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Frontiers in Public Health 2023This systematic review and meta-analysis aimed to evaluate the ingestion of toothpaste and its sequelae. The study adhered to the PRISMA guidelines and was registered in... (Meta-Analysis)
Meta-Analysis
This systematic review and meta-analysis aimed to evaluate the ingestion of toothpaste and its sequelae. The study adhered to the PRISMA guidelines and was registered in the PROSPERO database. A comprehensive search strategy was conducted across multiple databases, resulting in the inclusion of 18 relevant publications. Eligible studies encompassed various designs and included both children and adults as the study population. Data extraction was carried out systematically, and relevant information on study characteristics, interventions, and outcomes were collected. The assessment of bias was performed using the Joanna Briggs Institute's Critical Appraisal Tools showing variations of bias among the included studies. The overall risk of systemic toxicity was found to be low, and no severe or life-threatening events were reported in the included studies. Furthermore, some toothpaste formulations containing higher concentrations of fluoride were associated with an increased risk of dental fluorosis. These findings have several implications for practice and policy. Healthcare providers and dental professionals should emphasize the importance of promoting safe toothpaste use, especially in vulnerable populations such as young children who are more prone to accidental ingestion. Public health campaigns and educational initiatives should aim to raise awareness about appropriate toothpaste usage and the potential risks. In addition, toothpaste manufacturers and regulatory bodies should consider revising guidelines and regulations to ensure the safety of oral care products, including the appropriate concentration of active ingredients. Future research should focus on investigating the long-term effects of toothpaste ingestion, exploring potential interactions between different active ingredients, and evaluating the efficacy of current preventive measures.
Topics: Child; Adult; Humans; Child, Preschool; Toothpastes; Fluorides; Health Promotion; Health Personnel; Eating
PubMed: 37927882
DOI: 10.3389/fpubh.2023.1279915 -
Periodontology 2000 Sep 2023Periodontal diseases (gingivitis and periodontitis) are characterized by inflammatory processes which arise as a result of disruption of the balance in the oral... (Review)
Review
Periodontal diseases (gingivitis and periodontitis) are characterized by inflammatory processes which arise as a result of disruption of the balance in the oral ecosystem. According to the current S3 level clinical practice guidelines, therapy of patients with periodontitis involves a stepwise approach that includes the control of the patient's risk factors and the debridement of supra and subgingival biofilm. This debridement can be performed with or without the use of some adjuvant therapies, including physical or chemical agents, host modulating agents, subgingivally locally delivered antimicrobials, or systemic antimicrobials. Therefore, the main aim of this article is to review in a narrative manner the existing literature regarding the adjuvant application of local agents, either subgingivally delivered antibiotics and antiseptics or supragingivally applied rinses and dentifrices, during the different steps in periodontal therapy performed in Europe.
PubMed: 37766668
DOI: 10.1111/prd.12511 -
The Saudi Dental Journal Sep 2023Enamel, being the hardest and the highest mineralized tissue of the human body, contains nearly 96% inorganic components and 4% organic compounds and water. Dentin...
Enamel, being the hardest and the highest mineralized tissue of the human body, contains nearly 96% inorganic components and 4% organic compounds and water. Dentin contains 65% inorganic components and 35% organic and water content. The translucency and white appearance of enamel are attributed to Hydroxyapatite (HA), which constitutes the major part of the inorganic component of dental hard tissue. With the advent of nanotechnology, the application of Nanohydroxyapatite (nHA) has piqued interest in dentistry due to its excellent mechanical, physical, and chemical properties. Compared to HA, nHA is found to have superior properties such as increased solubility, high surface energy and better biocompatibility. This is due to the morphological and structural similarity of nanosized hydroxyapatite particles to tooth hydroxyapatite crystals. These nanoparticles have been incorporated into various dental formulations for different applications to ensure comprehensive oral healthcare. To prevent dental caries, several nHA based dentifrices, mouth rinsing solutions and remineralizing pastes have been developed. nHA-based materials, such as nanocomposites, nano impression materials, and nanoceramics, have proven to be very effective in restoring tooth deformities (decay, fracture, and tooth loss). The nHA coating on the surface of the dental implant helps it bind to the bone by forming a biomimetic coating. A recent innovative strategy involves using nHA to reduce dentinal hypersensitivity and to reconstruct periodontal bone defects. The purpose of the present review is to discuss the different applications of nHA in dentistry, especially in preventive and restorative dentistry, dental implantology, bleaching and dentine hypersensitivity management.
PubMed: 37817794
DOI: 10.1016/j.sdentj.2023.05.018 -
The Journal of Clinical Pediatric... Sep 2023The American Academy of Pediatric Dentistry (AAPD) affirms that the use of fluoride, as an adjunct in the prevention of caries, is safe and effective. The AAPD...
The American Academy of Pediatric Dentistry (AAPD) affirms that the use of fluoride, as an adjunct in the prevention of caries, is safe and effective. The AAPD encourages dentists, other healthcare providers, and parents to optimize fluoride exposures to reduce the risk of caries and to enhance the remineralization of affected teeth. However, there is resistance amongst patients towards fluoride overexposure and despite there being research on other effective remineralizing agents, most pediatric dentists primarily cater their practice to fluoride-based products. The objective of the study is to survey pediatric dentists' acceptance and awareness of fluoride-free remineralizing agents. A listserv of the southeastern and western private practice pediatric dentists was obtained from the AAPD consisting of 6490 email addresses. A questionnaire consisting of 15 questions was sent to each address using Qualtrics. Different trends in fluoride-free acceptance and awareness were seen based on region of practice, region of training and age of practitioner. Region of practice, residency training and age can be contributing factors toward fluoride-free remineralizing agent opinion. The data gathered trends towards western-trained pediatric dentists are more likely to recommend a fluoride-free toothpaste than a southeastern-trained dentist.
Topics: Child; Humans; Toothpastes; Dentists; Fluorides; Dental Care; Dental Caries; Private Practice
PubMed: 37732439
DOI: 10.22514/jocpd.2023.055 -
Frontiers in Public Health 2023Dental caries is a worldwide challenge for public health. The aim of this 18-month double-blinded, randomized, clinical trial was to compare the caries-preventing effect... (Randomized Controlled Trial)
Randomized Controlled Trial
BACKGROUND
Dental caries is a worldwide challenge for public health. The aim of this 18-month double-blinded, randomized, clinical trial was to compare the caries-preventing effect of a fluoride-free, hydroxyapatite toothpaste (test) and a toothpaste with sodium fluoride (1450 ppm fluoride; positive control) in adults.
METHODS
The primary endpoint was the percentage of subjects showing no increase in overall Decayed Missing Filled Surfaces (DMFS) index. The study was designed as non-inferiority trial. Non-inferiority was claimed if the upper limit of the exact one-sided 95% confidence interval for the difference of the primary endpoint DMFS between test and control toothpaste was less than the predefined margin of non-inferiority (Δ ≤ 20%).
RESULTS
In total, 189 adults were included in the intention-to-treat (ITT) analysis; 171 subjects finished the study per protocol (PP). According to the PP analysis, no increase in DMFS index was observed in 89.3% of subjects of the hydroxyapatite group and 87.4% of the subjects of the fluoride group. The hydroxyapatite toothpaste was not statistically inferior to a fluoride toothpaste with regard to the primary endpoint.
CONCLUSION
Hydroxyapatite was proven to be a safe and efficient anticaries agent in oral care.
CLINICAL TRIAL REGISTRATION
NCT04756557.
Topics: Adult; Humans; Toothpastes; Cariostatic Agents; Durapatite; Dental Caries; Dental Caries Susceptibility; Fluorides
PubMed: 37533523
DOI: 10.3389/fpubh.2023.1199728 -
Frontiers in Microbiology 2024Numerous studies have investigated the effects of stannous ions on specific microbes and their efficacy in reducing dental plaque. Nonetheless, our understanding of...
Numerous studies have investigated the effects of stannous ions on specific microbes and their efficacy in reducing dental plaque. Nonetheless, our understanding of their impact on the oral microbiome is still a subject of ongoing exploration. Therefore, this study sought to evaluate the effects of a stannous-containing sodium fluoride dentifrice in comparison to a zinc-containing sodium fluoride dentifrice and a control group on intact, healthy oral biofilms. Utilizing the novel 2bRAD-M approach for species-resolved metagenomics, and FISH/CLSM with probes targeting periodontal and caries associated species alongside Sn and Zn ions, we collected and analyzed biofilms from 15 generally healthy individuals with measurable dental plaque and treated the biofilms with dentifrices to elucidate variations in microbial distribution. Although significant shifts in the microbiome upon treatment were not observed, the use of a stannous-containing sodium fluoride dentifrice primarily led to an increase in health-associated commensal species and decrease in pathogenic species. Notably, FISH/CLSM analysis highlighted a marked reduction in representative species associated with periodontitis and caries following treatment with the use of a stannous-containing sodium fluoride dentifrice, as opposed to a zinc-containing sodium fluoride dentifrice and the control group. Additionally, Sn specific intracellular imaging reflected the colocalization of Sn ions with but not with other species. In contrast, Zn ions exhibited non-specific binding, thus suggesting that Sn could exhibit selective binding toward pathogenic species. Altogether, our results demonstrate that stannous ions could help to maintain a healthy oral microbiome by preferentially targeting certain pathogenic bacteria to reverse dysbiosis and underscores the importance of the continual usage of such products as a preventive measure for oral diseases and the maintenance of health.
PubMed: 38426054
DOI: 10.3389/fmicb.2024.1327913 -
Journal of Oral Science Oct 2023This study analyzed associations of cumulative learning, demographic characteristics, fluoride content, and toothbrush head size with the amount of toothpaste used by...
PURPOSE
This study analyzed associations of cumulative learning, demographic characteristics, fluoride content, and toothbrush head size with the amount of toothpaste used by dental students.
METHODS
Students in the third and fifth year of dental school were recruited. Each participant was asked to dispense three toothpastes (pediatric, regular fluoride, and high fluoride) on five toothbrushes (rotation-oscillation, sonic, manual pediatric, and two manual adult toothbrushes). The length and weight of the toothpaste dispensed were recorded. The data were evaluated by nonparametric correlation analysis (P < 0.05).
RESULTS
Eighty-one students (third year = 42; fifth year = 39; mean age: 26.2 ± 5.3 years) participated in the study. More toothpaste was dispensed by third-year students than by fifth-year students (weight: P = 0.014; length: P = 0.037). Men dispensed more toothpaste than did women (weight: P < 0.001; length: P = 0.042). Participants with higher educational attainment dispensed less toothpaste (weight: P < 0.001; length: P < 0.001). The type of toothbrush was associated with the weight of toothpaste dispensed (P < 0.001). Toothbrush head size was inversely associated with the length of toothpaste dispensed (P < 0.001).
CONCLUSION
The amount of toothpaste used by dental students was associated with cumulative learning, educational attainment, sex, and toothbrush head size but not with the fluoride content of the toothpaste.
Topics: Male; Adult; Humans; Child; Female; Young Adult; Toothpastes; Fluorides; Students, Dental; Toothbrushing
PubMed: 37612066
DOI: 10.2334/josnusd.23-0047 -
Journal of Dentistry Oct 2023To determine how daily consumption of a lozenge combining arginine and two probiotic strains affects the Relative Risk Reduction (RRR) in children regarding dental... (Randomized Controlled Trial)
Randomized Controlled Trial
The efficacy of combined arginine and probiotics as an add-on to 1450 ppm fluoride toothpaste to prevent and control dental caries in children - A randomized controlled trial.
OBJECTIVES
To determine how daily consumption of a lozenge combining arginine and two probiotic strains affects the Relative Risk Reduction (RRR) in children regarding dental caries transitions and lesion activity at tooth surface level during 10-12 months.
METHODS
A total of 21,888 tooth surfaces in 288 children were examined. The intervention group (n = 141) received a lozenge containing 2% arginine, Lacticaseibacillus rhamnosus, LGG® (DSM33156), and Lactobacillus paracasei subsp. paracasei, L. CASEI 431® (DSM33451). The placebo group (n = 147) received a placebo lozenge. Both groups received 1,450 ppm F toothpaste. Primary canines, molars, and first permanent molars were examined clinically (ICDAS) and radiographically (R) at baseline and follow-up. Sealed, filled, and missing surfaces were also included. Caries activity was computed as a sum of each caries lesion's location, color, texture, cavitation, and gingival bleeding. RRRs were computed with cluster effect on surface level. ICH-GCP was followed, including external monitoring.
RESULTS
A total of 19,950 surfaces were analyzed after excluding 1,938 tooth surfaces. No statistically significant differences were found between the groups. The RRRs showed less caries progression (13.6%, p = 0.20), more regression (0.3%, p = 0.44), and fewer active caries lesions (15.3%, p = 0.15) in the intervention group.
CONCLUSION
Daily consumption of a lozenge combining arginine and probiotics for 10-12 months given to 5-9-years-old children characterized being with low caries risk demonstrated a marked, though not statistically significant RRR for caries progression, regression, and number of active lesions in the intervention group compared to the placebo-group.
CLINICALTRIALS
gov (NCT03928587).
CLINICAL SIGNIFICANCE
Since all the RRRs were in favor of the intervention group and the PF of combined arginine and probiotics is high (81.6%) compared to fluoride toothpaste (24.9%) and arginine-fluoride toothpaste alone (19.6%) the combined pre-and probiotics approach may be a future additional tool regarding caries prevention and control.
Topics: Humans; Child; Dental Caries; Fluorides; Toothpastes; Arginine; Probiotics
PubMed: 37604396
DOI: 10.1016/j.jdent.2023.104670 -
European Journal of Orthodontics Sep 2023To evaluate the effect of high-fluoride mouth rinse and high-fluoride toothpaste on the development of demineralized lesions (DLs) during orthodontic treatment. (Randomized Controlled Trial)
Randomized Controlled Trial
OBJECTIVE
To evaluate the effect of high-fluoride mouth rinse and high-fluoride toothpaste on the development of demineralized lesions (DLs) during orthodontic treatment.
TRIAL DESIGN
Three-armed parallel-group randomized controlled trial.
METHODS
The trial was performed with 270 adolescent orthodontic patients. Randomization was performed in blocks of 30, enrolling the patients into one of the following groups: the fluoride mouth rinse (FMR) group receiving 0.2% sodium fluoride (NaF) mouth rinse plus 1450 ppm fluoride (F) toothpaste; high-fluoride toothpaste (HFT) group receiving 5000 ppm F toothpaste; and the Control (CTR) group receiving 1450 ppm F toothpaste. Inclusion criteria were patients scheduled for treatment in both arches with fixed appliances and age between 12 and 20 years. The primary outcome variable was the proportion of participants with at least one new demineralized lesion as assessed on digital photos taken before and after treatment, analysed by a blinded clinician. The analysis included all teeth or teeth in the aesthetic zone, i.e. all central incisors, lateral incisors, and canines. A random sample of 30 participants was assessed to check intra- and inter-reliability. For pairwise comparison between groups, Fisher's non-parametric permutation test was used for continuous variables. Blinding was employed during the caries registration and data analysis.
RECRUITMENT
October 2010 to December 2012.
RESULTS
In total, 270 patients were randomized, of which 22 were excluded during treatment. Therefore, 248 participants were included in the study. The number of patients with an increase of ≥1 DL, including only central- and lateral incisors and canines, during orthodontic treatment, was significantly lower in the HFT group, 51/85 60%, compared to the CTR group, 64/82 78%, RR 0.77 (CI 0.62; 0.95), P = .01 and in the FMR group, 47/81 58%, compared to the CTR group, RR 0.74 (CI 0.60; 0.92), P < .01.
CONCLUSIONS
To prevent demineralized lesions in the aesthetic zone, high-fluoride mouth rinse and high-fluoride toothpaste may be recommended.
LIMITATIONS
The protocol was not registered, and the present study did not use a double-blinded design.
Topics: Adolescent; Humans; Child; Young Adult; Adult; Fluorides; Toothpastes; Mouthwashes; Reproducibility of Results; Esthetics, Dental; Dental Caries; Sodium Fluoride; Cariostatic Agents
PubMed: 37524332
DOI: 10.1093/ejo/cjad044