Fluoride concentration in toothpaste marketed to children in Brazil and Mexico, and discussion on current regulations

Resumo Os dentifrícios fluoretados comercializados para crianças devem conter concentração mínima de 1000 ppm de fluoreto (F), que deve ser quimicamente solúvel para ter efeito anticárie. Portanto, determinamos as concentrações de fluoreto total (FT) e fluoreto solúvel total (FST) em dentifrícios comercializados para crianças no Brasil e no México e analisamos as regulamentações vigentes em ambos os países. Vinte e quatro marcas foram encontradas e adquiridas no Brasil (19 formuladas com NaF/SiO2, três com Na2FPO3/CaCO3 e duas com Na2FPO3/SiO2) e seis no México (todas com NaF/SiO2). As concentrações de FT e FST foram determinadas após a compra (amostras frescas), e a estabilidade do fluoreto nas formulações de Na2FPO3/CaCO3 foi verificada após 18 meses. As análises foram realizadas com eletrodo íon-específico e os resultados expressos em ppm F (mg F/kg). As concentrações de FT encontradas variaram de 476,0 a 1.385,3 ppm F e foram próximas às declaradas pelos fabricantes (500 a 1.450 ppm F). As concentrações de FT encontradas não ultrapassaram 1.500 ppm F, de acordo com as regulamentações vigentes de ambos os países. No entanto, dentifrícios com concentrações de FST inferiores a 1.000 ppm F foram encontrados tanto em dentifrício com baixa concentração (500 ppm F) formulado com NaF/SiO2 como em dentifrícios com Na2FPO3/CaCO3 frescos e envelhecidos, originalmente fabricados com 1.000-1.100 ppm de FT. Em conclusão, embora a maioria dos dentifrícios analisados apresentasse concentração de FST superior a 1.000 ppm F, as regulamentações vigentes em ambos os países permitem que produtos que não estejam de acordo com a melhor evidência disponível estejam presentes no mercado.

Abstract Fluoride toothpastes market to children should contain a minimum concentration of 1000 ppm of fluoride (F), which must be chemically soluble to provide anti-caries effect. Therefore, we determined the concentrations of total fluoride (TF) and total soluble fluoride (TSF) in toothpastes marketed to children in Brazil and Mexico and analyzed the current regulations in force in both countries. Twenty-four brands were found and purchased in Brazil (19 formulated with NaF/SiO2, three with Na2FPO3/CaCO3 and two with Na2FPO3/SiO2) and six in Mexico (all with NaF/SiO2). TF and TSF concentrations were determined after the purchase (fresh samples) but fluoride stability in Na2FPO3/CaCO3-formulations was checked after 18 months. The analyses were performed with an ion-specific electrode and the results expressed in ppm F (mg F/kg). The TF concentrations found ranged from 476.0 to 1385.3 ppm F and they were close the declared by the manufactures (500 to 1450 ppm F). The TF concentrations found were not greater than 1500 ppm F, in accordance with the current regulations of both countries. However, toothpastes presenting TSF concentrations lower than 1000 ppm F were found either in low fluoride toothpaste (500 ppm F) formulated with NaF/SiO2 as in fresh and aged Na2FPO3/CaCO3-toothpastes, originally fabricated with 1000-1100 ppm of TF. In conclusion, although most toothpastes analyzed showed TSF concentration higher than 1000 ppm F, the regulations in force in both countries allow that products not in agreement with the best available evidence are available in the market.

Formulations of desensitizing toothpastes for dentin hypersensitivity: a scoping review

Abstract Objective: This study aimed to review evidence from randomized controlled trials (RCTs) to describe: 1) the active ingredients and desensitizing toothpaste brands; 2) the evaluation of these active ingredients over time, and 3) the fluoride and abrasive content in the formulations designed to treat dentin hypersensitivity (DH). Methodology: In total, 138 RCTs and their tested toothpastes were included. Searches were updated up to August 19, 2021. Formulations, reported brands, active ingredients over time, and type of fluoride (ionizable or ionic fluoride) and abrasive (calcium or silica-based) were analyzed (PROSPERO #CRD42018086815). Results: Our trials assessed 368 toothpaste formulations, including 34 placebo (9%), 98 control toothpastes with fluoride (27%), and 236 (64%) with active ingredients to treat DH. We tested the following active ingredients: potassium compounds (n=68, 19%), calcium sodium phosphosilicate (CSP) (n=37, 10%), strontium compounds (n=28, 8%), arginine (n=29, 8%), stannous fluoride (SnF2) (n=21, 6%), hydroxyapatite (n=9, 2%), potassium combined with another active ingredient (n=19, 5%), inorganic salt compounds (n=11, 3%), citrate (n=5, 1%), formaldehyde (n=3, 1%), herbal (n=4, 1%), copolymer (n=1, 0.5%), and trichlorophosphate (TCP) (n=1, 0.5%). The number of toothpaste formulations increased since 1968, with the greatest increment after 2010. Most toothpastes described their type of fluoride as sodium monofluorphosphate (MFP) (n=105, 29%) and NaF (n=82, 22%), with silica-based (n=84, 23%) and calcium-based (n=64, 17%) abrasives. Conclusion: Patients and dentists enjoy an increasing number of brands and active ingredients to decide what desensitizing toothpaste to use. The most common types of fluoride are MFP and NaF.

In vitro determination of potentially bioavailable fluoride in diet and toothpaste after ingestion

Aim: To propose a new method to determine in vitro potentially bioavailable fluoride (F) in diet and toothpaste after ingestion. Methods: Diet samples (D) were obtained from 15 portions of a meal served to children in a day care centre. To simulate the ingestion of toothpaste during brushing after meals, a specific amount of toothpaste was added to the diet samples (D + T). F was determined in D and D + T after incubation in a solution that simulated "gastric juice" (0.01 M hydrochloric acid) at 37oC for 30, 60 and 120 min. Microdiffusion facilitated by HMDS was used to determine the total F concentrations in samples D and D + T. The analyses were performed using an ion specific electrode. Results: For D samples, incubation in "gastric juice" for 30, 60 and 120 min resulted in F concentrations (µg F/mL) of 0.75 ± 0.06c, 0.77 ± 0.07c and 0.91 ± 0.09b, corresponding to 75.3, 77.3 and 90.7% of the total F (1.02 ± 0.12a), respectively (p = 0.0001; ANOVA + Tukey). For D + T samples, these values of F concentrations (µg F/mL) were 2.55 ± 0.46b, 2.83 ± 0.44ab and 3.15 ± 0.37a, corresponding to 86.9, 94.8 and 106.7% of the total F (2.99 ± 0.34a), respectively (p = 0.0023; ANOVA + Tukey). Conclusion: Then, it can be concluded that the proposed method of "gastric juice" is a promising protocol for determining potentially bioavailable fluoride in the diet and toothpaste after ingestion. However, additional studies are desirable

Effect of treatment time on performance of nano-encapsulated fluoride dentifrices for remineralization of initial carious lesions: an in vitro study / Efeito do tempo de tratamento no desempenho de dentifrícios de fluoreto nanoencapsulado para remineralização de lesões iniciais de cárie: um estudo in vitro

ABSTRACT The aim of this in vitro study was to evaluate the influence of treatment time on the remineralization performance of nanoencapsulated fluoride dentifrices on initial carious lesions. Ninety-six human enamel samples were allocated to eight groups (n = 12): 50% NanoF + 50% free NaF, 100% NanoF, 100% NaF (positive control), and placebo (negative control), using two different treatment times (one and five minutes) for each dentifrice tested. After the carious lesion induction, the specimens were submitted to a pH remineralizing cycling model for seven days. Surface microhardness was measured before and after carious lesion induction and after treatment. The percentage of surface remineralization was calculated for each study time. Data were analyzed using two-way ANOVA and ANOVA repeated-measures tests followed by the Bonferroni correction (p < 0.05). Remineralization differences were observed in the dentifrices analyzed according to the treatment time used. NanoF formulations with 50% (one-min treatment) and 100% (five-min treatment) promoted significant remineralization of enamel after the caries challenge when compared to the placebo dentifrice (p < 0.05). Thus, time was considered an important factor for the fluoride release system. Nanotechnology can be a promising system for caries remineralization as it makes fluoride available on the dental surface for a longer time.

RESUMO O objetivo deste estudo in vitro foi de avaliar a influencia do tempo de tratamento no desempenho de dentifrícios fluoretados nano-encapsulados na remineralizagao de lesoes cariosas iniciáis. Noventa e seis amostras de esmalte humano foram divididas em oito grupos (n = 12): 50% NanoF + 50% NaF livre, 100% NanoF, 100% NaF (controle positivo) e Placebo (controle negativo) com dois tempos diferentes (um e cinco minutos). Após a indugao da lesao cariosa, os espécimes foram submetidos a um modelo de ciclagem de pH por sete dias. A microdureza superficial foi medida antes e após a indugao da lesao cariosa e após o tratamento. O percentual de remineralizagao superficial foi calculado para cada tempo de estudo. Os dados foram analisados pelo ANOVA e ANOVA de medidas repetidas, seguida de Bonferroni (p <0,05). Diferengas de remineralizagao foram observadas nos dentifrícios de acordo com o tempo de tratamento utilizado. Formulagoes NanoF com 50% (tratamento de um minuto) e 100% (tratamento de cinco minutos) promoveram uma remineralizagao do esmalte, após o desafio cariogènico, quando comparado com o dentifricio placebo (p <0,05). Assim, o tempo foi considerado um fator importante para o sistema de liberagao de flúor. A nanotecnologia pode ser um sistema promissor de remineralizagao da cárie, por disponibilizar o flúor por maior tempo na superficie dentària.

Remineralization efficacy of nonfluoride versus herbal-based pediatric dentifrice in demineralized primary teeth

Background: Dental caries is one of the most prevalent posteruptive bacterial infections worldwide, characterized by a progressive demineralization process that affects the mineralized dental tissues. Although the decline of dental caries prevalence can be attributed to the widespread use of dentifrices that contain fluoride, yet there is a need for an advanced alternative nonfluoride remineralizing dentifrice. Yet, there is a need for an advanced alternative nonfluoride remineralizing dentifrice. Aim: The aim of this study was to evaluate and compare the remineralizing effect of nonfluoride-based and herbal-based pediatric dentifrice in demineralized primary teeth with an ideal in vitro method of pH cycling and evaluating the values under Polarized Light Microscope (Olympus BX43) using image analysis software (ProgRes, Speed XT core3). Materials and Methods: A total of 30 tooth samples were collected and placed in the demineralizing solution for 96 h to produce a demineralized lesion of approximately 100 ?m, and then cut longitudinally into 60 sections that were randomly assigned to two groups with 27 samples each, Group A – nonfluoride-based dentifrice (Mee Mee®), Group B – herbal-based dentifrice (Mamaearth™), after which they were subjected to pH cycling for 7 days along with dentifrice slurry preparation. The sections were evaluated under the polarizing light microscopy for remineralizing efficacy. The lesion depth was measured and tabulated to be sent for statistical analysis. Results: The mean demineralization value for nonfluoride and herbal-based dentifrice groups were 7.8730 ?m and 28.3174 ?m, respectively. Hence, it can be inferred that since lesion depth measured was lesser in nonfluoride than herbal-based dentifrice, remineralization has occurred in the nonfluoride-based dentifrice group. Conclusion: Nonfluoride-based dentifrice showed significant results in remineralizing the demineralized lesion, while herbal-based dentifrice showed poor efficiency in remineralizing the demineralized lesion.

Silicon-enriched hydroxyapatite formed induced by REFIX-based toothpaste on the enamel surface / Formação de hidroxiapatita enriquecida com silício induzida por dentifrício à base de REFIX na superfície do esmalte

Objetivo: Este estudo in vitro objetivou caracterizar o teor de minerais e a morfologia das partículas de um dentifrício fluoretado contendo tecnologia REFIX e o teor de minerais e a morfologia da superfície do esmalte tratada com este produto. Material e Métodos: Blocos de esmalte bovino (n=5) foram obtidos (4×4×6 mm), desmineralizados (lesão de cárie artificial) e tratados (ciclagem de pH e escovação com dentifrício). Durante a ciclagem de pH de 7 dias (desmineralização e remineralização levaram 6 h e 18 h, respectivamente), o esmalte foi escovado por 5 min com uma escova dental elétrica antes de ser imerso em uma solução de remineralização. Avaliou-se a micromorfologia e os níveis elementares (% em peso) dos íons presentes no dentifrício e na camada formada sobre o esmalte após o tratamento. A morfologia da superfície foi avaliada por meio de microscopia eletrônica de varredura (MEV). As análises elementares foram realizadas usando um espectrômetro de energia dispersiva de raios-X (EDS). Resultados: A análise por MEV do dentifrício demonstrou uma distribuição de tamanho uniforme de partículas de forma regular que foram organizados esparsamente em "nanoclusters". A análise elementar da formulação do dentifrício demonstrou a presença de Si (silício), Na (sódio), P (fósforo) e F (flúor), entre outros. Observou-se também uma camada mineral na superfície de esmalte com espessura uniforme consistente em torno de 14 µm. Conclusão: De acordo com os resultados, conclui-se que a tecnologia REFIX modifica a superfície e subsuperfície da estrutura do esmalte, formando uma camada mineral rica em silício. (AU)

Objective: This in vitro study aimed at characterizing the mineral content and filler particle morphology of a fluoridated toothpaste containing REFIX technology and the mineral content and the morphology of the enamel surface treated with this product. Material and Methods: Bovine enamel blocks (n=5) were obtained (4×4×6 mm), demineralized (artificial caries lesion), and treated (pH cycling and brushing with the toothpaste). During the pH cycling, which lasted for 7 days (demineralization and remineralization took 6 h and 18 h, respectively), the enamel was brushed for 5 min using an electric toothbrush before being immersed in a remineralization solution. We evaluated the micromorphology and elemental levels (wt%) of ions present in the toothpaste and on the layer formed over the enamel following the treatment. The surface morphology was assessed using scanning electron microscopy (SEM). The elemental analyses were performed using an energy-dispersive X-ray spectrometer (EDS). Results: Scanning electron micrographs of the toothpaste demonstrated a uniform size distribution of regular-shaped fillers sparsely organized in nanoclusters. Elemental analysis of the toothpaste's formulation demonstrated the presence of Si (silicon), Na (sodium), P (phosphorus), and F (fluorine), among others. We also detected a mineral layer that had formed on the treated enamel surface; the layer had a consistent uniform thickness of ~14 µm. Conclusion: Based on the results, it can be stated that REFIX technology modifies the surface and subsurface of the enamel structure, forming a Si-rich mineral layer. (AU)

Evaluación de la actividad antimicrobiana de los dentífricos basados en propóleos en patógenos orales / Evaluation of the antimicrobial activity of propolis toothpastes on oral pathogens / Avaliação da atividade antimicrobial de dentífricos com base em própolis em patógenos orais

Resumen Introducción y objetivo: La incorporación de propóleos en los dentífricos tiene como objetivo ayudar de manera más efectiva al control y la prevención de patologías orales a través de la eliminación de los patógenos presentes en la biopelícula. Sin embargo, se sabe poco sobre la eficacia antimicrobiana de diferentes productos en el mercado de microorganismos para estas patologías. El objetivo de este estudio fue investigar la acción antimicrobiana de tres dentífricos que contienen propóleos sobre los patógenos orales. Material y métodos: Se utilizó el método de difusión en agar para analizar tres dentífricos basados en propóleos, que incluyen: Noplak Max®, Protta® y Forever Bright®. Se utilizó un dentífrico sin propóleos (Malvatrikids®) como control negativo. Los controles positivos fueron 0,2% de clorhexidina diluida adicionalmente al 30% para igualar la concentración de clorhexidina de uno de los dentífricos evaluados, y el extracto de propóleos (Apis Flora®) al 11%. Para la determinación de la actividad antimicrobiana se utilizaron las cepas de Fusobacterium nucleatum y Aggregatibacter actinomycetemcomitans, Enterococcus faecalis, Streptococcus mutans, Lactobacillus acidophilus y Candida albicans. Resultados: De los dentífricos probados, Protta® y Forever Bright® mostraron acción inhibitoria contra S. mutans, E. faecalis y microorganismos de C. albicans. El dentífrico Nopla k® mostró baja actividad antimicrobiana, limitándose a S. mutans y E. faecalis. Cuando hubo un efecto antimicrobiano, los diámetros de los halos de inhibición del crecimiento variaron de 9mm a 28,83mm. Conclusión: El uso de un dentífrico que contiene propóleos para su uso eventual como complemento terapéutico en odontología está justificado, considerando las actividades farmacológicas.

Abstract Introduction and objective: The incorporation of propolis in dentifrices aims to more effectively assist the control and prevention of oral pathologies through the elimination of pathogens present in the biofilm. However, little is known about the antimicrobial efficacy of different products on the market for microorganisms for these conditions. The aim of this study was to investigate the antimicrobial action of three propolis-containing dentifrices on oral pathogens. Material and methods: The agar diffusion method was used to analyze three propolis-based dentifrices, including: Noplak Max®, Protta® and Forever Bright®. A non-propolis dentifrice (Malvatrikids®) was employed as a negative control. Positive controls were 0.2% chlorhexidine, further diluted 30% to match the chlorhexidine concentration of one of the evaluated dentifrices and 11% propolis extract (Apis Flora®). For the determination of antimicrobial activity the strains of Fusobacterium nucleatum and Aggregatibacter actinomycetemcomitans, Enterococcus faecalis, Streptococcus mutans, Lactobacillus acidophilus and Candida albicans were used. Results: Of the tested dentifrices, Protta® and Forever Bright® showed inhibitory action against S. mutans, E. faecalis and C. albicans microorganisms. Noplak® dentifrice showed low antimicrobial activity, being limited to S. mutans and E. faecalis. When there was an antimicrobial effect, the diameter of the growth inhibition halos ranged from 9mm to 28.83mm. Conclusion: The use of a propolis-containing dentifrice for eventual use as a therapeutic adjunct in dentistry is fully justified, considering the pharmacological activities.

Resumo Introdução e objetivo: A incorporação de própolis em dentifrícios visa ajudar a controlar e prevenir patologias bucais de maneira mais eficaz, através da eliminação de patógenos presentes no biofilme. No entanto, pouco se sabe sobre a eficácia antimicrobiana de diferentes produtos no mercado de microrganismos para essas patologias. O objetivo deste estudo foi investigar a ação antimicrobiana de três dentifrícios contendo própolis em patógenos orais. Material e métodos: O método de difusão em ágar foi utilizado para analisar três dentífricos à base de própolis, incluindo: Noplak Max®, Protta® e Forever Bright®. Um creme dental não própolis (Malvatrikids®) foi usado como controle negativo. Os controles positivos foram 0,2% de clorexidina diluída para 30% para corresponder à concentração de clorexidina de um dos dentifrícios avaliados e 11% de extrato de própolis (Apis Flora®). Para a determinação da atividade antimicrobiana, foram utilizadas as linhagens Fusobacterium nucleatum e Aggregatibacter actinomycetemcomitans, Enterococcus faecalis, Streptococcus mutans, Lactobacillus acidophilus e Candida albicans. Resultados: Dos dentifrícios testados, Protta® e Forever Bright® apresentaram ação inibitória contra S. mutans, E. faecalis e microorganismos de C. albicans. O creme dental Noplak® apresentou baixa atividade antimicrobiana, limitada a S. mutans e E. faecalis. Quando houve efeito antimicrobiano, os diâmetros dos halos de inibição de crescimento variaram de 9 a 28,83 mm. Conclusão: O uso de um dentifrício contendo própolis para eventual uso como complemento terapêutico em odontologia é totalmente justificado, considerando as atividades farmacológicas.

Study of a tooth gel formulation for hygiene and oral sequelae management in irradiated patients

Cervical-facial radiotherapy causes innumerable sequelae, being systemic or restricted to the oral environment. Theoral mucosa of these patients is profoundly compromised by radiotherapeutic treatment with or without chemotherapy,presenting several complications. Dentifrices containing sodium lauryl sulfate cause damage, as they lead to drynessof the mucosa. The objective of this work was to develop a dentifrice capable of minimizing xerostomia related toa lower abrasive effect, which was intended for hygiene, prevention of caries, control of dental biofilm, and toothsensitivity in cancer patients. The qualitative composition and physicochemical characteristics of ten dentifrices wereanalyzed, which enabled the preparation of the proposed formulation (PF) that was analyzed periodically for 180days. The quantitative analysis of spreadability not only indicated favorable behavior of the PF in relation to thepackaging and storage conditions but also revealed the need to raise the propylene glycol concentration in the PF toavoid the occurrence of syneresis after 60 days. Furthermore, pH data showed that the PF is compatible with the pHof oral homeostasis thus avoiding the occurrence of dental demineralization. It is suggested that the PF has a singularcomposition and physicochemical quality to be used as a suitable dentifrice for patients undergoing anticancer therapy

Tobacco use patterns among women in reproductive age group: a cross sectional study in the rural area of Belgaum district, Karnataka, South India

Background: Tobacco imposes a colossal burden of disease and death leading to catastrophic health, social, economic, and environmental effects. “Tobacco” kills both men and women but sex-specific differences exist. Traditional forms of tobacco like dentifrice or tobacco tooth powder and betel quid, tobacco and lime mixture are commonly used and also, the new products use is increasing not only among men but even among children, teenagers, women of reproductive age. This study was done to know the patterns and other correlates of tobacco use among the rural women in the reproductive age group.Methods: A community based cross sectional study, conducted from January 2011 to December 2011 among 1200 rural women aged between 15 years to 49 years residing in primary health centre, Vantmuri area, Belgaum, Karnataka, India. Statistical analysis was done using rates, ratios and chi-square tests.Results: Tobacco consumption was seen in 9.7% of the study participants. A very high percentage of 79 (67.5%) had more than 10 years of exposure to tobacco amongst the users. Dentifrice was the most common form of tobacco used (85.5%) followed by 32 (27.4%) plain tobacco consumption. However, 49 (4.1%) consumed multiple forms of tobacco, most common being dentifrice along with plain tobacco or paan with beetelquid or used snuff.Conclusions: The distribution of tobacco consumption is likely to maintain, and perhaps increase, the current considerable socioeconomic differentials in health in India. Dual users are at much higher health risks than those who consume the individual tobacco product. It also emphasizes the variations in patterns of using tobacco among rural women. There is a need for periodical surveys using more consistent definitions of tobacco use and eliciting information on different types of tobacco consumed.

Eficácia de um dentifrício sem flúor no controle de Streptococcus mutans in vitro / Effectiveness of a non-fluoridated dentifrice in control of Streptococcus mutans in vitro

Objetivo: avaliar a eficácia de um dentifrício, que contém em sua composição extratos vegetais e xilitol para inibição de Streptococcus mutans (UA159). Materiais e método: para verificação da atividade antimicrobiana, foram realizados ensaios in vitro de difusão de ágar, baseados na metodologia da norma M2A8 Anvisa. O estudo foi feito utilizando inóculo de 108 UFC/mL da cepa de S. mutans. O princípio básico foi a difusão de uma solução de dentifrício na superfície do ágar a partir de um disco impregnado. O ensaio foi realizado utilizando como controle negativo água deionizada estéril e como controle positivo clorexidina 0,12%, e foram comparados aos dentifrícios Orgânico Natural® e Colgate Total 12®. O resultado foi analisado a partir da medição dos halos de inibição (mm). Resultados: a clorexidina 0,12% teve maior halo de inibição (21,08 ± 1,02), seguida do dentifrício Orgânico Natural® (11,33 ± 4,35) e do dentifrício Colgate Total 12 (3,93 ± 4,67) P<0,05. Conclusão: a inibição da cepa de S. mutans evidenciada neste ensaio in vitro demonstra o potencial antimicrobiano do dentifrício Orgânico Natural®, mesmo como um possível auxiliar no controle do biofilme dental cariogênico. (AU)

Objective: the goal was to evaluate the effectiveness of a dentifrice that has a chemical composition of plant extracts and xylitol to inhibit the Streptococcus mutans (UA159). Materials and methods: based on the methodology of the M2A8 Anvisa standard, in vitro agar diffusion assays were performed to verify antimicrobial activity. The study was carried out using inoculum of 108 CFU / mL of S. mutans strain. The principle was the diffusion of a dentifrice solution on the agar surface, from a disc impregnated therewith. The assay was performed using as a negative control the sterile deionized water, 0.12% chlorhexidine as a positive control compared to Orgânico Natural® and Colgate Total 12® toothpastes. The result was analyzed from the inhibition halos measurement (mm). Results: the chlorhexidine 0.12% had the biggest inhibition halo (21,08 ± 1,02) followed by the Orgânico Natural® dentifrice (11,33 ± 4,35) and the Colgate Total 12® dentifrice (3,93 ± 4,67) P<0,05. Conclusion: the inhibition of the S. mutans strain realized in these in vitro assay by the Orgânico Natural® dentifrice demonstrate the antimicrobial potential of the same as a possible aid in the control of the cariogenic dental biofilm. (AU)

Influence of fluoridated groundwater and 1, 100 ppm fluoride dentifrice on biomarkers of exposure to fluoride

Abstract This research aimed to determine the influence of fluoridated groundwater and 1,100 ppm fluoride dentifrice on biomarkers of exposure to fluoride in preschoolers. A cross-sectional study was performed on thirty preschoolers recruited from naturally fluoridated and non-fluoridated areas (n=15). Total Daily Fluoride Intake (TDFI) from diet and dentifrice, and Daily Urinary Fluoride Excretion (DUFE) was measured over 24 h. Nails samples were collected twice during 30 days. Fluoride analyses were performed using a fluoride-ion-specific electrode. Data were evaluated using the Student and paired t-test, Pearson correlation analysis, multiple linear regression analysis (α≤0.05). Fluoridated groundwater and dentifrice were the dominant sources (r2 > 0.83) of TDFI in children from a naturally fluoridated and a non-fluoridated area, respectively. A positive correlation between TDFI and DUFE (r=0.50), and between [F] in fingernails and toenails (r=0.60) were found in children from a naturally fluoridated area. The [F] in nails of finger and toe were not correlated to TDFI. The consumption of fluoridated groundwater influenced the fluoride concentration in urine. In addition, the use of 1,100 ppm fluoride dentifrice did not influence the fluoride concentration in urine and fingernails.

Resumo Esta pesquisa teve como objetivo determinar a influência de águas fluoretadas subterrâneas e do dentifrício com 1.100 ppm de fluoreto nos biomarcadores de exposição ao flúor em pré-escolares. Foi realizado um estudo transversal em trinta pré-escolares recrutados em áreas naturalmente fluoretadas e não fluoretadas (n = 15). A ingestão diária total de flúor (TDFI) a partir da dieta e do dentifrício, assim como a excreção urinária diária de flúor (DUFE), foram medidas ao longo de 24 horas. Amostras de unhas foram coletadas duas vezes durante 30 dias. As análises de flúor foram realizadas usando um eletrodo específico para íon flúor. Os dados foram analisados utilizando o teste t de Student e pareado, a análise de correlação de Pearson, e a análise de regressão linear múltipla (a≤0,05). As águas subterrâneas e dentifrícios fluoretados foram as fontes dominantes (r2>0,83) do TDFI em crianças da área naturalmente fluoretada e não fluoretada, respectivamente. Uma correlação positiva entre TDFI e DUFE (r=0,50) e entre [F] nas unhas das mãos e dos pés (r=0,60) foi encontrada em crianças da área naturalmente fluoretada. A [F] nas unhas das mãos e dos pés não foi correlacionada com TDFI. O consumo de águas subterrâneas fluoretadas influenciou a concentração de flúor na urina. Além disso, o uso de dentifrício com 1.100 ppm de fluoreto não influenciou a concentração de fluoreto na urina e nas unhas.

Clinical evaluation of the anti-gingivitis efficacy of a novel stabilized stannous-containing sodium fluoride dentifrice / 实用口腔医学杂志

Objective: To evaluate the anti-gingivitis efficacy of a novel stabilized stannous-containing sodium fluoride dentifrice. Methods: A randomized, controlled and double blind clinical study was conducted. 156 adults with gingivitis were enrolled and randomly assigned to experimental group(group of novel stabilized stannous-containing sodium fluoride dentifrice, n = 51), positive control group (group of Yunnan Baiyao dentifrice, n = 54) and negative control group (group of Crest dentifrice, n = 51). Gingival health was assessed using Mazza Modification of the Papillary Bleeding Index(Mazza GI) at Baseline, day 3 and week 4 and pocket depth was evaluated at baseline and week 4, respectively. Results: At day 3 and week 4, the experimental and positive control groups exhibited lower clinical parameters than the negative control group(P＜ 0. 000 1). At week 4, the mean Mazza GI scores and PD of the experimental group were significantly lower than those of the positive control group(P＜ 0. 05). Conclusion: The novel stannous-containing sodium fluoride dentifrice has anti-gingivitis efficacy.

Eficacia de la arginina al 8% y nitrato potásico al 5% en el tratamiento de la hipersensibilidad dentinaria: ensayo clínico aleatorio / Efficacy of 8% arginine and 5% potassium nitrate in dentin hypersensitivity therapy: a randomized clinical trial

RESUMEN: Objetivo: Comparar la eficacia clínica de dentífricos en base a arginina al 8%/ monofluorfosfato de sodio 1450 ppm versus nitrato de potasio al 5%/fluoruro de sodio 2500 ppm en la terapia de la hipersensibilidad dentinaria (HSD). Materiales y método: Ensayo clínico, aleatorio, controlado, doble ciego, de grupos paralelos. Treinta y cuatro voluntarios de 18 a 70 años, con HSD en escala Visual Análoga (EVA) ≥4 en 2 ó más dientes no molares, fueron distribuidos aleatoriamente en 2 grupos: grupo T1 (n=16): dentífrico de Arginina al 8%/ monofluorfosfato de sodio 1450 ppm; y grupo T2 (n=18): dentífrico de nitrato de Potasio al 5%/fluoruro de sodio 2500 ppm. Se evaluó HSD en EVA con estímulos evaporativos y térmicos, y se compararon sus valores, así como el grado promedio de HSD y su reducción (∆HSD), intra e intergrupal, al inicio y a las 4 semanas de tratamiento. Resultados: Ambos dentífricos disminuyeron el grado promedio de HSD entre el inicio y las 4 semanas de tratamiento (T1: 5.03 ± 1.23 versus 2.60 ± 1.27, p<0.05; T2: 4.73 ± 1.51 versus 2.71 ± 1.17, p<0.05). No hubo diferencias estadísticamente significativas entre ambos dentífricos al comparar el grado promedio de reducción de HSD durante la terapia (∆HSD T1: -2.43 ± 1.22 versus ∆HSD T2: -2.27 ± 1.42). Los datos fueron analizados en Stata versión 11. Conclusiones: Ambos dentífricos fueron clínicamente eficaces en reducir la HSD a las 4 semanas, sin existir diferencias estadísticamente significativas entre ambos.

ABSTRACT: Aim: To compare the clinical efficacy of 8% arginine/1450ppm sodium monofluorophosphate and 5% potassium nitrate/2500 ppm sodium fluoride dentifrices in the treatment of dentin hypersensitivity (DH). Methods: Parallel-design, double-masked, randomized controlled clinical trial. Thirty four volunteers aged 18 to 70 years, with DH and a visual analog scale (VAS) score ≥4 at least in two or more non-molar teeth, were randomized in two groups: T1 (n=16): 8% arginine/1450 ppm sodium monofluorophosphate dentifrice; and T2 (n=18): 5% potassium nitrate/2500 ppm sodium fluoride dentifrice. DH was assessed with evaporative and thermal stimuli; and their VAS measurements, mean DH value and DH reduction (∆DH) were compared, inside and between the groups at baseline and 4-week follow-up. Data were analysed through Stata® V11 program. Results: Both toothpastes decreased mean DH value between baseline and 4 weeks (T1: 5.03 ± 1.23 versus 2.60 ± 1.27, p<0.05; T2: 4.73 ± 1.51 versus 2.71 ± 1.17, p<0.05). There were no statistical differences between both dentifrices in mean DH reduction values during therapy (∆HSD T1: -2.43 ± 1.22 versus ∆HSD T2:-2.27 ± 1.42). Conclusions: Both dentifrices had clinical efficacy in decreasing DH in a 4- week therapy, without statistical differences between both of them.

Comparison of two commercial dentifrices in the reduction of gingivitis and plaque: a pilot study / Comparação de dois dentífricos comerciais na redução da gengivite e da placa bacteriana: um ensaio clínico randomizado controlado

Objectives: Chlorhexidine (CHX) and triclosan are the most used chemical agents in dentistry. However, the combination of these products has never been tested. We hypothesize that the addition of CHX to a triclosan dentifrice formulation may offer additional benefits in the reduction of plaque and gingivitis. Thus, the aim of this study was to compare a commercial dentifrice containing 0.05% chlorhexidine and 0.3% triclosan, with conventional toothpaste containing 0.3% triclosan, in the treatment of gingivitis and plaque reduction. Material and Methods: Thirty volunteers were randomly assigned to receive a dentifrice containing 0.05% CHX and 0.3% triclosan (CHX/ triclosan group) or a dentifrice containing basically 0.3% triclosan (Triclosan group). Subjects received clinical evaluation such as gingival index (GI) and plaque index (PI) at baseline, 30 and 60 days. Results: After 60 days, both treatments led to a significant improvement in GI and PI. There was no significant difference between groups as regards change in GI and PI (p>0.05). Conclusion: The combination of 0.05% CHX with 0.3% triclosan did not offer further benefits to gingival inflammation and plaque control when compared with a dentifrice containing 0.3% triclosan. (AU)

Objetivos: Clorexidina e triclosan são os agentes químicos mais utilizados em odontologia. No entanto, a combinação desses produtos nunca foi testada. Nós levantamos a hipótese de que a adição de clorexidina a um dentifrício contendo triclosan pode oferecer benefícios adicionais na redução de placa e gengivite. Assim, o objetivo deste estudo foi comparar um dentífrico comercial contendo 0,05% de clorhexidina e 0,3% de triclosan, com creme dental convencional contendo 0,3% de triclosan, no tratamento de gengivite e redução da placa. Material e Métodos: trinta voluntários foram distribuídos aleatoriamente para receber um dentifrício contendo 0,05% de clorexidina e 0,3% de triclosan ou um dentifrício contendo basicamente 0,3% de triclosan. Os indivíduos receberam avaliação clínica de índice gengival (IG) e índice de placa (IP) nos tempos 0, 30 e 60 dias. Resultados: após 60 dias, ambos os tratamentos levaram a uma melhora significativa no IG e IP. Não houve diferença significativa entre os grupos no que se refere à mudança no IG e IP (p> 0,05). Conclusão: A combinação de 0,05% de Clorexidina com 0,3% de triclosan não ofereceu benefícios adicionais para a redução de inflamação gengival e o controle da placa quando comparado com um dentifrício contendo 0,3% de triclosan (AU)

Efeito de agentes remineralizantes sobre a microdureza, cor e desgaste do esmalte dental clareado / Effect of remineralizing agents on the microhardness, color and wear enamel bleached

O objetivo deste estudo foi avaliar o efeito da aplicação de agentes remineralizantes contendo silicato de cálcio / fosfato e flúor ou fluoreto de sódio somente, sobre a redução da microdureza do esmalte causada pelo clareamento dental, cor dos dentes e perda de estrutura resultante da abrasão. Duzentos e quarenta amostras circulares de esmalte bovino foram preparadas, embutidas e polidas. Em seguida foram realizados testes iniciais de cor, microdureza e perfilometria. As amostras foram distribuídas aleatoriamente em 6 grupos (n=40): Grupo C ­(controle negativo) ­ nenhum tratamento; Grupo CL (controle positivo)- Aplicação do agente clareador a base de peróxido de hidrogênio a 40% (Opalescence boost, Ultradent); Grupo CL/Rs ­ Aplicação do agente clareador seguido da aplicação do gel remineralizante a base de silicato de cálcio/fosfato (Regenerate Boosting serum- Unilever); Grupo Rs/CL - Aplicação do gel de silicato de cálcio/fosfato seguido da aplicação do agente clareador; Grupo Rs/CL/Rs - Aplicação do gel de silicato de cálcio/fosfato seguida da aplicação do agente clareador e aplicação novamente do gel de silicato de cálcio/fosfato; Grupo CL/F ­ Aplicação do agente clareador seguida da aplicação do gel de fluoreto de sódio a 2%. Após a etapa de clareamento (3 aplicações de 20 min) foram novamente realizadas as leituras de cor e microdureza. Em seguida os espécimes foram submetidos a 100.000 ciclos abrasivos em máquina de escovação. Cada grupo foi dividido em dois subgrupos de acordo com o dentifrício utilizado (n=20): Subgrupo Cp ­creme dental Close Up proteção bioativa (Unilever); Subgrupo Rp- creme dental Regenerate (Unilever). Os perfis finais das superfícies do esmalte foram avaliados e o desgaste calculado. Os dados foram analisados utilizando o teste de análise de variância ANOVA e Tukey. Diferenças significativas foram observadas para a variação de cor (∆E) (p = 0,000). Os resultados do teste Tukey foram: C (1,31±0,58)a , Rs/CL/Rs (3,72±1,28)b, CL (3,75±1,04)b , CL/Rs (3,87±0,91)b, Rs/CL (3,88±0,94)b, CL/F (4,03±1,22)b. Diferenças estatisticamente significantes foram observadas para a microdureza (Knoop) após os tratamentos (p= 0,00001). Os resultados do teste Tukey foram: CL (246,28±30.46)a, Rs/CL/Rs (263,55±18,66)b, CL/Rs (264,06±28,54)b, Rs/CL (265,22±23,58)b, CL/F (269,10±25,66)b C (323,28±10,96)c. Para o desgaste dental (µm) o teste ANOVA a dois fatores mostrou diferenças significativas entre os grupos e os dentifrícios. Os resultados do teste de Tukey para os grupos foram: CL/F (2,12±0,70)a, Rs/CL (2,13±0,85)a, Rs/CL/Rs (2,19±0,70)a, CL/Rs (2,23±0,91)a, C (2,85±0,98)b , CL (3,36±0,84)c. Os resultados do teste de Tukey para os dentifrícios foram: Rp (2,04±0,80)a, Cp (2,92±0.88)b. Concluiu-se que todos os tratamentos com géis remineralizantes testados minimizaram a redução da microdureza promovida pelo clareamento, embora não evitaram que ela acontecesse. Além disso, a aplicação desses não interferiu na mudança da cor promovida pelo clareamento dental. O clareamento sozinho aumentou o desgaste abrasivo dos dentes, porém todos os tratamentos da superfície com géis remineralizantes testados reduziram a perda de estrutura por abrasão. O dentifrício Regenerate resultou em menor desgaste abrasivo do esmalte em relação ao Close UP. Não existiram diferenças significativas entre os diferentes tratamentos remineralizantes com relação aos efeitos sobre a microdureza, cor e desgaste(AU)

This study aimed to evaluate the effect of the application of remineralizing agents containing calcium/phosphate silicate and fluoride or only sodium fluoride on the reduction of enamel microhardness caused by tooth bleaching, tooth color and loss of structure resulting from abrasion. Two hundred and forty circular bovine enamel samples were prepared, embedded and polished. After that, initial tests of color, microhardness and profile were performed. Samples were randomized into six groups (n=40): Group C - (negative control) - no treatment; Group CL (positive control) ­ application of 40% hydrogen peroxide bleaching agent (Opalescence boost, Ultradent); Group CL/Rs - Application of bleaching agent followed by remineralizing gel based on calcium/phosphate silicate (Regenerate Boosting serumUnilever); Group Rs/CL ­ Application of calcium/phosphate silicate gel followed by bleaching agent; Group Rs/CL/Rs ­ Application of calcium/phosphate silicate gel followed by bleaching agent and new application of calcium/phosphate silicate gel; Group CL/F ­ Application of bleaching agent followed by 2% sodium fluoride gel. After bleaching stage (3 applications/20 min), color and microhardness readings were performed. Then, the specimens were subjected to 100.000 abrasive cycles in a brushing machine. Each group was divided into two subgroups according to the dentifrice used (n=20): Subgroup Cp ­Close Up bioactive protection toothpaste (Unilever); Subgroup Rp- Regenerate toothpaste (Unilever). Final profiles of enamel surface were evaluated and the wear was calculated. Data were analyzed using ANOVA and Tukey variance analysis. Significant differences were observed for color variation (∆E) (p=0.000). Tukey test results were: C (1.31±0.58)a, Rs/CL/Rs (3.72±1.28)b, CL (3.75±1.04)b, CL/Rs (3.87±0.91)b, Rs/CL (3.88±0.94)b, CL/F (4.03±1.22)b. Statistically significant differences were observed for microhardness (Knoop) after treatments (p=0.00001). Tukey test results were: CL (246.28±30.46)a, Rs/CL/Rs (263.55±18.66)b, CL/Rs (264.06±28.54)b, Rs/CL (265.22±23.58)b, CL/F (269.10±25.66)b, C (323.28±10.96)c. For dental wear (µm), two-factor ANOVA test showed significant differences among groups and dentifrices. Tukey test results were were: CL/F (2.12±0.70)a, Rs/CL (2.13±0.85)a, Rs/CL/Rs (2.19±0.70)a, CL/Rs (2.23±0.91)a, C (2.85±0.98)b, CL (3.36±0.84)c. Tukey test results for the dentifrices were: Rp (2.04±0.80)a, Cp (2.92±0.88)b. It was concluded that all treatments with the remineralizing gels minimized the reduction of microhardness promoted by bleaching, although they did not prevent it from happening; In addiction, their application did not interfere in the color change promoted by dental bleaching. Bleaching alone increased the abrasive wear of the teeth. However, all surface treatments, with the remineralizing gels, reduced abrasion structure. Regenerate toothpaste resulted in less abrasive enamel wear regarding Close up toothpaste. There were no significant differences among the different remineralizing treatments with regarding their effects on microhardness, color and wear(AU)

Improvement Effects of Dentifrice Containing Plant Extracts on Periodontal Disease / 日本補完代替医療学会誌

Effects of three plant extracts (Hordeum vulgare L., Apocynum Venetum L., Brasenia schreberi J.F.G mel.) on human gingival fibroblasts were examined. As a result, we observed the promoting effect of the extract of Hordeum vulgare L. and the extract of Apocynum Venetum L. respectively on FGF2 and FGF7 production. Moreover, the mixture of the three plant extracts showed the effect of improving the changes in type I collagen gene expression and matrix metalloproteinase 1 gene expression by LPS addition. Next, a dentifrice containing the three plant extracts was subjected to human efficacy trials. We measured periodontal pocket depth, attachment level, bleeding on probing and saliva TNFα as an indicator of periodontal disease. The results suggest that the dentifrice formulated with the three plant extracts were effective for the improvement of periodontal disease.

Protocol of toothbrushing based on bioavailability of fluoride in toothpaste: a systematic review / Protocolo de cepillado basado en la biodisponibilidad del flúor en dentífricos: una revisión sistemática

The objective of the study is to propose a protocol for the appropriate use of fluorides in dentifrices (Dt), based on its bioavailability in saliva (Bs) and / or plaque (Bp) through a systematic review (SR). SR of the literature from 2005 to 2015 in PubMed, Cochrane and SciELO. Inclusion criteria: clinical studies in vivo, Spanish and English, made only with Dt that measured Bs and Bp. The results were evaluated in relation to: 1) Concentration of fluoride in Dt, 2) Brushing time with Dt, 3) Frequency of brushing, 4) Rinse post-brushing and 5) Amount of Dt on the brush. Twelve (12) studies were selected. 1) Bs increases 241 % when using a 5000 ppm of Dt compared to 1450 ppm. 2) Bs is increased by 55 % by increasing the duration of brushing 40 s to 120 s 3) Bp increases by 68 % when brushing 3 times a day compared to 2 times. 4) Not rinsing or rinsing with <10 ml for <10 s increases Bs to 270 % compared to rinses higher volume / time. 5) By increasing the amount of Dt of 0.5 g to 1.5 g, Bs increases up to 266 %. The use of 1.5 g of Dt 1450 ppm of fluoride for 120 s, 3 times a day is recommended and once brushing is complete avoiding oral rinse with water or non fluoride mouthwash.

El objetivo de este studio es proponer un protocolo para el uso adecuado de fluoruros en dentífricos (Dt), basado en su biodisponibilidad en saliva (Bs) y/o placa (Bp) mediante una revisión sistemática (RS). RS de la literatura 2005- 2015 en PubMed, Cochrane y SciELO. Criterios de inclusión: estudios clínicos in vivo, español e inglés, realizados únicamente con Dt que midieran Bs y Bp. Los resultados fueron evaluados en relación a: 1) Concentración de flúor en el Dt, 2) Tiempo de cepillado con Dt, 3) Frecuencia de cepillado, 4) Enjuague post-cepillado y 5) Cantidad de Dt en el cepillo. Fueron seleccionados 12 estudios. 1) La Bs aumenta en un 241 % al utilizar un Dt de 5000 ppm en comparación con un 1450 ppm. 2) Bs aumenta en un 55 % al aumentar la duración del cepillado de 40 s a 120 s, 3) La Bp aumenta en un 68 % al cepillarse 3 veces al día en comparación a 2 veces. 4) No enjuagarse o enjuagues de <10 ml por <10 s puede aumentar la Bs hasta en un 270 % en comparación a enjuagues con mayor volumen/tiempo. 5) Al aumentar la cantidad de Dt de 0,5 g a 1,5 g, la Bs aumenta hasta en un 266 %. Se recomienda utilizar 1,5 g de Dt 1450 ppm de flúor por 120 s, 3 veces al día, y evitar enjuague oral con agua o colutorios sin flúor una vez finalizado el cepillado.

Dentifrice Containing Extract of Rosmarinus officinalis Linn: An Antimicrobial Evaluation

Abstract This study aimed to evaluate the antimicrobial activity of a dentifrice containing an alcoholic extract of rosemary on oral bacteria, compared to a commercially available herbal dentifrice. Standard strains of Streptococcus mutans (ATCC 25175), Streptococcus oralis (ATCC 9811) and Lactobacillus rhamnosus (ATCC 7469) were used, as well as different toothpastes based on rosemary (TR), on propolis (TH), triclosan (positive control) (TPC) and non-fluoridated dentifrice (negative control) (TNC). Bacteria were seeded in Petri dishes and paper discs soaked with dilutions of dentifrice placed on the plates. The inhibition halos were analyzed. It was observed that TR did not show statistical difference in relation to the TH to inhibit S. mutans and S. oralis, while TH was more active against L. rhamnosus. The toothpaste containing rosemary extract had the ability to inhibit the growth of S. mutans, S. oralis and L. rhamnosus, revealing an antimicrobial activity similar to commercially available toothpastes for inhibition of S. mutans and S. oralis.

Resumo O estudo teve como objetivo avaliar a atividade antimicrobiana de um dentifrício extrato alcoólico de alecrim sobre bactérias orais, comparando-o a um dentifrício herbal disponível no mercado. Cepas padrão de Streptococcus mutans (ATCC 25175), Streptococcus oralis (ATCC 9811) e Lactobacillus rhamnosus (ATCC 7469) foram utilizadas, bem como diferentes dentifrícios à base de alecrim (TR), própolis (TH), triclosan (controle positivo) (TPC) e sem flúor (controle negativo) (TNC). Placas de Petri foram inoculadas com as bactérias e discos de papel embebidos com diluições de cada dentifrício foram colocados nas placas. Em seguida, foram analisados os halos de inibição. Observou-se que o TR não mostrou diferença estatística em relação ao TH para inibição dos S. mutans e S. oralis, enquanto TH foi mais ativo contra L. rhamnosus. O dentifrício contendo extrato de alecrim foi capaz de inibir o crescimento de S. mutans, S. oralis e L. rhamnosus, revelando uma atividade antimicrobiana semelhante ao dentifrício disponível comercialmente na inibição de S. mutans e S. oralis.

Eugenia uniflora Dentifrice for Treating Gingivitis in Children: Antibacterial Assay and Randomized Clinical Trial

Abstract School-age children are frequently at high risk for the onset of biofilm-dependent conditions, including dental caries and periodontal diseases. The objective of this study was to evaluate the clinical efficacy of a dentifrice containing Eugenia uniflora Linn. (Surinam cherry) extract versus a triclosan-based comparator in treating gingivitis in children aged 10-12 years. The in vitro antibacterial potential of the dentifrice was tested against oral pathogens (Streptococcus mutans, Streptococcus oralis and Lactobacillus casei). Then a phase-II clinical trial was conducted with 50 subjects aged 10-12 years, with clinical signs of gingivitis. The subjects were randomly assigned to the experimental group (n=25) and control group (n=25), in which participants used the experimental dentifrice and a triclosan-based fluoridated dentifrice (Colgate Total 12(r)), respectively. Clinical examinations assessed the presence of gingivitis (primary outcome) and biofilm accumulation (secondary outcome) using the Gingival-Bleeding Index (GBI) and Simplified Oral Hygiene Index (OHI-S), respectively, at baseline and after seven days of tooth brushing 3x/day. The data were analyzed using paired and unpaired t-test (GBI) and Wilcoxon and Mann-Whitney (OHI-S), with p≤0.05. The experimental dentifrice showed efficient antibacterial activity in vitro. In the clinical trial, a significant reduction in gingival bleeding was observed in both experimental and control groups (p<0.0001), with no statistical difference between them (p=0.178), although a small size effect was observed. Biofilm accumulation was only reduced in the control group (p=0.0039). In conclusion, E. uniflora dentifrice showed anti-gingivitis properties in children aged 10-12 years. Thus, it may be a potentially efficient and safe product to be used alternatively in preventive dental practice.

Resumo Crianças em idade escolar apresentam, com frequência, alto risco para o desenvolvimento de doenças biofilme-dependentes, incluindo cárie e doenças periodontais. Este estudo investigou a eficácia clínica de um dentifrício contendo o extrato de Eugenia uniflora Linn. (pitanga) comparado a um dentifrício com triclosan no combate à gengivite em crianças de 10 a 12 anos. Foi avaliado o potencial antibacteriano in vitro do dentifrício sobre microorganismos da cavidade oral (S. mutans S. oralis and L. casei) e realizado um estudo clínico fase II incluindo 50 sujeitos, com sinais clínicos de gengivite, divididos aleatoriamente em dois grupos: Experimental - 25 sujeitos usaram o dentifrício contendo extrato de pitanga; e Controle - 25 sujeitos que usaram um dentifrício fluoretado contendo triclosan (Colgate Total 12(r)). Na baseline e após sete dias consecutivos de escovação, foi realizado o exame clínico para diagnóstico de gengivite (desfecho primário) e acúmulo de biofilme (desfecho secundário), utilizando o Índice de Sangramento Gengival (ISG) e Índice de Higiene Oral Simplificado (IHO-S). Os dados foram analisados utilizando o teste t pareado e não pareado (ISG) e teste de Wilcoxon e Mann-Whitney (IHO-S), com nível de significância de p≤0,05. Observou-se uma efetiva atividade antibacteriana do dentifrício experimental. No estudo clínico, observou-se redução de sangramento gengival em ambos os grupos experimental e controle (p<0,0001), não havendo diferença entre eles (p 0,178), embora com uma pequena magnitude de efeito. Apenas o grupo controle reduziu significantemente o acúmulo de biofilme (p=0,0039). Concluiu-se que o dentifrício experimental de E. uniflora mostrou-se eficaz na redução de gengivite em crianças de 10 a 12 anos. Assim, este dentifrício apresenta potencial para ser utilizado de forma eficaz e segura em odontologia preventiva.

Validade da medida indireta relativa à frequência de escovação com dentifrício / Validity of an indirect assessment instrument on the frequency of brushing with toothpaste

O efeito do dentifrício fluoretado na prevenção da cárie dentária aumenta conforme a frequência do seu uso. Essa frequência tem sido estimada em populações por meio de medidas indiretas. Entretanto a validade desse modo de mensuração não é conhecida. O objetivo foi determinar a validade de medidas indiretas da quantidade de dentifrício utilizada, do tamanho da cabeça da escova e da frequência de escovação com dentifrício. Excetuando-se o tamanho da cabeça da escova, os valores relativos à quantidade de creme dental utilizada e à frequência de escovação foram superestimados pela medida indireta. Recomenda-se que as estimativas produzidas por medida indireta semelhante à testada neste estudo sejam consideradas com cautela.

The effect of fluoride dentifrice in the prevention of tooth decay increases with the frequency of use. This frequency has been estimated in populations using indirect instruments, however, their validity is still unknown. This study aimed at determining the validity of indirect instruments related to the amount of dentifrice used, the size of the brush head and the frequency of brushing with toothpaste. Except for the size of the brush head, the values corresponding to the amount of toothpaste used and the frequency of brushing were overrated by the indirect instrument. The estimates obtained using the indirect instrument in this study should be considered with caution.