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International Journal of Environmental... May 2022(1) Background: Nano-hydroxyapatite (nHAp) has been reported to have a remineralizing effect on early carious lesions. The objective of this scoping review was to... (Review)
Review
(1) Background: Nano-hydroxyapatite (nHAp) has been reported to have a remineralizing effect on early carious lesions. The objective of this scoping review was to analyze the remineralization potential of nano-hydroxyapatite (nHAp)-containing dentifrices, by mapping the existing literature. (2) Methods: This review was performed using the PRISMA-ScR Checklist, which is an extension of the PRISMA Checklist for Systematic Reviews and Meta-Analyses. In this study, the population, concept, and context (PCC) framework was used to find relevant papers published between 2010 and 2021. Nano-hydroxyapatite (nHAp) and dentifrices containing nHAp as one of the ingredients were the two main concepts of the research question. MeSH phrases, keywords, and other free terms relevant to nano-hydroxyapatite and dentifrices were used to search the literature databases. (3) Results: Preliminary searches yielded 59 studies; the title and abstract screening results excluded 11 studies. The remaining studies were thoroughly reviewed by two reviewers on the basis of the inclusion and exclusion criteria. Finally, 28 studies were included, and 20 studies were excluded. Most of the studies that were included reported that when nHAp was used alone, it had many different effects, such as remineralization, caries prevention, less demineralization, brighter teeth, less pain, and remineralization of enamel after orthodontic debonding. (4) Conclusions: Dentifrices that contain nHAp offer a variety of therapeutic and preventative effects. Currently, there is insufficient evidence to support the efficacy of nHAp dentifrices in primary teeth. Additional long-term investigations using standardized protocols are required to reach decisive conclusions about the effects of nHAp dentifrices on primary and permanent dentitions.
Topics: Dental Caries; Dentifrices; Durapatite; Fluorides; Humans; Tooth; Tooth Remineralization
PubMed: 35565022
DOI: 10.3390/ijerph19095629 -
Canadian Journal of Dental Hygiene :... Oct 2021Dental caries is still one of the most prevalent diseases worldwide. Research has shown that fluoride has a role in caries prevention. For many reasons there are... (Meta-Analysis)
Meta-Analysis
UNLABELLED
Dental caries is still one of the most prevalent diseases worldwide. Research has shown that fluoride has a role in caries prevention. For many reasons there are concerns about young children using fluoride-containing oral care products. Consequently, there is a need to identify effective fluoride-free products. A large body of literature now exists on the use of biomimetic hydroxyapatite (HAP) as an active ingredient in oral care products to combat caries.
AIM
To conduct a systematic review of the clinical evidence of the effects of HAP-based fluoride-free oral care products in caries reduction and conduct a meta-analysis of available randomized clinical trials (RCTs).
METHODS
Using the PICO question "In individuals of all ages (P), do fluoride-free oral care products containing HAP as the anti-caries agent (I), compared to products with fluoride or without caries control products (C), reduce the risk of dental caries (O)?" Ovid MEDLINE (PubMed), Scopus, EMBASE, and Web of Science databases were searched using the following keywords: apatite, hydroxyapatite, caries, dental decay, dentin(e), enamel, toothpaste, dentifrice, mouthwash, gels, biofilm, (dental) plaque, ero(de, ded, sion), (de, re)mineral(ise, ized, ised, ization, isation). Reviews, tooth whitening, tooth sensitivity, and in vitro studies were excluded. PRISMA was used for the search and GRADE was used to assess quality. Clinical trials were subjected to the Cochrane Risk of Bias assessment followed by meta-analysis.
RESULTS
291 studies were retrieved; 22 were suitable for systematic review, 5 were clinical caries trials and 4 were RCTs. A meta-analysis of 3 RCTs was possible showing HAP provided 17% protection against caries. The other 17 trials had simpler proxy outcomes for anticaries effects. Some trials showed non-inferior performance of HAP products compared to those with fluoride.
CONCLUSION
There is good evidence that hydroxyapatite in oral care products in the absence of fluoride effectively reduces caries.
Topics: Biomimetics; Child; Child, Preschool; Dental Caries; Dental Caries Susceptibility; Durapatite; Fluorides; Humans
PubMed: 34925515
DOI: No ID Found -
The Cochrane Database of Systematic... Dec 2019Halitosis or bad breath is a symptom in which a noticeably unpleasant breath odour is present due to an underlying oral or systemic disease. 50% to 60% of the world... (Meta-Analysis)
Meta-Analysis
BACKGROUND
Halitosis or bad breath is a symptom in which a noticeably unpleasant breath odour is present due to an underlying oral or systemic disease. 50% to 60% of the world population has experienced this problem which can lead to social stigma and loss of self-confidence. Multiple interventions have been tried to control halitosis ranging from mouthwashes and toothpastes to lasers. This new Cochrane Review incorporates Cochrane Reviews previously published on tongue scraping and mouthrinses for halitosis.
OBJECTIVES
The objectives of this review were to assess the effects of various interventions used to control halitosis due to oral diseases only. We excluded studies including patients with halitosis secondary to systemic disease and halitosis-masking interventions.
SEARCH METHODS
Cochrane Oral Health's Information Specialist searched the following databases: Cochrane Oral Health's Trials Register (to 8 April 2019), the Cochrane Central Register of Controlled Trials (CENTRAL; 2019, Issue 3) in the Cochrane Library (searched 8 April 2019), MEDLINE Ovid (1946 to 8 April 2019), and Embase Ovid (1980 to 8 April 2019). We also searched LILACS BIREME (1982 to 19 April 2019), the National Database of Indian Medical Journals (1985 to 19 April 2019), OpenGrey (1992 to 19 April 2019), and CINAHL EBSCO (1937 to 19 April 2019). The US National Institutes of Health Ongoing Trials Register ClinicalTrials.gov (8 April 2019), the World Health Organization International Clinical Trials Registry Platform (8 April 2019), the ISRCTN Registry (19 April 2019), the Clinical Trials Registry - India (19 April 2019), were searched for ongoing trials. We also searched the cross-references of included studies and systematic reviews published on the topic. No restrictions were placed on the language or date of publication when searching the electronic databases.
SELECTION CRITERIA
We included randomised controlled trials (RCTs) which involved adults over the age of 16, and any intervention for managing halitosis compared to another or placebo, or no intervention. The active interventions or controls were administered over a minimum of one week and with no upper time limit. We excluded quasi-randomised trials, trials comparing the results for less than one week follow-up, and studies including advanced periodontitis.
DATA COLLECTION AND ANALYSIS
Two pairs of review authors independently selected trials, extracted data, and assessed risk of bias. We estimated mean differences (MDs) for continuous data, with 95% confidence intervals (CIs). We assessed the certainty of the evidence using the GRADE approach.
MAIN RESULTS
We included 44 trials in the review with 1809 participants comparing an intervention with a placebo or a control. The age of participants ranged from 17 to 77 years. Most of the trials reported on short-term follow-up (ranging from one week to four weeks). Only one trial reported long-term follow-up (three months). Three studies were at low overall risk of bias, 16 at high overall risk of bias, and the remaining 25 at unclear overall risk of bias. We compared different types of interventions which were categorised as mechanical debridement, chewing gums, systemic deodorising agents, topical agents, toothpastes, mouthrinse/mouthwash, tablets, and combination methods. Mechanical debridement: for mechanical tongue cleaning versus no tongue cleaning, the evidence was very uncertain for the outcome dentist-reported organoleptic test (OLT) scores (MD -0.20, 95% CI -0.34 to -0.07; 2 trials, 46 participants; very low-certainty evidence). No data were reported for patient-reported OLT score or adverse events. Chewing gums: for 0.6% eucalyptus chewing gum versus placebo chewing gum, the evidence was very uncertain for the outcome dentist-reported OLT scores (MD -0.10, 95% CI -0.31 to 0.11; 1 trial, 65 participants; very low-certainty evidence). No data were reported for patient-reported OLT score or adverse events. Systemic deodorising agents: for 1000 mg champignon versus placebo, the evidence was very uncertain for the outcome patient-reported visual analogue scale (VAS) scores (MD -1.07, 95% CI -14.51 to 12.37; 1 trial, 40 participants; very low-certainty evidence). No data were reported for dentist-reported OLT score or adverse events. Topical agents: for hinokitiol gel versus placebo gel, the evidence was very uncertain for the outcome dentist-reported OLT scores (MD -0.27, 95% CI -1.26 to 0.72; 1 trial, 18 participants; very low-certainty evidence). No data were reported for patient-reported OLT score or adverse events. Toothpastes: for 0.3% triclosan toothpaste versus control toothpaste, the evidence was very uncertain for the outcome dentist-reported OLT scores (MD -3.48, 95% CI -3.77 to -3.19; 1 trial, 81 participants; very low-certainty evidence). No data were reported for patient-reported OLT score or adverse events. Mouthrinse/mouthwash: for mouthwash containing chlorhexidine and zinc acetate versus placebo mouthwash, the evidence was very uncertain for the outcome dentist-reported OLT scores (MD -0.20, 95% CI -0.58 to 0.18; 1 trial, 44 participants; very low-certainty evidence). No data were reported for patient-reported OLT score or adverse events. Tablets: no data were reported on key outcomes for this comparison. Combination methods: for brushing plus cetylpyridium mouthwash versus brushing, the evidence was uncertain for the outcome dentist-reported OLT scores (MD -0.48, 95% CI -0.72 to -0.24; 1 trial, 70 participants; low-certainty evidence). No data were reported for patient-reported OLT score or adverse events.
AUTHORS' CONCLUSIONS
We found low- to very low-certainty evidence to support the effectiveness of interventions for managing halitosis compared to placebo or control for the OLT and patient-reported outcomes tested. We were unable to draw any conclusions regarding the superiority of any intervention or concentration. Well-planned RCTs need to be conducted by standardising the interventions and concentrations.
Topics: Adolescent; Adult; Aged; Chewing Gum; Chlorhexidine; Dental Scaling; Female; Halitosis; Humans; Male; Middle Aged; Mouthwashes; Oral Health; Oral Hygiene; Randomized Controlled Trials as Topic; Tongue; Toothbrushing; Toothpastes; Young Adult
PubMed: 31825092
DOI: 10.1002/14651858.CD012213.pub2 -
Brazilian Dental Journal Jun 2020There is an increased accessibility of over-the-counter (OTC) whitening agents with very little data in the literature regarding their effectiveness. This review was...
There is an increased accessibility of over-the-counter (OTC) whitening agents with very little data in the literature regarding their effectiveness. This review was done to determine their effectiveness of the predominant OTC whitening agents from 2006 until 2018 where a comparison of each agent was made with a placebo, no treatment or with other OTC whitening agents. The major categories of OTC whitening agents such as dentifrices, whitening strips and paint on gels. Dentist prescribed bleaching applied at home and in-office bleaching studies and studies that demonstrated whitening products to participants were excluded. Articles were searched for in the databases of Medline (Ovid), PubMed, the Cochrane Library and Cochrane Central Register of Controlled Trials. Twenty-four articles were included in the systematic review and the quality of studies was determined by the GRADE (Grading of Recommendations, Assessment, Development and Evaluations) ranking criteria. Compared to other OTC, strips are reported to be effective. Two studies determined whitening strips to be effective. Whitening strips have been shown to be effective when compared with placebos and other OTC whitening agents. Dentifrices are effective in changing the shade of the tooth "by removing extrinsic stains" when compared to a placebo and non-whitening dentifrices, but they are not as effective in comparison to whitening strips. There is a lack of evidence with regards to the effectiveness of paint-on gels. While there is some evidence that OTC can alter shade in the short term, there is a need for better-designed studies.
Topics: Carbamide Peroxide; Humans; Tooth Bleaching; Tooth Bleaching Agents; Tooth Discoloration; Urea
PubMed: 32667517
DOI: 10.1590/0103-6440202003227 -
PeerJ 2022Dental erosion is a chemical loss of the mineralized dental tissue caused by exposure to nonbacterial acids. Different treatment protocols have been adopted with the use...
BACKGROUND
Dental erosion is a chemical loss of the mineralized dental tissue caused by exposure to nonbacterial acids. Different treatment protocols have been adopted with the use of fluoride compounds to promote the formation of a layer of mineral precipitation in eroded lesions.
AIM
This systematic review aimed to evaluate the main treatments for dental erosion.
METHODOLOGY
This study followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines and recorded in the Open Science Framework database (OSF) under DOI 10.17605/OSF.IO/XMFNZ. The searches were conducted in six electronic databases (Pubmed, Embase, Web of Science, Cochrane, Scopus, Lilacs) and two grey literature sources (Google Scholar and OpenGrey). The eligibility criteria included studies that evaluated eroded teeth under treatment with some topical agent. Risk of bias assessment and qualitative synthesis were performed using the Cochrane collaboration's tool for assessing risk of bias modified for studies.
RESULTS
A total of 522 studies were identified, and only four studies that fulfilled our eligibility criteria were included in this review. Among these studies, three were considered to have a low risk of bias, and one to have a high risk of bias. Two studies evaluated the anti-erosion effect of fluoride toothpaste, and the other two assessed the action of casein phosphopeptide-amorphous calcium phosphate (CPP-ACP) on the surface of human teeth. Among the products analyzed, CPP-ACP was the only one that promoted a significant increase in enamel microhardness and reduced tooth wear.
CONCLUSION
Based on the studies included in this review, there was no anti-erosion effect after using different fluoride toothpaste. However, it should be considered that one of these studies presented a high risk of bias. On the other hand, studies with CPP-ACP showed anti-erosion efficacy when applied before or after erosive wear.
Topics: Humans; Fluorides; Tooth Erosion; Toothpastes; Tooth Remineralization; Minerals
PubMed: 36389398
DOI: 10.7717/peerj.13864 -
Annals of Anatomy = Anatomischer... Jan 2023Tooth whitening is currently one of the most requested treatments to change the color of teeth. There are different types of whitening in the dental office and at home....
INTRODUCTION
Tooth whitening is currently one of the most requested treatments to change the color of teeth. There are different types of whitening in the dental office and at home. There are also many whitening agents on the market. Nowadays, the public has shown great interest in a new natural compound: activated charcoal. It has an abrasive effect and it is included in toothpastes to whiten teeth quickly and easily.
OBJECTIVES
The main objective of the systematic review is to perform a qualitative synthesis of the available literature on the use of activated charcoal-based toothpaste for tooth whitening.
MATERIAL AND METHODS
An electronic search was carried out in PubMed, Web of Science, and Scopus databases. The search included the terms (charcoal-based OR activated charcoal OR charcoal OR soot) AND (toothpaste OR dentifrices OR bleaching OR oral hygiene OR enamel OR teeth). Inclusion criteria were articles that were published in English, that included activated charcoal toothpastes, that assessed the efficacy of activated charcoal bleaching and/or the safety of using activated charcoal toothpastes, that were conducted on humans or extracted teeth regardless of their origin and the year of publication.
RESULTS
Out of 208 articles, 11 met the inclusion criteria, the Risk of Bias of the selected studies was determined as medium-high. Regarding the whitening effect, there is a variety of results depending on the study: in some there are no significant differences between the proposed treatments and in others activated charcoal is not the most whitening agent. Regarding the abrasive effect, most studies agree that activated charcoal toothpaste has a higher abrasive potential.
CONCLUSION
Toothpastes based on activated charcoal possess a lower whitening effect than other alternatives and can be considered as less safe due to its high abrasive potential.
Topics: Humans; Toothpastes; Bleaching Agents; Charcoal; Tooth Bleaching; Tooth
PubMed: 36183933
DOI: 10.1016/j.aanat.2022.151998 -
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 -
Antibiotics (Basel, Switzerland) Oct 2022The aim of this systematic review was to verify if the presence of different antimicrobial agents in dentifrices is effective in reducing the number of microorganisms... (Review)
Review
The aim of this systematic review was to verify if the presence of different antimicrobial agents in dentifrices is effective in reducing the number of microorganisms for disease prevention. This review followed the Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) guidelines and was registered with the Open Science Framework (OSF). A search was conducted in the PubMed, Embase, Scopus, and Web of Science databases. Two independent authors reviewed the titles and abstracts according to the inclusion criteria, which comprised in vitro studies published in English that evaluated the efficacy of antimicrobial agents in dentifrices and their antimicrobial activity. A total of 527 articles were found. Of these, 334 were included for reading of the title and abstract, and 69 were selected for reading in full. In the end, 39 articles remained in this review. Triclosan, sodium fluoride, and sodium monofluorophosphate were the most commonly used chemical antimicrobial agents. Among the herbal agents, miswak extract and neem extract were the most commonly used. The presence of antimicrobial agents in dentifrice formulations can promote the reduction of the number of microorganisms involved in oral diseases, but with variations in their effectiveness, depending on the agent used and the microorganism evaluated.
PubMed: 36290071
DOI: 10.3390/antibiotics11101413 -
Journal of International Society of... 2021The important cause of chronic gingivitis was proved to be dental plaque, which is a well-organized biofilm. However, self-care efforts or mechanical control of dental... (Review)
Review
INTRODUCTION
The important cause of chronic gingivitis was proved to be dental plaque, which is a well-organized biofilm. However, self-care efforts or mechanical control of dental plaque by toothbrushing was important; these alone will not be enough to prevent gingivitis.
AIM
The aim of the present systematic review was to compare the effectiveness of herbal and conventional toothpastes on reduction of dental plaque and gingivitis.
MATERIALS AND METHODS
Data from original scientific papers published in PubMed, Cochrane, Lilacs, and Google Scholar were taken for review up to November 2020. Randomized controlled trials and clinical trials compare the effectiveness of herbal and non-herbal toothpastes on reduction of dental plaque and gingivitis. Articles published in English language only were included. References from the identified publications were manually searched to identify additional relevant articles. Seven publications fulfilled all the inclusion criteria and were finally selected for systematic review. Outcome measurements for gingivitis were gingival index and dental plaque index.
RESULTS
As all the studies were randomized controlled trials, level of evidence was II. Among all studies, green tea dentifrice toothpastes showed significant reduction when compared with conventional dentifrice, and ayurvedic toothpaste and Carica papaya leaf extract were also effective.
CONCLUSION
Herbal toothpaste seems to be powerful similar to non-herbal toothpaste; however, it is no longer extra superior to fluoride toothpaste. Further, long-term randomized studies of >6 months are needed to investigate the beneficial effects of intervention alone.
PubMed: 35036369
DOI: 10.4103/jispcd.JISPCD_171_21 -
F1000Research 2022: Whitening toothpastes exert a whitening effect on teeth through higher surface cleaning effectiveness resulting from the abrasive properties of the paste or specific... (Meta-Analysis)
Meta-Analysis
: Whitening toothpastes exert a whitening effect on teeth through higher surface cleaning effectiveness resulting from the abrasive properties of the paste or specific chemical components. This systematic review and meta-analysis was conceptualized to examine the relationship between whitening toothpastes and surface roughness as well as microhardness of human teeth and to clarify the evidence base available around this relationship by conducting a systematic review and meta-analysis of studies in this topic area, looking at randomized control trials. : Criteria for including studies in the review were done based on population, intervention, comparison, outcomes and study and studies were identified from electronic databases. Covidence® was used for data screening and data extraction. The CONSORT tool was used for checking relevant content and methodology used in each of the papers reviewed. Systematic review was done followed by meta-analysis, using Review Manager. : A total of 125 articles were obtained on key word search. After duplicate removal and title screening, 17 articles were eligible for full text review. Finally, 7 studies were included for systematic review and meta-analysis was conducted on 4 studies. The forest plot for surface roughness showed that that the meta-analytic effect was statistically significant with surface roughness value being higher in the intervention group. The forest plot for microhardness showed that the meta-analytic effect was statistically significant with the microhardness value being lesser in the intervention group. : Although whitening toothpastes typically can lighten tooth color by about one or two shades, there is some evidence to show that these toothpastes also affect the mineral content of teeth by increasing surface roughness and reducing microhardness. More evidence and further research are needed to identify the type of whitening agent which will whiten the tooth effectively while maintaining the integrity of the tooth structure.
Topics: Humans; Tooth; Tooth Bleaching; Toothpastes
PubMed: 35265322
DOI: 10.12688/f1000research.76180.3