Inhibitory activity of garlic (Allium sativum) extract on multidrug-resistant Streptococcus mutans.

J Indian Soc Pedod Prev Dent. 2007 Oct-Dec;25(4):164-8

Authors: Fani MM, Kohanteb J, Dayaghi M

Garlic ( Allium sativum ) extract has been known to have inhibitory activity on various pathogenic bacteria, viruses and fungi. The objective of present investigation was to study in vitro inhibitory activity of garlic extract on multidrug-resistant (MDR) strains of Streptococcus mutans isolated from human carious teeth. Filter sterilized aqueous extract of garlic was prepared and used in the present study. For isolation of S. mutans , extracted human carious teeth were cultured in Todd-Hewit broth and Mitis-Salivarius-Bacitracin agar. S. mutans was characterized by colony morphology, biochemical tests and other conventional bacteriological procedures. Disk sensitivity tests and broth dilution methods were used to determine antibiotic sensitivity profile and inhibitory activity of garlic extract on S. mutans isolated from carious teeth. Of 105 carious teeth tested, 92 (87.6%) isolates of S. mutans were recovered, among which 28 (30.4%) were MDR since they were resistant to four or more antibiotics. The highest rate of resistance was observed for tetracycline (30.4%) and least resistance (0%) to teichoplanin and vancomycin while 22.8% and 23.9% of the isolates were resistant to penicillin and amoxicillin, respectively. Chlorhexidine minimum inhibitory concentration (MIC) for MDR and non-MDR S. mutans varied from 2 to 16 microg ml-1 and from 0.25 to 1 microg ml-1 , respectively ( P S. mutans were sensitive to garlic extract with the MIC ranging from 4 to 32 mg ml-1 . Considering in vitro data obtained in the present study, mouthwashes or toothpaste containing optimum concentration of garlic extract could be used for prevention of dental caries.

PMID: 18007101 [PubMed - in process]

Anticaries potential of commercial dentifrices as determined by fluoridation and remineralization efficiency.

J Contemp Dent Pract. 2007;8(7):1-10

Authors: Casals E, Boukpessi T, McQueen CM, Eversole SL, Faller RV

AIM: The aim of this in vitro study was to investigate fluoride uptake in human enamel after use of commercially available toothpastes containing different fluoride compounds, or combinations of fluoride actives formulated into a single product, as a means of determining the efficiency of each formula for delivering caries preventing fluoride to demineralized (caries active) enamel. METHODS AND MATERIALS: Four test dentifrices and two controls were assessed and placed in groups as follows: Group 1: Lacer (Spain); Group 2: Positive control-USP Reference Standard 1100 ppm F; Group 3: Fluocaril Bi-Fluor&#xE9; 250 (France); Group 4: Colgate Fluor Active (Denmark); Group 5: Elmex (France); and Group 6: A placebo (formulated the same as the USP Reference Standard toothpaste with the exception that it contained < 1 ppm F). Cores 3 mm in diameter were removed from erupted human enamel specimens (extracted by local oral surgeons for orthodontic reasons) and stored in 1% Thymol solution prior to use. They were ground and polished to remove the natural fluoride rich enamel layer, then exposed to a demineralization solution, and assessed for surface microhardness to enable randomization for use in the study. Each group of five specimens underwent a daily pH cycling procedure that involved exposure to pooled human saliva (refreshed three times daily). The groups were then exposed to dentifrice slurries four times daily for one minute per exposure and to a demineralization solution for three hours. The cycling procedure was repeated for five days. Specimens were again analyzed for surface microhardness and fluoride uptake upon completion of five days of treatment. RESULTS: Average surface hardness: Groups 2 and 3 showed a statistically significant greater (p<0.05) change indicating greater remineralization compared to all other groups. The average change was 23.45 for Group 2 and 22.65 for Group 3. All other groups had changes ranging from 4.25-8.62. No other statistically significant differences were observed between groups. Fluoride uptake results: Groups 2 and 3 showed statistically significantly greater fluoride uptake versus all other groups (p<0.05). Groups 1 and 5 were significantly different from Group 6. No other statistically significant differences were observed for either analysis. CONCLUSIONS: Of the marketed products included in the study, the Fluocaril Bi-Fluoré 250 product formulation provided both the highest level of fluoride uptake and mineralization to the demineralized enamel. The clinical significance of these in vitro results is the confirmation Fluocaril Bi-Fluoré 250 is effective at remineralizing enamel caries lesions.

PMID: 17994149 [PubMed - in process]

Epidemiology of dental caries in Chandigarh school children and trends over the last 25 years.

J Indian Soc Pedod Prev Dent. 2007 Jul-Sep;25(3):115-8

Authors: Goyal A, Gauba K, Chawla HS, Kaur M, Kapur A

The prevalence of dental caries in 6, 9, 12 and 15-year-old school children of Chandigarh, selected on a randomized basis was evaluated using Moller's criteria (1966) and correlated with the various risk factors. The mean deft was found to be 4.0 +/- 3.6 in 6 year old and 4.61 +/- 3.14 in 9 year old, whereas the mean DMFT in 12 and 15 year old was found to be 3.03 +/- 2.52 and 3.82 +/- 2.85 respectively. The high prevalence of dental caries in these children was attributed to the lack of use of fluoride toothpaste (80% children), lack of knowledge about etiology of dental caries (98%) and frequency of sugar exposures up to more than five times per day (30%).

PMID: 17951925 [PubMed - in process]

Effect of pH of amine fluoride containing toothpastes on enamel remineralization in vitro.

BMC Oral Health. 2007;7:14

Authors: Arnold WH, Haase A, Hacklaender J, Gintner Z, B&#xE1;nóczy J, Gaengler P

ABSTRACT: BACKGROUND: One of the important factors of the demineralization and remineralization equilibrium of enamel is the pH of the surrounding solutions. Effort has been laid in the formulation of different fluoride compounds and the fluoride content in toothpastes but much less is known about the influence of the pH of the toothpastes on their effectiveness. It was therefore the aim of this study to investigate the influence of different pH levels on enamel remineralization in an in vitro experiment using polarization light microscopy and EDX quantitative element analysis. METHODS: A 5 x 5 mm window on the enamel surface of 40 caries free extracted human premolars was demineralized in a hydroxyethylcellulose solution at pH 4.8. The teeth were divided into 8 groups and the lower half of the window was covered with varnish serving as control. Each group was then immersed in toothpaste slurry containing amine fluoride (1400 ppm) at pH 4.1, 4.5, 5.1 and 6.9 or control toothpaste slurry without fluoride at pH 4.3, 4.7, 5.3 and 7.0. Serial sections were cut through the lesions and investigated with polarization light microscopy and quantitative EDX element analysis. RESULTS: The PLM results showed a decreased porous volume of the body of the lesion after incubation with fluoridated toothpaste at pH 4.53 and 5.16. No differences between the experimental window and the control window were found in the other groups. The quantitative element analysis showed no differences in the element content of any of the groups. CONCLUSION: From the results it can be concluded that slightly acidified fluoridated dentifrices may have a certain positive effect on enamel remineralization.

PMID: 17941981 [PubMed - in process]

Contact allergy to propolis in beekeepers.

Allergol Immunopathol (Madr). 2007 May-Jun;35(3):95-100

Authors: Münstedt K, Hellner M, Hackethal A, Winter D, von Georgi R

BACKGROUND: Some toothpastes, cosmetics and ointments contain propolis, a bee product, and it is increasingly popular as a dietary supplement. Although propolis is known to cause contact allergy, there have been no studies of the prevalence of this. OBJECTIVES: This study aimed to determine the prevalence of contact allergy to propolis in beekeepers and any relationship between propolis allergy and environmental and physical and mental health characteristics in this group. SUBJECTS AND METHODS: A specially developed instrument which included a validated questionnaire on emotional stability was included in the issues of three German beekeeping journals sent to subscribers in a number of regions (potential readership 35,000). A reference group also completed questionnaire. RESULTS: 1051 questionnaires were returned and 37 cases of allergic reactions to propolis were reported (3.6%). Only 10 of the 37 (27%) beekeepers had recognised the allergy before participating in this study. Propolis contact allergy was significantly associated with lung diseases and other allergic reactions. Only some affected beekeepers protected their hands more while working with bees and showed significantly greater emotional instability than those not sensitised to propolis. CONCLUSIONS: Contact allergy to propolis is common among beekeepers, but they do not seem to recognise the problem or protect themselves properly.

PMID: 17594872 [PubMed - indexed for MEDLINE]

Plasma cell gingivitis among herbal toothpaste users: a report of three cases.

J Contemp Dent Pract. 2007;8(4):60-6

Authors: Anil S

AIM: The aim of this article is to present a brief review of plasma cell gingivitis (PCG) along with reports of three cases with varying clinical presentations of the condition associated with the use of herbal toothpaste. BACKGROUND: PCG is a rare benign condition of the gingiva characterized by sharply demarcated erythematous and edematous gingivitis often extending to the mucogingival junction. This is considered a hypersensitive reaction. The histological appearance consists of a dense infiltration of normal plasma cells separated by collagenous stroma, usually confined to the free and attached gingiva. The lesion can be eliminated by identifying and avoiding the source of the allergen. REPORT: Three patients ages 26, 27, and 36, respectively, presented with acutely inflamed gingival and a history of recently switching to herbal toothpaste. The gingiva bled readily on probing. Blood tests and gingival biopsy were not contributory. Patients were advised to refrain from the use of herbal toothpaste, and, along with periodontal treatment, the condition underwent remission within a week to two weeks in all three cases. SUMMARY: As more and more herbal products are gaining popularity, clinicians should be aware of some of the untoward effects of these products. Since PCG mimics lesions associated with leukemia and myeloma an early diagnosis of the condition is vital.

PMID: 17486188 [PubMed - indexed for MEDLINE]

Effect of a xylitol and fluoride containing toothpaste on the remineralization of human enamel in vitro.

J Oral Sci. 2007 Mar;49(1):67-73

Authors: Sano H, Nakashima S, Songpaisan Y, Phantumvanit P

The aim of this study was to examine the effect of a fluoride and xylitol containing toothpaste on the remineralization of human enamel using Quantitative Light-induced Fluorescence (QLF). Human extracted teeth were cut longitudinally into three or four parts, and artificial subsurface lesion windows (2 mm x 3 mm) were created by immersion in demineralizing solution. Each enamel sample (n = 7) was treated for 3 min at 25 degrees C twice a day for consecutive 14 days with the slurry of a silica-based toothpaste 1) without F- and xylitol (blank), 2) with 500 ppm F- and 3) with 500 ppm F- and 5% xylitol toothpaste. In addition, we measured the remineralization ability of a commercially available toothpaste 4) with 500 ppm F-. The average fluorescence loss F (%) and lesion size (mm2) were determined with QLF. Another variable, delta Q, which was defined as the fluorescence loss integrated over the lesion size (%, mm2), was calculated. The results showed that the combination of 500 ppm F- and 5% xylitol toothpaste significantly (P < 0.05) recovered both the size and delta Q compared to the other groups. These findings suggested that inclusion of xylitol in fluoride toothpaste might be useful to enhance the remineralization in vivo. (J. Oral Sci. 49, 67-73, 2007).

PMID: 17429185 [PubMed - in process]

Chronic relapsing allergic contact cheilitis from a toothpaste. A case report.

Minerva Stomatol. 2007 Mar;56(3):145-52

Authors: Farina R, Andreotti C

The paper describes the case of a 25 year-old caucasian man whose cheilitis was initially erroneously diagnosed and treated as herpetic cheilitis, and was then correctly identified as a toothpaste allergic contact cheilitis. The remission of the pathology was achieved through the elimination of the allergen, while the clinical symptoms were controlled by means of topic application of corticosteroids, with a complete and stable restitutio ad integrum of the perioral tissues.

PMID: 17327819 [PubMed - indexed for MEDLINE]

Dentinal hypersensitivity?--Can this agent be the solution?

Indian J Dent Res. 2006 Oct-Dec;17(4):178-84

Authors: Madhu PS, Setty S, Ravindra S

AIM: To test the efficacy of desensitizing tooth paste containing EMS salts in alleviating dentinal hypersensitivity, reducing plaque accumulation, and reducing gingivitis. METHODS: A randomised, single blind, parallel placebo controlled study was conducted in 40 cases. The cases were randomly assigned to test and control groups. The test group was instructed to use the test tooth paste (containing EMS salts) and control group a placebo tooth paste (without any therapeutic agents) for a period of 6 weeks. The hypersensitivity levels were measured with scratchometer and verbal rating scale. Student t test and wilcoxon's Mann-Whitney test were used to compare the test and control groups. RESULTS AND CONCLUSION: The results indicated that both the test as well as the control toothpastes were effective in alleviating dentinal hypersensitivity as well as reducing gingivitis. However, the test toothpaste was superior in alleviation of dentinal hypersensitivity.

PMID: 17217214 [PubMed - indexed for MEDLINE]

A comparative evaluation of self-reported oral hygiene practices among medical and engineering university students with access to health-promotive dental care.

J Contemp Dent Pract. 2007 Jan 1;8(1):68-75

Authors: Doshi D, Baldava P, Anup N, Sequeira PS

AIM: This study was conducted to test the null hypothesis that no difference exists in the oral hygiene knowledge and practices of university students in different courses when they have equal opportunity to access health-promotive dental care. METHODS AND MATERIALS: The study was conducted using 120 students each from the medical and engineering colleges at the University of Manipal Academy of Higher Education who had easy access to the dental college within the campus which provides health-promotive dental care to all its patients. A self-administered structured questionnaire consisting of questions on demographic data, oral hygiene knowledge and practices, and dental service utilization patterns was distributed among the students. The data collected was analyzed using SPSS 10 version. RESULTS: Statistically significant differences were found between the two groups with respect to the knowledge of fluoridated toothpastes, frequency of toothbrush renewal, use of dental floss, and a tongue cleaner (p < 0.001). The groups were similar in all other practices including the utilization of dental services. There were no significant differences between the self-reported oral hygiene knowledge and practices among medical and engineering university students, but the knowledge levels of the students were considerably lower than expected.

PMID: 17211507 [PubMed - indexed for MEDLINE]

Efficacy of a herbal toothpaste on patients with established gingivitis--a randomized controlled trial.

Braz Oral Res. 2006 Apr-Jun;20(2):172-7

Authors: Ozaki F, Pannuti CM, Imbronito AV, Pessotti W, Saraiva L, de Freitas NM, Ferrari G, Cabral VN

The aim of this randomised, double blind controlled trial was to verify the efficacy of a herbal dentifrice on the reduction of plaque and gingivitis. Forty eight volunteers with established gingivitis were randomly assigned to either a test group (herbal dentifrice) or positive control group (dentifrice with triclosan and fluoride). The dentifrices were distributed in plain white tubes by an independent pharmacy, which revealed the contents of each tube only after the experimental period. Plaque and gingivitis assessments were carried out on baseline and after 28 days of product use. All examinations were conducted by the same calibrated investigator. Subjects were instructed to brush their teeth three times daily using their assigned dentifrice for 28 days. There was a significant reduction in plaque levels in both the test and control groups. However, there was no significant difference between the groups. A significant reduction in gingivitis was observed in both groups, although there was no significant difference between them. No adverse reactions were reported. The authors concluded that both dentifrices were effective in reducing plaque and gingivitis in subjects with established gingivitis.

PMID: 16878213 [PubMed - indexed for MEDLINE]

Treatment of cyclosporine-induced gingival overgrowth with azithromycin-containing toothpaste.

Exp Clin Transplant. 2006 Jun;4(1):420-4

Authors: Argani H, Pourabbas R, Hassanzadeh D, Masri M, Rahravi H

OBJECTIVES: Gingival overgrowth is a complication of cyclosporine therapy following organ transplantation. Oral azithromycin is frequently used to treat this complication. This study examined the efficacy of local azithromycin, in the form of toothpaste, against cyclosporine-induced gingival overgrowth. MATERIALS AND METHODS: Twenty stable renal transplanted patients (10 men and 10 women) with gingival hyperplasia were randomly assigned to a test group and a control group. Azithromycincontaining toothpaste had 85 mg azithromycin per gram of toothpaste. Both toothpastes were prescribed b.i.d., each time using 1.5 cm, for 1 month. All participants received scaling, root planing, polishing, and oral hygiene instructions, at least 4 weeks prior to initiation of the study. Gingival overgrowth index, bleeding on probing, blood urea nitrogen, creatinine, and serum cyclosporine levels were measured at baseline, and then again in the second and fourth weeks after tooth brushing. Patient satisfaction with the toothpastes was evaluated by a visual analogue scale. The stability of clinical responses was followed for 3 months after cessation of the toothpastes. RESULTS: Gingival overgrowth index decreased significantly in the azithromycin-containing toothpaste group (from 1.1+/-0.56 to 0.51+/-0.47, P<.001); however, in the control group, this decrease was not significant (P=.22). Bleeding on probing also decreased significantly in patients in the azithromycin-containing toothpaste group compared with controls (P=.001). When compared with baseline levels, trough levels of cyclosporine, blood urea nitrogen, and creatinine did not change in either of the groups. Patients in the control group were more satisfied with the toothpaste than were patients in the test group (53 vs 38). CONCLUSIONS: Azithromycin-containing toothpaste is an effective, simple, and noninvasive treatment for cyclosporine-induced gingival overgrowth.

PMID: 16827637 [PubMed - indexed for MEDLINE]

Penetration of fluids into periodontal pockets using a powered toothbrush/irrigator device.

J Contemp Dent Pract. 2006 Jul 1;7(3):30-9

Authors: Brackett MG, Drisko CL, Thompson AL, Waller JL, Marshall DL, Schuster GS

This study was a single-blind, randomized, controlled clinical trial. The researchers evaluated a powered brush/irrigating device (HydraBrush Oral Health System; OHS) for its safety and ability to deliver a solution to the bottom of 5-6 mm pockets, compared to rinsing alone with a solution following brushing with a powered toothbrush (Sonicare Elite 7800; SE). An evaluation technique to measure the quantity and quality of solution able to enter the pocket was also introduced in this project. METHODS: Subjects were randomized in one of two-groups: brush plus simultaneous irrigation (OHS) versus brush plus rinsing (SE). Subjects used their devices at home for two weeks. At the measurement visit, subjects used the OHS to irrigate and brush simultaneously for 1 minute (30 seconds per each side of the mouth) with a 0.01% erythrosine disclosing solution in 10 oz of distilled water. Control subjects brushed for 2 minutes with a SE followed by a 1 minute rinse with an identical disclosing solution. A blinded evaluator collected six samples of approximately of 1 microL of sucular fluid from six 5-6 mm evaluation sites. This was accomplished by inserting a microcapillary tip with a 20 microL micropipette in the sulcus. Two-group repeated measures ANOVA was used to examine differences in two measures of the disclosing solution between OHS and SE subjects; the spectrometer reading of the disclosing solutions, and by visual inspection of the samples (positive/negative) to determine the presence or absence of solution in the samples. Subjects' diaries were collected. Bleeding and discomfort during the evaluation period was reported. RESULTS: Visually, OHS had a significantly greater proportion of solution taken from the base of 5-6 mm sites than the SE (p=0.0001). However, there was no statistical difference between the two groups (p=.1359) in the spectrophotometer readings. CONCLUSION: The experimental device is more efficient in delivering a solution to the base of 5-6 mm pockets than rinsing following use of a control powered toothbrush. Both devices have demonstrated they are safe and well accepted by patients. The technique developed provides a useful method for quantitative and qualitative studies of solutions from the base of periodontal pockets.

PMID: 16820805 [PubMed - indexed for MEDLINE]

A 24-hour dental plaque prevention study with a stannous fluoride dentifrice containing hexametaphosphate.

J Contemp Dent Pract. 2006 Jul 1;7(3):1-11

Authors: White DJ, Kozak KM, Gibb R, Dunavent J, Klukowska M, Sagel PA

Recently, a novel antibacterial fluoride dentifrice containing stannous fluoride and sodium hexametaphosphate (CrestPRO-HEALTH) was introduced. A digital plaque image analysis (DPIA) technique was used to quantify in situ plaque formation in a population carrying out a phased intervention protocol that included: (1) an initial treatment regimen including toothbrushing with standard sodium fluoride dentifrice in conventional bid brushing, (2) a second treatment regimen where a modified hygiene regimen was applied using standard sodium fluoride dentifrice including a period of 24 hours of non-brushing, and (3) a third treatment regimen where the 24-hour non-brushing regimen was continued using the antimicrobial stannous fluoride/sodium hexametaphosphate dentifrice. The quantitative evaluation of plaque formation was assessed in morning measurements following either standard evening hygiene (treatment period 1) or 24 hours since brushing (treatment periods 2 and 3). Post-brushing plaque measurements were also taken in each treatment regimen. Sixteen subjects completed all three treatment regimens with no side effects or oral complaints. Morning plaque coverage in treatment period 1 was 13.3%. Plaque coverage significantly increased in treatment period 2 when pre-bedtime brushing was discontinued, with 24-hour growth covering 18.4% of the dentition. Intervention of the antimicrobial stannous fluoride/hexametaphosphate dentifrice in treatment period 3 provided significant inhibition of plaque regrowth over 24 hours (15.2% coverage, a 17% reduction vs. sodium fluoride dentifrice control). These results support the strong retention and lasting antimicrobial efficacy of high stabilized stannous fluoride/sodium hexametaphosphate dentifrices.

PMID: 16820802 [PubMed - indexed for MEDLINE]

Managing dentin hypersensitivity.

J Am Dent Assoc. 2006 Jul;137(7):990-8; quiz 1028-9

Authors: Orchardson R, Gillam DG

BACKGROUND: The objective of this review is to inform practitioners about dentin hypersensitivity (DH) and its management. This clinical information is described in the context of the underlying biology. TYPES OF STUDIES REVIEWED: The authors used MEDLINE to find relevant English-language literature published in the period 1999 to 2005. They used combinations of the search terms "dentin*," "tooth," "teeth," "hypersensit*," "desensiti*" and "desensitiz*." They read abstracts and then full articles to identify studies describing etiology, prevalence, clinical features, controlled clinical trials of treatments and relevant laboratory research on mechanisms of action. RESULTS: The prevalence of DH varies widely, depending on the mode of investigation. Potassium-containing toothpastes are the most widely used at-home treatments. Most in-office treatments employ some form of "barrier," either a topical solution or gel or an adhesive restorative material. The reported efficacy of these treatments varies, with some having no better efficacy than the control treatments. Possible reasons for this variability are discussed. A flowchart summarizes the various treatment strategies. CLINICAL IMPLICATIONS: DH is diagnosed after elimination of other possible causes of the pain. Desensitizing treatment should be delivered systematically, beginning with prevention and at-home treatments. The latter may be supplemented with in-office modalities.

PMID: 16803826 [PubMed - indexed for MEDLINE]

Effect of fluoride toothpastes on enamel demineralization.

BMC Oral Health. 2006;6:8

Authors: Arnold WH, Dorow A, Langenhorst S, Gintner Z, B&#xE1;nóczy J, Gaengler P

BACKGROUND: It was the aim of this study to investigate the effect of four different toothpastes with differing fluoride compounds on enamel remineralization. METHODS: A 3 x 3 mm window on the enamel surface of 90 human premolars was demineralized in a hydroxyethylcellulose solution at pH 4.8. The teeth were divided into 6 groups and the lower half of the window was covered with varnish serving as control. The teeth were immersed in a toothpaste slurry containing: placebo tooth paste (group 1); remineralization solution (group 2); Elmex Anticaries (group 3); Elmex Sensitive (group 4); Blend-a-med Complete (group 5) and Colgate GRF (group 6). Ten teeth of each group were used for the determination of the F- content in the superficial enamel layer and acid solubility of enamel expressed in soluble phosphorus. Of 6 teeth of each group serial sections were cut and investigated with polarization light microscopy (PLM) and quantitative energy dispersive X-ray analysis (EDX). RESULTS: The PLM results showed an increased remineralization of the lesion body in the Elmex Anticaries, Elmex Sensitive and Colgate GRF group but not in the Blend-a-med group. A statistically significant higher Ca content was found in the Elmex Anticaries group. The fluoride content in the superficial enamel layer was significantly increased in both Elmex groups and the Blend-a-med group. Phosphorus solubility was significantly decreased in both Elmex groups and the Blend-a-med group. CONCLUSION: It can be concluded that amine fluoride compounds in toothpastes result in a clearly marked remineralization of caries like enamel lesions followed by sodium fluoride and sodium monofluorophosphate formulations.

PMID: 16776820 [PubMed]

The 'new' operative dentistry.

J Am Dent Assoc. 2006 Apr;137(4):531-3

Authors: Christensen GJ

During the past few decades, life expectancy has increased significantly. As a result, mature patients often have receding gingival tissues, physical and mental debilitation, less energy and motivation, and the resultant Class V carious lesions. In this article, I suggest the use of high-level fluoride in toothpastes, remineralizing pastes and high-level fluoride gels for topical application in trays to reduce the progression of caries. To accompany fluoride therapy, high-fluoride-releasing restorative materials are indicated for Class V carious lesions. Adequate caries-preventive and restorative concepts for mature patients require planning, patient education and close patient supervision.

PMID: 16637483 [PubMed - indexed for MEDLINE]

A critical review of non-carious cervical (wear) lesions and the role of abfraction, erosion, and abrasion.

J Dent Res. 2006 Apr;85(4):306-12

Authors: Bartlett DW, Shah P

The terms 'abfraction' and 'abrasion' describe the cause of lesions found along the cervical margins of teeth. Erosion, abrasion, and attrition have all been associated with their formation. Early research suggested that the cause of the V-shaped lesion was excessive horizontal toothbrushing. Abfraction is another possible etiology and involves occlusal stress, producing cervical cracks that predispose the surface to erosion and abrasion. This article critically reviews the literature on abrasion, erosion, and abrasion, and abfraction. The references were obtained by a MEDLINE search in March, 2005, and from this, hand searches were undertaken. From the literature, there is little evidence, apart from laboratory studies, to indicate that abfraction exists other than as a hypothetical component of cervical wear.

PMID: 16567549 [PubMed - indexed for MEDLINE]

A prospective, randomized clinical study on the effects of an amine fluoride/stannous fluoride toothpaste/mouthrinse on plaque, gingivitis and initial caries lesion development in orthodontic patients.

Eur J Orthod. 2006 Feb;28(1):8-12

Authors: &#xD8;gaard B, Alm AA, Larsson E, Adolfsson U

The aim of this study was to examine the effect of combined use of a toothpaste/mouthrinse containing amine fluoride/stannous fluoride (AmF/SnF2; meridol) on the development of white spot lesions, plaque, and gingivitis on maxillary anterior teeth in orthodontic patients. A prospective, randomized, double-blind study with 115 orthodontic patients (42 males and 73 females, average age 14.4 years, drop outs 18) was designed. Group A (50) brushed twice daily with an AmF/SnF2 toothpaste (1400 ppm F) and rinsed every evening with an AmF/SnF2 solution (250 ppm F). Group B (47) brushed twice daily with a sodium fluoride (NaF) toothpaste (1400 ppm F) and rinsed every evening with a NaF solution (250 ppm F). Visible plaque index (VPI), gingival bleeding index (GBI) and white spot lesion index (WSL) were recorded on the six maxillary anterior teeth at bonding and after debonding, and evaluated with t tests. In group A no significant differences between bonding and debonding were recorded for WSL (1.02 +/- 0.08 versus 1.05 +/- 0.13, P = 0.14), VPI (0.10 +/- 0.21 versus 0.12 +/- 0.21, P = 0.66) or GBI (0.13 +/- 0.21 versus 0.16 +/- 0.22, P = 0.47), whereas statistically significant differences were found in group B between bonding and debonding for WSL (1.00 +/- 0.02 versus 1.08 +/- 0.17, P = 0.01), VPI (0.06 +/- 0.13 versus 0.17 +/- 0.25, P = 0.01) and GBI (0.06 +/- 0.12 versus 0.16 +/- 0.21, P = 0.01). The increase in lesions on the upper anterior teeth was 4.3 per cent in group A and 7.2 per cent in group B. It was concluded that the combined use of an AmF/SnF2 toothpaste/mouthrinse had a slightly more inhibitory effect on white spot lesion development, plaque and gingivitis on maxillary anterior teeth during fixed orthodontic treatment compared with NaF.

PMID: 16230329 [PubMed - indexed for MEDLINE]

The effective use of fluorides in public health.

Bull World Health Organ. 2005 Sep;83(9):670-6

Authors: Jones S, Burt BA, Petersen PE, Lennon MA

Dental caries remain a public health problem for many developing countries and for underprivileged populations in developed countries. This paper outlines the historical development of public health approaches to the use of fluoride and comments on their effectiveness. Early research and development was concerned with waterborne fluorides, both naturally occurring and added, and their effects on the prevalence and incidence of dental caries and dental fluorosis. In the latter half of the 20th century, the focus of research was on fluoride toothpastes and mouth rinses. More recently, systematic reviews summarizing these extensive databases have indicated that water fluoridation and fluoride toothpastes both substantially reduce the prevalence and incidence of dental caries. We present four case studies that illustrate the use of fluoride in modern public health practice, focusing on: recent water fluoridation schemes in California, USA; salt fluoridation in Jamaica; milk fluoridation in Chile; and the development of "affordable" fluoride toothpastes in Indonesia. Common themes are the concern to reduce demands for compliance with fluoride regimes that rely upon action by individuals and their families, and the issue of cost. We recommend that a community should use no more than one systemic fluoride (i.e. water or salt or milk fluoridation) combined with the use of fluoride toothpastes, and that the prevalence of dental fluorosis should be monitored in order to detect increases in or higher-than-acceptable levels.

PMID: 16211158 [PubMed - indexed for MEDLINE]

Effects of two types of emulsifying salts on the functionality of nonfat pasta filata cheese.

J Dairy Sci. 2005 Oct;88(10):3411-25

Authors: Mizuno R, Lucey JA

Effects of 2 types of emulsifying salts (ES) on the functionality of nonfat pasta filata cheese were examined. Nonfat pasta filata cheese was made from skim milk by direct acidification. Trisodium citrate (TSC) and tetrasodium pyrophosphate (TSPP) were added to curds (at 1, 3, and 5%, wt/wt) at the dry-salting step, together with glucono-delta-lactone to maintain a constant pH. When TSC was added, there were no significant compositional differences, although insoluble Ca and P contents significantly decreased with the addition of TSC. When TSPP was added, fat content was not significantly different, but protein content decreased with increasing concentrations of TSPP. Both insoluble Ca and P contents increased with the addition of 1% TSPP. The addition of ES affected textural and functional properties. With increasing concentrations of TSC, meltability increased, whereas increasing the TSPP content decreased meltability. Cheese made with 1% TSC had better stretchability compared with control cheese. However, the addition of more than 3% TSC decreased stretchability. Addition of TSPP caused a considerable decrease in stretchabilty. Scanning electron microscopy revealed that the size and number of serum pockets decreased and protein appeared more hydrated with the addition of both ES. These results suggested that TSC and TSPP influenced the functionality of nonfat pasta filata cheese differently; that is, the effects of TSC were probably caused by a decrease in the number of colloidal calcium phosphate cross-links and an increase in electrostatic repulsion, whereas the effects of TSPP may have been related to the formation of new TSPP-induced casein-casein interactions.

PMID: 16162514 [PubMed - indexed for MEDLINE]

Effects of emulsifying salts on the turbidity and calcium-phosphate-protein interactions in casein micelles.

J Dairy Sci. 2005 Sep;88(9):3070-8

Authors: Mizuno R, Lucey JA

Influence of emulsifying salts (ES) on some physical properties of casein micelles was investigated. A reconstituted milk protein concentrate (MPC) solution (5% wt/wt) was used as the protein source and the effects of ES [0 to 2.0% (wt/wt)] were estimated by measuring turbidity, acid-base titration curves and amount of casein-bound Ca and inorganic P (P(i)). Various ES, trisodium citrate (TSC), or sodium phosphates (ortho-, pyro-, or hexameta-) were added to MPC solution, and all samples were adjusted to pH 5.8. Acid-base buffering curves were used to observe changes in the amount and type of insoluble Ca phosphates. An increase in the concentration of TSC added to MPC solution decreased turbidity, buffering at pH approximately 5 (contributed by colloidal Ca phosphate), and amount of casein-bound Ca and P(i). Addition of up to 0.7% disodium orthophosphate (DSP) did not significantly influence turbidity, buffering curves, or amount of casein-bound Ca and P(i). When higher concentrations (i.e., > or =1.0%) of DSP were added, there was a slow decrease in turbidity. With increasing concentration of added tetrasodium pyrophosphate (TSPP), turbidity and buffering at pH approximately 5 decreased, and amount of casein-bound Ca and P(i) increased. When small concentrations (i.e., 0.1%) of sodium hexameta-phosphate were added, effects were similar to those when TSPP were added but when higher concentrations (i.e., > or =0.5%) were added, the buffering peak shifted to a higher pH value, and amount of casein-bound Ca and P(i) decreased. These results suggested that each type of ES influenced casein micelles by different mechanisms.

PMID: 16107395 [PubMed - indexed for MEDLINE]

[The effect of regular scaling on periodontal health in fixed orthodontic treatment]

Shanghai Kou Qiang Yi Xue. 2005 Apr;14(2):140-2

Authors: Wei J

PURPOSE: The purpose of this study was to investigate the effect of scaling and teeth brushing with YAHAO toothpaste (eugenol and borax cream) on periodontal health in fixed orthodontic treatment. METHODS: 48 patients who needed fixed orthodontics were chosen to enroll a single-blind randomized study. The patients were randomly divided into two groups: the control group and the treatment group. Patients in the treatment group were treated with scaling and teeth brushing with YAHAO toothpaste. The changes of GI, PLI and SBI were recorded at the beginning of the treatment and after 3 months. SPSS 10.0 software package was used for Student's t test and Chi-square test. RESULTS: There was no significant difference in the periodontal indexes between the two groups before treatment. But there was a statistically significant difference in the incidence of gingivitis (P<0.01) between the two groups after treatment. CONCLUSION: The increase in the periodontal index and the rate of gingivitis in the treatment group were statistically significantly lower than that in the control group, which means that using scaling and teeth brushing with YAHAO toothpaste can effectively reduce the rate of gingivitis.

PMID: 15886837 [PubMed - in process]

Comparison of two cleansing pastes for the removal of biofilm from dentures and palatal lesions in patients with atrophic chronic candidiasis.

Braz Dent J. 2004;15(3):220-4

Authors: Andrucioli MC, Macedo LD, Panzeri H, Lara EH, Paranhos Hde F

The efficacy of 2 oral hygiene products, an experimental toothpaste specific for complete denture cleansing and a regular standard toothpaste, was compared in terms of denture biofilm removal and cure of palatal lesions in patients with atrophic chronic candidiasis. The degree of correlation between presence of biofilm and mucosa erythema was also evaluated. Twenty-four complete denture wearers (45-80 years old) were divided into 2 groups: experimental paste and standard toothpaste (Sorriso-Kolynos, Brazil). Both groups received soft toothbrushes. The internal surfaces of upper dentures were stained using 1% sodium fluorescein and photographed at a 45 masculine angle at 0, 15, 30 and 60 days. The slides were scanned and the areas of interest (denture total area and biofilm area) were measured (Image Tool software). The degree of erythema was evaluated on slides according to the Prosthesis Tissue Index. There was a significant reduction (1%) in the degree of biofilm (ANOVA/Tukey) between the two initial visits (0 and 15 days) and the two final visits (30 and 60 days), and in the average erythema scores (Kruskal-Wallis) between 0 and 60 days, in both groups. The Mann-Whitney test showed a significant difference (1%) between pastes in terms of biofilm degree, but no difference was found for the erythema score. Correlation values between biofilm and erythema degree were 0.3801 (experimental paste) and (0.3678 (standard toothpaste). We may therefore conclude that the experimental product was efficient for the removal of denture plaque biofilm.

PMID: 15798827 [PubMed - in process]

The effect of a bi-annual professional application of APF foam on dental caries increment in primary teeth: 24-month clinical trial.

J Dent Res. 2005 Mar;84(3):265-8

Authors: Jiang H, Bian Z, Tai BJ, Du MQ, Peng B

The purpose of this study was to evaluate the effect of a bi-annual professional application of acidulated phosphate fluoride (APF) foam on caries increment in the primary dentition over a two-year period in the People's Republic of China. In a double-blind, cluster-randomized, placebo-controlled trial, 392 children aged 3-4 years from 15 classes were randomly assigned to two groups on a school class basis. The experimental group (8 classes) received a bi-annual APF foam application, and the control group (7 classes) received the placebo. The mean increment of dmfs in the experimental group was 24.2% lower than that in the control group (p < 0.05). The significant caries reduction was observed on approximal surfaces in the experimental group compared with the control group (p < 0.01), but there were no differences on occlusal surfaces (p > 0.05). A bi-annual professional application of APF foam was effective in reducing the increment of dental caries in the primary teeth.

PMID: 15723868 [PubMed - indexed for MEDLINE]

Toothpaste abrasion.

J Am Dent Assoc. 2004 Nov;135(11):1520, 1522; author reply 1522

Authors: Cohen RB

PMID: 15622655 [PubMed - indexed for MEDLINE]

White lesions after orthodontic treatment: does low fluoride make a difference?

J Orthod. 2004 Sep;31(3):235-42; discussion 202

Authors: Willmot DR

OBJECTIVE: To compare and measure the changes in size of post-orthodontic demineralized white lesion enamel lesions treated with a low fluoride (50 ppm) versus a non-fluoride mouthrinse/toothpaste regime. STUDY DESIGN: An experimental double-blind prospective randomized clinical controlled trial. SETTING: A university dental school orthodontic clinic (Sheffield, UK). PARTICIPANTS: Twenty-six patients identified as having post-orthodontic demineralized white lesions on removal of their fixed appliance. METHOD AND INTERVENTIONS: The participants were randomly and blindly assigned to either a low fluoride mouthrinse/toothpaste treatment regime or an inactive control. Computerized image analysis of calibrated photographic images taken under polarized light were used to measure the lesions. OUTCOME MEASURES: Lesion size and proportion (DWL%t) and percentage reduction (ADPR) at debond, and at 12 and 26 weeks later. RESULTS: Five participants dropped out of the study, 12 had the low fluoride regime and 9 did not. As a percentage of the total labial tooth area (DWL%t) the mean size of the lesions at debond was 8.1% (SD 3.7). After 12 weeks the mean size of lesion had reduced to 4.6% (SD 2.6), which was a significant reduction (p=0.03). After 26 weeks the mean size was 3.5% (SD 2.1), which was a very significant reduction (p<0.003). This confirmed statistically that post-orthodontic demineralized white lesions do reduce in size with time reflecting remineralization or other enamel surface changes. Intervention using a test low fluoride mouthrinse/toothpaste combination at 26 weeks showed an average difference percentage reduction (ADPR) of 54.3% (Upper 95% CI=62.08, Lower 95% CI=46.44%) compared with a non-active control combination, which showed an ADPR of 66.1% (Upper 95% CI=77.74, Lower 95% CI=54.51%). This failed to show any differences or therapeutic affect. CONCLUSIONS: Post-orthodontic demineralized white lesions reduced in size during the 6 months following treatment by approximately half the original size. There was no clinical advantage in using the low fluoride formulation of mouthrinse/toothpaste in this study.

PMID: 15489367 [PubMed - indexed for MEDLINE]

[The inhibitive effect of IgY toothpaste against oral Streptococcus mutans]

Shanghai Kou Qiang Yi Xue. 2004 Aug;13(4):256-8

Authors: Chi ZB, Gao YX, Pan Y, Zhang B, Feng XP

PURPOSE: To study the effect of the toothpaste containing IgY against oral Streptococcus mutans. METHODS: 140 subjects were divided into 2 groups randomly (test group and control group). Before the beginning of the test, every subject underwent a elution period in order to lessen the other interference factors, then used different toothpastes were used respectively and the test began. Streptococcus mutans values were determined with Dentocult SM Strip just before test, at 1, 3, 7, 30 days after toothpaste used and 14 days after stopping toothpaste used. RESULTS: (1) In test group,Streptococcus mutans values decreased at 1 day after toothpaste used. In control group Streptococcus mutans values decreased at 3 days after toothpaste used. (2) Streptococcus mutans values decreased gradually in each groups after toothpaste used. (3) In test group, 2 weeks after stopping toothpaste used, Streptococcus mutans values were still suppressed. CONCLUSION: The application of the toothpaste containing IgY may reduce oral Streptococcus mutans levels significantly.

PMID: 15349658 [PubMed - indexed for MEDLINE]

Using survival methodologies in demonstrating caries efficacy.

J Dent Res. 2004;83 Spec No C:C99-102

Authors: Hannigan A

Exploiting recent advances in statistical methods, particularly for correlated intra-subject data, could increase the efficiency of caries clinical trials. Methods of analysis using the tooth surface as the unit should be investigated. Whole-mouth measures such as the DMFS increment ignore the variation in the number of surfaces at risk between subjects and within a subject over time. The use of "survival time" for each surface as the outcome measure--i.e., the time from the start of the trial to when a surface is recorded as decayed or filled--is proposed. Data from caries clinical trials could be described as clustered survival data, where clustering of tooth surfaces exists such that survival times within the same cluster or subject are correlated. Advances in the analysis of clustered survival data, such as the use of marginal models with robust variance estimators, have recently been exploited in the analysis of caries clinical trials. The analysis produced results similar to those achieved by conventional DMFS-based analysis. The results using survival analysis are easily interpreted-for example, the median survival time of tooth surfaces in female subjects using a toothpaste with a higher level of fluoride (1500 ppm F) is 1.07 times the median survival time of surfaces in female subjects using toothpaste with less fluoride (1000 ppm F). Further research is required to investigate if survival analysis is a more sensitive method of analysis, i.e., whether causative factors can be identified with fewer subjects than with the conventional method of analysis.

PMID: 15286132 [PubMed - indexed for MEDLINE]

Clinical effect of a herbal dentifrice on the control of plaque and gingivitis: a double-blind study.

Pesqui Odontol Bras. 2003 Oct-Dec;17(4):314-8

Authors: Pannuti CM, Mattos JP, Ranoya PN, Jesus AM, Lotufo RF, Romito GA

The aim of this randomized, double-blind clinical trial was to evaluate the effect of the Paradontax dentifrice on the reduction of plaque and gingivitis. Subjects were randomly allocated into either the test group (n = 15, Paradontax) or the control group (n = 15, standard dentifrice with fluoride). Plaque levels were measured using the Turesky modification of the Quigley & Hein Plaque Index (PI), and gingivitis was evaluated with the Gingival Index (GI). Subjects were asked to brush their teeth with the allocated dentifrice, three times a day, for 21 days. There was no significant difference between groups in relation to the PI and GI medians, at baseline and at the end of the 21-day period. There was no significant reduction in PI in either the test or control groups. There was a significant decrease in GI in the test group. The authors concluded that there was no difference between the dentifrices in the reduction of plaque and gingivitis.

PMID: 15107912 [PubMed - indexed for MEDLINE]

[Safety evaluation of the infants using toothpaste containing fluoride]

Shanghai Kou Qiang Yi Xue. 1998 Dec;7(4):237-9

Authors: Cai YM, Yang XP

PMID: 15071640 [PubMed - as supplied by publisher]

[The investigation of accidental swallowing of Fluoride toothpaste in young children]

Shanghai Kou Qiang Yi Xue. 1999 Sep;8(3):150-2

Authors: Cai YM, Feng XP, Liu YL

OBJECTIVE:This study was to investigate the accidental swallowing of fluoride toothpastes in young children during their toothbrushing and then to discuss the security of fluoride toothpastes used by young children.METHODS:The accidental ingesting of fluoride toothpastes in 180 young children aged 3-6 years old was assayed with fluoride-specific electrode.RESULTS:Among the 180 children invited to join the test,the average amount of the ingestion of fluoride toothpastes was 0.053g.The average swallowing ratio was 26.163%.The maximums presented in the group aged 3.0 to 3.9years old were 0.082g and 30.348%;respectively.CONCLUSION:Young children swallow a quantity of toothpaste on the brush during toothbrushing inevitably.It may result in the excessive daily fluoride ingestion which includes the fluoride ingestion from toothpaste,food and surroundings.So the incidence of fluorosis will increase certainly.

PMID: 15048245 [PubMed - as supplied by publisher]

[An in vitro study of anti acidic etching effect of polypeptide-containing toothpaste on dental enamel]

Shanghai Kou Qiang Yi Xue. 1999 Dec;8(4):195-6

Authors: Zhang B, Zhang WG, Li L

OBJECTIVE:The present study was to investigate the anti-acidic etching effect of a kind of toothpaste containing biotin-polypeptide. METHODS:28 enamel slabs were treated with polypeptide-containing toothpaste in the pH-cycle environment,and then were analyzed by micro-hardness detector and polarized light microscope.RESULTS:The dental enamel treated with polypeptide-containing toothpaste was harder than the control group (P<0.0001);and the degree of demineralization in treated group was also less than the control one.CONCLUSION:There was certain acid resistant effect using the polypeptide containing toothpaste to treat the dental enamel.

PMID: 15048206 [PubMed - as supplied by publisher]

[Effects of different quantity of fluoride toothpaste on fluoride intake by preschool children]

Shanghai Kou Qiang Yi Xue. 2002 Mar;11(1):13-5

Authors: Zhou J, Feng XP, Liu YL

OBJECTIVE: This study was to investigate the influence of different quantity of fluoride toothpaste(1000 microg/g)on the intake level of fluoride among three children age groups of preschool children,to explore the rational and security quantity of fluoride toothpaste in preschool children. METHODS: Urinary fluoride excretion of 24-hour urinary samples was measured by fluoride ion electrode among three age groups of preschool children,serving 24-hour urinary fluoride excretion before using fluoride toothpaste as self-control. RESULTS: There were statistically significant differences in 24-hour urinary fluoride excretion among four different quantity toothpastes (P<0.01),and among three age groups (P<0.05). CONCLUSION: Fluoride intake level was influenced by the accidental swallowing of fluoride toothpaste among preschool children.So children under 6-year-old should decrease quantity of fluoride toothpaste,no more than a small pea (about 0.25g).

PMID: 14983324 [PubMed]

Remineralization potential of a new toothpaste formulation: an in vitro study.

J Contemp Dent Pract. 2004 Feb 15;5(1):18-30

Authors: Torrado A, Valiente M, Zhang W, Li Y, Mu&#xF1;oz CA

The aim of the present study was to determine the ability of a dentifrice containing a mixture of ion-exchange resins (named NMTD), which supplies calcium, fluoride, phosphate, and zinc ions, to promote remineralization and/or inhibit demineralization of dental human enamel in a pH cycling model in vitro. A fluoride toothpaste was used as the control. The enamel specimens were tested for microhardness before and after 10 days and 16 days of the demineralizing and remineralizing treatments. The results of this study showed both dentifrices were effective in limiting in vitro enamel demineralization although the effects were not significantly different from each other. Inclusion of calcium and phosphate ion-exchange resins in the dentifrice containing a fluoride ion-exchange resin maintained a similar net outcome of the conventional dentifrice in the demineralization/remineralization process under the experimental conditions employed.

PMID: 14973557 [PubMed - indexed for MEDLINE]

Guestimates.

J R Soc Med. 2004 Jan;97(1):49

Authors: Sarll DW

PMID: 14702377 [PubMed - indexed for MEDLINE]

Predictive thermal inactivation model for effects of temperature, sodium lactate, NaCl, and sodium pyrophosphate on Salmonella serotypes in ground beef.

Appl Environ Microbiol. 2003 Sep;69(9):5138-56

Authors: Juneja VK, Marks HM, Mohr T

Analyses of survival data of a mixture of Salmonella spp. at fixed temperatures between 55 degrees C (131 degrees F) and 71.1 degrees C (160 degrees F) in ground beef matrices containing concentrations of salt between 0 and 4.5%, concentrations of sodium pyrophosphate (SPP) between 0 and 0.5%, and concentrations of sodium lactate (NaL) between 0 and 4.5% indicated that heat resistance of Salmonella increases with increasing levels of SPP and salt, except that, for salt, for larger lethalities close to 6.5, the effect of salt was evident only at low temperatures (<64 degrees C). NaL did not seem to affect the heat resistance of Salmonella as much as the effects induced by the other variables studied. An omnibus model for predicting the lethality for given times and temperatures for ground beef matrices within the range studied was developed that reflects the convex survival curves that were observed. However, the standard errors of the predicted lethalities from this models are large, so consequently, a model, specific for predicting the times needed to obtained a lethality of 6.5 log(10), was developed, using estimated results of times derived from the individual survival curves. For the latter model, the coefficient of variation (CV) of predicted times range from about 6 to 25%. For example, at 60 degrees C, when increasing the concentration of salt from 0 to 4.5%, and assuming that the concentration of SPP is 0%, the time to reach a 6.5-log(10) relative reduction is predicted to increase from 20 min (CV = 11%) to 48 min (CV = 15%), a 2.4 factor (CV = 19%). At 71.1 degrees C (160 degrees F) the model predicts that more than 0.5 min is needed to achieve a 6.5-log(10) relative reduction.

PMID: 12957896 [PubMed - indexed for MEDLINE]

Efficacy of oral hygiene products against MRSA and MSSA isolates.

J Antimicrob Chemother. 2003 Oct;52(4):738-9

Authors: Smith AJ, Morrison D, Robertson D, Tang MK, Al-Doori Z

PMID: 12917232 [PubMed - indexed for MEDLINE]

For the dental patient. Sensitive teeth: causes and treatment.

J Am Dent Assoc. 2003 Jun;134(6):787

Authors:

PMID: 12839416 [PubMed - indexed for MEDLINE]

Effects of a betaine-containing toothpaste on subjective symptoms of dry mouth: a randomized clinical trial.

J Contemp Dent Pract. 2003 May 15;4(2):11-23

Authors: Rantanen I, Tenovuo J, Pienih&#xE4;kkinen K, Söderling E

Our aim was to study the effects of mildly flavoured sodium lauryl sulphate (SLS)-containing and detergent-free toothpastes with and without betaine (BET) on subjective symptoms of dry mouth in a randomised clinical trial. BET is an osmoprotectant that reacts with molecules to supply the surface with a water coating that protects cells from surfactants. Twenty-seven xerostomic patients and 18 healthy controls took part in the randomised, double-blind clinical trial with a crossover design. Three mildly flavoured toothpastes: (1) 4% BET, (2) 1% SLS and 4% BET, and (3) 1% SLS were used for six weeks each. The reference or washout paste contained neither SLS nor BET. The subjects' dental appointments were at the beginning of the trial and before and after the use of each toothpaste. At each appointment, the subjects were interviewed about subjective sensations of dry mouth (Visual Assessment Scoring (VAS) Index). The subjects did not report any adverse effects in connection with the use of the toothpastes. The VAS scores for lip dryness and eating difficulties were significantly lower for the BET paste (lip dryness: BET<BET+SLS; p < 0.005 and eating difficulties: BET<BET+SLS; p = 0.02; BET<reference; p = 0.003). The BET paste relieved dry mouth symptoms in 44% of the xerostomic patients, the corresponding figures for the other pastes being BET+SLS 22% (p = 0.002 as compared with BET), SLS 18% (p = 0.022), and reference 7% (p = 0.000). In conclusion, all the mildly flavoured toothpastes used in this study were well accepted by the xerostomic subjects. Thus, other toothpaste components may be more mucosa-irritating than just SLS, or else they enhance the effect of SLS. The detergent-free, BET-containing toothpaste appeared to be associated with relief of some symptoms of dry mouth.

PMID: 12761586 [PubMed - indexed for MEDLINE]

[Dose-response effect of a dentifrice formulation with low fluoride concentration - an in vitro study]

Pesqui Odontol Bras. 2002 Oct-Dec;16(4):361-5

Authors: Negri HM, Cury JA

The utilization of dentifrices with low fluorine concentration, for children under 6 years of age, has been suggested to reduce the risks of dental fluorosis. However, in order to have anticariogenic potential, the dentifrice should form loosely-bound fluorine (CaF2) on dental enamel. Considering that the formation of CaF2 is a function inversely related to pH, dentifrices with pH 5.5, with 275, 550 and 1,100 ppm F (NaF/silica) were developed in order to assess dose-response effects. A comparison between those dentifrices, a placebo product and the Crest toothpaste (positive control - standard) was carried out. Furthermore, the bioavailability of dentifrices, in terms of formation of total fluorine (TF), CaF2, and fluorapatite (FA) on human dental enamel, was evaluated. An ion-specific electrode was utilized for the determination of the dosage of fluorine. The results revealed that the dentifrice with 550 ppm F was more effective than both the placebo and the dentifrice with 275 ppm, presenting no difference in relation to the positive control (p > 0.05). A dose-effect correlation was observed as to the CaF2 formed. In conclusion, the modified formulation with 550 ppm F can be considered as effective as the standard dentifrice with 1,100 ppm, and its utilization would be safer with regard to dental fluorosis.

PMID: 12612777 [PubMed - indexed for MEDLINE]

Construct and predictive validity of clinical caries diagnostic criteria assessing lesion activity.

J Dent Res. 2003 Feb;82(2):117-22

Authors: Nyvad B, Machiulskiene V, Baelum V

Even though there is no "gold standard" for determining caries lesion activity, it is nonetheless possible to evaluate the validity of such diagnostic measures. The aim of this study was to estimate the construct and predictive validity of caries lesion activity assessments by means of their ability to reflect known effects of fluoride on caries. A three-year trial of the effect of daily supervised brushing with fluoride toothpaste was carried out among 273 12-year-old children. All children were examined clinically according to diagnostic criteria for activity assessment. The relative risk (fluoride vs. control) for caries lesion transitions among diagnostic categories was calculated. Fluoride inhibited progression of caries at all stages of lesion formation while at the same time enhancing lesion regression. The effects were most pronounced for active non-cavitated lesions. It is concluded that the clinical diagnostic criteria have construct and predictive validity for the assessment of caries lesion activity.

PMID: 12562884 [PubMed - indexed for MEDLINE]

Fluorosis development in seven age cohorts after an 11-month break in water fluoridation.

J Dent Res. 2003 Jan;82(1):64-8

Authors: Burt BA, Keels MA, Heller KE

This study used an 11-month break in water fluoridation to identify the time when developing incisors are most sensitive to fluorosis development. The study was based in Durham, NC, where an interruption to water fluoridation occurred between September, 1990, and August, 1991. A total of 1896 children was dentally examined. Fluorosis was measured by the TF index, and parents or guardians completed a questionnaire on demographics and fluoride history. Age cohorts ranged from those born 5 years before the break, to those born 1 year after the resumption of fluoridation. Fluorosis prevalence for seven age cohorts whose birth years ranged from 1985-86 to 1991-92 was 57.1, 62.3, 33.0, 32.3, 39.8, 30.2, and 36.8%, respectively. Children aged from birth to 3 years at the break, and those born 1 year after it, had less fluorosis than those aged 4-5 years at the break.

PMID: 12508048 [PubMed - indexed for MEDLINE]

[Anticaries effectiveness of fluoride toothpaste: a meta-analysis]

Rev Saude Publica. 2002 Oct;36(5):598-606

Authors: Chaves SC, Vieira-da-Silva LM

OBJECTIVE: To carry out a meta-analysis on the effectiveness of fluoride toothpaste for reducing dental caries to calculate the effect size of different hypothesis. METHODS: MEDLINE and LILACS databases were studied in the period from 1980 to 1998. To evaluate the quality of the studies, methodological rigor criteria proposed by Kay & Locker (1996) were applied after the criteria were submitted to an expert committee of CNPq (National Scientific Council of Brazil) senior researchers. Of 43 papers selected, 22 met the proposed criteria. The effect size of intervention was calculated from differences among the groups and the overall effect of five groups of hypothesis. RESULTS: The high concentration of fluoride in the toothpaste is associated with a larger effect (overall effect = -0.17 CI 95% -0.22/-0.12). The largest caries reductions were observed when comparing fluoride toothpastes and no fluoride toothpastes (overall effect = -0.29 IC 95% -0.34/-0.24). The addiction of antimicrobial agents (overall effect = -0.03 IC 95% -0.07/+0.02), differences in abrasive systems (overall effect = -0.02 IC 95% -0.09/+0.04) and active components do not increase the effectiveness of fluoride toothpastes (overall effect = -0.04 IC 95% -0.10/+0.01). CONCLUSIONS: The highest caries reductions were seen in studies where there was supervised tooth brushing. This review reinforced the importance of tooth brushing with fluoride toothpastes for controlling dental caries. However it showed the emphasis put on medical approaches for disease control rather than specific educational actions. The heterogeneity of the results shows the need to consider issues such as the scenario for implementing preventive methods in the evaluation process.

PMID: 12471385 [PubMed - indexed for MEDLINE]

For the dental patient...Buying oral care products.

J Am Dent Assoc. 2002 Nov;133(11):1587

Authors:

PMID: 12462703 [PubMed - indexed for MEDLINE]

Tooth whitening today.

J Am Dent Assoc. 2002 Nov;133(11):1535-8; quiz 1541

Authors: Sarrett DC

BACKGROUND: Methods to improve the esthetics of the dentition by tooth whitening are of interest to dentists, their patients and the public. In the past 20 years, research on bleaching and other methods of removing tooth discolorations has dramatically increased. Dentist-supervised and over-the-counter products now are available to solve a variety of tooth discoloration problems without restorative intervention. The indications for appropriate use of tooth-whitening methods and products are dependent on correct diagnosis of the discoloration. OVERVIEW: Tooth-whitening methods include the use of peroxide bleaching agents to remove internal discolorations or abrasive products to remove external stains. Peroxide bleaching procedures are completed by the dentist in single or multiple appointments, or by the patient over a period of weeks to months using custom trays loaded with a bleaching agent. Both methods are safe and effective when supervised by the dentist. Microabrasion is indicated for the removal of isolated discolorations that often are associated with fluorosis. Whitening toothpastes remove surface stains only through the polishing effect of the abrasives they contain. CONCLUSIONS AND PRACTICE IMPLICATIONS: Tooth whitening is a form of dental treatment and should be completed as part of a comprehensive treatment plan developed by a dentist after an oral examination. When used appropriately, tooth-whitening methods are safe and effective.

PMID: 12462698 [PubMed - indexed for MEDLINE]

Intentional use of the Hawthorne effect to improve oral hygiene compliance in orthodontic patients.

J Dent Educ. 2002 Oct;66(10):1129-35

Authors: Feil PH, Grauer JS, Gadbury-Amyot CC, Kula K, McCunniff MD

The purpose of this study was to evaluate whether the home care of noncompliant adolescent orthodontic patients with "poor" oral hygiene could be improved through the use of a deception strategy designed to intentionally induce the Hawthorne effect. This effect is often cited as being responsible for oral health improvements of control groups that receive placebo treatments. It is thought that participating in and fulfilling the requirements of a study alters subjects' behavior, thereby contributing to the improvement. Forty patients with histories of poor oral hygiene were assigned, in a quasi-random fashion, to two groups. Experimental subjects (n = 20) were presented with a situation that simulated participation in an experiment. These included the use of a consent form; distribution of tubes of toothpaste labeled "experimental"; instructions to brush twice a day for two minutes using a timer; and a request to return unused toothpaste. Control subjects (n = 20) had no knowledge of study participation. Tooth surface area covered with plaque was used as a proxy measure of home care behavior. It was measured at baseline, three months, and six months. Mean percentages of tooth surface covered with plaque for the experimental and control groups were 71 (+/- 11.52) and 74 (+/- 11.46) at baseline; 54 (+/- 13.79) and 78 (+/- 12.18) at three months; and 52 (+/- 13.04) and 79 (+/- 10.76) at six months. No statistically significant difference (p > .05) was obtained between groups at baseline. Statistically significant differences (p < .05) were found between groups at three and six months. Significant differences (p < .05) were also found only for the experimental subjects between baseline and each of the two subsequent observation periods. The efficiency and potential effectiveness of this strategy suggest that additional research be conducted to assess oral health improvements and possible applications to the private practice setting.

PMID: 12449206 [PubMed - indexed for MEDLINE]

Fluorosis: is it really a problem?

J Am Dent Assoc. 2002 Oct;133(10):1405-7

Authors: Bowen WH

BACKGROUND: Scientists have noted an association between mottled enamel and fluoride exposure since the early 1900s. By the mid-1900s, they also recognized that fluoride intake was related to lower caries incidence. To harness the protective effect of fluoride while limiting the occurrence of fluorosis, dental researchers have recommended that the fluoride level in chinking water be 1 part per million or less. OVERVIEW: Despite the recognition that fluoride levels in water can be controlled to offer caries protection with minimal risk of fluorosis, the cosmetic defect continues to appear. However, although the word "fluorosis" conjures up images of brown stained and pitted enamel, such severe cases rarely are seen in the United States. Children in this country are exposed to fluoride from numerous sources and the appearance of mild fluorosis is not unusual. CONCLUSIONS AND PRACTICE IMPLICATIONS: In most cases, fluorosis is a minor cosmetic defect that should not be cause for alarm. Dentists should educate their patients about the optimal range of fluoride intake for caries protection, sources of fluoride and the possibility of fluorosis.

PMID: 12403544 [PubMed - indexed for MEDLINE]

Clinical dentin hypersensitivity: understanding the causes and prescribing a treatment.

J Contemp Dent Pract. 2001 Feb 15;2(1):1-12

Authors: Jacobsen PL, Bruce G

Dentin hypersensitivity is a common condition of transient tooth pain associated with a variety of exogenous stimuli. There is substantial variation in the response to such stimuli from one person to another. Except for sensitivity associated with tooth bleaching or other tooth pathology, the clinical cause of dentin hypersensitivity is exposed dentinal tubules as a result of gingival recession and subsequent loss of cementum on root surfaces. The most widely accepted theory of how the pain occurs is Br&#xE4;nnström's hydrodynamic theory of dentin hypersensitivity. Dentinal hypersensitivity must be differentiated from other conditions that may cause sensitive teeth prior to treatment. Three principal treatment strategies are used. Dentinal tubules can be covered by gingival grafts or dental restorations. The tubules can be plugged using compounds that can precipitate together into a large enough mass to occlude the tubules. The third strategy is to desensitize the nerve tissue within the tubules using potassium nitrate. Several over-the-counter products are available to patients to treat this condition.

PMID: 12167939 [PubMed - indexed for MEDLINE]

Use of a whitening dentifrice for control of chlorhexidine stain.

J Contemp Dent Pract. 1999 Nov 15;1(1):9-15

Authors: Tilliss TS

A major drawback to clinicians prescribing and patients using chlorhexidine rinse is the development of extrinsic staining. In order to assess the effectiveness of a whitening dentifrice in controlling chlorhexidine stain, fifty-seven subjects rinsed with chlorhexidine twice daily while brushing twice daily with either fluoridated whitening or a fluoridated regular dentifrice. Stain was assessed at 1, 2, and 3 month intervals using a stain index with two components; one with parameters for color intensity and one for tooth percentage covered with stain. Facial surfaces accumulated less stain than lingual surfaces. For many, although not all surfaces, and at many, although not all time periods, the group utilizing the whitening dentifrice exhibited less staining. It is advantageous to recommend a whitening dentifrice that has demonstrated stain suppression when prescribing a chlorhexidine rinse. Improved patient satisfaction leading to increased compliance with the antimicrobial regimen is a desired outcome.

PMID: 12167896 [PubMed - indexed for MEDLINE]