High-potency sodium fluoride: a literature review.

A considerable number of clinical studies are documented in the literature on oral products containing 5,000 ppm fluoride (F), mainly nonabrasive gels. Study results show that this level of fluoride provides marked caries protection. These high-potency gels are especially effective for irradiated head and neck cancer patients, who typically develop rampant caries. Radiation therapy causes a marked decrease in salivation (xerostomia), which predisposes the teeth to caries formation and results in devastating consequences. The currently recommended treatment for these patients involves a 2-step regimen using a 5,000 ppm F gel and a conventional 1,000 ppm F dentifrice. Unfortunately, this treatment usually results in noncompliance because two steps are inconvenient for most patients. A 5,000 ppm F dentifrice meets the oral-hygiene needs of these patients. It provides an effective level of fluoride and a convenient one-step application procedure that increases patient compliance.

The effects of a 0.3% triclosan-containing dentifrice on the microbial composition of supragingival plaque.

144 subjects completed a 6-month, double-blind study which examined the effects of a 0.3% triclosan/2% copolymer/0.243% sodium fluoride dentifrice on the microflora of supragingival dental plaque. The subjects were randomly assigned to use, in an oral hygiene program, either the triclosan/copolymer/fluoride test dentifrice or a control dentifrice. The latter had the same formulation as the test dentifrice except it did not contain triclosan. Supragingival plaque was collected from the buccal and lingual surfaces of 4 teeth at baseline, 3 months, and 6 months, and microbiologically examined by darkfield microscopy, gram stain morphology, immunofluorescence, and selective and non-selective media. Antimicrobial susceptibilities were determined by agar dilution and whole plaque susceptibility methodologies on plaque samples from 136 subjects at each of the above sample periods and at 6-week intervals for an additional 6 months post-therapy. Both dentifrices resulted in highly statistically significant reductions in the total cultivable flora obtained at both the 3 and 6-month samples relative to baseline as well as at 6 months relative to the 3-month sample. The relative decrease in total anaerobic counts and in strict anaerobes, while not statistically significant, was more pronounced at both the 3- and 6-month sample periods in subjects receiving the triclosan dentifrice than for the controls. Neither dentifrice resulted in detrimental shifts in the microbial composition of the normal flora nor led to the emergence of periodontal or opportunistic pathogens.(ABSTRACT TRUNCATED AT 250 WORDS)

Effect of a triclosan/copolymer/fluoride dentifrice on the oral microflora.

Eighty-one human subjects completed a double-blind study which examined the effects of a 0.3% triclosan/2% Gantrez copolymer/0.243% sodium fluoride dentifrice on the microflora of supragingival dental plaque. Subjects were divided into an experimental group which performed normal oral hygiene with the triclosan/copolymer/fluoride dentifrice and a control group which also performed normal oral hygiene with the same dentifrice minus the triclosan/copolymer. At baseline, 10 weeks, and 28 weeks, supragingival dental plaque was collected from buccal and lingual surfaces of the four first molar teeth and assayed for: 1) bacterial morphotypes by phase contrast microscopy, 2) Actinobacillus actinomycetemcomitans, Actinomyces species, Bacteroides forsythus, Bacteroides gingivalis, Bacteroides intermedius, Streptococcus mutans, Streptococcus sanguis, and Wolinella recta by immunofluorescence microscopy, and 3) Lactobacillus, yeast, enterics, Staphylococcus, aerobes and anaerobes by bacterial culture. After 28 weeks' use of their respective dentifrices, changes in the supragingival plaque microflora of the subjects were similar between the triclosan/copolymer/fluoride dentifrice group and the control dentifrice group, except for statistically significant reductions in fusiforms, spirochetes and staphylococci and significant increases in S. sanguis in the triclosan/copolymer/fluoride dentifrice group, as compared to the control dentifrice group. The subject population was unusual in the presence of enteric species and anaerobes found in supragingival plaque sites. This study indicates that the use of a dentifrice containing 0.3% triclosan and 2% Gantrez copolymer over an extended period of time (28 weeks) does not result in shifts in the microflora of supragingival plaque favoring the growth of either opportunistic or pathogenic bacterial species.