Extrinsic Stain Research Articles

Effect of chlorhexidine mouthwashes on periodontal parameters and extrinsic tooth staining in orthodontic patients

Periodontal health and biofilm control are primordial to success in orthodontic treatment. This study aimed to evaluate the effect of chlorhexidine (CHX) mouthwashes on periodontal status and extrinsic tooth staining in orthodontic patients. Thirty-three patients of both sexes, aged 11-33 years, under orthodontic treatment with fixed appliances at<16 months, were randomly distributed into 2 groups. In the control group, patients received mechanical hygiene instruction, and in the experimental group, patients also used CHX wash twice a week for 60 days. The effectivity of the protocols was evaluated using the plaque, gingival, gingival bleeding, and discoloration indexes before the hygiene protocol was applied, 15, 30, and 60 days after protocol implementation. In the experimental group, there was a decrease in the plaque, gingival, and gingival bleeding indexes at the different evaluation periods (P<0.05). In addition, there was a significant difference in the discoloration index at 60 days compared with initial time points after implementing hygiene protocols in the experimental group (P<0.05). In contrast, there were no significant differences in plaque, gingival, gingival bleeding, and discoloration indexes in the control group at any time (P>0.05). CHX mouthwash administered 30 days, twice a week, significantly improved the periodontal status with mild brown staining. After this period, expressive extrinsic tooth staining was observed.

Evaluation of herbal gel toothpaste formulated using bay leaf essential oil on physicochemical characteristics and extrinsic stain removal

Evaluation of herbal gel toothpaste formulated using bay leaf essential oil on physicochemical characteristics and extrinsic stain removal

Minimally invasive technique for improvement of aesthetic in cases of mild to moderate fluorosis: A case report

Patients have been increasingly worried about tooth discolouration in recent years, particularly when the maxillary anterior teeth are implicated. Dental fluorosis appears clinically as white patches or opaque white lines, or the tooth surface may have a white, parchment-like look. The brown stains visible in moderate to severe fluorosis are caused by the ingestion of extrinsic stains, primarily from the food. Higher fluoride concentrations cause discontiguous or confluent pitting of the enamel surface, which is accompanied by extrinsic stains.The aim of this case report is to demonstrate a conservative technique of minimally invasive procedures for esthetic correction in anterior teeth which includes methods like microabrasion, tooth bleaching and resin infiltration carried out in sequence for the removal or masking of fluorosis stains in maxillary and mandibular anteriors.

Investigation of the effects of Bipolar Radiofrequency Energy on the Structural Morphology of Dental Plaque.

To investigate the effects of radiofrequency (RF) energy, applied through a power toothbrush, on the structural morphology of dental plaque and its bacteria components. Previous studies showed that a toothbrush powered by RF (ToothWave) effectively reduces extrinsic tooth stains, plaque, and calculus. However, the mechanism by which it reduces dental plaque deposits is not fully established. Multispecies plaques at sampling time points of 24, 48, and 72 hours were treated with the application of RF using ToothWave with the toothbrush bristles 1 mm above the plaque surface. Groups that underwent the same protocol but without RF treatment served as paired controls. Confocal laser scanning microscope (CLSM) was used to determine cell viability at each time point. Plaque morphology and bacteria ultrastructure were viewed using scanning electron microscope (SEM) and transmission electron microscope (TEM), respectively. Data were analyzed statistically using analysis of variance (ANOVA) and Bonferroni post-tests. At each time, RF treatment significantly (p < 0.05) reduced the viable cells in plaque and caused a substantial disruption of plaque morphology, while the untreated plaque had intact morphology. Cells in treated plaques showed disrupted cell walls, cytoplasmic material, huge vacuoles, and heterogeneity in electron density, while these organelles remained intact in untreated plaques. The application of RF via a power toothbrush can disrupt plaque morphology and kill bacteria. These effects were enhanced by the combined application of RF and toothpaste.

Characterization of the oral microbiome and gut microbiome of dental caries and extrinsic black stain in preschool children.

A lower prevalence of dental caries (hereafter termed "caries") has been observed in children with dental extrinsic black stain (EBS). We investigated the epidemiologic characterization of EBS and explored the possible role of the oral microbiome (OM) and gut microbiome (GM) in EBS formation and caries prevention. In an epidemiologic survey, 2,675 children aged 3-6 years were included. Thirty-eight of these children (7 children had both caries and EBS, 10 had EBS only, 11 had caries only, and 10 were healthy children) were recruited for 16S rRNA sequencing and collection of samples of supragingival plaque and feces. Collected plaque samples were divided into four groups: BCP (EBS+, caries+), BP (EBS+, caries-), CP (EBS-, caries+), and P (EBS-, caries-). Fecal samples were also divided into four groups: BCF (EBS+, caries+), BF (EBS+, caries-), CF (EBS-, caries+), and F (EBS-, caries-). EBS was observed in 12.10% of this population. Children with EBS had a significantly reduced prevalence of caries and a lower mean value of decayed-missing-filled teeth (dmft; p < 0.01). According to analyses of dental plaque, the P group had the most complex microbiome. The BCP group exhibited greater operational taxonomic unit (OTU) richness but a reduced evenness compared with the BP group, and the CP group showed greater OTU richness than the BP group. At the genus level, higher abundance of Actinomyces and Cardiobacterium species was observed in the BCP group. Higher abundance of Lautropia and Pesudopropionibacteriumin species was observed in the BP group compared with P and CP groups, respectively (p < 0.05). Veillonella species were significantly more common in P and CP groups than in BP groups, whereas Porphyromonas and Fusobacterium species were more common in the CP group (p < 0.05). With regard to the GM, the CF group exhibited greater OTU diversity than the BF group. The GM in the BCF group exhibited the most complex relationships across all fecal groups. GM groups could be distinguished by various unique biomarkers, such as Escherichia and Shigella species in the BCF group, Agathobacter and Ruminococcus species in the CF group, Lactobacillus species in the BF group, and Roseburia species in the F group. Our results suggest that EBS is a possible protective factor against early-childhood caries. Dental plaque and the GM may be relevant to EBS in primary dentition.

The mechanical properties, tribological behaviors and color stability of a feldspar nanoceramics strengthening extrinsic stain for high-translucent zirconia

The present work is aimed to explore the mechanical properties, tribological behaviors and color stability of nanoceramics and microceramics strengthened extrinsic stain coatings (NS and MS) upon high-translucent zirconia (TZ). The Na-rich feldspar ceramics component, microstructure and particle size of NS and MS were verified. The mechanical properties including elastic modulus and hardness of NS were enhanced compared to MS. Reciprocating wear tests under a ball-on-plate configuration manifested that the reduced coefficient of friction, wear depth and wear volume loss of NS was evaluated after 1 × 10 4 cycles and the wear scar morphology of NS characterized by microcracks while MS featured more delamination and wear debris. Post toothbrushing simulation revealed that the color stability of extrinsic stain coatings was elevated with the addition of feldspar nanoceramics. The feldspar nanoceramics strengthening extrinsic stain exhibited enhanced elastic modulus, hardness, wear resistance and color stability, especially for TZ.

Modified extrinsic tooth stain index and its clinical applicability.

The first index for the assessment of extrinsic stain was published by Lobene in 1986. Using the Lobene stain index in the field is very cumbersome as well it does not meet the general requirement of an index, i.e., the index is to be simple, rapid, highly reproducible, and sensitive enough to detect small changes in the staining level. Hence, there was a need to develop an alternative index for the same purpose. Hence, the only present study was undertaken to propose a modified stain index with more simplicity and clarity. An observational study was carried out among 16-44-year-old participants who had at least six natural teeth and were generally healthy. For the revised index, the criteria and codes for intensity were kept the same as MacPherson Index but the criteria for recording area were modified. The data scoring for each tooth was mentioned in the proposed table and was recorded for each of the surfaces according to the proposed area and intensity codes. Analysis was carried out using SPSS version 21 (IBM, Inc. Virginia, United States). Inferential statistics were performed using the Mann-Whitney U-test. Nonparametric tests were applied following the imposition of a numerical interval scale the same as the Lobene index. No statistically significant difference was appreciated for the area, intensity, and product of area × intensity when compared for measurements recorded by two indices as P > 0.05. Hence, validating the proposed index for the clinical application. The proposed modified index may be advantageous over its conventional counterpart due to its ease of recording and concise scoring and also less complexity in the area to be recorded.

Effect of papaya extract (Carica papaya L.) on color changes of dental elements due to coffee extrinsic stain: An experimental laboratory study

Abstract Aim: Papaya fruit was known to have papain enzymes that are able to break down the protein that makes up plaque, where extrinsic stains attach to teeth. The purpose of this study was to determine the effect of papaya fruit extract (Carica papaya L.) on color change of denture elements due to coffee extrinsic stain. Materials and Methods: This study was an experimental laboratory using pre-test and post-test designs. The specimens used in this study were elements of the maxillary central incisor (24 acrylic resin dentures) that have been stained by coffee, totaling 6 specimens per group. The specimens were immersed for 9 days in papaya fruit extract with a concentration of 40%, 60%, 80%, and 100%. Measurement of the specimen color change was done visually before and after soaking papaya extract using Shade Guide Vita 3D Master. Statistical test was carried out with a confidence level of 95%. Results: The results showed that there was a significant color change of the denture elements after soaking papaya extract. The value color dimension changes to be brighter, while the hue and chroma have no significant changes. In the comparison test of four treatment groups with extract concentration (40%, 60%, 80%, and 100%). This study showed that the 60% concentration group had a greater influence on the change in color dimension value. Conclusion: Papaya fruit extract can affect the color change of acrylic resin denture elements that have undergone coffee staining. Immersion of denture elements in papaya fruit extract with a concentration of 60% had a greater effect on color brightness.

Overview on Mechanisms and Complications of Dental Bleaching

Abstract: The practice of bleaching teeth is very common, and various tools and methods have been developed specifically for this purpose. Whiten teeth, various approaches and products are available, each with a distinctive mode of operation. These include products used at home, such as toothpaste, gels, and films, and systems used in dental offices where products with highly concentrated bleaching agents are used under close supervision. Intrinsic and extrinsic staining are the two main types of tooth discolouration causes. Intrinsic staining, also known as internal staining, can be caused by a variety of things, including genetics, ageing, antibiotics, high fluoride levels, and developmental disorders. It can even begin before the tooth has fully emerged. The effectiveness of these various techniques depends on the specific tooth discolouration being treated. Dental bleaching procedures have emerged due to technical advancements to make the procedure easier to use and increase comfort, safety, and efficiency. External dental whitening is typically accomplished with hydrogen peroxide that has been photoactivated or not or carbamate. However, the teeth whitening process in the home and business leads to sensitivity. Certain risks associated with tooth whitenings, such as increased tooth sensitivity and gingival irritation, have been known to the public and professional communities. Recent research has identified other risks, including tooth surface softening and roughening, increased demineralization risk, dental restoration degradation, and unfavourable colour change. This article aims to review and synthesize the most recent research on tooth bleaching methods and side effects.

Comparison of bleaching effect on discolored teeth by different beverages: an in vitro study

Background: Tooth bleaching is an effective method to remove both endogenous and exogenous stains. This study aims to evaluate and compare the bleaching efficacy of tea, coffee and cola stains on teeth. Materials and Methods: 30 bovine tooth samples were divided into three groups: tea, coffee and cola (n = 10/group). Staining was obtained by soaking the tooth samples for 3 weeks in each drinks. Before bleaching, tooth samples were polished with fine pumice powder and slow-speed handpiece for 10 seconds, speed of 2500 rpm. The bleaching process was performed with 10% carbamide peroxide for 14 days, 8 hours/day. The effectiveness of the bleaching process is evaluated through the change in the brightness (L*), saturation (a*, b*) values and the total color change (DE*) of the CIELAB system with Crystaleye spectrocolorimeter. Results: After bleaching process, all three stained groups showed the color changes in the following direction: increase L*, decrease a*, decrease b*. The polishing phase could remove part of the staining and the whitening phase achieved the fastest bleaching effect after 1 week. The tea group achieved a greater color change than the cola group during all phases and greater than the coffee group at the polishing phase (p&lt;0.05). Conclusions: The polishing phase is effective in removing the exogenous stains on teeth due to beverage consumption. The bleaching efficacy between the teeth stained with tea, coffee and cola is different, in which the teeth stained with tea have a higher whitening effect. Key words: tea, coffee, cola, extrinsic stain, bleaching

Effect on Dental Stains by Potassium Tripolyphosphate Added Chewing Gum

Background: Today, people worldwide consider the discoloration of teeth the main concern, therefore, dental stains are an important problem for a lot of patients, especially for smokers, and tea and coffee consumers. Objective: This trial was planned to evaluate the effectiveness of a sugar-free chewing gum added with potassium tripolyphosphate, compared to a placebo chewing gum on the development or the removal of dental extrinsic stains preserving regular daily oral hygiene. Methods: This was a single-center, double-blind, randomized, 6-week parallel controlled clinical trial. Among those who were eligible for the trial, 162 adult participants were randomly allocated into two groups of 81 each and were instructed to maintain customary oral hygiene. All subjects started the trial period after an in-office dental visit to set the stain index baseline. They chewed one of the two chewing gums for six weeks, five pieces per day, preferably after meals and snacks, for 10 minutes. Both chewing gums were sugar-free, 2g of weight with the same size and shape. The test chewing gum contained potassium tripolyphosphate (24.4 mg per piece), the control chewing gum was identical without potassium tripolyphosphate, therefore, it did not contain any anti-stain agent. The dental extrinsic stain was measured at the first visit and at the end of six weeks by the Modified Lobene Stain Index (MLSI). Comparisons between the groups were performed using ANOVA after adjustment of the baselines, and comparisons between initial and final indexes inside the groups were performed using paired t-tests. Results: After the 6 weeks, 154 subjects completed the trial, 77 in each group. The mean difference in stain composite index for all sites after six weeks was 0.04±0.07 in the control group and -0.03±0.07 in the test group. This difference was statistically significant after baseline adjustment (p&lt;0.001). Moreover, the differences in stain indexes for both buccal or lingual-palatal sites showed a statistically significant difference (p&lt;0.001) for those using the test chewing gum versus the control chewing gum. Conclusion: The overall findings of this clinical study suggest that the use of chewing gum containing potassium tripolyphosphate can reduce dental stains versus placebo chewing gum on frontal teeth after six weeks of maintaining regular oral hygiene with normal tooth brushing.

Walnut consumption as a cause of black tongue: A case report

Oral staining can be secondary to intrinsic or extrinsic environmental factors [1]. Extrinsic staining is recognized mostly on dental surfaces and is commonly associated with the use of chlorhexidine mouthwash [2,3,4], certain toothpastes [5], and frequent intakes of tea and/or coffee [6,7]. When the discoloration appears on a mucosal surface, the clinician should be careful to take a thorough history and build a differential diagnosis based on the findings.

Relación entre la mancha negra extrínseca y la caries dental en una población de Argentina

Many published studies express that the presence of extrinsic black stain on the enamel of tooth surfaces in children and adolescents is associated with less dental caries (CD) activity, this being valid for both primary and permanent dentition.The objective or this researh was to carry out a multifactorial approach to know the relationship between the presence of extrinsic black stain and the presence of caries, in a population of the city of Córdoba, Argentina.Methods. A case-control study (5: 1) was carried out in patients of both sexes from 3 to15 years of age, between the years 2016-2019, who were attended by spontaneous request to the Chair "A" of Pediatric Dentistry, of the Faculty of Dentistry, from the National University of Córdoba (n = 184). All patients underwent a Clinical History. Stimulated saliva was extracted for calcium and phosphate determination and dental biofilm was taken to measure CFU / mL of Streptococcus mutansand Lactobacillus spp.Results. The prevalence of extrinsic black spot was 1.78%. No significant association was found between sex, age and types of dentition between the groups studied. In the problem group, a lower amount of CFU / mL of S. mutans and Lactobacilluss pp was found, a higher concentration of calcium and phosphate and a lower caries index of the primary dentition. Patients with extrinsic black spot had a much lower rate.Conclusions. The extrinsic black spot could be an element of protection against caries, the recommendation for patients who present them would be to remove them from the visible areas and keep them in the rest of the dental elements

The Effect of Composite Brushing with Different Types of Toothpaste on Stain Due to Immersion in Coffee, Tea and Cuko Pempek Water

ABSTRACTComposite is a tooth-colored filling material that can change color by extrinsic staining such as coffee, tea and cuko pempek. Abrasive toothpaste can reduce stains but increase surface roughness. This study aims to determine the effect of the type of toothpaste for brushing on the formation of stains caused by coffee, tea and cuko pempek. This research is a quasi-experimental with pre and post control group design. 39 composite discs with a diameter of 1 cm and a thickness of 5 mm were prepared and divided into several groups, 1 group of negative control without treatment, 3 groups of immersion. Each immersion group was divided into 4 brushing groups, namely without brushing, brushing without toothpaste, brushing with abrasive paste and brushing with non-abrasive paste. Pre and post treatment discs were photographed and color changes were assessed using the CIE L*a*b and E system. Friedman, Kruskall Wallis and Mann Whitney U non-parametric analysis test was used to compare color values and color differences within groups and between groups. Based on this study, it can be concluded that there were significant color changes before and after the soaking treatment with coffee, tea and cuko pempek. The color change in coffee was significantly greater than that of tea and cuko pempek. There was no significant difference in color change between tea and cuko pempek. Conclusion: Brushing with toothpaste Keywords: composite; coffee; tea; cuko pempek; CIE LAB

&lt;strong&gt;Effectiveness of green tea, bay leaf, and lime peel extracts as toothpastes active agents for extrinsic stain removal on teeth, artificial teeth, and denture base&lt;/strong&gt;

Introduction: Tea consumption causes extrinsic stain formation on teeth and denture surfaces, affecting personal appearance. Herbal plants extract such as green tea, bay leaf, and lime peel are potentially active agents for extrinsic stain removal. This study aimed to analyse the effectiveness of green tea, bay leaf, and lime peel extracts as toothpaste active agents for extrinsic stain removal on teeth, artificial teeth, and denture base. Methods: Twenty-five post-extracted human permanent central incisors, 25 artificial teeth, and 25 heat polymerised acrylic resin denture base (20x20x10mm) were divided into three treatment groups and two control groups. Pictures of all specimens were taken before and after stain induction and after brushing. All specimens were immersed in a tea solution made from 2 grams of tea and 100ml of 100°C boiled water to induce extrinsic stain. The immersion process was repeated every 24 hours for seven days. All specimens were then brushed using an automatic toothbrushing machine for 70 seconds on each surface, 200 grams loads, and five speeds/second. Toothpaste used for brushing were three different active agent toothpaste (treatment groups), no active agent toothpaste, and commercial whitening (control groups). Colour index analysis of the specimen pictures computerised by CIELAB method. The data were analysed by one-way ANOVA (α=0.05). Results: Green tea, bay leaf, and lime peel extract toothpaste and positive control had higher L-values of extrinsic stain removal than essential toothpaste on all specimens. There was a significant difference between green tea, bay leaf, and lime peel extract toothpaste and negative control toothpaste (p&lt;0.05), while no significant difference was found when compared to the positive control toothpaste (p&gt;0.05). Conclusion: Green tea, bay leaf, and lime peel extract toothpaste are effective as extrinsic stain removal on teeth and acrylic resin denture base because of abrasive materials that work together with the active agents such as epigallocatechin-3-gallate (EGCG) in green tea, eugenol in bay leaf, and naringin in lime peel.

EFFECTIVITY OF MULTIFUNCTION HERBAL TOOTHPASTE CONTAINING BAY LEAF (EUGENIA POLYANTHA WIGHT) EXTRACT AS EXTRINSIC STAIN REMOVAL ON TEETH AND DENTURE

Background: White teeth colour influence aesthetical appearance which leads to self-confidence and quality of life. Extrinsic stain is the most common aetiology of teeth discoloration, which caused by widely consumed products such as tea, coffee, and tobacco. It also formed on denture and cause negative impacts. Commercial extrinsic stain removal toothpastes only indicated for teeth and contain chemical active agent with undesirable effects. Aim of this study is to determine effectivity of bay leaf (Eugenia polyantha Wight) extract as toothpaste active agent for extrinsic stain removal on teeth and dentures.Method: Pictures of teeth, artificial teeth, and acrylic resin base taken before experiment, after stain induction (using 25g of tea in 100ml of 100oC water for 7 days, tea solution replaced every 24 hours), and after brushing. Toothpastes used for brushing were no active agent basic formulation toothpaste, bay leaf extract toothpastes at 5%, 10%, 15% concentrations, and commercial stain removal toothpaste as positive control. Specimens were brushed using automatic brushing machine for 70 seconds/surface, using 250g load, and speed 5 movements/sec. Colour index analysis of specimens’ pictures were computerized and analysed using CIELAB method to obtain L-value of extrinsic stain removal. Data analysis performed using one-way ANOVA (α=0.05).Result: There is effect of toothpaste containing bay leaf extract 15% to remove extrinsic stain both on teeth, artificial teeth, and acrylic resin base according to one-way ANOVA.Conclusion: Bay leaf extract is effective and potential to be used as toothpaste active agent for extrinsic stain removal on teeth and denture.

Deciphering Black Extrinsic Tooth Stain Composition in Children Using Metaproteomics

The present study focuses on the use of a metaproteomic approach to analyze Black Extrinsic Tooth Stains, a specific type of pigmented extrinsic substance. Metaproteomics is a powerful emerging technology that successfully enabled human protein and bacterial identification of this specific dental biofilm using high-resolution tandem mass spectrometry. A total of 1600 bacterial proteins were identified in black stain (BS) samples and 2058 proteins in dental plaque (DP) samples, whereas 607 and 582 human proteins were identified in BS and DP samples, respectively. A large diversity of bacteria genera (142) in BS and DP was identified, showing a high prevalence of Rothia, Kingella, Neisseria, and Pseudopropionibacterium in black stain samples. In this work, the high diversity of the dental microbiota and its proteome is highlighted, including significant differences between black stain and dental plaque samples.

Epidemiological and Microbiome Characterization of Black Tooth Stain in Preschool Children.

ObjectiveTo assess the epidemiologic attributes and microbial variations associated with extrinsic black tooth stain (BTS) among Chinese preschool children.MethodsThis cross-sectional study included 250 preschool children (3–4 years) from three kindergartens in Shanghai, China. Following clinical examination, and using a case-control design, saliva and dental plaque specimens were collected from caries-free participants with (n = 21, BTS group) and without (n = 48, control group) BTS. The chi-square test and logistic regression model were used to evaluate factors associated with BTS. 16S rRNA sequencing were used to characterize the associated microbial communities.ResultsBTS was detected in 12.4% of participants, with a mean of 13.7 black-stained teeth. Participants with BTS had a lower caries burden and better oral hygiene (P = 0.003). Children with less frequent intake of marmalade or honey (P = 0.033) and regular application of fluoride (P = 0.007) had a lower likelihood of having BTS. Microbiota analysis revealed 14 phyla, 35 classes, 63 orders, 113 families, 221 genera, 452 species, and 1,771 operational taxonomic units (OTUs). In terms of microbial diversity, no significant differences were observed in the saliva of the two groups (P > 0.05). Dental plaque from the BTS group exhibited higher OTU richness but lower evenness than that from the control group (Chao P = 0.006, Shannon P = 0.007, respectively) and showed a significant difference in β diversity (P = 0.002). The microbiome in the two groups was characterized by various microbial biomarkers, such as Pseudomonas fluorescens, Leptotrichia sp._HMT_212, Actinomyces sp._HMT_169, and Aggregatibacter sp._HMT_898 in plaques from the BTS group. Functional analysis of the microbial species suggested the existence of a hyperactive metabolic state on teeth surfaces with BTS plaques and revealed that ferric iron, the iron complex transport system, and the iron (III) transport system were more abundant in BTS plaque samples.ConclusionsThis study provides insights into the epidemiologic and microbial features of BTS in preschool children. The microbiome in BTS is characterized by various microbial biomarkers, which can serve as indicators for BTS diagnosis and prognosis.

Conservative esthetic management with in-office bleaching of dental fluorosis

Tooth discoloration varies in etiology, appearance, localization, severity, and adherence to the tooth structure. It can be intrinsic, extrinsic, or a combination of both. Extrinsic stains are typically caused by tobacco use or by drinking coffee and tea, wine, and pigmented residue from food. This can be removed by regular dental cleaning and brushing the teeth with whitening toothpaste. Intrinsic teeth stains occur most commonly due to exposure of high levels of fluoride, tetracycline antibiotic administration and pulpitis, inherited developmental disorders, and trauma. This can be treated with professional bleaching or at-home chemical teeth-whitening products, porcelain, and composite veneering. Among these procedures, bleaching procedures are more conservative, simple to perform, and less expensive. This case report suggests that in-office bleaching is an effective and conservative method for esthetic correction of tooth discoloration in severe and mild dental fluorosis.

Combined use of baking soda and electric toothbrushing for removal of artificial extrinsic stain on enamel surface: An in vitro study.

BackgroundThis study aimed to investigate the combined effect of baking soda and electric toothbrushing on the removal of artificial extrinsic stain in vitro. Material and MethodsFlat enamel surfaces of 15 bovine incisors were artificially stained with 10% citric acid / 3% ferric chloride solution followed by 1% tannic acid solution. These specimens were randomly divided into three groups (n = 5) – Group S+B: brushing with an electric toothbrush and baking soda, Group S+C: brushing with an electric toothbrush and fluoride dentifrice, Group S: brushing only with an electric toothbrush. Color values (L*, a*, and b*) and surface roughness were measured before and after brushing (after 1, 2, 3, and 5 min). The data were statistically analyzed using two-way analysis of variance and Tukey’s honest significant difference test as a post hoc test (p< 0.05). ResultsThe L* value of Group S+B increased over time, and was significantly different between before brushing and at 5 min (p< 0.05). A significant difference in the ΔE* value of Group S+B was found at 5 min (p< 0.05). However, no significant difference was found in the ΔE* values of Group S+C and Group S. No significant differences in Ra were found in any of the groups. ConclusionsThe results of this study suggest that the combined use of baking soda and electric toothbrushing has an excellent stain-removing effect compared with electric toothbrushing with a fluoride dentifrice. Additionally, the changes in surface roughness were similar to the changes caused by the use of general dentifrices. Key words:Baking soda, dentifrice, extrinsic stain removal, color change, surface roughness.