Cariostatic effects of a xylitol/NaF dentifrice in vivo.

Xylitol has been shown to reduce plaque acids, but its topical cariostatic effect has been equivocal. The purpose of the studies reported here was to optimise the xylitol/NaF combination in dentifrices for an improved anticaries activity. In the first study, the combination of 10 per cent xylitol with 1100 ppm F (NaF), 1100 ppm F (NaF), and placebo dentifrices were tested in a rat caries model to assess the cariostatic effect. The combination was significantly more effective than fluoride by itself (P = 0.05). The xylitol/NaF combination provided significantly more remineralisation of dentine than fluoride by itself. Collectively, results of these investigations confirm the improved anticaries effectiveness of the xylitol/NaF combination in a variety of animal and intra-oral models. A three-year clinical study confirmed these findings.

The effect of bicarbonate/fluoride dentifrices on human plaque pH.

The acidogenic response in dental plaque after rinsing with sodium bicarbonate/fluoride dentifrice slurries was studied using three intra-oral models. In the first model, resting plaque pH was monitored in mesiobuccal plaque on upper molars and premolars in six healthy subjects after abstinence from normal oral hygiene for three days. These measurements were followed by a three-minute rinse with 10% sucrose and, following a two-minute interval, a three-minute rinse with a test dentifrice slurry. After the test dentifrice rinse, pH was monitored at regular intervals up to 60 minutes. Flow rate, pH and buffer capacity of stimulated saliva were also determined. Changes in resting pH, plaque pH minima, and maximum pH drop were calculated. A clear elevation in the resting pH was observed after bicarbonate/fluoride dentifrice rinses, and a significant increase was obtained in the pH minima. The smallest pH drop also was found after treatment with the bicarbonate/fluoride dentifrice rinse treatment (p < 0.02). A second model using telemetric partial dentures with interproximally placed micro-antimony pH electrodes was used to study the effects of rinsing with increasing concentrations of sodium bicarbonate and calcium carbonate solutions, and with a fluoride dentifrice containing sodium bicarbonate. The response to these treatments was found to be rapid, dose-dependent, and was the greatest from the sodium bicarbonate. A third model used 24 subjects to assess the effects of sodium bicarbonate/fluoride dentifrice on plaque pH before and after a glucose challenge. The use of the bicarbonate/fluoride dentifrice resulted in significantly less measurable plaque acid than the fluoride dentifrice treatment. Collectively, these results indicate bicarbonate in dentifrice to be an effective buffering agent for stabilizing the pH and neutralizing plaque acids in dental plaque.

Effect of calcium in model plaque on the anticaries activity of fluoride in vitro.

The uptake of calcium by a polysaccharide (agarose) gel used as a model for plaque from a two-step treatment (consisting of a calcium rinse followed by a fluoride treatment) and the effect of the deposited calcium in model plaque on caries lesion formation in enamel were determined. Calcium uptake was measured by treatment of the model plaques with [45Ca]-CaCl2 solutions with or without NaF. A two-step treatment consisting of calcium followed by fluoride produced a 100% increase in calcium content of model plaque, presumably due to the formation of CaF2, compared with a treatment with artificial saliva followed by calcium alone. The effects of these increased plaque minerals on caries lesion formation were studied by subjecting model-plaque-covered enamel blocks to a cyclic demineralization-remineralization treatment. Artificial-plaque-covered enamel blocks were treated daily with 180 ppm calcium for ten min, then 100 ppm fluoride for ten min, followed by demineralization for 16 h, and finally, remineralization for seven h and 40 min. After five days, the blocks were sectioned, and lesion formation was determined by microradiography-microdensitometry. Artificial plaque treated with a calcium rinse followed by a fluoride rinse reduced lesion size by 90%, compared with a 68% reduction by a fluoride rinse alone. When the experiment was repeated with a simulated pre-brush calcium rinse (180 ppm calcium) followed by a fluoride dentifrice suspension (110 ppm fluoride), lesion size was reduced by 46%, compared with a 32% reduction by the fluoride dentifrice suspension alone.