Control Toothpaste Research Articles

A study to assess the plaque inhibitory action of herbal-based toothpaste: A double blind controlled clinical trial

Incorporating herbal extracts in the formulation of toothpastes is becoming an accepted mode of chemical plaque control. This study has been conducted to determine whether an herbal-based toothpaste would inhibit de novo plaque formation beyond that of a conventional fluoride Toothpaste. Fifteen adult volunteers, meeting the inclusion criteria (age range19 - 22) participated in a double-blind, cross-over controlled clinical trial, based on a variation of a 4 day plaque regrowth model. After professional tooth cleaning, subjects were asked to refrain from all mechanical hygiene measures for the next 96 h, and to use two rinses (1 min) a day as the only oral hygiene measure. At day 4, teeth were stained to assess the whole mouth plaque index (PI) using Turesky modification of Quigley Hein PI (TMQH), and to evaluate the PI for anterior teeth using a 10 scaled method of plaque scoring (NMPS). Herbal-based toothpaste provided statistically significant plaque inhibitory action measured by whole mouth plaque index, over control toothpaste (P = 0.032). There was no significant difference between test and control dentifrices in plaque index for anterior teeth using NMPS index. Pearson´s correlation coefficient showed significant values indicating close similarity between the two indices (r = 0.962, P < 0.0001). This study demonstrated the effectiveness of herbal-based toothpaste in the control of dental plaque formation over control paste. Further investigation into the potential value of this formulation among target population is recommended. Key words: Plaque inhibition, herbal based toothpaste, clinical trial, plaque index.

In vivo delivery of fluoride and calcium from toothpaste containing 2% hydroxyapatite

Objective: To measure the in vivo delivery of fluoride and calcium of a new oral health toothpaste containing zinc citrate trihydrate, hydroxyapatite, potassium citrate and α-tocopherol acetate (Vitamin E) compared to standard fluoride toothpaste. Methods: The new toothpaste contained 2% hydroxyapatite and 0.1% Vitamin E acetate (α-tocopherol acetate). It also included an anti-caries agent (1.1% sodium monofluorophosphate) an antigingivitis agent (2% zinc citrate trihydrate) and an anti-sensitivity agent (potassium cit-rate). Two studies were carried out. In study 1 the bio-availability of fluoride was measured in plaque after brushing with the test and a clinically tested fluoride toothpaste (control). In study 2 the effect of the test toothpaste on calcium levels in saliva and on the tooth surface was investigated compared to a toothpaste without added hydroxyapatite. Results: The fluoride concentration in plaque after brushing with the test and control toothpaste was significantly higher in both groups than before brushing (p<0.001). The difference in post-brushing fluoride concentration between the two groups was not statistically significant. The calcium concentration in saliva after brushing with the test toothpaste was higher than after brushing with the control toothpaste. The difference between the two means was statistically significant (p<0.001). Mean calcium concentration in tooth surface swab samples were significantly higher in the test group than in the control group (p<0.001). Conclusion: Plaque fluoride concentration was significantly increased after brushing with a new toothpaste containing 2% hydroxyapatite. The concentration of calcium in saliva and on the tooth surface was significantly increased compared to a standard toothpaste.

Enamel benefits of a new hydroxyapatite containing fluoride toothpaste

Objectives: To evaluate the enamel benefits of a new toothpaste containing hydroxyapatite (HAP) and sodium monofluorophosphate (SMFP). Methods: Salivary pellicle coated sound bovine enamel specimens were cycled six times through either HAP/water slurry or water alone treatments, followed by citric acid (15mM or 50mM, pH 3.8) challenges and saliva. The extent of enamel demineralisation was determined by changes in the enamel surface microhardness (SMH). In a second study, the sound enamel specimens were treated with either water, non-fluoride toothpaste, the HAP/SMFP toothpaste or the HAP/SMFP toothpaste pre-treated with a phosphatase enzyme, followed by a citric acid challenge (50mM, pH 3.8) and saliva. Changes in SMH were detemined after six cycles. The reduction in enamel demineralisation by the HAP/SMFP toothpaste was further evaluated in a pH cycling experiment where the acid challenge was 50mM acetic acid (pH 5.0) for 60mins. The remineralisation of sub-surface enamel lesions was measured via changes in SMH following treatment with the HAP/SMFP toothpaste or control toothpastes. In a radiolabelled study, sound and subsurface enamel lesions were treated with 45Ca labelled HAP toothpaste in an in vitro pH cycling study and the uptake of labelled calcium determined. Results: The HAP water slurry significantly (p<0.05) reduced the enamel demineralisation caused by the citric acid challenges, at both concentrations, compared to the water controls. The HAP/SMFP toothpaste significantly (p<0.05) reduced the enamel demineralisation caused by both citric acid and acetic acid challenges compared to the control treatments. In the remineralisation study, the HAP/SMFP toothpaste significantly (p<0.05) increased the remineralisation of enamel compared to a non-fluoride toothpaste. The radiolabelled HAP toothpaste study demonstrated the uptake of calcium to sound enamel and subsurface enamel lesions. Conclusions: A new HAP/SMFP containing toothpaste significantly (p<0.05) reduced the demineralisation of enamel caused by acid challenges compared to control treatments and significantly (p<0.05) increased the remineralisation of sub-surface enamel lesions compared to a non-fluoride toothpaste. A radiolabelled HAP study has demonstrated that calcium ions from the HAP are available to be involved in enamel remineralisation processes that are relevant to help protection from dental erosion and dental caries in vivo.

The clinical effects of a hydroxyapatite containing toothpaste for dentine hypersensitivity

Purpose: The aim of this study was to compare the effectiveness of hydroxyapatite containing toothpaste with positive control toothpastes in reducing dentine hypersensitivity. Materials and methods: This clinical trial was a double-blind, randomized, parallel group comparison of two, namely hydroxyapatite containing toothpaste and strontium chloride containing toothpaste. A total of 55 subjects were included in this study. The subjects were given randomly assigned one of the two toothpastes after received tooth brushing instruction at baseline. Some clinical indices(PI, GI, PD), verbal rating score(VRS) for sensitivity to stimulus, the effect in relieving sensitivity and visual analogue scale(VAS) for sensitivity at baseline, week 2, week 4 and week 8 were assessed. All data were evaluated by intention-to-treat analysis. Results: Overall, PI and GI scores were significantly reduced compare baseline in all groups(p 0.05). Conclusion: This study demonstrated that the new hydroxyapatite containing toothpaste was similarly effective in reducing dentine hypersensitivity with pre-existing benchmark toothpaste. (J Korean Acad Periodontol 2009;39:87-94)

Instant tooth whitening from a silica toothpaste containing blue covarine

Objective To measure the instant whitening effect delivered immediately after brushing with a novel silica whitening toothpaste containing blue covarine. Methods A controlled, single blind, cross-over study was performed to compare the tooth colour measured in a group of subjects at baseline and immediately after brushing with a silica whitening toothpaste containing blue covarine versus a clear gel negative control toothpaste. Measurements of tooth colour were made using a mobile non-contact camera-based digital imaging system and expressed as CIELAB and WIO whiteness index. Results Analysis of covariance (ANCOVA) showed that the silica whitening toothpaste containing blue covarine was significantly more effective than the negative control toothpaste ( p < 0.05), and made teeth measurably less yellow, less red and overall whiter immediately after brushing. Conclusion A statistically significant reduction in tooth yellowness and improvement in tooth whiteness was measured immediately after brushing with a novel whitening toothpaste containing blue covarine.

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

BackgroundOne 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.MethodsA 5 × 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.ResultsThe 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.ConclusionFrom the results it can be concluded that slightly acidified fluoridated dentifrices may have a certain positive effect on enamel remineralization.

The plaque and gingivitis reducing effect of a chlorhexidine and aluminium lactate containing dentifrice (Lacalut aktiv®) over a period of 6 months

The aim of the study was to determine the plaque and gingivitis reducing effect of a dentifrice containing chlorhexidine and aluminium lactate compared with a control toothpaste during the course of 6 months. This randomized, double-blind study looked prospectively at participants over a 6-month period. Plaque, gingivitis, calculus formation and tooth staining were assessed in 59 participants, who were divided into parallel groups. The participants used either a chlorhexidine and aluminium lactate-containing toothpaste (test group) or a minus active control toothpaste (control group). Parameters were assessed at baseline and again after 1, 3 and 6 months. After 6 months of product use, both groups had less gingivitis compared with the baseline evaluation (p<0.001). At this time point, the test group showed a statistically significant lower gingival index values compared with the control group (p=0.001). No statistically significant differences between either the groups or time points were detected with regard to plaque index and the development of calculus and staining. Although there was a statistically significant difference at 6 months between test and control groups, this difference was too small to be considered clinically meaningful.

In vivo evaluation of an oral health toothpaste with 0.1% vitamin E acetate and 0.5% sunflower oil (with vitamin F)

Objectives: To measure the delivery of active ingredients of a new oral health toothpaste with zinc citrate trihydrate/triclosan and containing α-tocopherol acetate (vitamin E) and sunflower oil (vitamin F) and compare its anti-plaque/anti-ginigvitis efficacy to that of a clinically proven control toothpaste. Methods: The new toothpaste contained 0.1% vitamin E acetate (α-tocopherol acetate) and 0.5% sunflower oil as a source for vitamin F (linoleic acid). It also included an anti-caries agent (0.32% sodium fluoride) and a proven gum-health active system (0.3% triclosan and 0.75% zinc citrate trihydrate). Three studies were carried out. In study 1 (n=45) the bio-availability of zinc and triclosan was measured in plaque 12h after brushing with the test toothpaste. In study 2 (n=93) the effect of the test toothpaste on plaque and gingival condition was investigated over three weeks in a randomised, parallel, double-blind, controlled design. The control toothpaste was a fluoride toothpaste containing 0.3% triclosan. Healthy adult volunteers with GI>1.0 were enrolled and given a full mouth scale and polish. Plaque levels (Modified Quigley and Hein Index) and gingival condition (Gingival Index) were assessed at baseline and after three weeks. Study 3 (n=93) lasted for nine weeks. Subjects did not receive a full mouth scale and polish at baseline but the study was otherwise identical to study 2. Results: In study 1, no triclosan was detected in baseline plaque samples; mean triclosan concentration in plaque 12h after last brushing with the test toothpaste was 5.78μg/g (std=4.74); the mean zinc concentration rose from 15.2μg/g zinc ion in baseline plaque samples to 84.3μg/g zinc ion (p>0.0001) in samples taken 12h after brushing. In study 2, mean plaque and gingival indices were significantly reduced in both test and control group after three weeks compared to baseline; there was no significant difference between the test and control group after three weeks. In study 3, mean plaque and gingival indices were significantly reduced in both test and control group after three and nine weeks compared to baseline; there was no significant difference between the test and control group after three and nine weeks. Conclusion: The delivery of zinc and triclosan from a new oral health toothpaste containing zinc citrate trihydrate and triclosan was unaffected by the addition of α-tocopherol acetate (vitamin E) and sunflower oil (vitamin F). The new toothpaste was effective in reducing plaque levels and improving gingival conditions to the same degree as a clinically proven positive control. Regular oral hygiene with this toothpaste is therefore beneficial for maintaining healthy and strong gums.

The anti-caries efficacy of a silica-based fluoride toothpaste containing zinc citrate, triclosan, vitamin E and sunflower oil

Aim: To evaluate the ability of a new fluoridated toothpaste, containing 1450 ppm fluoride (as sodium fluoride), vitamin E and sunflower oil, to reduce the acid-dissolution of sound dental enamel (demineralisation study), promote remineralisation of demineralised enamel (remineralisation study) and deliver and incorporate fluoride into demineralised enamel (fluoride uptake), when compared to a clinically-tested fluoride toothpaste and a non-fluoride negative control toothpaste. Methods: The de- and remineralisation studies both utilised pH cycling protocols. In the demineralisation study, sound enamel sections were used and efficacy was measured by calcium analysis of experimental solutions. For the remineralisation study, artificial carious lesions were microradiographed before and after pH-cycling. For fluoride-uptake, lesions were immersed in slurries of the toothpastes and subsequently, an acid-etching technique was used to sample the lesions. Results: Expressed as mean values (SD), for the new fluoride toothpaste, the positive and negative controls respectively were: demin study, calcium demineralisation rate = 0.0980 (0.010), 0.110 (0.009) and 0.493 (0.043) μg Ca.mm-2.h-1; remin study, Δ;Z = 20.7 (16.6), 24.6 (14.9) and −34.7 (13.1) %; F-uptake = 27.8 (1.56), 29.6 (2.00) and 1.06 (0.430) μg F.cm-2. Compared with the negative control, both the positive control and the test toothpaste significantly reduced enamel demineralisation and increased both remineralisation and fluoride uptake to enamel. There were no significant differences between the new fluoride toothpaste and positive control. Conclusion: Fluoride delivered from the new silica-based toothpaste containing vitamin E and sunflower oil was as effective as that delivered from a clinically proven toothpaste.

Electric Pulp Tester Conductance Through Various Interface Media

A conducting media is necessary when using an electric pulp tester (EPT). The objective of this study was to observe differences in conductance through various media. We hypothesized that variations in current conductance through different media exist. The pulp chamber of a freshly extracted premolar was exposed, and the cathode of a voltmeter was inserted into the pulpal tissue. The anode was coupled to the EPT handpiece. The measurement taken during dry (no interface media) EPT tip-to-tooth contact was 0 V, which served as negative control. EPT tip directly touching the cathode measured 3.9V and served as positive control. A number of media readily available in the dental office were tested. Data was analyzed using single factor ANOVA. Listerine (3.3) conducted the most voltage (p < 0.5). Of nonliquids, K-Y Brand UltraGel and Crest Baking Soda & Peroxide Whitening Tartar Control toothpaste recorded significantly (p < 0.05) higher voltage readings (1.4 V).

Effect of triclosan/copolymer‐containing toothpaste on the association between plaque and gingival bleeding: a randomized controlled clinical trial

To study longitudinal associations between plaque and gingival bleeding and multilevel variance/covariance structures after introducing triclosan-containing toothpaste. A 10-week, randomized, two-arm, double-masked, controlled clinical trial was conducted in 34 healthy, non-smoking females with plaque-induced gingivitis. Clinical periodontal examinations were repeated every other week. At week 4, test toothpaste containing 0.24% sodium monofluorophosphate, 0.3% triclosan, and 2% polyvinyl-methyl ether maleic acid; or control toothpaste containing 0.76% sodium monofluorophosphate and 0.1% sodium fluoride, were randomly distributed. Multivariate multilevel models indicated that, after introducing experimental toothpastes, subject random error was reduced from 0.6 to below 0.2. The odds ratio (OR) of bleeding on probing (BOP) was about 30% less in the test than in the control group (p<0.01). At the end of the experiment, ORs for BOP and plaque index scores 1-3 (reference 0) were 2.1-2.4 in the control group, but 1.1-1.9 in the test group (p<0.05). No effects on plaque levels and calculus were observed. Multivariate multilevel modelling allows the study of fixed and random effects of experimental toothpastes on gingival inflammation in small sample. Triclosan appears to attenuate the causal association between supragingival plaque and gingival bleeding in gingivitis.

Review of the extrinsic stain removal and enamel/dentine abrasion by a calcium carbonate and perlite containing whitening toothpaste

There has been an increase in the demand from consumers and patients for products that whiten teeth. To meet this demand, a whitening toothpaste containing calcium carbonate and perlite as the abrasive system and an efficacious fluoride source has recently been launched. The aim of the current paper is to review the toothpaste's stain removal efficacy and its effects on enamel and dentine wear. It has been shown to be effective at removing model extrinsic stain in vitro. Further, it has been shown to be more effective in removing naturally occurring extrinsic tooth stain than a silica non-whitening control toothpaste after two weeks of twice daily brushing in a parallel group, double-blind clinical study using 152 adult volunteers. In addition, the enhanced whitening effect did not give a clinically relevant level of wear to enamel or a significant increase in dentine wear compared to marketed non-whitening toothpaste formulations, as shown by using an in situ type model with ex vivo brushing.

Potassium containing toothpastes for dentine hypersensitivity.

Dentine hypersensitivity may be defined as the pain arising from exposed dentine, typically in response to external stimuli, and which cannot be explained by any other form of dental disease. Many treatment regimens have been recommended over the years, and in recent years particular attention has been focused on toothpastes containing various potassium salts. To compare the effectiveness of potassium containing toothpastes with control toothpastes in reducing dentine hypersensitivity. The following databases were searched: Cochrane Oral Health Group Trials Register (searched until August 2005); CENTRAL (until August 2005); EMBASE/MEDLINE, PubMed, Web of Science (until September 2005). Bibliographies of clinical studies and reviews identified in the electronic search were checked for studies published outside the electronically searched journals. Randomised controlled trials (RCTs) in which the effect on dentine hypersensitivity of potassium containing toothpastes was tested against non-potassium containing control toothpastes. Two of the review authors independently recorded the results of the included trials using a specially designed form. Sensitivity was assessed by using thermal, tactile, air blast, and subjective methods. Six studies were included in the meta-analysis which showed the statistically significant effect of potassium nitrate toothpaste on air blast and tactile sensitivity at the 6 to 8 weeks follow up, e.g. the meta-analysis of air blast sensitivity showed a standardized mean difference in sensitivity score of -1.25 (95% CI: -1.65 to -0.851) in favour of treatment. The subjective assessment failed to show a significant effect at the 6 to 8 week assessment. The evidence generated by this review is based on a small number of individuals. Furthermore, the effect varies with the methods applied for assessing the sensitivity. Thus no clear evidence is available for the support of potassium containing toothpastes for dentine hypersensitivity.

Dentinal hypersensitivity?-Can this agent be the solution?

To test the efficacy of desensitizing tooth paste containing EMS salts in alleviating dentinal hypersensitivity, reducing plaque accumulation, and reducing gingivitis. 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. 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.

The effect of a calcium carbonate/perlite toothpaste on the removal of extrinsic tooth stain in two weeks

To assess the effect of a calcium carbonate/perlite toothpaste on the levels of extrinsic stain removed at two weeks compared to a silica control toothpaste. In this parallel group, double-blind study, subjects were stratified by natural baseline stain and tobacco use and allocated at random to one of the two study toothpastes. Subjects brushed with their allocated toothpaste twice daily for two weeks before extrinsic tooth stain was again assessed. The study was performed at 4-Front Research UK Limited, Maldon, UK. 152 adult subjects with at least eight assessable incisors/ canines with natural extrinsic tooth stain completed the study. The extrinsic tooth stain on the facial surfaces of incisors and canines was measured using the Macpherson modification of the Lobene Stain Index. Both of the toothpaste groups had significantly less stain after two weeks of use compared to the baseline value (p<0.001). Analysis of covariance on the sum of the whole mouth stain scores showed that the calcium carbonate/perlite toothpaste removed significantly more stain over the two week study than the silica control toothpaste (p<0.05). Twice daily brushing for two weeks with a calcium carbonate/perlite toothpaste removes more extrinsic stain than a silica control toothpaste.

O10 The technology behind Colgate® TotalTM toothpaste

In the early 1990s, a break‐through toothpaste, known as Colgate® Total™, was launched with documented long‐lasting activity against plaque, gingivitis, calculus, tooth decay and bad breath. The technology behind this toothpaste is the combination of triclosan, a polyvinyl methyl ether maleic acid (PVM/MA) copolymer and sodium fluoride (TCF). The function of the copolymer is to ensure optimal oral retention and prolonged release of the antibacterial triclosan. Effective levels of triclosan have been measured in the oral cavity 12 h after brushing the teeth. This allows prolonged control of oral bacteria that can lead to the formation of dental plaque and gingivitis and bad breath. Similarly, the retention of triclosan to oral surfaces during 2 years regular use of the product has led to a significant reduction in incremental coronal caries compared to an ADA‐approved anti‐cavity fluoride toothpaste. Furthermore, significantly less calcium phosphate has been shown to be present in dental plaque after brushing the teeth with the triclosan/copolymer toothpaste, and this has resulted in the reduced formation of tartar. A new variant of the triclosan/copolymer/fluoride toothpaste, having the numerous therapeutic and aesthetic benefits of the original formula, has been made available to consumers. The new dentifrice, which contains an impactful breath freshening flavor, has been documented to be significantly better (P &lt; 0.05) than a control toothpaste in providing sustained control of bad breath over 12 h. After 12 h, breath odor was reduced from 51% compared to the control. The long term retention and subsequent release of triclosan by the copolymer in the TCF formula provide consumers protection against plaque, gingivitis, tartar, caries and bad breath.

Efficacy of Fluoride Toothpaste in Preventing Demineralization of Smooth Dentin Surfaces and Narrow Grooves in situ under Frequent Exposures to Sucrose or Bananas

The use of models simulating fissures allows studying demineralization at sites that are most prone to caries in vivo. In practice, most in situ models use flat surfaces. Our objectives were: (1) to compare the demineralizing potential of sucrose solution with that of bananas and (2) to study the effect of fluoride toothpaste on demineralization in situ in an easily accessible site and a plaque stagnation site. Four volunteers wore bovine dentin specimens with narrow grooves and a smooth surface for two 1-week in situ periods, with eight 1-min sugar exposures daily: either by a rinse with 10% sucrose, or by consumption of a piece of banana. Twice daily, the appliance was dipped in toothpaste slurry of a control (fluoride-free) toothpaste at one side and a fluoride toothpaste at the contralateral side. Demineralization was assessed by transversal microradiography. We found no difference in dentin demineralization after frequent exposure to either sucrose solution or bananas. Fluoride toothpaste effectively protected dentin only at the smooth surface. In the grooves, fluoride affected the demineralization pattern; it drove lesions towards the bottom of the groove. We conclude that assessing only smooth surfaces in intraoral tests might lead to underestimated food cariogenicity and to overestimated efficacy of fluoride-containing toothpaste.

Clinical studies to determine the effectiveness of a whitening toothpaste at reducing stain (using a forced stain model)

Two single centre, randomized single-blind, crossover studies were performed, to compare the effect of a test toothpaste with a conventional fluoride paste in the inhibition and removal of extrinsic dental stain promoted by repeated chlorhexidine/tea rinses. These studies used 24 subjects in each of two separate clinical trials. On the Friday before each trial period, the subjects received a prophylaxis to remove all staining, plaque and calculus deposits. On the following Monday, subjects were checked whether they were stain free and then under direct supervision they rinsed with a 0.2% chlorhexidine mouthrinse, immediately followed by a rinse with a warm black tea solution. This cycle was repeated hourly eight times throughout the day and on the following days until the Friday. In addition subjects also received daily a single toothpaste slurry rinse or control water rinse in the morning and lunchtime. No other form of oral hygiene was permitted during this period. On the Friday, both stain area and intensity was assessed using the Lobene Stain Index. For the stain removal study, stain was promoted again using chlorhexidine and tea rinses. After 4 days, stain was measured both prior to and immediately after brushing with the allocated toothpaste for 2 min. Subjects were then instructed to use the toothbrush at home according to their normal oral hygiene practices. On the following Wednesday, the amount of stain present was re-assessed. Each subject subsequently received a thorough prophylaxis to remove all plaque calculus and staining before starting the following periods of the study. The study showed no difference in the ability of the test whitening toothpaste, control toothpaste and water control at inhibiting stain. There was also only a small difference (3.5% for product of area and intensity) between the ability of the two toothpastes to help remove stain after a single brushing. The difference was however in favour of the test product which approached a conventional level of significance (P = 0.089). There was no evidence of superiority for either of the pastes after normal home usage. This study has suggested that the test product may have some advantage over the conventional paste at removing stain but the magnitude of difference would appear to be small and of little clinical relevance.

The effect of a new toothpaste containing potassium nitrate and triclosan on gingival health, plaque formation and dentine hypersensitivity

The purpose of this study was to investigate the effect of a new toothpaste containing an antiplaque and antiinflammatory agent (0.3% triclosan), a desensitizing agent (5% potassium nitrate) and an anticaries agent (0.76% sodium monofluorophosphate (SMFP)) on gingival health, plaque formation and dentine hypersensitivity in a 12-week home study. The efficacy of the test toothpaste was compared with that of a control toothpaste containing 5% potassium nitrate and 0.76% SMFP and a benchmark product containing only 0.76% SMFP. One hundred and two healthy volunteers, who had a minimum of 20 natural permanent teeth with no probing depth >4 mm and at least one sensitive tooth, participated in this study. Following enrollment, the subjects received a dental prophylaxis and instruction in brushing technique. After a 4-week pre-experimental phase, baseline gingival bleeding index (GBI), plaque index (PI) and visual analogue scales (VASs) indicating dentine hypersensitivity levels responding to tactile and air stimuli were assessed. The subjects were then randomly given one of the three toothpastes; test, control, or benchmark toothpaste, and a soft-filamented toothbrush for home use. The GBI, PI and VASs were re-examined at weeks 4 and 12. Overall, the GBI scores were significantly reduced compared with baseline in all groups (p<0.01). However, there was no significant difference in GBI score among the three comparison groups. The PI score decreased in the test group and benchmark group from baseline to the end of study, whereas there was no significant change in the control group. Post hoc comparison indicated that the PI score was not statistically different between the three groups. There was a significant difference between the three treatment groups for sensitivity. For both the tactile and air stimuli, the reductions in VAS sensitivity scores for the test group and the control group were significantly greater compared with the benchmark group. Although the sensitivity score for air stimulus decreased more rapidly from baseline to week 4 in the test group, there was no overall difference between the test group and the control group. This study demonstrated that the new toothpaste was effective in reducing dentine hypersensitivity. More studies are needed to further determine the potential interaction between triclosan and potassium nitrate in dentifrices.

The effect of a triclosan/copolymer/fluoride liquid dentifrice on interproximal enamel remineralization and fluoride uptake

The authors measured the enamel remineralization of dental interproximal surfaces by a triclosan/copolymer/fluoride liquid dentifrice to test its performance against that of a standard toothpaste. In a randomized, crossover, blinded, in situ protocol, the authors fitted 19 healthy adult subjects with mandibular appliances holding bilateral, interproximal bovine enamel slabs. They measured initial abrasion levels and fluoride content. In a two-phase crossover protocol, they evaluated the percentage of surface mineral recovery, or SMR, and fluoride uptake caused by the experimental dentifrice and a fluoride-containing traditional control toothpaste. Abrasion depths were similar and not different statistically (P > .05). The interproximal blocks exposed to the triclosan-containing liquid dentifrice had a mean fluoride uptake that was nearly 100 parts per million (13.1 percent) greater than that achieved with the American Dental Association-accepted control dentifrice. This finding, while not statistically significant, may indicate enhanced performance of the experimental dentifrice because the initial enamel slab abrasion depths were shown to be quite uniform. Moreover, the blocks exposed to the experimental toothpaste had a 49.8 percent SMR, while the positive control blocks had an SMR of only 36.9 percent. This enhanced remineralization performance was statistically significant (P < .05). This is the first study to show enhanced performance of a triclosan-containing liquid dentifrice in preventing interproximal dental caries. The difference in percentage of SMR was statistically significant and is likely to be clinically relevant. The results of this preliminary study offer evidence supporting clinicians' recommendation of the new liquid dentifrice to patients who are prone to developing interproximal carious lesions.