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BMC Oral Health
Published in: BMC Oral Health 1/2006

Open Access 01-06-2006 | Proceedings

Dentifrices, mouthwashes, and remineralization/caries arrestment strategies

Author: Domenick T Zero

Published in: BMC Oral Health | Special Issue 1/2006

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Abstract

While our knowledge of the dental caries process and its prevention has greatly advanced over the past fifty years, it is fair to state that the management of this disease at the level of the individual patient remains largely empirical. Recommendations for fluoride use by patients at different levels of caries risk are mainly based on the adage that more is better. There is a general understanding that the fluoride compound, concentration, frequency of use, duration of exposure, and method of delivery can influence fluoride efficacy. Two important factors are (1) the initial interaction of relatively high concentrations of fluoride with the tooth surface and plaque during application and (2) the retention of fluoride in oral fluids after application.
Fluoride dentifrices remain the most widely used method of delivering topical fluoride. The efficacy of this approach in preventing dental caries is beyond dispute. However, the vast majority of currently marketed dentifrice products have not been clinically tested and have met only the minimal requirements of the FDA monograph using mainly laboratory testing and animal caries testing. Daily use of fluoride dental rinses as an adjunct to fluoride dentifrice has been shown to be clinically effective as has biweekly use of higher concentration fluoride rinses. The use of remineralizing agents (other than fluoride), directed at reversing or arresting non-cavitated lesions, remains a promising yet largely unproven strategy. High fluoride concentration compounds, e.g., AgF, Ag(NH3)2F, to arrest more advanced carious lesions with and without prior removal of carious tissue are being used in several countries as part of the Atraumatic Restorative Treatment (ART) approach.
Most of the recent innovations in oral care products have been directed toward making cosmetic marketing claims. There continues to be a need for innovation and collaboration with other scientific disciplines to fully understand and prevent dental caries.
Literature
1.
Stookey GK: Critical evaluation of the composition and use of topical fluorides. J Dent Res. 1990, 69 (Spec Iss): 805-812.CrossRefPubMed
2.
Hargreaves JA, Thompson GW, Wagg BJ: Changes in caries prevalence of Isle of Lewis children between 1971 and 1981. Caries Res. 1983, 17: 554-559.CrossRefPubMed
3.
Jenkins GN: Recent changes in dental caries. Br Med J. 1985, 291: 1297-1298.CrossRef
4.
Marinho VC, Higgins JP, Sheiham A, Logan S: Fluoride toothpastes for preventing dental caries in children and adolescents. Cochrane Database Syst Rev. 2003, 1: CD002278-PubMed
5.
Twetman S, Axelsson S, Dahlgren H, Holm AK, Kallestal C, Lagerlof F, Lingstrom P, Mejare I, Nordenram G, Norlund A, Petersson LG, Soder B: Caries-preventive effect of fluoride toothpaste: a systematic review. Acta Odontol Scand. 2003, 61: 347-355. 10.1080/00016350310007590.CrossRefPubMed
6.
Fluoride Recommendations Work Group: Recommendations for using fluoride to prevent and control dental caries in the United States. Centers for Disease Control and Prevention MMWR Recomm Rep. 2001, 50 (RR-14): 1-42.
7.
Food and Drug Administration: Final monograph on anticaries drug products for over-the-counter human use. Federal Register. 1995, 60: 52474-52510.
8.
Food and Drug Administration: Anticaries drug products for over-the-counter human use; use of intraoral appliance models for compliance with biological testing requirements; request for information and comments. Federal Register. 2001, 66: 52418-52420.
9.
Stamm JW: The classic caries clinical trial: constraints and opportunities. J Dent Res. 2004, 83 (Spec Iss C): C6-14.CrossRefPubMed
10.
Pitts NB, Stamm JW: International Consensus Workshop on Caries Clinical Trials (ICW-CCT)--final consensus statements: agreeing where the evidence leads. J Dent Res. 2004, 83 (Spec No C): C125-128.CrossRefPubMed
11.
Proskin HM, Chilton NW, Kingman A: Interim report of the ad hoc committee for the consideration of statistical concerns related to the use of intra-oral models in submission for product claims approved by the American Dental Association. J Dent Res. 1992, 71 (Spec Iss): 949-952.PubMed
12.
Bibby BG: A test of the effect of fluoride-containing dentifrices on dental caries. J Dent Res. 1945, 24: 297-303.CrossRefPubMed
13.
Muhler JC, Fadike AW, Nebergall WH, Day HG: The effect of stannous fluoride-containing dentifrice on caries reduction in children. J Dent Res. 1954, 33: 606-612.CrossRefPubMed
14.
Holloway PJ, Worthington HV: Sodium fluoride or sodium monofluorophosphate? A critical view of a meta-analysis on their relative effectiveness in dentifrices. Am J Dent. 1993, S55-58. B Spec No
15.
Johnson MF: Comparative efficacy of NaF and SMFP dentifrices in caries prevention: a meta-analytic overview. Caries Res. 1993, 27: 328-336.CrossRefPubMed
16.
Proskin HM, Volpe AR: Comparison of the anticaries efficacy of dentifrices containing fluoride as sodium fluoride or sodium monofluorophosphate. Am J Dent. 1995, 8: 51-58.PubMed
17.
Stookey GK, DePaola PF, Featherstone JD, Fejerskov O, Moller IJ, Rotberg S, Stephen KW, Wefel JS: A critical review of the relative anticaries efficacy of sodium fluoride and sodium monofluorophosphate dentifrices. Caries Res. 1993, 27: 337-360.CrossRefPubMed
18.
Volpe AR, Petrone ME, Davies RM: A critical review of the 10 pivotal caries clinical studies used in a recent meta-analysis comparing the anticaries efficacy of sodium fluoride and sodium monofluorophosphate dentifrices. Am J Dent. 1993, 6 (Spec No): S13-42.PubMed
19.
Volpe AR, Petrone ME, Davies R, Proskin HM: Clinical anticaries efficacy of NaF and SMFP dentifrices: overview and resolution of the scientific controversy. J Clin Dent. 1995, 6 (Spec No): 1-28.PubMed
20.
Duckworth RM: The science behind caries prevention. Int Dent J. 1993, 43: 529-539.PubMed
21.
Biesbrock AR, Chesters RK, Ellwood RP, Smith SR: The challenges of validating diagnostic methods relative to a conventional two-year caries clinical trial. J Dent Res. 2004, 83 (Spec Iss C): C53-55.CrossRefPubMed
22.
White DJ: Tartar control dentifrices: current status and future prospects. Clinical and Biological Aspects of Dentifrices. Edited by: Embery G, Rolla G. 1992, Oxford University Press, 277-291.
23.
Zero DT, Fu J, Espeland MA, Featherstone JD: Comparison of fluoride concentrations in unstimulated whole saliva following the use of a fluoride dentifrice and a fluoride rinse. J Dent Res. 1988, 67: 1257-1262.CrossRefPubMed
24.
Zero DT, Raubertas RF, Pedersen AM, Fu J, Hayes A, Featherstone JDB: Studies of fluoride retention by the oral soft tissues after application of home-use topical fluorides. J Dent Res. 1992, 71: 1546-1552.CrossRefPubMed
25.
Zero DT, Raubertas RF, Fu J, Pedersen AM, Hayes AL, Featherstone JDB: Fluoride concentration in plaque, whole saliva and ductal saliva after application of home-use topical fluorides. J Dent Res. 1992, 71: 1768-1775.CrossRefPubMed
26.
Duckworth RM, Knoop DT, Stephen KW: Effect of mouthrinsing after toothbrushing with a fluoride dentifrice on human salivary fluoride levels. Caries Res. 1991, 25: 287-291.CrossRefPubMed
27.
Sjögren K, Birkhed D: Factors related to fluoride retention after toothbrushing and possible connection to caries activity. Caries Res. 1993, 27: 474-477.CrossRefPubMed
28.
Chesters RK, Huntington E, Burchell CK, Stephen KW: Effect of oral care habits on caries in adolescents. Caries Res. 1992, 26: 299-304.CrossRefPubMed
29.
Chestnutt IG, Schafer F, Jacobson AP, Stephen KW: The influence of toothbrushing frequency and post-brushing rinsing on caries experience in a caries clinical trial. Community Dent Oral Epidemiol. 1998, 26: 406-411.CrossRefPubMed
30.
Aasenden R, Brudevold F, Richardson B: Clearance of fluoride from the mouth after topical treatment or the use of a fluoride mouthrinse. Arch Oral Biol. 1968, 13: 625-636. 10.1016/0003-9969(68)90141-6.CrossRefPubMed
31.
Sjögren K, Birkhed D: Effect of various post-brushing activities on salivary fluoride concentration after toothbrushing with a sodium fluoride dentifrice. Caries Res. 1994, 28: 127-131.CrossRefPubMed
32.
Koch G, Petersson L-G, Kling E, Kling L: Effect of 250 and 1000 ppm fluoride dentifrice on caries: a three-year clinical study. Swed Dent J. 1982, 6: 233-238.PubMed
33.
Mitropoulos CM, Holloway PJ, Davies TGH, Worthington HV: Relative efficacy of dentifrices containing 250 or 1000 ppm F- in preventing dental caries-report of a 32-month clinical trial. Community Dent Health. 2003, 1: 193-200.
34.
Pendrys DG: Risk of enamel fluorosis in nonfluoridated and optimally fluoridated populations: considerations for the dental professional. J Am Dent Assoc. 2000, 131 (6): 746-755.CrossRefPubMed
35.
Warren JJ, Levy SM: A review of fluoride dentifrice related to dental fluorosis. Pediatr Dent. 1999, 21: 265-271.PubMed
36.
van Loveren C, Moorer WR, Buijs MJ, van Palenstein Helderman WH: Total and free fluoride in toothpastes from some non-established market economy countries. Caries Res. 2005, 39: 224-230. 10.1159/000084802.CrossRefPubMed
37.
Finn S, Moller P, Jamison H, Regattieri L, Manson-Hing L: The clinical cariestatic effectiveness of two concentrations of acidulated phosphate fluoride mouthwash. JADA. 1975, 90: 398-402.PubMed
38.
Driscoll WS, Swango PA, Horowitz AM, Kingman A: Caries-preventive effects of daily and weekly fluoride mouthrinsing in a fluoridated community: final results after 30 months. JADA. 1982, 105: 1010-1013.PubMed
39.
Marinho VC, Higgins JP, Logan S, Sheiham A: Fluoride mouthrinses for preventing dental caries in children and adolescents. Cochrane Database Syst Rev. 2003, 3: CD002284-PubMed
40.
Twetman S, Petersson L, Axelsson S, Dahlgren H, Holm AK, Kallestal C, Lagerlof F, Lingstrom P, Mejare I, Nordenram G, Norlund A, Soder B: Caries-preventive effect of sodium fluoride mouthrinses: a systematic review of controlled clinical trials. Acta Odontol Scand. 2004, 62: 223-230. 10.1080/00016350410001658.CrossRefPubMed
41.
Stamm JW, Bohannan HM, Graves RC, Disney JA: The efficiency of caries prevention with weekly fluoride mouthrinses. J Dent Educ. 1984, 48: 617-626.PubMed
42.
Disney JA, Bohannan HM, Klein SP, Bell RM: A case study in contesting the conventional wisdom: school-based fluoride mouthrinse programs in the USA. Community Dent Oral Epidemiol. 1990, 18: 46-54. 10.1111/j.1600-0528.1990.tb00661.x.CrossRefPubMed
43.
Horowitz AM: A report on the NIH consensus development conference on diagnosis and management of dental caries throughout life. J Dent Res. 2004, 83 (Spec Iss C): C15-17.CrossRefPubMed
44.
Koulourides T: Implications of remineralization in the treatment of dental caries. Higashi Nippon Shigaku Zasshi. 1986, 5: 1-97.PubMed
45.
Kashket S: Historical review of remineralization research. J Clin Dent. 1999, 10: 56-64.
46.
Zero D: Application of clinical models in remineralization research. J Clin Dent. 1999, 10: 74-85.
47.
Bader JD, Shugars DA, Bonito AJ: A systematic review of selected caries prevention and management methods. Community Dent Oral Epidemiol. 2001, 29: 399-411. 10.1034/j.1600-0528.2001.290601.x.CrossRefPubMed
48.
Larsen MJ, Fejerskov O: Chemical and structural challenges in remineralization of dental enamel lesions. Scand J Dent Res. 1989, 97: 285-296.PubMed
49.
Robinson C, Hallsworth AS, Shore RC, Kirkham J: Effect of surface-zone deproteinisation on the access of mineral ions into subsurface carious lesions of human enamel. Caries Res. 1990, 24: 226-230.CrossRefPubMed
50.
Flaitz CM, Hicks MJ: Role of the acid-etch technique in remineralization of caries-like lesions of enamel: a polarized light and scanning electron microscopic study. ASDC J Dent Child. 1994, 61: 21-28.PubMed
51.
ten Cate JM, Featherstone JD: Mechanistic aspects of the interactions between fluoride and dental enamel. CRC Crit Rev Oral Biol Med. 1991, 2: 283-296.
52.
ten Cate JM: Current concepts on the theories of the mechanism of action of fluoride. Acta Odontol Scand. 1999, 57 (6): 325-329. 10.1080/000163599428562.CrossRefPubMed
53.
Chow LC, Takagi S: Deposition of fluoride on tooth surfaces by a two-solution mouthrinse in vitro. Caries Res. 1991, 25: 397-401.CrossRefPubMed
54.
Tenovuo J, Hurme T, Ahola A, Svedberg C, Ostela I, Lenander-Lumikari M, Neva M: Release of cariostatic agents from a new buffering fluoride- and xylitol-containing lozenge to human whole saliva in vivo. J Oral Rehab. 1997, 24: 325-331. 10.1046/j.1365-2842.1997.00519.x.CrossRef
55.
Reynolds EC: The prevention of sub-surface demineralization of bovine enamel and change in plaque composition by casein in an intra-oral model. J Dent Res. 1987, 66: 1120-1127.CrossRefPubMed
56.
Shen P, Cai F, Nowicki A, Vincent J, Reynolds EC: Remineralization of enamel subsurface lesions by sugar-free chewing gum containing casein phosphopeptide-amorphous calcium phosphate. J Dent Res. 2001, 80: 2066-2070.CrossRefPubMed
57.
Reynolds EC, Cai F, Shen P, Walker GD: Retention in plaque and remineralization of enamel lesions by various forms of calcium in a mouthrinse or sugar-free chewing gum. J Dent Res. 2003, 82: 206-211.CrossRefPubMed
58.
Reynolds EC, Cain CJ, Webber FL, Black CL, Riley PF, Johnson I, Perich JW: Anticariogenicity of calcium phosphate complexes of tryptic casein phosphopeptides in the rat. J Dent Res. 1995, 74: 1272-1279.CrossRefPubMed
59.
Chow LC, Takagi S, Shern RJ, Chow TH, Takagi KK, Sieck BA: Effects on whole saliva of chewing gums containing calcium phosphates. J Dent Res. 1994, 73: 26-32.CrossRefPubMed
60.
Vogel GL, Zhang Z, Carey CM, Ly A, Chow LC, Proskin HM: Composition of plaque and saliva following a sucrose challenge and use of an alpha-tricalcium-phosphate-containing chewing gum. J Dent Res. 1998, 77: 518-524.CrossRefPubMed
61.
Chow LC, Takagi S, Frukhtbeyn S, Sieck BA, Parry EE, Liao NS, Schumacher GE, Markovic M: Remineralization effect of a low-concentration fluoride rinse in an intraoral model. Caries Res. 2002, 36: 136-141. 10.1159/000057872.CrossRefPubMed
62.
Tung MS, Eichmiller FC: Dental applications of amorphous calcium phosphates. J Clin Dent. 2003, 10 (1 Spec No): 1-6.
63.
Clarkson BH, Rafter ME: Emerging methods used in the prevention and repair of carious tissues. J Dent Educ. 2001, 65: 1114-1120.PubMed
64.
Papas A, Russell D, Singh M, Stack K, Kent R, Triol C, Winston A.: Double blind clinical trial of a remineralizing dentifrice in the prevention of caries in a radiation therapy population. Gerodontology. 1999, 16: 2-10. 10.1111/j.1741-2358.1999.00002.x.CrossRefPubMed
65.
Featherstone JD, Cutress TW, Rodgers BE, Dennison PJ: Remineralization of artificial caries-like lesions in vivo by a self-administered mouthrinse or paste. Caries Res. 1982, 16: 235-242.CrossRefPubMed
66.
Klinger HG, Wiedemann W: Enhancement of in-vivo remineralization of approximal initial caries in man by an organic and inorganic remineralization agent. Arch Oral Biol. 1986, 31: 269-272. 10.1016/0003-9969(86)90039-7.CrossRefPubMed
67.
Pearce EIF, Nelson DGA: In vivo comparison of caries inhibition by a plaque mineral enriching mouthrinse and a fluoride dentifrice. Caries Res. 1988, 22: 362-370.CrossRefPubMed
68.
Yamaga R, Nishino M, Yoshida S, Yokomizo I: Diammine silver fluoride and its clinical application. J Osaka Univ Dent Sch. 1972, 12: 1-20.PubMed
69.
Craig GG, Powell KR: Caries progression in primary molars: 24-month results from a minimal treatment programme. Community Dent Oral Epidemiol. 1981, 9: 260-265. 10.1111/j.1600-0528.1981.tb00342.x.CrossRefPubMed
70.
McDonald SP, Sheiham A: A clinical comparison of non-traumatic methods of treating dental caries. Int Dent J. 1994, 44: 465-470.PubMed
71.
Gotjamanos T: Pulp response in primary teeth with deep residual caries treated with silver fluoride and glass ionomer cement ('atraumatic' technique). Aust Dent J. 1996, 41: 328-334.CrossRefPubMed
72.
Chu CH, Lo EC, Lin HC: Effectiveness of silver diamine fluoride and sodium fluoride varnish in arresting dentin caries in Chinese pre-school children. J Dent Res. 2002, 81: 767-770.CrossRefPubMed
73.
Brook AH, Gawthorpe J, Winter GB: Calcium glycerophosphate and dental plaque. Clinical pilot study. Caries Res. 1975, 9: 156-162.CrossRefPubMed
74.
Duke SA, Rees DA, Forward GC: Increased plaque calcium and phosphorus concentrations after using a calcium carbonate toothpaste containing calcium glycerophosphate and sodium monofluorophosphate. Pilot study. Caries Res. 1979, 13: 57-59.CrossRefPubMed
75.
Naylor MN, Glass RL: A 3-year clinical trial of calcium carbonate dentifrice containing calcium glycerophosphate and sodium monofluorophosphate. Caries Res. 1979, 13: 39-46.CrossRefPubMed
76.
Mainwaring PJ, Naylor MN: A four-year clinical study to determine the caries-inhibiting effect of calcium glycerophosphate and sodium fluoride in calcium carbonate base dentifrices containing sodium monofluorophosphate. Caries Res. 1983, 17: 267-276.CrossRefPubMed
77.
Sidi AD: Effect of brushing with fluoride toothpastes on the fluoride, calcium, and inorganic phosphorus concentrations in approximal plaque of young adults. Caries Res. 1989, 23: 268-271.CrossRefPubMed
78.
Sidi AD, Wilson RF: Fluoride, calcium and inorganic phosphorus concentrations in approximal plaque collected from young adults 1 and 24 h after toothbrushing with fluoride toothpastes. Caries Res. 1991, 25: 330-334.CrossRefPubMed
79.
van der Hoeven JS, Schaeken MJ, Creugers TJ: Effect of a mouthrinse containing calcium lactate on the formation and mineralization of dental plaque. Caries Res. 1989, 23: 146-150.CrossRefPubMed
80.
Schaeken MJ, van der Hoeven JS: Influence of calcium lactate rinses on calculus formation in adults. Caries Res. 1990, 24: 376-378.CrossRefPubMed
81.
Brudevold F, Tehrani A, Attarzadeh F, Goulet D, van Houte J: Effect of some salts of calcium, sodium, potassium, and strontium on intra-oral enamel demineralization. J Dent Res. 1985, 64: 24-27.CrossRefPubMed
82.
Kashket S, Yaskell T: Effectiveness of calcium lactate added to food in reducing intraoral demineralization of enamel. Caries Res. 1997, 31: 429-433.CrossRefPubMed
83.
Averill HM, Bibby BG: A clinical test of additions of phosphate to the diet of children. J Dent Res. 1964, 43 (Suppl): 1150-1155.CrossRefPubMed
84.
Finn SB, Jamison HC: The effect of a dicalcium phosphate chewing gum on caries incidence in children: 30-month results. JADA. 1967, 74: 987-995.PubMed
85.
Richardson AS, Hole LW, McCombie F, Kolthammer J: Anticariogenic effect of dicalcium phosphate dihydrate chewing gum: results after two years. J Can Dent Assoc. 1972, 38: 213-218.PubMed
86.
DePaola PF, Soparkar PM, Triol C, Volpe AR, Garcia L, Duffy J, Vaughan B: The relative anticaries effectiveness of sodium monofluorophosphate and sodium fluoride as contained in currently available dentifrice formulations. Am J Dent. 1993, 6 (Spec No): S7-12.PubMed
87.
Boneta AE, Neesmith A, Mankodi S, Berkowitz HJ, Sanchez L, Mostler K, Stewart B, Sintes J, De Vizio W, Petrone ME, Volpe AR, Zhang YP, McCool JJ, Bustillo E, Proskin HM: The enhanced anticaries efficacy of a sodium fluoride and dicalcium phosphate dihydrate dentifrice in a dual-chambered tube. A 2-year caries clinical study on children in the United States of America. Am J Dent. 2001, 14 (Spec No): 13A-17A.PubMed
88.
Silva MF, Melo EV, Stewart B, De Vizio W, Sintes JL, Petrone ME, Volpe AR, Zhang Y, McCool JJ, Proskin HM: The enhanced anticaries efficacy of a sodium fluoride and dicalcium phosphate dihydrate dentifrice in a dual-chambered tube. A 2-year caries clinical study on children in Brazil. Am J Dent. 2001, 14 (Spec No): 19-23A.
89.
Zhang YP, Din CS, Miller S, Nathoo SA, Gaffar A: Intra-oral remineralization of enamel with a MFP/DCPD and MFP/silica dentifrice using surface microhardness. J Clin Dent. 1995, 6: 148-153.PubMed
90.
Sullivan RJ, Masters J, Cantore R, Roberson A, Petrou I, Stranick M, Goldman H, Guggenheim B, Gaffar A: Development of an enhanced anticaries efficacy dual component dentifrice containing sodium fluoride and dicalcium phosphate dihydrate. Am J Dent. 2001, 14 (Spec No): 3-11A.
91.
Itthagarun A, King NM, Yiu C, Dawes C: The effect of chewing gums containing calcium phosphates on the remineralization of artificial caries-like lesions in situ. Caries Res. 2005, 39: 251-254. 10.1159/000084806.CrossRefPubMed
Metadata
Title
Dentifrices, mouthwashes, and remineralization/caries arrestment strategies
Author
Domenick T Zero
Publication date
01-06-2006
Publisher
BioMed Central
Published in
BMC Oral Health / Issue Special Issue 1/2006
Electronic ISSN: 1472-6831
DOI
https://doi.org/10.1186/1472-6831-6-S1-S9

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