Reduction of calculus and Peridex stain with Tartar-Control Crest.

Regular use of an effective oral rinse (0.12% chlorhexidine [CHX]) may be accompanied by tooth staining and slightly increased calculus formation. Since dentifrices containing soluble pyrophosphates are known to significantly reduce calculus formation, this study was designed to investigate whether CHX-induced staining and increased calculus may be reduced by the use of such dentifrices. The study compared stain and calculus formation in 163 subjects using a CHX oral rinse (Peridex, Procter & Gamble) according to label directions and either a pyrophosphate-containing anticalculus toothpaste (Tartar-Control Crest, 3.3% pyrophosphate) or an otherwise similar toothpaste without pyrophosphate (Regular Crest). Subjects were instructed to brush and floss ad lib and were examined after three and six months. Whole-mouth calculus occurrence was significantly reduced in the anticalculus toothpaste group at three and six months. Also, staining on the cosmetically important facial-anterior surfaces was significantly reduced at the 3-month examination. After six months the difference in facial anterior staining was still directionally favorable to the anticalculus toothpaste group but no longer statistically significant. These results indicate that routine brushing with an anticalculus toothpaste such as Tartar-Control Crest significantly reduces both facial-anterior staining and calculus occurrence in subjects using a CHX oral rinse. Whether more frequent or more thorough brushing would lead to still greater reductions remains to be investigated.

A clinical comparison of antibacterial mouthrinses: effects of chlorhexidine, phenolics, and sanguinarine on dental plaque and gingivitis.

This study compared the clinical efficacy of three mouthrinses containing either 0.12% chlorhexidine, phenolic compounds, or sanguinarine, which were used unsupervised, in a placebo-controlled, double-blind study of 6 months' duration. The study was conducted according to ADA clinical guidelines for evaluation of antigingivitis agents and was completed by 481 adults. Following baseline exams and a prophylaxis, subjects were randomly divided into treatment groups matched for age, gender, and gingivitis severity, and were instructed to use the rinses in accordance with manufacturer's directions. Followup examinations evaluated supragingival plaque, gingivitis, and gingival bleeding. Compared to placebo at 6 months, the group rinsing with 0.12% chlorhexidine had significantly less gingivitis (31% reduction), gingival bleeding (39% reduction), and plaque (49% reduction) and was significantly better than any of the other treatment groups (P less than 0.05). Both the phenolic and sanguinarine groups showed moderate, yet significant, reductions in plaque compared to placebo (24% and 12% respectively) yet were significantly less effective than the 0.12% chlorhexidine rinse (P less than 0.05). However, neither the phenolic nor sanguinarine rinses were significantly different than placebo in their effects on gingivitis or gingival bleeding. These results support previous published results on the superiority of 0.12% chlorhexidine when used in conjunction with professional care and as an adjunct to routine oral hygiene practices.

The use of chlorhexidine in the management of gingivitis in children.

Two double-blind studies were conducted in 191 children in Mexico. Following a dental prophylaxis, either a 0.12% chlorhexidine gluconate mouthrinse or a placebo was used under supervised conditions in comparable groups twice per day. The chlorhexidine treatments resulted in a significant decrease of gingivitis when compared to the placebo rinse. Although superficial mucosal desquamations were seen in some chlorhexidine users, they were transient and without discomfort. The increase of cosmetic side effects, e.g., dental stain and supragingival calculus, was without consequence to the gingival health of the subjects. The use of a chlorhexidine rinse twice per day and as adjunct to regular oral hygiene procedures achieved a considerable benefit against gingivitis in children in two studies extending over ten and 12 weeks.

A three-year clinical comparison of a sodium monofluorophosphate dentifrice with sodium fluoride dentifrices on dental caries in children.

This study compared the anticaries effects of these three fluoride-containing dentifrices: 1100 ppm F as NaF (positive control); 2800 ppm F as SMFP; and 2800 ppm F as NaF. The group using the 2800 SMFP dentifrice showed no significant differences in DMFS or DMFT, compared to the positive control, at anytime during the study. This indicated that higher levels of sodium monofluorophosphate in a dentifrice offer no advantage in caries protection over the conventional level of sodium fluoride, 1100 ppm F.

A comparison of 3 clinical indices for measuring gingivitis.

A clinical study was conducted among 200 adult males and females to compare the intrusive gingival index (GI) for estimating gingivitis with the nonintrusive and only visually applied papillary-marginal-gingivitis index (PMGI). The GI examinations were performed by a senior examiner with long experience and a junior examiner, while the PMGI was graded by only a senior examiner with long experience. A 4th examiner was included for grading bleeding sites by gentle intrusion at the orifice of the gingival crevice. Following the baseline examination by all examiners, the subjects were randomly assigned to either a group that received an oral prophylaxis immediately or to a group that received an oral prophylaxis 6 weeks after the baseline. All subjects were regraded by all examiners 4 days after the 2nd group received a prophylaxis. This delayed prophylaxis design created a difference in the responses between treatment groups. Both the GI examiners and the PMGI examiner concluded there was significantly less gingivitis in the group receiving a prophylaxis second. There were also significantly fewer bleeding sites in the group receiving a prophylaxis second as determined by both GI examiners and the bleeding-sites examiner.

The effect of a fluoride dentifrice containing an anticalculus agent on dental caries in children.

In this double-blind caries study, 1160 Taiwanese children (ages 8-15) completed a program using a test dentifrice containing 1.243 percent sodium fluoride and soluble pyrophosphates, or a control dentifrice without these agents. The average reduction of new carious tooth surfaces was 39 percent with the sodium fluoride dentifrice.

A clinical procedure for determining the proficiency of gingivitis examiners.

The purpose of the present study was to evaluate a clinical procedure for determining the proficiency of gingivitis examiners. After 4 examiner trainees were instructed by and participated in practice examination sessions with a senior examiner, the 5 examiners participated in a 2-group clinical study which employed appropriately timed-staggered dental prophylaxes to create a gingivitis treatment effect between the 2 groups. The 1st group received dental prophylaxes 30 days before the 2nd group. 10 days after the 2nd group had received dental prophylaxes, both groups were examined independently by all 5 examiners. Baseline examinations had been made on all subjects by all 5 examiners independently to serve as a covariable in the statistical analyses. During this clinical exercise, the examiners did not know at what time prophylaxes had been given nor did they have access to the previous examination records. The expected presence of a treatment effect, as confirmed by the senior examiner, was found by all of the examiner trainees in this exercise. The treatment effect for all examiners was statistically significant.

Clinical reduction of gingivitis through the use of a mouthwash containing two quaternary ammonium compounds.

A commercially available antimicrobial mouthrinse was evaluated among students in Mexican boarding schools. The application was made daily for 3 months under the direct supervision of the project personnel. The observations indicated that the use of this mouthrinse decreased gingivitis substantially in comparison to the use of a control rinse which consisted of flavored water. It is concluded that this mouthwash, containing the known antimicrobial agents cetylpyridinium chloride and domiphen bromide, can be of clinical benefit if conscientiously applied as an adjunct in an oral hygiene regimen of regular toothbrushing with a dentifrice.

Method for the clinical evaluation of enamel polish.

Enamel polish of 600 children was scored. The method used is simple and comprises a visual comparison of the facial surfaces of incisors with a polish standard prepared by selectively polishing extracted teeth. Examiners with little experience can distinguish degrees of enamel polish. A high-polish dentifrice produced significantly greater enamel polish during the 27-month study. A "polish" with flour of pumice at the beginning of the study did not influence this enamel polish.