for 2 min, therefore specimens from Groups 04 and 05 were also abraded, for 30 s. The enamel surfaces were morphological characterized using CLSM images, with mineral loss being measured using the resulting 3D images referenced to an un-challenged portion of the sample. Step values were compared using the one-way ANOVA test. CLSM was shown to be a viable, noncontact, and simple technique to characterize eroded surfaces. The statistical difference in the step size was significant between the groups (P = 0.001) and using multiple comparisons a statistically significant protective effect of toothpastes was shown when these were applied as slurries. Although groups submitted to tooth brush showed mineral loss similar to reference control group, due to the damages of abrasion associated.

Mouthwashes with hydrogen peroxide are carcinogenic, but are freely indicated on the Internet: warn your patients!

It all began in Ancient Egypt where people used to bleach their teeth with antiseptic mouthwashes made of urea from human urine. Teeth harmony is promoted by expression of feelings, communication, a real window of the brain and its content! Tooth bleaching products are medicines, not cosmetics! Mouth washing with hydrogen peroxide is an illogical and dangerous procedure! Hydrogen peroxide must be used in one's mouth only when employed by a dentist who has been properly instructed to protect the mucosa, preventing it from receiving these products. How and for how long these products are going to be used require caution in order to avoid or decrease any adverse effects on the tissues. Many websites instruct people on how to purchase and prepare hydrogen peroxide so that it is used as an antiseptic mouthwash and tooth bleaching agent. Some websites even refer to dentists as "exploiters", accusing them of not instructing patients properly. In this article, we aim at providing evidence and information upon which dentists and assistants may base their thinking as well as their opinion and procedures regarding "the indiscriminate and free use of hydrogen peroxide in the mouth, on teeth and oral mucosa". Those websites, blogs and social network profiles trespass the limits of public trust and should be immediately sued by the government for committing a crime against public health.

The influence of desensitizing dentifrices on pain induced by in-office bleaching.

The purpose of this study was to evaluate whether the use of desensitizing dentifrices used 15 days prior to and after in-office tooth bleaching could eliminate or reduce tooth sensitivity. After institutional review board approval and informed consent, 45 subjects were selected and divided into 3 groups according to the dentifrice selected: Colgate Total (CT), Colgate Sensitive Pro-Relief (CS) or Sensodyne ProNamel (SP). The subjects used toothpaste and a toothbrush provided to them for 15 days prior to bleaching. They were then submitted to two in-office bleaching sessions (Whiteness HP Blue Calcium). Their tooth sensitivity was assessed using the Visual Analog Scale (VAS) for a week after each session. Their tooth shade alteration was measured with a Vitapan Classical shade guide to determine if the dentifrices could influence the effectiveness of the bleaching agent. The data were submitted to Wilcoxon, Kruskal-Wallis and Mann-Whitney tests (α = 0.05). The use of desensitizing dentifrices did not affect the bleaching efficacy. In regard to tooth sensitivity, there was a statistically significant difference between the results of the Control Group and Group T2 after the first session (p = 0.048). There was no statistically significant difference in the results for the other groups after the first session. In regard to the second session, there was no statistically significant difference in the results for all the groups. The use of a desensitizing dentifrice containing nitrate potassium reduced tooth sensitivity during the bleaching regimen. Dentifrices containing arginine and calcium carbonate did not reduce tooth sensitivity. Color change was not influenced by the dentifrices used.

The influence of desensitizing dentifrices on pain induced by in-office bleaching

The purpose of this study was to evaluate whether the use of desensitizing dentifrices used 15 days prior to and after in-office tooth bleaching could eliminate or reduce tooth sensitivity. After institutional review board approval and informed consent, 45 subjects were selected and divided into 3 groups according to the dentifrice selected: Colgate Total (CT), Colgate Sensitive Pro-Relief (CS) or Sensodyne ProNamel (SP). The subjects used toothpaste and a toothbrush provided to them for 15 days prior to bleaching. They were then submitted to two in-office bleaching sessions (Whiteness HP Blue Calcium). Their tooth sensitivity was assessed using the Visual Analog Scale (VAS) for a week after each session. Their tooth shade alteration was measured with a Vitapan Classical shade guide to determine if the dentifrices could influence the effectiveness of the bleaching agent. The data were submitted to Wilcoxon, Kruskal-Wallis and Mann-Whitney tests (α = 0.05). The use of desensitizing dentifrices did not affect the bleaching efficacy. In regard to tooth sensitivity, there was a statistically significant difference between the results of the Control Group and Group T2 after the first session (p = 0.048). There was no statistically significant difference in the results for the other groups after the first session. In regard to the second session, there was no statistically significant difference in the results for all the groups. The use of a desensitizing dentifrice containing nitrate potassium reduced tooth sensitivity during the bleaching regimen. Dentifrices containing arginine and calcium carbonate did not reduce tooth sensitivity. Color change was not influenced by the dentifrices used.

Mouthwashes with hydrogen peroxide are carcinogenic, but are freely indicated on the internet: warn your patients!

It all began in Ancient Egypt where people used to bleach their teeth with antiseptic mouthwashes made of urea from human urine. Teeth harmony is promoted by expression of feelings, communication, a real window of the brain and its content! Tooth bleaching products are medicines, not cosmetics! Mouth washing with hydrogen peroxide is an illogical and dangerous procedure! Hydrogen peroxide must be used in one's mouth only when employed by a dentist who has been properly instructed to protect the mucosa, preventing it from receiving these products. How and for how long these products are going to be used require caution in order to avoid or decrease any adverse effects on the tissues. Many websites instruct people on how to purchase and prepare hydrogen peroxide so that it is used as an antiseptic mouthwash and tooth bleaching agent. Some websites even refer to dentists as "exploiters", accusing them of not instructing patients properly. In this article, we aim at providing evidence and information upon which dentists and assistants may base their thinking as well as their opinion and procedures regarding "the indiscriminate and free use of hydrogen peroxide in the mouth, on teeth and oral mucosa". Those websites, blogs and social network profiles trespass the limits of public trust and should be immediately sued by the government for committing a crime against public health.

Tudo começou no Egito antigo, onde procurava-se clarear os dentes com bochechos antissépticos com ureia da urina humana. Os dentes se harmonizam com expressões de sentimentos, na comunicação, como uma verdadeira vitrine do cérebro e seus conteúdos! Clareadores dentários são medicamentos, e não cosméticos! Bochecho com água oxigenada representa um procedimento improcedente e perigoso! O uso do peróxido de hidrogênio ou água oxigenada na boca deve ser feito diretamente pelo profissional da Odontologia, treinado para proteger as mucosas contra o contato desses produtos. O tempo e a forma de uso requerem cuidados, para se proteger ou diminuir os efeitos indesejáveis sobre os tecidos. Vários websites "ensinam" como adquirir e preparar água oxigenada para fazer bochechos antissépticos e clarear os dentes. Alguns websites se referem ao profissional da Odontologia como um "explorador", por não ensinar isso ao paciente. No presente artigo, procuraremos informar e dar fundamentos para que os profissionais da Odontologia e auxiliares possam embasar suas reflexões, opiniões e condutas relacionadas ao tema "uso indiscriminado e livre de peróxido de hidrogênio na boca sobre os dentes e mucosa bucal". Esses websites, blogs e perfis em redes sociais abusam da fé pública e deveriam ser acionados judicialmente, imediatamente, pelas autoridades públicas, pelo crime contra a saúde das pessoas.

Fluorose dentaria em criancas de Sao Paulo, SP, 1998-2010 / Fluorosis dentaria en ninos de Sao Paulo, SP, 1998-2010 / Dental fluorosis in children from Sao Paulo, Southeastern Brazil, 1998-2010

OBJETIVO: Analisar a tendência de prevalência de fluorose dentária em crianças de 12 anos em contexto de exposição a múltiplas fontes de flúor. MÉTODOS: Realizou-se análise de tendência da prevalência de fluorose dentária no período de 1998 a 2010 na cidade de São Paulo, SP. As prevalências foram calculadas para diferentes anos (1998, 2002, 2008 e 2010), a partir de dados secundários obtidos em levantamentos epidemiológicos com amostras representativas da população de 12 anos de idade. A ocorrência de fluorose foi avaliada sob luz natural utilizando o índice de Dean, preconizado pela Organização Mundial da Saúde e categorizada em normal, questionável, muito leve, leve, moderada e severa. Em 1998 foram examinadas 125 crianças; 249 em 2002; 4.085 em 2008; e 231 em 2010. RESULTADOS: Em 1998 a prevalência de fluorose foi de 43,8% (IC95%35,6;52,8), em 2002 de 33,7% (IC95% 28,2;39,8), de 40,3% (IC95% 38,8;41,8) em 2008 e de 38,1% (IC95% 32,1;44,5) em 2010. As categorias muito leve + leve registraram 38,4% (IC95%30,3;47,6) em 1998, 32,1% (IC95% 26,6;38,2) em 2002, 38,0% (IC95% 36,5;39,5) em 2008 e 36,4% (IC95%30,4;42,7) em 2010. Não se observou fluorose severa com significância estatística. CONCLUSÕES: A prevalência de fluorose dentária em crianças paulistanas pode ser classificada como estacionária no período de 1998 a 2010, tanto em geral quanto ao se considerarem apenas as categorias muito leve + leve. .

OBJETIVO: Analizar la tendencia de prevalencia de fluorosis dentaria en niños de 12 años en contexto de exposición a múltiples fuentes de flúor. MÉTODOS: Se realizó análisis de tendencia de la prevalencia de fluorosis dentaria en el período de 1998 a 2010 en la ciudad de Sao Paulo, SP, Brasil. Las prevalencias fueron calculadas para diferentes años (1998, 2002, 2008 y 2010), a partir de datos secundarios obtenidos en pesquisas epidemiológicas con muestras representativas de la población de 12 años de edad. La ocurrencia de fluorosis fue evaluada bajo la luz natural utilizando el índice de Dean, recomendado por la Organización Mundial de la Salud y, categorizada como normal, cuestionable, muy leve, leve, moderada y severa. En 1998 fueron examinadas 125 niños; 249 en 2002; 4.085 en 2008 y 231 en 2010. RESULTADOS: En 1998 la prevalencia de fluorosis fue de 43,8% (IC95%35,6;52,8), en 2002 de 33,7% (IC95% 28,2;39,8), de 40,3% (IC95% 38,8;41,8) en 2008 y de 38,1% (IC95% 32,1;44,5), en 2010. Las categorías muy leve+leve registraron 38,4% (IC95%30,3;47,6) en 1998, 32,1% (IC95% 26,6;38,2) en 2002, 38,0% (IC95% 36,5;39,5) en 2008 y 36,4% (IC95%30,4;42,7) en 2010. No se observo fluorosis severa con significancia estadística. CONCLUSIONES: La prevalencia de fluorosis dentaria en niños paulistanos pudo ser clasificada como estacionaria en el período de 1998 a 2010, tanto en general como al considerar sólo las categorías muy leve+leve. .

OBJECTIVE: To assess the trend of dental fluorosis prevalence in 12-year-old children, in the context of exposure to multiple sources of fluoride. METHODS: An analysis was carried out of the trends in prevalence of dental fluorosis in the city of São Paulo, Southeastern Brazil, between 1998 and 2010. The rates of prevalence were calculated for different years (1998, 2002, 2008 and 2010) using secondary data obtained from epidemiological surveys of representative samples of 12-year-old children. Occurrence of fluorosis was assessed in natural light using the Dean index, recommended by the World Health Organization and categorized into normal, questionable, very mild, mild, moderate and severe. In 1998, 125 children were examined, 249 in 2002, 4,085 in 2008 and 231 in 2010. RESULTS: In 1998 the prevalence of fluorosis was 43.8% (95%CI 35.6;52.8) in 2002 it was 33.7% (95%CI 28.2;39.8), it was 40.3% (95%CI 38.8;41.8) in 2008 and 38.1% (95%CI 32.1;44.5) in 2010.The categories very mild + mild totaled 38.4% (95%CI 30.3;47.6) in 1998, 32.1% (95%CI 26.6;38.2) in 2002, 38.0% (95%CI 36.5;39.5) in 2008 and 36.4% (95%CI 30.4;42.7) in 2010. Severe fluorosis was not observed, with statistical significance, in the analyzed period. CONCLUSIONS: The prevalence of dental fluorosis in children from São Paulo can be classified as stationary between 1998 and 2010, both when considering all categories, and when considering only the categories very mild + mild. .

Effect of fluoride varnish supplemented with sodium trimetaphosphate on enamel erosion and abrasion: an in situ/ex vivo study.

OBJECTIVE: To evaluate the effect of fluoride (F) varnishes supplemented or not with sodium trimetaphosphate (TMP) on enamel erosive wear followed or not by abrasion in situ. METHODS: Ten volunteers were selected and randomly divided into four groups, according to the varnishes tested: placebo (no F or TMP), 5% NaF (positive control), 2.5% NaF and 2.5% NaF/5% TMP. Enamel blocks (n=4) were mounted in palatal devices and received an application of each test varnish, following a double-blind, crossover protocol. After 6h, varnishes were completely removed and the blocks were subjected to erosive challenges by ex vivo immersion in citric acid (5 min, 4×/dia, 5 days). Following, half of the blocks were subjected to abrasion by brushing with a placebo dentifrice slurry for 15s. Enamel wear (µm), surface hardness (SHf) and cross-sectional hardness (ΔKHN) were assessed after each experimental period. Results were analyzed by ANOVA, Student-Newman-Keuls's test and Pearson correlation coefficient (p<0.05). RESULTS: The fluoride varnish supplemented with TMP promoted significantly lower wear and ΔKHN when compared to the other groups after erosive challenges, followed or not by abrasion (p<0.05). As for (SHf) the fluoride varnish supplemented with TMP promoted similar results to the 5% NaF product, being significantly higher than the remaining groups after erosive and erosive+abrasive challenges (p<0.05). CONCLUSION: TMP significantly enhanced the effects of F on enamel wear after erosive challenges, followed or not by abrasion.