In vitro assessment of a toothpaste range specifically designed for children
|
|
- Stanley Johnson
- 5 years ago
- Views:
Transcription
1 ORIGINAL ARTICLE International Dental Journal 2013; 63 (Suppl. 2): doi: /idj In vitro assessment of a toothpaste range specifically designed for children David Churchley 1 and Bruce R. Schemehorn 2 1 GlaxoSmithKline Consumer HealthCare, Weybridge, UK; 2 Therametric Technologies Inc, Noblesville, IN, USA. Objective: To evaluate the ability of a range of low abrasivity experimental toothpastes designed for use by children at different stages of their development (typically ages 0 2 years, 3 5 years and 6+ years) to promote fluoride uptake and remineralisation of artificial caries lesions. Methods: ph cycling study: demineralised human permanent enamel specimens were subjected to a daily ph cycling regime consisting of four 1-minute treatments with toothpaste slurries, a 4-hour acid challenge and remineralisation in pooled whole human saliva. Surface microhardness (SMH) was measured at baseline, 10 days and 20 days, and the fluoride content determined at 20 days. Enamel Fluoride Uptake (EFU): these studies were based on Method #40 described in the US Food and Drug Administration (FDA) testing procedures. Abrasivity: relative enamel abrasivity (REA) and relative dentine abrasivity (RDA) were measured using the Hefferren abrasivity test. Bioavailable fluoride: the bioavailable fluoride was determined for all experimental toothpastes from slurries of one part toothpaste plus 10 parts deionised water. Results: Enamel remineralisation measured by changes in SMH correlated with enamel fluoride content. A statistically significant fluoride dose response was observed for all toothpastes tested across all age groups (P < 0.05). The fluoride content of specimens in the ph cycling model correlated with the EFU testing results. The enamel and dentine abrasivities were low and the level of bioavailable fluoride was high for all experimental toothpastes. Conclusion: A series of low abrasivity experimental toothpastes were developed which were effective at promoting fluoride uptake and remineralisation of artificial caries lesions. Key words: Remineralisation, fluoride, children, toothpaste INTRODUCTION In children, the deciduous or primary teeth typically begin to erupt at 6 8 months of age. However, from around the age of 6 years, these teeth start to be replaced by permanent teeth. At this stage, the mouth will contain both deciduous and permanent teeth until the last deciduous tooth is lost at around 12 years of age 1,2. There are a number of important differences between deciduous and permanent enamel. Specifically, deciduous enamel contains more organic material 3, is generally less mineralised in the outer enamel layers 4 and has a higher porosity 5. This makes deciduous enamel more susceptible to acid-mediated dissolution than permanent enamel 6 8. In addition, deciduous enamel is softer and therefore less mechanically resistant than permanent enamel. Consequently, tooth wear owing to abrasion can be more pronounced in deciduous than in permanent teeth 9. Childhood caries is recognised as being a major public health problem among the general population. According to the National Health and Nutrition Examination Survey carried out from 1999 to 2004 in the USA, 42% of children aged 2 11 years have had dental caries in their primary teeth and 21% of children aged 6 11 years have had dental caries in their permanent teeth 10. A number of comprehensive reviews of caries clinical trial data in children and adolescents concluded that there was strong evidence that daily use of fluoride (F)-containing toothpastes can reduce the incidence of caries compared with a placebo or with non-brushing 11,12. These effects were also improved with supervised brushing and increased frequency of brushing 11. Mechanistic studies have shown that the anti-caries effect of fluoride is through the prevention of demineralisation and enhancement of remineralisation 13.In addition, fluoride has been shown to interfere with bacterial metabolism in vitro, which may inhibit plaque acid production 14. A series of guidelines have been established by the US Food and Drug Administration (FDA), the American FDI World Dental Federation
2 In vitro assessment of a toothpaste range Dental Association (ADA) and FDI World Dental Federation to ensure that marketed toothpastes are safe and effective Caries clinical trials are considered to be the ultimate proof of anti-caries effectiveness, however, because of the long duration and high costs associated with these types of studies, a number of preclinical methods known as bioequivalence studies have been developed to evaluate fluoride efficacy 18. In these studies, the experimental toothpaste is tested against a clinically proven control toothpaste containing the same active ingredient at the same nominal concentration. The maximum permitted concentrations of fluoride for toothpastes in different markets are governed by regulatory requirements; however, fluoride concentrations for specific child age ranges are generally set by national guidance via health authorities or dental associations. A new range of toothpastes have been developed for use by children at different stages of their development (typical ages are 0 2 years, 3 5 years and 6+ years) containing different concentrations of fluoride and for different markets. The aim of the present studies was to evaluate the efficacy of these toothpastes to (1) promote lesion remineralisation under dynamic demineralising/remineralising conditions simulating in vivo caries formation, and (2) promote enamel fluoride uptake. The enamel and dentine abrasivities of these toothpastes were also determined relative to the ADA reference abrasive. MATERIALS AND METHODS Materials The experimental toothpastes and commercial toothpaste controls evaluated are shown in Tables 1 and 2, respectively. The placebo toothpastes were fluoride-free variants of the corresponding experimental toothpastes. ph cycling The method used was based on the model of White 19,20 which was subsequently modified by Schemehorn et al Specimen preparation. Enamel specimens (3 mm diameter) were removed from extracted human permanent teeth and mounted on rods. The specimens were initially ground by hand on a lapidary wheel (600 grit wet/dry paper). Following hand grinding the specimens were mounted on a counter rotational grinding/polishing apparatus and finally ground for 3 minutes with the same paper. The specimens were then polished on the same apparatus with 0.05 lm Gamma Alumina (Buehler, Lake Bluff, IL, USA) against a urethane pad using a force of 0.1 N for 1 hour. Baseline surface microhardness. The initial baseline surface microhardness (SMH) of the sound enamel Table 1 Typical age ranges, fluoride concentrations, abrasive, pack type and intended markets for each experimental toothpaste Age range Fluoride concentration (ppm) and source Abrasive Pack type Intended market 0 2 years 0*, 500 or 1,000 (as sodium fluoride (NaF)) Silica Tube Non-US 3 5 years 0*, 250, 500, 1,000 or 1,450 (as NaF) Silica Tube Non-US 6+ years 0*, 500, 1,450 (as NaF) Silica Tube Non-US 2 5 years 1,150 (as NaF) Silica Tube and pump US 6+ years 0*, 250, 1,150 (as NaF) Silica Tube US *Matched placebo formulation. Matched dose response control. Table 2 Age ranges, fluoride concentrations, abrasive and current market for each commercial toothpaste control Toothpaste Age range Fluoride concentration (ppm) and source Abrasive Market Manufacturer Odol-Med3 Milchzahn 0 6 years 500 (as NaF) Silica Germany GlaxoSmithKline Aquafresh Milk Teeth 0 3 years 1,000 (as sodium Silica UK GlaxoSmithKline monofluorophosphate (SMFP)) Aquafresh Little Teeth 4 6 years 1,000 (as NaF) Silica South Africa GlaxoSmithKline Aquafresh Kids Bubble Fresh 2 years and older 1,100 (as SMFP) Chalk US GlaxoSmithKline Aquafresh Big Teeth 6+ years 1,400 (as NaF) Silica UK GlaxoSmithKline Aquafresh Little Teeth 4 6 years 1,400 (as NaF) Silica UK GlaxoSmithKline Aquafresh Fresh and Minty Not specified 1,450 (as NaF) Silica UK GlaxoSmithKline USP Reference Toothpaste N/A Concentration not specified (as NaF) Silica N/A Not specified 2013 FDI World Dental Federation 49
3 Churchley and Schemehorn specimens was determined using a Vickers hardness indenter at a load of 200 g for 15 seconds. The average baseline specimen SMH was determined from four indentations. Only specimens with a sound SMH range of Vickers hardness numbers (VHN) were accepted. Initial demineralisation. Artificial lesions were formed in the enamel specimens by a 68-hour immersion into a solution of 0.1 M lactic acid and 0.2% w/v Carbopol C907 which had been 50% saturated with hydroxyapatite and adjusted to ph 5.0 with potassium hydroxide. The initial SMH of the demineralised specimens was determined using the procedure described above. Only specimens with a lesion SMH range between 25 and 45 VHN were accepted into the studies. Specimens were balanced into groups and subgroups based on their post-demineralisation SMH values. Thirty specimens per treatment group were used in this study. Treatment slurries. During the treatment period, the specimens were immersed in toothpaste slurries to simulate daily exposure to toothpaste. The slurries were prepared by adding 5.0 g of toothpaste to 10.0 g of pooled human saliva in a beaker with a magnetic stirrer bar. All treatments were stirred at 350 rpm. A fresh slurry was prepared immediately before each treatment period. Treatment regimen. The ph cycling regimen consisted of a 4 hour per day acid challenge in the lesion forming solution and minute treatment periods with toothpaste slurries. After the treatments, the specimens were rinsed with running deionised water. During remineralisation periods, specimens were stored in pooled human saliva. This regimen was repeated for 20 days. The treatment schedule is shown in Table 3. Post-treatment surface microhardness. After 10 days and 20 days of treatment, the average specimen SMH Table 3 ph cycling regimen Time of day Treatment 08:00 08:01 Toothpaste treatment* 08:01 09:00 Saliva treatment 09:00 09:01 Toothpaste treatment 09:01 10:00 Saliva treatment 10:00 14:00 Acid challenge 14:00 15:00 Saliva treatment 15:00 15:01 Toothpaste treatment 15:01 16:00 Saliva treatment 16:00 16:01 Toothpaste treatment 16:01 08:00 Saliva treatment *On the first day this treatment was not given; the study started with the saliva treatment to allow a pellicle to form. was determined from four indentations on each specimen, next to the baseline indentations. The difference between the SMH following treatment and the initial lesion SMH indicated the ability of that treatment to enhance remineralisation after 10 days and 20 days of treatments. Fluoride analysis. At the end of the 20-day treatment regimen, the fluoride content of each enamel specimen was determined using the microdrill technique to a depth of 100 lm. The diameter of the drill hole was also determined. The enamel powder from the drill hole was collected and dissolved in 20 ll of perchloric acid (HClO 4 ) followed by the addition of 40 ll of citrate/ethylenediaminetetraacetic acid (EDTA) buffer and 40 ll of deionised water. Solutions were analysed for fluoride using an ion-selective electrode by comparison with a similarly prepared standard curve. Fluoride content was calculated as lg F/cm 3. Enamel fluoride uptake (EFU) The methodology was identical to the one identified as Method 40 in the US Anti-Caries Monograph 18 except that the lesions were formed using a solution of 0.1 M lactic acid containing 0.2% w/v Carbopol 907 and 50% saturated with hydroxyapatite (ph 5.0). Sound, upper, central, bovine incisors were selected and cleaned of all adhering soft tissue. A core of enamel 3 mm in diameter was prepared from each tooth by cutting perpendicular to the labial surface with a hollow-core diamond drill bit. Each specimen was embedded in the end of a Plexiglas rod using methyl methacrylate and polished with 600 grit wet/ dry paper followed by 0.05 lm Gamma Alumina (Buehler, Lake Bluff, IL, USA). Twelve specimens per group were used in this study. Each enamel specimen was etched by immersion into 0.5 ml of 1 M HClO 4 for 15 seconds with continuously agitation. A sample of each solution was then buffered with a total ionic strength adjustment buffer (TISAB) to a ph of 5.2 (0.25 ml of sample, 0.5 ml of TISAB and 0.25 ml of 1 M sodium hydroxide) and the fluoride content determined by comparison to a similarly prepared standard curve (1 ml standard and 1 ml TISAB). This data formed the baseline fluoride concentration of each specimen before treatment. The specimens were once again ground and polished as described above. An incipient lesion was formed in each enamel specimen by immersion into 0.1 M lactic acid containing 0.2% w/v Carbopol 907 and 50% saturated with hydroxyapatite (ph 5.0) for 24 hours at room temperature. These specimens were then rinsed with deionised water and stored in a humid environment until used FDI World Dental Federation
4 In vitro assessment of a toothpaste range The treatments were performed using supernatants of the toothpaste slurries. The slurries were prepared by adding 9.0 g of toothpaste to 27.0 ml of deionised water. The slurries were mixed well and then centrifuged. The specimens were then immersed into 25 ml of their assigned supernatant with constant stirring (350 rpm) for 30 minutes. Following treatment, the specimens were rinsed with deionised water and etched with 0.5 ml of 1 M HClO 4 for 15 seconds with continuous agitation. The etch solution was analysed for fluoride as outlined above. The baseline fluoride concentration of each specimen was then subtracted from the post-treatment value to determine the change in enamel fluoride due to the test treatment. Relative dentine abrasivity (RDA) The procedure used in this study was the Hefferren abrasivity test 24 recommended by the ADA and described in ISO 11609: for determination of toothpaste abrasiveness in dentine. Eight human dentine specimens were subjected to neutron bombardments resulting in the formation of radioactive phosphorus ( 32 P) 15. The specimens were mounted in methyl methacrylate and placed into a V- 8 cross-brushing machine (Sabri Dental Enterprises, Inc., Downers Grove, IL, USA). The specimens were brushed for a 1,500 stroke, precondition run using a slurry consisting of 10 g ADA reference material [calcium pyrophosphate (Ca 2 P 2 O 7 )] in 50 ml of a 0.5% w/v carboxymethylcellulose (CMC)/10% w/v glycerine solution. The brushes used were those specified by the ADA (Oral-B P-40) with a brushing force of 1.5 N. Following the precondition run the test was performed using the above parameters (1.5 N and 1,500 strokes) in a sandwich design. Before and after brushing with the test toothpaste (25 g product/40 ml deionised water) each tooth set was brushed with the ADA reference material. This dilution produces a final slurry volume and a concentration similar to those of the reference abrasive slurry. The procedure was repeated so that each toothpaste was assayed on each tooth set. RDA calculations. One millilitre samples were taken, weighed and added to 5 ml of Ultima Gold scintillation cocktail. The samples were mixed well and immediately put on a liquid scintillation counter for radiation detection. The counts per minute (CPM) values for the test and reference products were measured. The RDA of the test toothpaste is calculated using Equations 1 and 2: G mr ¼ G pre þ G post 2 ð1þ where G mr = mean reference net CPM per mass of slurry (g) G pre = pre-net CPM per mass of slurry (g) G post = post-net CPM per mass of slurry (g) RDA ¼ 100 G mt G mr ð2þ where G mt = mean test toothpaste net CPM per mass of slurry (g) G mr = mean reference net CPM per mass of slurry (g) 100 = Dentine abrasivity of the ADA reference material Relative enamel abrasivity (REA) The procedure was identical to that used for determination of RDA except that human enamel was used instead of dentine. In addition, specimens were brushed for 5,000 strokes. In this test, the ADA reference material was assigned a value of 10. Determination of bioavailable fluoride Toothpaste slurries were prepared by homogenisation for 10 minutes of one part test toothpaste with 10 parts (w/w) deionised water. The slurries were centrifuged at ca g to obtain the supernatant. The supernatants were diluted with water such that the range of the working standard bracketed the concentration of the fluoride ion. These solutions were analysed by Dionex Ion Chromatography (Dionex Corporation, Camberley, UK) with suppressed conductivity detection. Fluoride concentrations were determined by external standardisation. Statistical analysis Statistical analyses were conducted using an analysis of variance model (ANOVA) (Sigma Stat Software, Version 3.1, Systat Software, Chicago, IL, USA). Where significant differences were found, additional pair-wise comparisons were performed using a Student Newman Keuls test (P < 0.05). RESULTS ph Cycling Studies The change in hardness (DVHN), fluoride content and slurry ph data from the ph cycling studies are shown in Tables 4 7. The ph of all toothpaste slurries tested 2013 FDI World Dental Federation 51
5 Churchley and Schemehorn as one part test product with two parts (w/w) pooled human saliva ranged from Ages 0 2 years (Non-US toothpastes) All fluoride-containing toothpastes were significantly more effective at promoting remineralisation compared with the fluoride-free placebo after 10 days and 20 days (Table 4). A significant difference in DVHN between the 500 and 1,000 ppm F toothpastes was only observed after 20 days. All differences in the enamel fluoride content between toothpaste treatments were significant. Ages 3 5 years (non-us toothpastes) All fluoride containing toothpastes were significantly more effective at promoting remineralisation compared with the fluoride-free placebo after 10 days and 20 days (Table 5). After 10 days, all DVHN treatment differences were significant with the exception of the 250 versus 500 ppm F and 1,000 versus 1,450 ppm F toothpastes. After 20 days, a statistically significant dose response in DVHN was only observed up to 500 ppm F. While there were no statistically significant differences between the 500, 1,000 and 1,450 ppm F toothpastes at this timepoint, the differences were directional. All differences in the enamel fluoride content between toothpaste treatments were significant. Ages 2 5 years and 6+ years (US toothpastes) All fluoride containing toothpastes were significantly more effective at promoting remineralisation compared with the fluoride-free placebo after 10 days and 20 days (Table 6). At both timepoints, a statistically significant dose response was observed for DVHN, however, there were no statistically significant differences between the 250 ppm F dose response toothpaste, the current US Aquafresh Kids Bubble Fresh toothpaste and the USP reference toothpaste. After 20 days, there were no significant differences between the two experimental toothpastes containing 1,150 ppm F and the USP reference toothpaste. The enamel fluoride content data show a statistically significant dose response; however, the differences between the two experimental toothpastes containing 1,150 ppm F and the USP reference toothpaste were not significant. Table 4 Summary of DVHN and enamel fluoride content after ph cycling with experimental toothpastes (ages 0 2 years/non-us) toothpastes (n = 30). The ph of the toothpaste slurry is also reported Treatment DVHN 10 day DVHN 20 day Enamel fluoride content (lg F/cm 3 ) ph of toothpaste slurry 0 ppm F 1 (0.7) a 3.6 (1.0) a 585 (19) a ppm F 12 (1.0) b 17.3 (1.0) b 2,259 (101) b ,000 ppm F 14.2 (0.9) b 24.2 (1.2) c 3,181 (131) c 7.20 Table 5 Summary of DVHN and enamel fluoride content after ph cycling with experimental toothpastes (ages 3 5 years/non-us) toothpastes (n = 30). The ph of the toothpaste slurry is also reported Treatment DVHN 10 day DVHN 20 day Enamel fluoride content (lg F/cm 3 ) ph of toothpaste slurry 0 ppm F 0.6 (0.7) a 3.2 (0.9) a 352 (12) a ppm F 11.2 (0.7) b 14.3 (0.8) b 1,484 (56) b ppm F 13.3 (0.8) b 19.0 (0.9) c 1,692 (62) c ,000 ppm F 15.7 (0.9) c 20.1 (1.1) c 1,886 (86) d ,450 ppm F 17.3 (0.9) c 20.7 (0.8) c 2,301 (68) e 7.21 Table 6 Summary of DVHN and enamel fluoride content after ph cycling with experimental toothpastes (ages 2 5 years and 6+ years/us) toothpastes (n = 30). The ph of the toothpaste slurry is also reported Treatment DVHN 10 day DVHN 20 day Enamel fluoride content (lg F/cm 3 ) ph of toothpaste slurry 0 ppm F ( 6+ years) 5.9 (0.9) a 9.5 (0.8) a 365 (15) a ppm F (6+ years) 11.7 (1.2) b 18.5 (1.1) b,c 1,062 (56) b ,150 ppm F (2 5 years) 15.3 (1.1) b 23.9 (1.5) d 1,539 (59) c ,150 ppm F (6+ years) 22.7 (1.5) c 22.6 (1.4) c,d 1,655 (66) c 7.11 USP Reference Toothpaste 14.9 (1.3) b 20.7 (2.5) b,c,d 1,633 (67) c 7.09 Aquafresh Kids Bubble Fresh 15.5 (0.7) b 16.8 (0.9) b 1,048 (39) b FDI World Dental Federation
6 Table 7 Summary of DVHN and enamel fluoride content after ph cycling with experimental toothpastes (ages 6+ years/non-us) toothpastes (n = 30). The ph of the toothpaste slurry is also reported Treatment DVHN 10 day DVHN 20 day Enamel fluoride content (lg F/cm 3 ) ph of toothpaste slurry 0 ppm F 8.0 (0.8) a 5.8 (0.7) a 582 (20) a ppm F 14.7 (0.9) b 17.6 (0.9) b 2,029 (51) b ,450 ppm F 20.2 (1.2) c 23.2 (1.4) c 3,074 (146) c 7.20 Letter superscripts represent the different statistical groupings. Standard error in brackets In vitro assessment of a toothpaste range Ages 6+ years (Non-US toothpastes) At both the 10-day and 20-day time-points, all differences in DVHN and enamel fluoride content between the 0, 500 and 1,450 ppm F toothpastes were statistically significantly (Table 7). EFU The EFU results for the US and non-us experimental toothpastes with commercially available controls are shown in Tables 8 and 9 respectively. All fluoride containing toothpastes promoted significant fluoride uptake into demineralised enamel compared with the fluoride free placebo. The fluoride uptake data in Table 8 show that there were no significant differences between the three US experimental toothpastes. However, these toothpastes were significantly more effective at promoting fluoride uptake than the USP reference toothpaste. The order of fluoride uptake was 0 ppm F < Aquafresh Kids Bubble Fresh < USP reference toothpaste < 1,150 ppm F (ages 2 5 years (Tube) = 1,150 ppm F (ages 2 5 years (Pump) = 1,150 ppm F (ages 6+ years). For all non-us toothpastes, the fluoride uptake data showed a dose response (Table 9). The fluoride uptake from the experimental toothpastes was either equivalent to or statistically higher than the commercial controls containing the same fluoride concentration. For the 500 and 1,000 ppm F experimental toothpastes, fluoride uptake from toothpastes for ages 3 5 years was significantly higher than from toothpaste for ages 0 2 years. RDA & REA The RDA and REA data for the experimental toothpastes and the commercial controls are shown in Table 10. The products evaluated in this study have a wide range of RDA values (from ) Table 8 Enamel fluoride uptake data for US experimental and commercial toothpastes using FDA method #40 (n = 12) Treatment Pack fluoride concentration (ppm) Mean enamel fluoride concentration (ppm) Experimental Toothpaste (6+ years) 0 8 (2) a Experimental Toothpaste (2 5 years/tube) ,779 (59) b Experimental Toothpaste (2 5 years/pump) ,730 (37) b Experimental Toothpaste (6+ years) ,818 (53) b USP standard N/A 1,296 (51) c Aquafresh Kids Bubble Fresh (17) d Table 9 Enamel fluoride uptake data for non-us experimental and commercial toothpastes using FDA Method #40 (n = 12) Treatment Pack fluoride concentration (ppm) Mean enamel fluoride concentration (ppm) Experimental Toothpaste (3 5 years) 0 40 (6) a Aquafresh Milk Teeth 1, (20) b Odol-med 3 Milchzahn 500 1,000 (21) c Experimental Toothpaste (0 2 years) 500 1,383 (27) d Experimental Toothpaste (3 5 years) 500 1,521 (42) e Aquafresh Little Teeth 1,400 1,540 (72) e Experimental Toothpaste (0 2 years) 1,000 1,648 (46) e,f Aquafresh Little Teeth 1,000 1,758 (36) f,g Experimental Toothpaste (3 5 years) ,860 (35) g,h Aquafresh Big Teeth 1,450 1,919 (54) h,i Experimental Toothpaste (3 5 years) 1,450 1,959 (41) h,i Experimental Toothpaste (6+ years) 1,450 2,035 (53) i 2013 FDI World Dental Federation 53
7 Churchley and Schemehorn Table 10 Relative enamel and dentine abrasion results for experimental and commercial toothpastes (n = 8) Treatment REA RDA Aquafresh Fresh and Minty 4.58 (0.23) a (2.13) a Aquafresh Kids Bubble Fresh 2.49 (0.11) b (1.90) b Experimental Toothpaste 2.26 (0.17) b,c (1.60) d (6+ years/non-us) Experimental Toothpaste 2.25 (0.18) b,c (1.88) d (0 2 years/non-us) Aquafresh Big Teeth 2.03 (0.12) b,c,d (1.20) c Experimental Toothpaste 2.02 (0.12) b,c,d (1.21) d (2 5 years/us tube) Experimental Toothpaste 2.00 (0.17) b,c,d (1.65) d (6+ years/non-us) Experimental Toothpaste 1.76 (0.21) c,d (1.13) d (2 5 years/us pump) Experimental Toothpaste 1.64 (0.18) c,d (1.35) d (6+ Years/US) Aquafresh Milk Teeth 1.49 (0.08) d (1.87) a Odol-Med 3 Milchzahn 0.93 (0.19) e (2.96) d Letter superscripts represent the different statistical groupings. Standard error in brackets. Table 11 Bioavailable fluoride results for experimental toothpastes Age range Pack fluoride concentration (ppm) Bioavailable fluoride (ppm) 0 2 years years years 1, years 0 None detected 3 5 years years years 1, years 1,150 (Tube) 1, years 1,150 (Pump) 1, years 1,450 1, years years years years 1,150 1, years 1,450 1,335 whereas the range of REA values is considerably smaller (from ). The statistical analysis showed that while there were no differences between the experimental toothpastes for both RDA and REA, there were significant differences between the commercial control toothpastes. Bioavailable fluoride The bioavailable fluoride data for the experimental toothpastes is shown in Table 11. All placebo formulations contained 4 ppm fluoride. For all other toothpastes, the concentration of bioavailable fluoride was high and similar to that of the on-pack fluoride concentration. DISCUSSION The range of experimental toothpastes evaluated in this study have been developed for use by children at the different stages of their development. The formulations for the three age groups are different; specifically, in the level of surfactant and the type of thickening gums used. In addition, flavour and colour variations are present across the three formulations. The rationale for these differences is discussed by Stovell et al. 25 These toothpastes were designed to maximise fluoride availability, minimise abrasivity and incorporate levels and types of surfactant that will minimise interference with fluoride delivery. In vitro ph cycling models are frequently used to replicate the dynamics of demineralisation and remineralisation involved in caries lesion formation and daily toothpaste usage 26. The ph cycling model described in this paper has been previously used to investigate the effect of fluoride containing toothpastes on remineralisation of artificial caries lesions 27,28. The cycling studies described here used permanent human teeth because of the difficulty in obtaining sufficient numbers of deciduous teeth. Furthermore, deciduous teeth are smaller and so there is less surface area for experimental manipulation 26. While there are a number of distinct differences between deciduous and permanent enamel, it has been reported that remineralisation of initial caries lesions is similar in both substrates 29. This means that permanent enamel can be used as a surrogate for deciduous enamel in these studies. The lesions used in this study represented early stage lesions where the mineral loss was confined to the outer regions of the enamel where fluoride is considered most effective 30. The changes in specimen hardness following ph cycling were less that those reported by Newby et al. using the same experimental protocol 28. These differences may be explained by compositional variations in the saliva used as the remineralisation medium. As saliva varies from person to person, and the composition of an individual s saliva can vary depending on the time of collection 31, the saliva used in these studies was pooled from at least five individuals in an attempt to mitigate this variability. In this paper, the enamel remineralisation neared a plateau in the range of ppm F, however, in most cases the dose response continued to be significant up to higher fluoride concentrations. Similar remineralisation plateaux have been observed by other authors for shallow lesions 32. In addition, while net remineralisation increased from 10 days to 20 days for all fluoride-containing toothpastes, the changes were small. A plausible explanation could be a surface-zone blocking effect, which reduces the number of diffusion pathways to the lesion body. This FDI World Dental Federation
8 In vitro assessment of a toothpaste range effect has been demonstrated during mechanistic studies in vitro 33,34. The fluoride source in all experimental toothpastes and the majority of the commercial control toothpastes is NaF. Only the Aquafresh Kids Bubble Fresh and Aquafresh Milk Teeth Toothpastes use SMFP as a fluoride source. To be effective in the mouth, the fluoride ion needs to be freely available. While this is the case for NaF, the SMFP must be initially hydrolysed by salivary or microbial phosphatases in order to release the fluoride ion 35. As a result, the toothpaste slurries used in the ph cycling studies were prepared in human saliva in order to initiate hydrolysis. It is worth noting that whilst the in vitro ph cycling data has shown that treatment with both experimental toothpastes (US) produced greater lesion remineralisation and a higher enamel fluoride content than the Aquafresh Kids Bubble Fresh toothpaste, a number of caries clinical trials have shown no significant differences in the anti-caries effectiveness of toothpastes containing fluoride as either NaF or SMFP 36. Fluoride uptake has long been accepted as a positive indicator of the anti-caries activity of fluoride toothpastes. All experimental toothpastes contain a high level of bioavailable fluoride and were effective at delivering this fluoride to demineralised enamel. However, not all toothpaste containing an equivalent fluoride source and concentration produced the same fluoride uptake. This demonstrates that fluoride uptake can be influenced by different toothpaste excipients 25. In both EFU studies, the fluoride uptake was higher from NaF than from SMFP toothpastes containing equivalent fluoride ion concentrations. For comparison, Arends et al. 37 and de Rooij et al. 38 reported similar findings using sound enamel. For the US experimental toothpastes, the fluoride uptake was either equivalent to or greater than the USP reference toothpaste and therefore satisfies this part of the monograph testing requirements 18. However, as the EFU method does not incorporate biological factors that in vivo would promote SMFP hydrolysis, it is not possible to make any inference from this study as to the efficacy of the Aquafresh Kids Bubble Fresh toothpaste relative to the USP reference toothpaste. Although not reported in this paper, the Aquafresh Kids Bubble Fresh toothpaste fulfils all testing requirements listed in the anti-caries monograph. The fluoride uptake results were consistent with those measured in the ph cycling studies. Abrasives are added to toothpastes to remove plaque and further to remove the stained pellicle on the tooth surface and thus it is important to ensure that the abrasive will not cause mechanical damage to the teeth 39,40. In vitro abrasivity tests are routinely performed to provide information on the abrasive potential of toothpastes; however, the protective nature of the pellicle towards toothpaste abrasion means that any extrapolation of in vitro data to levels of in vivo abrasive wear should be treated with caution 41. While no specific REA and RDA limits have been established for children s toothpaste, ISO 11609:2010 sets toothpaste abrasivity limits of 250 for RDA and 40 for REA. As RDA is not a predictor of REA and vice versa, both abrasivity tests were conducted. In consideration of the differences between primary and permanent enamel with regard to its abrasion resistance, all children s toothpastes have been designed to have low levels of abrasivity. The results show that all toothpastes were below the recommended abrasivity limits and are therefore considered safe for everyday use. CONCLUSION In conclusion, a range of toothpastes have been developed for use by children at different stages of their development and contain different concentrations of fluoride for different markets. These toothpastes were specifically formulated to maximise fluoride availability and have low abrasivity. The in vitro findings reported here demonstrate that the experimental toothpastes were effective at promoting fluoride uptake and remineralisation of artificial caries lesions. Toothpastes for the US market were shown to comply with the in vitro testing requirements of the US anti-caries monograph. Conflict of interest Author Churchley is employed by GlaxoSmithKline Consumer Healthcare. Author Schemehorn is employed by Therametric Technologies Inc., an independent research facility that received funding from GlaxoSmithKline Consumer Healthcare for this work. REFERENCES 1. Tooth structures. In: Berkowitz BKB, Holland GR, Moxham BJ, editors. Color Atlas and Textbook of Oral Anatomy. Chicago: Year Book Medical Publishers Inc, pp Tooth eruption, succession and replacement. In: Atkinson ME, White FH, editors. Principles of Anatomy and Oral Anatomy for Dental Students. Edinburgh London Madrid Melbourne New York and Tokyo: Churchill Livingstone, pp Stack MV. Variation in the organic content of deciduous enamel and dentine. Biochem J : XV. 4. Wilson PR, Beynon AD. Mineralisation differences between human deciduous and permanent enamel measured by quantitative microradiography. Arch Oral Biol : Linden LA, Bjorkman S, Hattab F. The diffusion in vitro of fluoride and chlorhexidine in the enamel of human deciduous and permanent teeth. Arch Oral Biol : Featherstone JDB, Mellberg JR. Relative rates of progress of artificial carious lesions in bovine, ovine and human enamel. Caries Res : FDI World Dental Federation 55
9 Churchley and Schemehorn 7. Wang LJ, Tang R, Bonstein P et al. Enamel demineralisation in primary and permanent teeth. J Dent Res : Shellis RP. Relationship between human enamel structure and the formation of caries like lesions in vitro. Arch Oral Biol : Lussi A, Schaffner M, Jaeggi T. Dental erosion diagnosis and prevention in children and adults. Int Dent J : Dental Caries (Tooth Decay) in Children (Age 2 to 11). National Health and Nutrition Examination Survey, Twetman S. Caries prevention with fluoride toothpaste in children: an update. Eur Arch Paediatr Dent : Marinho VCC, Higgins JPT, Logan S et al. Fluoride toothpastes for preventing dental caries in children and adolescents. Cochrane Database Syst Rev 2003 Issue 1 Art No: CD Featherstone JDB. Prevention and reversal of dental caries: role of low level fluoride. Community Dent Oral Epidemiol : Marquis RE, Clock SA, Mota-Meira M. Fluoride and organic weak acids as modulators of microbial physiology. FEMS Microbiol Rev : International Standards Organization ISO 11609, Dentistry toothpastes requirements, test methods and marketing Guidelines for the acceptance of fluoride containing dentifrices. J Am Dent Assoc : Guidance on the assessment of the efficacy of toothpastes. Int Dent J : CFR Parts 310, 355 and 369, Anti-caries Drug Products for Over-the-Counter Human Use; Final Monograph; Final Rule, Federal Register, 1995 Vol.60, No White DJ. Reactivity of fluoride dentifrices with artificial caries I. Effects on early lesion: F uptake, surface hardening and remineralisation. Caries Res : White DJ. Reactivity of fluoride dentifrices with artificial caries II. Effects on subsurface lesions: F uptake, F distribution, surface hardening and remineralisation. Caries Res : Schemehorn BR, Farnham RL, Wood GD et al. A bovine enamel model for in vitro remin/demin tests. J Dent Res : 260. (Abstract 1213) 22. Schemehorn BR, Farnham RL, Wood GD et al. Fluoride uptake and remineralization in human and bovine enamel. J Dent Res : 186. (Abstract #644) 23. Schemehorn BR, Roberts JA, Wood GD. An in vitro remin/demin model showing a fluoride dose response. J Dent Res : 241. (Abstract #1117) 24. Hefferren JJ. A laboratory method for assessment of dentifrice abrasivity. J Dent Res : Stovell AG, Newton BM, Lynch RJM. Important considerations in the development of toothpaste formulations for Children. Int Dent J (Suppl 2): Buzalaf MAR, Hannas AR, Magalhaes AC et al. ph Cycling models for in vitro evaluation of the efficacy of fluoridated dentifrices for caries control: strengths and limitations. J Appl Oral Sci : Karlinsey RL, Mackey AC, Walker ER et al. Remineralisation potential of 5000 ppm fluoride dentifrices evaluated in a ph cycling model. J Dent Oral Hyg : Newby EE, Newby CS, Wood GD et al. Surface hardness changes and enamel fluoride uptake in a 20 day in vitro caries cycling model. Caries Res : 328. (Abstract 173) 29. Hellwig E, Altenburger MA, Attin T et al. Remineralisation of initial carious lesions in deciduous enamel after application of dentifrices of different fluoride concentrations. Clin Oral Invest : Bjarnason S, Finnbogason SY. Effect of different fluoride level in dentifrice on the development of aproximal caries. Caries Res : Edgar WM. Saliva: its secretion, composition and functions. Br Dent J : Ten Cate JM, Exterkate RAM, Buijs MJ. The relative efficacy of fluoride toothpastes assessed with ph cycling. Caries Res : Silverstone LM, Wefel JS, Zimmerman BF et al. Remineralisation of natural and artificial lesions in human dental enamel in vitro. Caries Res : Ten Cate JM, Duijsters PP. Alternating demineralisation and remineralisation of artificial enamel lesions Caries Res : Bowen WH. The role of fluoride toothpastes in the prevention of dental caries. J Royal Soc Med : Volpe AR, Petrone ME, Davies R. Clinical anticaries efficacy of NaF and SMFP dentifrices: overview and resolution of the scientific controversy. J Clin Dent : Arends J, Lodding A, Petersson L. Fluoride uptake in enamel in vitro comparison of topical agents. Caries Res : de Rooij JF, Arends J, Kolar Z. Diffusion of monofluorophosphate in whole bovine enamel at ph 7. Caries Res : Barbakow F, Lutz F, Imfeld T. Abrasives in dentifrices and prophylaxis pastes. Quintessance Int : White DJ. Development of an improved whitening dentifrice based on stain specific soft silica technology. J Clin Dent : Dorfer CE. Abrasivity of dentifrices from a clinical perspective. J Clin Dent (Spec Iss): S4. Correspondence to: David Churchley, GlaxoSmithKline Consumer HealthCare, St Georges Avenue, Weybridge, Surrey, KT13 0DE, UK david.r.churchley@gsk.com FDI World Dental Federation
Comparative Analysis of Remineralizing Potential of Three Commercially Available Agents- An in Vitro Study
IOSR Journal of Dental and Medical Sciences (IOSR-JDMS) e-issn: 2279-0853, p-issn: 2279-0861.Volume 16, Issue 2 Ver. III (February. 2017), PP 01-05 www.iosrjournals.org Comparative Analysis of Remineralizing
More informationTri-Calcium Phosphate (TCP) Espertise
Tri-Calcium Phosphate (TCP) Espertise A Collection of Scientific Results 2008 2011 NOTE: Some uses described in this abstract collection have not been approved or cleared by the TGA. See full prescribing
More informationquantitative light-induced fluorescence study. Caries research, 45(2), https://doi.org/ /
Enamel demineralization and remineralization under plaque fluid-like conditions a QLF study F Lippert a, A Butler b, R J M Lynch b a Department of Preventive and Community Dentistry, Oral Health Research
More informationLinking Research to Clinical Practice
Prevention of Root Caries Denise M. Bowen, RDH, MS Linking Research to Clinical Practice The purpose of Linking Research to Clinical Practice is to present evidence based information to clinical dental
More informationAnticaries effect of dentifrices with calcium citrate and sodium trimetaphosphate
www.scielo.br/jaos Anticaries effect of dentifrices with calcium citrate and sodium trimetaphosphate 1 2 3 4, 1 5 1- DDS, MS, PhD, Araçatuba Dental School, UNESP- Univ. Estadual Paulista, Araçatuba, SP,
More informationTooth hypersensitivity and Dental erosion DR. KÁROLY BARTHA
Tooth hypersensitivity and Dental erosion DR. KÁROLY BARTHA 2 Why Is Erosion an Issue Now? Changing dietary habits Higher consumption of acidic beverages (colas, sport drinks) Higher incidence of xerostomia
More informationTiming of fluoride toothpaste use and enamel-dentin demineralization
Cariology Cariology Timing of fluoride toothpaste use and enamel-dentin demineralization Sandro Carvalho Kusano (a) Livia Maria Andaló Tenuta (a) Altair Antoninha Del Bel Cury (b) Jaime Aparecido Cury
More informationRecommendation for a non-animal alternative to rat caries testing
Position Article Recommendation for a non-animal alternative to rat caries testing JOHN D.B. FEATHERSTONE, MSC, PHD, GEORGE K. STOOKEY, PHD, MICHAEL A. KAMINSKI, PHD & ROBERT V. FALLER, BS ABSTRACT: Purpose:
More informationEffect of different fluoride concentrations on remineralization of demineralized enamel: an in vitro ph-cycling study
Effect of different fluoride concentrations on remineralization of demineralized enamel: an in vitro ph-cycling study Ferda Dogan, Arzu Civelek, Inci Oktay Istanbul, Turkey This study was supported by
More informationZurich Open Repository and Archive
University of Zurich Zurich Open Repository and Archive Winterthurerstr. 190 CH-8057 Zurich http://www.zora.uzh.ch Year: 2010 Remineralization of initial carious lesions in deciduous enamel after application
More informationSOFT DRINKS & DENTAL HEALTH.
SOFT DRINKS & DENTAL HEALTH www.giveuplovingpop.org.uk @gulpnow SOFT DRINKS & DENTAL HEALTH All text tables, copyright Health Equalities Group 2017 Primary authors: Alexandra Holt, MSc. Health Equalities
More informationComparative Evaluation of Remineralizing Potential of Three Pediatric Dentifrices
Ashna Kapoor et al Original Article 10.5005/jp-journals-10005-1361 Comparative Evaluation of Remineralizing Potential of Three Pediatric Dentifrices 1 Ashna Kapoor, 2 KR Indushekar, 3 Bhavna G Saraf, 4
More informationNEW ZEALAND DATA SHEET
1 PRODUCT NAME Clinpro 5000 anti-cavity toothpaste Vanilla Mint Clinpro 5000 anti-cavity toothpaste Spearmint Clinpro 5000 anti-cavity toothpaste Bubble Gum 2 QUALITATIVE AND QUANTITATIVE COMPOSITION Thick
More informationOral Care. Excellent cleaning performance, remineralization and whitening for toothpaste
Oral Care Excellent cleaning performance, remineralization and whitening for toothpaste Toothpaste is one of the most commonly used cosmetics across all cultures, irrespective of age or sex. In fact, it
More informationTHE IMPACT OF MODIFIED FRUIT JUICE ON ENAMEL MICROHARDNESS: AN IN-VITRO ANALYSIS
Original Article International Journal of Dental and Health Sciences Volume 02,Issue 02 THE IMPACT OF MODIFIED FRUIT JUICE ON ENAMEL MICROHARDNESS: AN IN-VITRO ANALYSIS Shailee Shelke 1,Shaila Masih 1,Namita
More informationTHE INFLUENCE OF BASELINE HARDNESS AND CHEMICAL COMPOSITION ON ENAMEL DEMINERALIZATION AND SUBSEQUENT REMINERALIZATION.
THE INFLUENCE OF BASELINE HARDNESS AND CHEMICAL COMPOSITION ON ENAMEL DEMINERALIZATION AND SUBSEQUENT REMINERALIZATION by Rana Alkattan Submitted to the Graduate Faculty of the School of Dentistry in partial
More informationIs there any clinical evidence?
Current treatment objectives Anticariogenic capacity of restorative materials in paediatric dentistry: in vitro evidence vs. clinical efficiency Prof. Lisa Papagianoulis Restoration with minimal intervention
More informationInfluence of Bioactive Materials on Whitened Human Enamel Surface in vitro study
Influence of Bioactive Materials on Whitened Human Enamel Surface Influence of Bioactive Materials on Whitened Human Enamel Surface in vitro study Pinheiro HB, Cardoso PEC, Universidade de São Paulo, São
More informationRemineralizing Effect of Child Formula Dentifrices on Artificial Enamel Caries Using a ph Cycling Model
Original Article Remineralizing Effect of Child Formula Dentifrices on Artificial Enamel Caries Using a ph Cycling Model Beheshteh Malekafzali 1, Maliheh Ekrami 2, Armin Mirfasihi 3, Zahra Abdolazimi 4
More informationPRESS DOSSIER June 2011 WHITENING TOOTH PASTE
PRESS DOSSIER June 2011 CONSUMER TRENDS The offer of beauty products in pharmacies and parapharmacies is becoming increasingly broader and more varied. Anticellulite and slimming products, anti-aging products
More informationOmya Consumer Goods omya.com. Oral Care. Natural Minerals for Toothpaste Formulations
Omya Consumer Goods omya.com Oral Care Natural Minerals for Toothpaste Formulations About Omya Omya is a leading global producer of Calcium Carbonate and a worldwide distributor of specialty chemicals.
More informationTHE COMBINED EFFECT OF XYLITOL AND FLUORIDE IN VARNISH ON BOVINE TEETH SURFACE MICROHARDNESS
Effect of Xylitol and Fluoride in Varnish on Teeth Surface Microhardness THE COMBINED EFFECT OF XYLITOL AND FLUORIDE IN VARNISH ON BOVINE TEETH SURFACE MICROHARDNESS Kadkao Vongsavan 1, Rudee Surarit 2
More informationEffect of Fluoridated Dentifrices on Surface Microhardness of the Enamel of Deciduous Teeth
Original Article Effect of Fluoridated Dentifrices on Surface Microhardness of the Enamel of Deciduous Teeth Seyed Ebrahim Jabbarifar 1, Shadiafarin Salavati 2, Ali Akhavan 3, Kazem Khosravi 4, Naser Tavakoli
More informationFluor Protector Overview
Fluor Protector Overview Superior protection against dental caries and erosion Fluoride Clinically proven Fluoride varnish Features and mechanism of action Application Intensive care gel Risks to teeth
More informationInfluence of Individual Saliva Secretion on Fluoride Bioavailability
The Open Dentistry Journal, 2010, 4, 185-190 185 Influence of Individual Saliva Secretion on Fluoride Bioavailability E.A. Naumova, P. Gaengler, S. Zimmer and W.H. Arnold* Open Access Department für Zahn-,
More informationFluoride Dose-Response of Human and Bovine Enamel Artificial Caries Lesions under ph-cycling Conditions
Fluoride Dose-Response of Human and Bovine Enamel Artificial Caries Lesions under ph-cycling Conditions Frank Lippert, Kalp Juthani Department of Preventive and Community Dentistry, Oral Health Research
More informationHealth Promotion and Disease Prevention are the Foundation of Community Based Health Care
Health Promotion and Disease Prevention are the Foundation of Community Based Health Care Joan I. Gluch, RDH, Ph.D. Director of Community Health Associate Dean for Academic Policies Renewed Perspective
More informationR EVIEWS OF S YSTEMATIC R EVIEWS
Seven systematic reviews confirm topical fluoride therapy is effective in preventing dental caries Robert J. Weyant University of Pittsburgh School of Dental Medicine 1. Marinho VCC, Higgins JPT, Logan
More informationEFFECT OF ADDING TRICALCIUM PHOSPHATE TO FLUORIDE MOUTHRINSE ON MICROHARDNESS OF DEMINERALIZED PRIMARY HUMAN TOOTH
EFFECT OF ADDING TRICALCIUM PHOSPHATE TO FLUORIDE MOUTHRINSE ON MICROHARDNESS OF DEMINERALIZED PRIMARY HUMAN TOOTH Praphasri Rirattanapong 1, Kadkao Vongsavan 1, Chavengkiat Saengsirinavin 2 and Pimonchat
More informationDespite a plethora of in situ studies and clinical trials evaluating the efficacy of fluoridated dentifrices
www.scielo.br/jaos ph-cycling models for in vitro evaluation of the efficacy of fluoridated dentifrices for caries control: strengths and limitations Marília Afonso Rabelo BUZALAF 1, Angélica Reis HANNAS
More informationOral clearance of NaF from chewing gum and tablets in children and adults
Oral clearance of NaF from chewing gum and tablets in children and adults M. R. GIUCA*, S. SARACINO**, E. GIANNOTTI**, A. CECCARINI*** ABSTRACT. Aim Aim of the present study was to evaluate the salivary
More informationGC Tooth Mousse Plus. Made from milk. Perfect for teeth.
GC Tooth GC Tooth Made from milk. Perfect for teeth. 1 We all brush our teeth everyday. But people who really want to care for their teeth are discovering the many benefits that come from moussing their
More informationMI Varnish The ultimate fluoride varnish
MI Varnish The ultimate fluoride varnish GC introduces MI Varnish, the first fluoride varnish with RECALDENT (CPP-ACP) MI Varnish is a 5% NaF varnish enhanced with 2% RECALDENT (CPP-ACP) to give an exceptional
More informationTitle:Is there a place for Tooth Mousse(R) in the prevention and treatment of early dental caries? A systematic review.
Author's response to reviews Title:Is there a place for Tooth Mousse(R) in the prevention and treatment of early dental caries? A systematic review. Authors: Sarah L Raphael (sarah.raphael@sydney.edu.au)
More informationComparative Evaluation of Fluoride Uptake Rate in the Enamel of Primary Teeth after Application of Two Pediatric Dentifrices
Original Article Comparative Evaluation of Fluoride Uptake Rate in the Enamel of Primary Teeth after Application of Two Pediatric Dentifrices B. Malekafzali 1, N. Tadayon 2 1 Assistant Professor, Department
More informationResearch Article Effect of Enamel Caries Lesion Baseline Severity on Fluoride Dose-Response
Hindawi International Dentistry Volume 2017, rticle ID 4321925, 6 pages https://doi.org/10.1155/2017/4321925 Research rticle Effect of Enamel aries Lesion aseline Severity on Fluoride Dose-Response Frank
More informationEFFECTIVENESS OF SOY MILK WITH CALCIUM ON BOVINE ENAMEL EROSIONS AFTER SOAKING IN CHLORINATED WATER
EFFECTIVENESS OF SOY MILK WITH CALCIUM ON BOVINE ENAMEL EROSIONS AFTER SOAKING IN CHLORINATED WATER Kadkao Vongsavan 1, Rudee Surarit 2 and Praphasri Rirattanapong 1 1 Department of Pediatric Dentistry,
More informationDental erosion: In vitro model of wine assessor s erosion
ADRF REPORT Australian Dental Journal 21;46:(4):263-268 Dental erosion: In vitro model of wine assessor s erosion Tong Bee Mok,* J McIntyre,* D Hunt* Abstract Background: Wine makers and assessors frequently
More informationEffects of miswak and nano calcium carbonate toothpastes on the hardness of demineralized human tooth surfaces
Journal of Physics: Conference Series PAPER OPEN ACCESS Effects of miswak and nano calcium carbonate toothpastes on the hardness of demineralized human tooth surfaces To cite this article: F Dianti et
More informationAustralian Dental Journal
Australian Dental Journal The official journal of the Australian Dental Association Australian Dental Journal 2013; 58: 478 482 doi: 10.1111/adj.12110 Role of arginine and fluoride in the prevention of
More informationEffect of CPP-ACP paste on tooth mineralization: an FE-SEM study
115 Journal of Oral Science, Vol. 49, No. 2, 115-120, 2007 Original Effect of CPP-ACP paste on tooth mineralization: an FE-SEM study Maki Oshiro 1), Kanako Yamaguchi 2), Toshiki Takamizawa 1,3), Hirohiko
More informationEFFICACY OF FLUORIDE MOUTHRINSE CONTAINING TRICALCIUM PHOSPHATE ON PRIMARY ENAMEL LESIONS : A POLARIZED LIGHT MICROSCOPIC STUDY
EFFICACY OF FLUORIDE MOUTHRINSE CONTAINING TRICALCIUM PHOSPHATE ON PRIMARY ENAMEL LESIONS : A POLARIZED LIGHT MICROSCOPIC STUDY Praphasri Rirattanapong 1, Kadkao Vongsavan 1, Chavengkiat Saengsirinavin
More informationSUMMARY OF PRODUCT CHARACTERISTICS 1 NAME OF THE MEDICINAL PRODUCT 2 QUALITATIVE AND QUANTITATIVE COMPOSITION
SUMMARY OF PRODUCT CHARACTERISTICS 1 NAME OF THE MEDICINAL PRODUCT DURAPHAT 2800 ppm FLUORIDE TOOTHPASTE 2 QUALITATIVE AND QUANTITATIVE COMPOSITION Sodium Fluoride 0.619 % w/w (2800 ppm F) For the full
More informationEffect of different frequencies of fluoride dentifrice and mouthrinse administration: an in situ study
Cariology Cariology Effect of different frequencies of fluoride dentifrice and mouthrinse administration: an in situ study Daniela Correia Cavalcante Souza (a) Lina Naomi Hashizume (a) Morjana Eidelwein
More informationEFFECT OF 4% TITANIUM TETRAFLUORIDE SOLUTION ON THE EROSION OF PERMANENT AND DECIDUOUS HUMAN ENAMEL: AN IN SITU/EX VIVO STUDY
www.fob.usp.br/jaos or www.scielo.br/jaos J Appl Oral Sci. 2009;17(1):56-60 EFFECT OF 4% TITANIUM TETRAFLUORIDE SOLUTION ON THE EROSION OF PERMANENT AND DECIDUOUS HUMAN ENAMEL: AN IN SITU/EX VIVO STUDY
More informationChapter 14 Outline. Chapter 14: Hygiene-Related Oral Disorders. Dental Caries. Dental Caries. Prevention. Hygiene-Related Oral Disorders
Chapter 14 Outline Chapter 14: Hygiene-Related Oral Disorders Hygiene-Related Oral Disorders Dental caries Prevention Gingivitis Prevention Tooth hypersensitivity Pathophysiology Treatment 2 Hygiene-Related
More informationTake-Home Whitening. in vitro study. Benefits of ACP TAKE-HOME WHITENING
Fluoride and Potassium Nitrate-Fluoride Whitening Agents: in vitro Caries Study Fluoride and Potassium Nitrate-Fluoride Whitening Agents: in vitro Caries Study in vitro study Hicks J and Flaitz C. Effects
More informationOriginal Research. Fluoride varnish and dental caries prevention Mohammadi TM et al. Contributors: 1
Received: 10 th August 2014 Accepted: 03 rd November 2014 Conflict of Interest: None Source of Support: Nil Original Research Fluoride Varnish Effect on Preventing Dental Caries in a Sample of 3-6 Years
More informationVol. XXVI, No. 2 The Journal of Clinical Dentistry 45
Erosion Prevention Potential of an Over-the-Counter Stabilized SnF 2 Dentifrice Compared to 5000 ppm F Prescription-Strength Products S.L. Eversole, AAS K. Saunders-Burkhardt The Procter & Gamble Company
More informationStandards for the Nova Scotia Fluoride Mouthrinse Program
Standards for the Nova Scotia Fluoride Mouthrinse Program Approved by the Fluoride Mouthrinse Steering committee October 1, 2004 Table of Contents Introduction... 3 Rationale for the Standards... 4 Purpose
More informationAbrasion of eroded dentin caused by toothpaste slurries of different abrasivity and
Abrasion of eroded dentin caused by toothpaste slurries of different abrasivity and toothbrushes of different filament diameter ANNETTE WIEGAND 1, MIRJAM KUHN 1, BEATRICE SENER 1, MALGORZATA ROOS 2 & THOMAS
More informationIonic Brushing Superpowers
Ionic Brushing Superpowers EN Technical Brochure At Sanyei we believe, true to the Japanese way of thinking, that mouth care directly relates to being healthier and happier in body and therefore happier
More informationSaliva. Introduction. Salivary Flow. Saliva and the Plaque Biofilm. The Minerals in Saliva
Saliva Introduction Saliva is like a bloodstream to the mouth. As does blood, saliva helps build and maintain the health of the soft and hard tissues. Saliva removes waste products and provides disease-fighting
More informationGC Tooth Mousse Plus for Orthodontics. Helps keep you smiling. Made from milk
GC Tooth Mousse Plus for Orthodontics Helps keep you smiling Made from milk Prevention Daily application of GC Tooth Mousse Plus with RECALDENT (CPP-ACP) throughout the full course of orthodontic treatment
More informationENHANCING REMINERALIZATION OF PRIMARY ENAMEL LESIONS WITH FLUORIDE DENTIFRICE CONTAINING TRICALCIUM PHOSPHATE
ENHANCING REMINERALIZATION OF PRIMARY ENAMEL LESIONS WITH FLUORIDE DENTIFRICE CONTAINING TRICALCIUM PHOSPHATE Praphasri Rirattanapong 1, Kadkao Vongsavan 1, Chavengkiat Saengsirinavin 2 and Sumana Waidee
More informationEFFECT OF RESIN MODIFIED GLASS IONOMER CEMENT ON MICROHARDNESS OF INITIAL CARIES LESIONS
EFFECT OF RESIN MODIFIED GLASS IONOMER CEMENT ON MICROHARDNESS OF INITIAL CARIES LESIONS Woranun Prapansilp 1, Kadkao Vongsavan 1, Praphasri Rirattanapong 1 and Rudee Surarit 2 1 Department of Pediatric
More informationEveryday Relief. Everyday Protection.
Everyday Relief. Everyday Protection. CLINICAL RESULTS ON BACK! A Targeted Approach to Practice Building! Treats Sensitivity Soothes & Moisturizes Dry Mouth Tissues Helps to Prevent Caries & Gingivitis
More informationThe Abrasive Effect of Toothpastes Containing Remineralization
International Journal of Clinical Preventive Dentistry Volume 8, Number 4, December 20 The Abrasive Effect of Toothpastes Containing Remineralization Components Jae-Hyun Ahn 1, Ji-Hye Kim 1, Seung-Chul
More informationSUMMARY OF PRODUCT CHARACTERISTICS 2 QUALITATIVE AND QUANTITATIVE COMPOSITION
SUMMARY OF PRODUCT CHARACTERISTICS 1 NAME OF THE MEDICINAL PRODUCT Fluoride 2800 ppm Toothpaste 2 QUALITATIVE AND QUANTITATIVE COMPOSITION 1 g of toothpaste contains contains 2.8 mg fluoride (as sodium
More informationIn Situ Fluoride Response of Caries Lesions with Different Mineral Distributions at Baseline
In Situ Fluoride Response of Caries Lesions with Different Mineral Distributions at Baseline F Lippert, R.J.M. Lynch, G.J. Eckert, S.A. Kelly, A.T. Hara, D.T. Zero Department of Preventive and Community
More informationEffects of a sodium fluoride- and phytate-containing dentifrice on remineralisation of enamel erosive lesions an in situ randomised clinical study
Clinical Oral Investigations (2018) 22:2543 2552 https://doi.org/10.1007/s00784-018-2351-z ORIGINAL ARTICLE Effects of a sodium fluoride- and phytate-containing dentifrice on remineralisation of enamel
More informationDental Quality and Outcomes Framework for
Dental Quality and Outcomes Framework for 2016-17 March 2016 Title: Dental Quality and Outcomes Framework for 2016-17 Author: Finance Commercial and NHS Directorate NHS Group Legislation and Policy Unit,
More informationEnhanced enamel benefits from a novel fluoride toothpaste
International Dental Journal (2009) 59, 244-253 Enhanced enamel benefits from a novel fluoride toothpaste Andrew Joiner, Fred Schäfer, Kate Hornby, Mark Long, Margaret Evans, Tim Beasley and Pam Abraham
More informationEvaluation of the remineralisation of enamel by different. formulations and concentrations of fluoride toothpastes in vitro.
Evaluation of the remineralisation of enamel by different formulations and concentrations of fluoride toothpastes in vitro. Jarrah Jamal Ali Mohammad Al-Kandari Submitted in accordance with the requirements
More informationFluoridens 133 Fluorosilicic acid 136 Fluorosis, see Dental fluorosis Foams 118 acute toxicity 71, 122 clinical efficacy 122 Free saliva 149, 150
Subject Index Abrasive systems, dentifrices 123 Absorption 23, 24, 38, 78 Accidental poisonings 66, 67, 69, 70, see also Acute toxicity Acid-base status, see also ph metabolism effects 28, 29 toxicity
More informationUses of Fluoride in Dental Practices
Uses of Fluoride in Dental Practices BY: Sulafa El-Samarrai Preventive &pedodontic department General Mechanisms of Action in Caries Reduction 1-Increase enamel resistance or reduction in enamel solubility
More informationRoot Surface Protection Simple. Effective. Important.
GC Fuji VII / Fuji VII EP Root Surface Protection Simple. Effective. Important. Brush up your painting skills and help your patients Q&A Prof. Laurie Walsh University of Queensland lifestyle factors (frequency
More informationUniversity of Bristol - Explore Bristol Research
Seong, J., Hall, C., Young, S., Parkinson, C., Macdonald, E., Jones, S., & West, N. (2017). A randomised clinical in situ study to evaluate the effects of novel low abrasivity anti-sensitivity dentifrices
More informationSPACE MAINTAINER. Multimedia Health Education. Disclaimer
Disclaimer This movie is an educational resource only and should not be used to manage your health. All decisions about the management of premature loss of primary teeth and use of space maintainers must
More informationDOSAGE FORMS AND STRENGTHS White toothpaste containing 1.1% sodium fluoride (3)
HIGHLIGHTS OF PRESCRIBING INFORMATION These highlights do not include all the information needed to use 3M TM ESPE TM Clinpro TM 5000 Anti-Cavity Toothpaste safely and effectively. See full prescribing
More informationFluoride Release Rate from an Orthodontic Sealant and Its Clinical Implications
Original Article Fluoride Release Rate from an Orthodontic Sealant and Its Clinical Implications Manal M. Soliman a ; Samir E. Bishara b ; James Wefel c ; Judi Heilman d ; John J. Warren e ABSTRACT The
More informationPolicy Statement Community Oral Health Promotion: Fluoride Use (Including ADA Guidelines for the Use of Fluoride)
Policy Statement 2.2.1 Community Oral Health Promotion: Fluoride Use (Including ADA Guidelines for the Use of Fluoride) Position Summary Water fluoridation is the safest and the most effective way to reduce
More informationComplete Mouth Care System Stimulate natural repair with Dr. Ellie's Complete Mouth Care System
ELLIE PHILLIPS DDS Complete Mouth Care System It only takes 5 minutes, twice a day, to protect your smile and improve your oral health. Stimulate natural repair with Dr. Ellie's Complete Mouth Care System»
More informationComparing the Effects of Whey Extract and Case in Phosphopeptide- Amorphous Calcium Phosphate (CPP-ACP) on Enamel Microhardness
Short Communication Comparing the Effects of Whey Extract and Case in Phosphopeptide- Amorphous Calcium Phosphate (CPP-ACP) on Enamel Microhardness Mohammad Bagher Rezvani a, Mehrdad Karimi b, Raheleh
More informationMANAGEMENT OF ROOT CARIES USING OZONE
MANAGEMENT OF ROOT CARIES USING OZONE DENTAL NEWS, VOLUME XI, NUMBER II, 2004 BACKGROUND OZONE CAN BE CONSIDERED AS an alternative management strategy for root caries.
More informationThe Effects of Fluoride, Strontium, Theobromine and their Combinations on Caries Lesion Rehardening and Fluoridation
The Effects of Fluoride, Strontium, Theobromine and their Combinations on Caries Lesion Rehardening and Fluoridation Running Title: F, Sr and theobromine effects on lesions Frank Lippert Indiana University
More informationSUMMARY OF PRODUCT CHARACTERISTICS 1 NAME OF THE MEDICINAL PRODUCT 2 QUALITATIVE AND QUANTITATIVE COMPOSITION
SUMMARY OF PRODUCT CHARACTERISTICS 1 NAME OF THE MEDICINAL PRODUCT Duraphat 5000 ppm Fluoride Toothpaste 2 QUALITATIVE AND QUANTITATIVE COMPOSITION 1 g of toothpaste contains 5 mg fluoride (as sodium fluoride),
More informationCAries Management By Risk Assessment"(CAMBRA) - a must in preventive dentistry
CAries Management By Risk Assessment"(CAMBRA) - a must in preventive dentistry Nanda Kishor KM* *MDS, Reader, Department of Conservative and Endodontics Pacific Dental College, Udaipur, Rajasthan, India
More informationDISCOVER A NEW APPROACH TO COMFORT. Clinically proven immediate and lasting sensitivity relief with just one application!
Clinically proven immediate and lasting sensitivity relief with just one application! PLUS the stain removal strength you trust! DISCOVER A NEW APPROACH TO COMFORT PERFORMANCE meets PROTECTION For better
More informationDeposition of fluoride on enamel surfaces released from varnishes is limited to vicinity of fluoridation site
Clin Oral Invest (2007) 11:83 88 DOI 10.1007/s00784-006-0080-1 ORIGINAL ARTICLE Deposition of fluoride on enamel surfaces released from varnishes is limited to vicinity of fluoridation site T. Attin &
More informationRemineralization of Eroded Enamel Lesions by Simulated Saliva In Vitro
Send Orders of Reprints at reprints@benthamscience.org The Open Dentistry Journal, 2012, 6, 170-176 170 Open Access Remineralization of Eroded Enamel Lesions by Simulated Saliva In Vitro Robert L. Karlinsey
More informationAnalysis of fluoride levels retained intraorally or ingested following routine clinical applications of topical fluoride products
ADRF RESEARCH REPORT Australian Dental Journal 2001;46:(1):24-31 Analysis of fluoride levels retained intraorally or ingested following routine clinical applications of topical fluoride products K Heath,*
More informationPREMATURE PRIMARY TOOTH LOSS
Disclaimer This movie is an educational resource only and should not be used to manage your dental health. All decisions about the management of premature primary tooth loss must be made in conjunction
More informationThe Science Behind Sonicare
The Science Behind Sonicare Notes from Dr. Joerg Strate Vice President, Philips Oral Healthcare, Clinical & Scientific Affairs Philips Sonicare has redefined personal oral hygiene once again When we decide
More informationRecovery percentage of remineralization according to severity of early caries
Research Article Recovery percentage of remineralization according to severity of early caries HEE EUN KIM, RDH, PHD, HO KEUN KWON, DDS, PHD & BAEK IL KIM, DDS, PHD ABSTRACT: Purpose: To analyze the cutoff
More informationDENTAL MATTERS. This has been produced by Bayer
DENTAL MATTERS This has been produced by Bayer WHY IS GOOD DENTAL CARE IMPORTANT FOR HAEMOPHILIA? Haemophilia doesn t directly affect the teeth. However, like everyone else it is important to brush and
More informationEFFECT OF NANO-HYDROXYAPATITE ON REMINERALIZATION OF ENAMEL-A SYSTEMATIC REVIEW
International Journal of Dental Research & Development (IJDRD) ISSN(P): 2250-2386; ISSN(E): 2321-0117 Vol. 5, Issue 2, Aug 2015, 13-20 TJPRC Pvt. Ltd. EFFECT OF NANO-HYDROXYAPATITE ON REMINERALIZATION
More informationComparative Investigation of the Desensitizing Efficacy of a New Dentifrice Containing 5.5% Potassium Citrate : An Eight-Week Clinical Study
Comparative Investigation of the Desensitizing Efficacy of a New Dentifrice Containing 5.5% Potassium Citrate : An Eight-Week Clinical Study Deyu Hu, DDS College of Stomatology West China University of
More informationBIOACTIVE CAPABILITIES EXPLORED IN POLYURETHANE MICROCAPSULES AND THE INCLUSION INTO DENTAL SEALANTS AND CEMENT PASTES. By BRANT D.
BIOACTIVE CAPABILITIES EXPLORED IN POLYURETHANE MICROCAPSULES AND THE INCLUSION INTO DENTAL SEALANTS AND CEMENT PASTES By BRANT D. BURBANK A THESIS Submitted to the faculty of the Graduate School of Creighton
More informationContinually Fluoride Releasing Aesthetic Dental Restorative Material
Continually Fluoride Releasing Aesthetic Dental Restorative Material Research is our best product Image provided by Dr. Sushil Koirala BEAUTIFIL II More than just filling BEAUTIFIL II stands out for its
More informationAnalysis of Therapeutic Efficacy of Clinically Applied Varnish
Research Article Analysis of Therapeutic Efficacy of Clinically Applied Varnish Dobrinka M. Damyanova *, Radosveta Andreeva-Borisova Department of Pediatric Dental Medicine, Faculty of Dental Medicine,
More informationBenefits of a silica-based fluoride toothpaste containing o-cymen-5-ol, zinc chloride and sodium fluoride
ORIGINAL ARTICLE International Dental Journal 2011; 61 (Suppl. 3): 74 80 doi: 10.1111/j.1875-595X.2011.00053.x Benefits of a silica-based fluoride toothpaste containing o-cymen-5-ol, zinc chloride and
More informationFluor Protector S. The protective fluoride varnish. Superior protection against dental caries and erosion
Fluor Protector S The protective fluoride varnish Superior protection against dental caries and erosion Fluor Protector S The strong fluoride varnish In order to stay healthy and look good, teeth need
More informationThe Efficacy of Laser Fluorescence to Detect in Vitro Demineralization and Remineralization. of smooth enamel surfaces.
Photomedicine and Laser Surgery Volume 27, Number 1, 2009 Mary Ann Liebert, Inc. Pp. 57 61 DOI: 10.1089/pho.2007.2230 The Efficacy of Laser Fluorescence to Detect in Vitro Demineralization and Remineralization
More informationThe Caries Balance: Contributing Factors and Early Detection
FEBRUARY 2003 JOURNAL OF THE CALIFORNIA DENTAL ASSOCIATION Caries The Caries Balance: Contributing Factors and Early Detection John D.B. Featherstone, MSc, PhD John D.B. Featherstone, MSc, PhD, is professor
More informationMeasurement of surface hardness of primary carious lesions in extracted human enamel Measurement of Knoop hardness using Cariotester
Dental Materials Journal 2015; 34(2): 252 256 Measurement of surface hardness of primary carious lesions in extracted human enamel Measurement of Knoop hardness using Cariotester Akihiko SHIMIZU 1, Takatsugu
More informationEffect of experimental xylitol and fluoride-containing dentifrices on enamel erosion with or without abrasion in vitro
163 Journal of Oral Science, Vol. 53, No. 2, 163-168, 2011 Original Effect of experimental xylitol and fluoride-containing dentifrices on enamel erosion with or without abrasion in vitro Isabela D. Rochel
More informationFluoride varnishes play an important role in the prevention of dental caries, promoting
www.scielo.br/jaos TiF 4 and NaF varnishes in vitro Department of Biological Sciences, Bauru School of Dentistry, University of São Paulo, Bauru-SP, Brazil. Prof. Dr. Ana Carolina Magalhães - Department
More informationOutline : Tooth Anatomy Dental Caries Maintaining oral hygiene. Oral care products: 1. Toothpaste 2. Mouthwash 3. Teeth Whitening
Oral Care Products Outline : Tooth Anatomy Dental Caries Maintaining oral hygiene Oral care products: 1. Toothpaste 2. Mouthwash 3. Teeth Whitening I] Tooth Anatomy : 1. CROWN OF THE TOOTH (part of the
More informationFrom the office of: Nahidh D. Andrews, DMD 3332 Portage Ave South Bend, IN (574) Are Your Teeth a Sensitive Subject?
From the office of: Nahidh D. Andrews, DMD 3332 Portage Ave South Bend, IN 46628-3656 (574) 273-3900 Are Your Teeth a Sensitive Subject? A patient s guide to sensitive teeth and better oral care ARE YOUR
More information