Abstract
BackgroundIt is important for Dental Professionals to consider the evidence for the effectiveness of the preventive strategies used to maintain good oral health and reduce the risk of caries in their patients. Whilst many of the traditional preventive activities, including the recommendation and use of fluoride products and the placement of fissure sealants have a wealth of clinical evidence to support their use, some of the newer preventive agents have a more limited evidence base. In order to investigate the level of scientific support behind one such technology, a systematic literature review was carried out to assess the effectiveness of Tooth Mousse® (MI Paste®) and Tooth Mousse Plus® (MI Paste Plus®) in the prevention and treatment of early dental caries.MethodsA broad search strategy using Medline via OvidSP and EMBASE was performed in order to capture all published studies to related Casein Phosphopeptide-Amorphous Calcium Phosphate. In addition to the above searches the terms “CPP ACP” and “casein phosphopeptide amorphous calcium phosphate” were searched using PREMEDLINE and the Cochrane Central Register of Controlled Trials. Inclusion criteria were clinical trials of participants of any age, comparing the use of Tooth Mousse® (MI Paste®) or Tooth Mousse Plus® (MI Paste Plus®) to a routine oral care regimen and reporting recognised clinical outcome measures for early caries lesions. Only research studies in English were selected.Results7576 articles were identified, but the majority were duplicates. Once these were removed 172 articles were inspected and the focus on ‘CPP-ACP formulations of Tooth Mousse® (MI Paste®) and Tooth Mousse Plus® (MI Paste Plus®) resulted in 29 articles being selected, and of these 12 studies met the inclusion criteria and were considered acceptable for the systematic review.DiscussionThe overall findings of this review did not show any significant benefits of using Tooth Mousse® (MI Paste®) products over brushing with a fluoride toothpaste for the prevention of early dental caries. With regard to the regression of white spot lesions in orthodontic patients there is a tendency towards a benefit for the use of Tooth Mousse® (MI Paste®) but the quality of evidence is limited. There is a lack of evidence to support the use of Tooth Mousse Plus® (MI Paste Plus®) over Tooth Mousse® (MI Paste®) at this time.ConclusionThis review suggests that further well-designed randomized controlled trials are required prior to the widespread recommendation of Tooth Mousse® products for the prevention and treatment of early dental caries in the general population.Electronic supplementary materialThe online version of this article (doi:10.1186/s12903-015-0095-6) contains supplementary material, which is available to authorized users.
Highlights
It is important for Dental Professionals to consider the evidence for the effectiveness of the preventive strategies used to maintain good oral health and reduce the risk of caries in their patients
As the current systematic review is focussed entirely on the Casein phosphopeptideamorphous calcium phosphate (CPP-amorphous calcium phosphate (ACP)) formulations of Tooth Mousse® (MI Paste®) and Tooth Mousse Plus® (MI Paste Plus®) – all studies employing any other formulations of Calcium phosphopeptide (CPP)-ACP including solutions, chewing gum and dentifrice were excluded
A double-blind randomized clinical trial to test whether more white spot lesions would regress in participants using Tooth Mousse® than a placebo paste
Summary
It is important for Dental Professionals to consider the evidence for the effectiveness of the preventive strategies used to maintain good oral health and reduce the risk of caries in their patients. Despite the general improvements in oral health, caries continues to be a challenge for the dental team, for those clinicians working in low income and socially disadvantaged areas where the prevalence of caries is still a public health issue. Another change that has had an impact on clinical practice is the increased prevalence of new carious lesions in adults, reaching a level as high as that seen in children [5]. The profession has to plan treatment and preventive care pathways based on the understanding that dental caries is no longer a rapidly developing problem in childhood, but a slowly progressing disease of adulthood
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