Triclosan-containing Dentifrice Research Articles

In vitro efficacy of essential oil mouthrinse versus dentifrices

ObjectivesTo compare the antimicrobial efficacy and kill penetration of essential oils (EO) mouthrinse versus stannous fluoride, and triclosan dentifrice slurries on saliva-derived biofilms using confocal laser scanning microscopy (CLSM). MethodsSaliva-derived biofilms were grown for 48h on hydroxyapatite discs using pooled, homogenized saliva from 8 healthy volunteers as the inoculum. The mean thickness of these biofilms was 84μm (range, 23–241μm). CLSM with viability mapping was used to visualize the antimicrobial kill penetration of each treatment regime within a biofilm. ResultsAt 30s treatment durations, CLSM imaging revealed greater antimicrobial activity and kill penetration of EO mouthrinse compared to sodium fluoride-, stannous fluoride-, and triclosan-containing dentifrice slurries. Quantification of biovolume revealed that EO mouthrinse treatment at 30s resulted in a greater non-viable biovolume proportion (84.6%±15.0%) than other treatment groups. Increasing the treatment duration of the triclosan dentifrice (to 60 and 120s) resulted in better penetration and an increased reduction of viable cells, comparable to EO mouthrinse treatment at 30s duration. Further, CLSM imaging showed that the combined treatment of a non-antimicrobial dentifrice (45s) with EO mouthrinse (30s) showed superior antimicrobial activity (96.2%±3.7%) compared to the antimicrobial triclosan-containing dentifrice used without a mouthrinse step (26.0%±32.0%). ConclusionsWithin typical exposure times, the EO-containing mouthrinse can penetrate deep into the accumulating plaque biofilm compared to the chemotherapeutic dentifrice slurries, and may provide an efficacious alternative to triclosan, when used as an adjunct with a mechanical oral care regimen. Clinical significanceUsing viability mapping and CLSM, this study demonstrated that EO-containing mouthrinse penetrates and kills microorganisms deeper and more effectively in plaque biofilm in typical exposure times when compared to dentifrice chemotherapeutic agents, providing an efficacious alternative to triclosan or stannous fluoride when used as an adjunct to mechanical oral care.

Community-level assessment of dental plaque bacteria susceptibility to triclosan over 19 years.

BackgroundTriclosan is a broad-spectrum antimicrobial agent used in toothpaste to reduce dental plaque, gingivitis and oral malodor. This community-level assessment evaluated the susceptibility of dental plaque bacteria to triclosan in samples collected over 19 years.MethodsA total of 155 dental plaque samples were collected at eleven different times over 19 years from 58 adults using 0.3% triclosan, 2% copolymer, 0.243% sodium fluoride toothpaste and from 97 adults using toothpaste without triclosan. These included samples from 21 subjects who used triclosan toothpaste for at least five years and samples from 20 control subjects. The samples were cultured on media containing 0, 7.5 or 25 μg/ml triclosan. Descriptive statistics and p values were computed and a linear regression model and the runs test were used to examine susceptibility over time.ResultsGrowth inhibition averaged 99.451% (91.209 - 99.830%) on media containing 7.5 μg/ml triclosan and 99.989% (99.670 - 100%) on media containing 25 μg/ml triclosan. There was no change in microbial susceptibility to triclosan over time discernible by regression analysis or the runs test in plaque samples taken over 19 years including samples from subjects using a triclosan-containing dentifrice for at least five years.ConclusionsThis community-level assessment of microbial susceptibility to triclosan among supragingival plaque bacteria is consistent with the long-term safety of a 0.3% triclosan, 2% copolymer, 0.243% sodium fluoride dentifrice.

An in vitro comparison of dentifrice formulations in three distinct oral microbiotas

ObjectivesIn vitro biofilm models, representative of some aspects of nascent, supra-gingival plaques (Hydroxyapatite Disc Biofilm Models), developed supra-gingival plaques (Modified Drip-flow Biofilm Reactors) and sub-gingival plaques (Multiple Sorbarod Devices) were used to compare the antimicrobial effects of a triclosan-containing dentifrice with a stannous fluoride and zinc lactate combination. DesignTriplicate salivary biofilm microcosms were maintained for 2d (hydroxyapatite discs), 5d (Sorbarods) or up to 6d (drip flow reactors). Dentifrice slurries (10%, w/v) were added once to the discs and repeatedly to the Drip Flow Reactors and Sorbarods. Plaques were analysed by differential culture and gravimetrically. ResultsWhilst both dentifrices were comparably effective at reducing viability and plaque accumulation in mature supragingival plaques, the triclosan dentifrice produced comparatively larger reductions in total streptococci and anaerobes in nascent plaques (p<0.05) and greater reductions in Gram-negative anaerobes and streptococci in subgingival plaques. ConclusionsWe have used a multi-model approach to determine the effectiveness and specificity of dentifrices against compositionally distinct plaques. Whilst both formations reduced bacterial viability and plaque accumulation, their effects could be differentiated in nascent and deep plaques where the triclosan dentifrice caused larger viability reductions.

Assessment of the Effects of Dentifrice on Periodontal Disease Biomarkers in Gingival Crevicular Fluid

Periodontal disease has been studied primarily from clinical outcomes in lengthy human studies. Comprehensive biochemical profiling (metabolomics) has become a powerful tool for disease characterization and biomarker discovery. In a previous study, we performed a metabolomic analysis of gingival crevicular fluid collected from healthy, gingivitis, and periodontitis sites. Many metabolites associated with inflammation, oxidative stress, tissue degradation, and bacterial metabolism were found to be significantly induced by the diseases. A panel of 10 markers was selected from the previous metabolomic study based on their statistical significance. Thirty-nine chronic periodontitis subjects were randomly assigned to a toothpaste regimen: control dentifrice (n = 21) or triclosan-containing dentifrice ([CT] n = 18). Subjects were instructed to use their assigned dentifrice twice daily for 6 weeks. Gingival crevicular fluid samples from six healthy, six gingivitis, and three periodontitis sites were collected from each subject at baseline, 1 week, and 6 weeks. The relative levels of the markers in the samples were determined by mass spectrometry. One-sided matched-paired t tests were performed to compare data from healthy, gingivitis, and periodontitis sites. Statistical analysis indicates that CT significantly decreased the levels of inosine, lysine, putrescine, and xanthine at the gingivitis sites as early as week 1. In contrast, control dentifrice had little effect. This result provides biochemical confirmation for the therapeutic effects of CT on gingivitis. Biomarkers were significantly altered by CT before clinical changes were observed, suggesting that the markers have predicative value for disease state assessment.

Evaluation of alternative methods for the disinfection of toothbrushes

The aim of this study was to evaluate alternative methods for the disinfection of toothbrushes considering that most of the previously proposed methods are expensive and cannot be easily implemented. Two-hundred toothbrushes with standardized dimensions and bristles were included in the study. The toothbrushes were divided into 20 experimental groups (n = 10), according to microorganism considered and chemical agent used. The toothbrushes were contaminated in vitro by standardized suspensions of Streptococcus mutans, Streptococcus pyogenes, Staphylococcus aureus or Candida albicans. The following disinfectants were tested: 0.12% chlorhexidine digluconate, 50% white vinegar, a triclosan-containing dentifrice solution, and a perborate-based tablet solution. The disinfection method was immersion in the disinfectant for 10 min. After the disinfection procedure, the number of remaining microbial cells was evaluated. The values of cfu/toothbrush of each group of microorganism after disinfection were compared by Kruskal-Wallis ANOVA and Dunn's test for multiple comparisons (5%). The chlorhexidine digluconate solution was the most effective disinfectant. The triclosan-based dentifrice solution promoted a significant reduction of all microorganisms' counts in relation to the control group. As to the disinfection with 50% vinegar, a significant reduction was observed for all the microorganisms, except for C. albicans. The sodium perborate solution was the less effective against the tested microorganisms. Solutions based on triclosan-containing dentifrice may be considered effective, nontoxic, cost-effective, and an easily applicable alternative for the disinfection of toothbrushes. The vinegar solution reduced the presence of S. aureus, S. mutans and S. pyogenes on toothbrushes.

Long‐term effect of the combined use of powered toothbrush and triclosan dentifrice in periodontal maintenance patients

To test the hypothesis of a superior clinical and microbiological effect of the combined use of powered toothbrush+triclosan-containing dentifrice compared with manual toothbrush+regular fluoride-containing dentifrice in periodontal maintenance patients. A total of 128 periodontitis subjects involved in recall programmes were randomized to use either powered toothbrush with triclosan-dentifrice (test) or manual toothbrush and standard dentifrice (control). Supportive periodontal treatment was provided at baseline and every 6 months. Plaque, bleeding on probing (BoP), probing pocket depth (PPD) and relative attachment level (RAL) were scored at baseline, 1, 2 and 3 years. Subgingival plaque samples were taken and analysed for their content of 40 bacterial species at each examination interval. All analyses were performed by "intention-to-treat" protocol. Both groups showed significant reduction in BoP, PPD and in mean total counts of the 40 bacterial species between baseline and 3 years, while plaque score and RAL remained almost unchanged. No significant differences between the two prevention programmes were found for any of the clinical outcome variables or in mean counts of the various bacterial species. The study failed to demonstrate superior clinical and microbiological effects of powered toothbrush+triclosan dentifrice compared with manual toothbrush+standard fluoride-dentifrice in periodontitis-susceptible patients on regular maintenance therapy.

Oral malodor reduction by a combination of chemotherapeutical and mechanical treatments

Bacterial proliferation and plaque accumulation on the surface of the tongue are major factors contributing to oral malodor. In this research, we used subjective and objective methods to evaluate the breath benefit of a triclosan-containing dentifrice (Blend-a-Med Complete Night) with and without tongue brushing in a randomized, examiner-blinded, three-period crossover clinical trial. Twenty-nine adults (mean age 40.2 years) with morning malodor were randomly assigned to a treatment sequence: triclosan dentifrice, triclosan dentifrice plus tongue brushing, and a control dentifrice (Crest Cavity Protection). The subjects used each product four times in 27 h with a 2-day wash-out period between treatments. Halimeter measurements were taken at baseline and at 3, 24 and 27 h. Subject questionnaire data assessing the breath quality were collected at 24 and 27 h. Both triclosan regimens showed significant improvement in oral malodor (p < 0.03) relative to the control. Significant (p = 0.035) malodor benefit was observed when tooth brushing with triclosan dentifrice was supplemented with tongue brushing. The triclosan dentifrice was associated with significant improvement (p < 0.05) in morning mouth feel and feeling of clean and fresh breath during the day relative to the control. There were no adverse events reported. The triclosan dentifrice was effective against overnight and daytime oral malodor. Supplementing routine brushing with tongue brushing resulted in additional breath improvement and breath benefits of the triclosan dentifrice were first-person noticeable.

The effectiveness of self‐performed mechanical plaque control with triclosan containing dentifrices

To assess the effectiveness of self-performed mechanical plaque control with triclosan (5-chloro-2-(2,4 dichlorophenoxy)phenol) containing dentifrice. An electronic search of the National Library of Medicine, Washington DC (Medline-PubMed; up to and including March 2005) was performed using specific search terms to identify clinical trials of >or=6 months in duration, which assessed the effect of various forms of plaque control in gingivitis subjects. In those trials the manual toothbrush group (frequently the control group) served to provide data for the assessment of the effectiveness of self-performed mechanical plaque control with a triclosan-containing dentifrice. The data were analysed depending on the (baseline) intervention, being either a professional oral hygiene instructions, a prophylaxis, or both. Two reviewers extracted information (KPKJH and GAW). Where appropriate plaque and gingivitis data for baseline and end-trial were used to calculate weighted mean differences (WMD) with the appropriate 95% confidence intervals (CI) using a random effect models. Of 105 titles and abstracts, 18 trials were found suitable for clinical data were extracted. Meta-analysis were conducted. In studies (n=9) evaluating a triclosan/copolymer dentifrice, plaque control [Quigley and Hein (1962) Journal of American Dental Association, Vol. 65: pp. 26-29] was significantly improved compared with a control fluoride dentifrice, with a WMD of -0.48 (95% CI: -0.73 to -0.24). For gingival inflammation as assessed with the gingival index [Löe and Silness (1963) Acta Odontologica Scandinavica, Vol. 21: pp. 533-551] a significant WMD of -0.24 (95% CI: -0.35 to -0.13) was found. From studies (n=6) evaluating the Triclosan zinc/citrate dentifrices a small but significant WMD for plaque control [Silness and Löe (1964) Acta Odontologica Scandinavica, Vol. 22: pp. 121-135] was observed in favour of the test group as compared with the standard fluoride dentifrice formulations (WMD -0.07, 95% CI: -0.10 to 0.05). While at baseline the proportion of bleeding was comparable, at the end of the studies a significant -10.81% WMD (95% CI: -12.69 to -8.93) in favour of the triclosan/zinc citrate dentifrice was observed. This systematic review indicates, based on studies >or=6 months of duration in adults with gingivitis, that the effectiveness of self-performed mechanical plaque control with a triclosan-containing dentifrice, had a significant albeit small positive effect on the reduction of plaque and gingivitis.

The effect of a triclosan-containing dentifrice on the progression of periodontal disease in an adult population

The effect of a triclosan-containing dentifrice on the progression of periodontal disease in an adult population

Effect of a Triclosan-Containing Toothpaste Supplemented with 10% Xylitol on Mutans Streptococci in Saliva and Dental Plaque

The aim of the present investigation was to evaluate the effect of the combination of triclosan and xylitol in toothpaste on mutans streptococci (MS) in saliva and dental plaque. 155 individuals with >10⁵ MS/ml saliva were included in a 6-month double-blind clinical study. They were divided into three groups (n = 51–52) balanced according to their MS counts at baseline. Each group used one of the following types of dentifrice: (1) Colgate Total^© with the addition of 10% xylitol (Total-Xylitol), (2) Colgate^© Total and (3) Colgate Total^© without triclosan and without xylitol. Whole saliva and pooled plaque samples were obtained after 2, 4 and 6 months. When comparing the MS counts within the groups for saliva and plaque samples, Total-Xylitol showed significant reduction at all three sampling occasions (p < 0.001). Mean reduction at the 6-month sample for saliva was 0.81/ml and for plaque 0.89 per sample (log values). ANOVA revealed significant differences between Total-Xylitol and the two other products at 6 months for MS in saliva and dental plaque. The conclusion from this 6- month study is that the addition of 10% xylitol to a triclosan-containing dentifrice reduces the number of MS in saliva and dental plaque.