Erosion protection benefits of stabilized SnF2 dentifrice versus an arginine–sodium monofluorophosphate dentifrice: results from in vitro and in situ clinical studies

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Abstract

Objectives

The aim of these investigations was to assess the ability of two fluoride dentifrices to protect against the initiation and progression of dental erosion using a predictive in vitro erosion cycling model and a human in situ erosion prevention clinical trial for verification of effectiveness.

Materials and methods

A stabilized stannous fluoride (SnF ₂) dentifrice (0.454 % SnF ₂ + 0.077 % sodium fluoride [NaF]; total F = 1450 ppm F) [dentifrice A] and a sodium monofluorophosphate [SMFP]/arginine dentifrice (1.1 % SMFP + 1.5 % arginine; total F = 1450 ppm F) [dentifrice B] were tested in a 5-day in vitro erosion cycling model and a 10-day randomized, controlled, double-blind, two-treatment, four-period crossover in situ clinical trial. In each study, human enamel specimens were exposed to repetitive product treatments using a standardized dilution of test products followed by erosive acid challenges in a systematic fashion.

Results

Both studies demonstrated statistically significant differences between the two products, with dentifrice A providing significantly better enamel protection in each study. In vitro, dentifrice A provided a 75.8 % benefit over dentifrice B ( p < 0.05, ANOVA), while after 10 days in the in situ model, dentifrice A provided 93.9 % greater protection versus dentifrice B ( p < 0.0001, general linear mixed model).

Conclusion

These results support the superiority of stabilized SnF ₂ dentifrices for protecting human teeth against the initiation and progression of dental erosion.

Clinical relevance

Stabilized SnF ₂ dentifrices may provide more significant benefits to consumers than conventional fluoride dentifrices.

Related collections

Most cited references 39

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Can tooth brushing damage your health? Effects on oral and dental tissues.

Jennifer M. Hunter, Laura M. Addy-Orduna (2002)

Circumstantial evidence based on anecdote, case reports, epidemiological data and studies in vitro and in situ implicate tooth brushing with toothpaste with tooth wear, gingival recession and dentine hypersensitivity. This review attempts to assess the clinical significance of the potential harm produced by this most common oral hygiene habit. The toothbrush alone appears to have no effect on enamel and very little on dentine. Most toothpaste also has very little effect on enamel and in normal use would not cause significant wear of dentine in a lifetime of use. Wear of enamel and dentine can be dramatically increased if tooth brushing follows an erosive challenge. Gingival recession has a multi-factorial aetiology and certain individuals and specific teeth may be predisposed to trauma from tooth brushing. Tooth brushing is known to cause gingival abrasions but how these relate to gingival recession is not known. The role of toothpaste in gingival abrasion and recession surprisingly has received little if any attention. Gingival recession most commonly exposes dentine and localises sites for dentine hypersensitivity. Some toothpaste products can expose dentinal tubules but erosion is probably the more dominant factor in dentine hypersensitivity. There is no evidence to indicate that electric and manual toothbrushes differ in effects on soft and hard tissues. It is only under, over or abusive use or when combined with erosion that significant harm may be thus caused. In normal use it must be concluded that the benefits of tooth brushing far out-way the potential harm.

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Dentin hypersensitivity: from diagnosis to a breakthrough therapy for everyday sensitivity relief.

Diane Cummins (2008)

This paper provides an overview of the current knowledge of diagnosis, epidemiology, etiology, and clinical management of dentin hypersensitivity. It summarizes technical approaches to relieve sensitivity in professional and home-use products, with emphasis on the clinical evidence for the efficacy of desensitizing toothpaste, and introduces a new innovative dentifrice technology containing 8% arginine, calcium carbonate, and 1450 ppm fluoride. Dentin hypersensitivity is characterized by short, sharp pain arising from exposed dentin in response to external stimuli which cannot be ascribed to any other form of dental defect or disease. The hydrodynamic theory proposes that pain-producing stimuli cause a change in dentin fluid flow that activates intra-dental nerve fibers, via a mechanoreceptor response, to cause pain. To be hypersensitive, dentin must be exposed and dentin tubules must be open to external stimuli and patent at the pulp. Gingival recession is the primary cause of dentin exposure, and a major predisposing factor for dentin hypersensitivity. Dentin hypersensitivity is a prevalent condition. It has been reported to afflict 15-20% of the adult population, typically 20 to 50-year-olds, with peak incidence between 30 and 39 years. Some studies have reported higher prevalence levels of up to 57%. The incidence of dentin hypersensitivity is expected to rise with changing diets, and as caries and periodontal disease prevention result in improved oral health status, and retention and functionality of the dentition. Treatments to relieve dentin hypersensitivity are based on interruption of the neural response to pain stimuli or occlusion of open tubules to block the hydrodynamic mechanism. Effective and robust dentin occlusion offers the greatest prospect for instant and lasting relief of dentin hypersensitivity. In particular, materials which can coat exposed dentin surfaces, in addition to plugging and sealing open dentin tubules, offer the intriguing prospect of strengthening dentin and rendering it less susceptible to predisposing factors, while concurrently reducing dentin hypersensitivity. Clinical studies have shown that a new toothpaste containing 8% arginine, calcium carbonate, and 1450 ppm fluoride as sodium monofluorophosphate offers significantly increased efficacy in reducing sensitivity, compared to a market-leading toothpaste containing 2% potassium ion. Mechanism of action studies have shown that this technology physically seals dentin tubules with a plug that contains arginine, calcium carbonate, and phosphate. This plug, which is resistant to normal pulpal pressures and to acid challenge, effectively reduces dentin fluid flow and, thereby, reduces sensitivity.

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Dental erosion, gastro-oesophageal reflux disease and saliva: how are they related?

Rebecca Moazzez, David Bartlett, Angela Anggiansah (2004)

The purpose of this study was to assess the prevalence of tooth wear, symptoms of reflux and salivary parameters in a group of patients referred for investigation of gastro-oesophageal reflux disease (GORD) compared with a group of control subjects. Tooth wear, stimulated salivary flow rate and buffering capacity and symptoms of GORD were assessed in patients attending an Oesophageal Laboratory. Patients had manometry and 24-h pH tests, which are the gold standard for the diagnosis of GORD. Tooth wear was assessed using a modification of the Smith and Knight tooth wear index. The results were compared to those obtained from a group of controls with no symptoms of GORD. Patients with symptoms of GORD and those subsequently diagnosed with GORD had higher total and palatal tooth wear (p<0.05). The buffering capacity of the stimulated saliva from the control subjects was greater than patients with symptoms of GORD (p<0.001). Patients with hoarseness had a lower salivary flow rate compared with those with no hoarseness. Tooth wear involving dentine was more prevalent in patients complaining of symptoms of GORD and those diagnosed as having GORD following 24-h pH monitoring than controls. Patients had poorer salivary buffering capacity than control subjects. Patients complaining of hoarseness had lower salivary flow rate than controls.

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Author and article information

Contributors

N. X. West: 44 0117 3424314 , N.X.West@bristol.ac.uk

Journal

Journal ID (nlm-ta): Clin Oral Investig

Journal ID (iso-abbrev): Clin Oral Investig

Title: Clinical Oral Investigations

Publisher: Springer Berlin Heidelberg (Berlin/Heidelberg )

ISSN (Print): 1432-6981

ISSN (Electronic): 1436-3771

Publication date (Electronic): 1 August 2016

Publication date PMC-release: 1 August 2016

Publication date (Print): 2017

Volume: 21

Issue: 2

Pages: 533-540

Affiliations

[1 ]ISNI 0000 0004 1936 7603, GRID grid.5337.2, School of Oral and Dental Sciences, , Bristol Dental School and Hospital, ; Lower Maudlin Street, Bristol, BS1 2LY UK

[2 ]GRID grid.418758.7, , Procter and Gamble, ; Cincinnati, OH USA

Article

Publisher ID: 1905

DOI: 10.1007/s00784-016-1905-1

PMC ID: 5318474

PubMed ID: 27477786

SO-VID: 4d20ec52-638c-47ce-bcdc-ca448d4f3e81

License:

Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made.

History

Date received : 9 June 2015

Date accepted : 7 July 2016

Funding

Funded by: FundRef http://dx.doi.org/10.13039/100004357, Procter & Gamble;

Custom metadata

ScienceOpen disciplines: Dentistry

Keywords: erosion,tooth wear,dentifrice,clinical trial

Data availability:

ScienceOpen disciplines: Dentistry

Keywords: erosion, tooth wear, dentifrice, clinical trial

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