What are methods of reducing inflammation?
Dentifrices and mouthrinses
What are the benefits for dentifrices and mouthrinses?
preventive
Therapeutic
Cosmetic
Preventive and therapeutic benefits for Dentifrices
Prevention of dental caries
Remineralization
Reduction of biofilm
Reduction of gingivitis/inflammation
Reduction of dentin hypersensitivity
Reduction of supragingival calculus
Cosmetic effects
Which of the following is the primary agent that has shown efficacy in reducing gingival inflammation?
A) Xylitol
B) Triclosan
C) Zinc citrate
D) Stannous fluoride
B) Triclosan is the correct answer.
Triclosan is the primary agent for reducing gingival inflammation. Xylitol is a flavoring agent in some dentifrices that has been shown to provide anticaries benefits. Zinc citrate and stannous fluoride are agents used
Basic Components of Dentifrices
Detergent 1% to 2%
Abrasive 20% to 40%
Binder 1% to 2%
Humectant 20% to 40%
Flavoring 1% to 1.5%
Water 20% to 40%
Therapeutic agent 1.5% to 2%
Preservative 2% to 3%
Detergents
Foaming Agents/Surfactants
Abrasives
Cleaning/Polishing Agents
Binders
Thickeners and stabilizes formula
-Humectants
*Preservatives
-Moisture Stabilizers; prevents water loss/hardening of dentifrice
*prevents microorganisms from destroying the dentifrice in storage
-Flavoring Agents
*Water
-Sweeteners
*maintain the ingredient in formulation
In a dentifrice, what is the function of the humectant?
A) Prevents separation of ingredients
B) Prolongs a product's shelf life
C) Maintains the consistency of the product
D) Retains moisture
D) Retains moisture is the correct answer.
The purpose of the humectant is to retain moisture. The binder prevents separation and maintains consistency and the preservative prolongs shelf life.
Active Components of Dentifrices
Anti-caries
Anti-biofilm/anti-gingivitis
Anti-calculus
Anti-oral malodor (halitosis)
Anti-sensitivity
Selection of Dentifrices - Things to Consider
Prevention or reduction of oral disease
Considerations for the pediatric patient
Patient-specific dentifrice recommendations
Prevention or reduction of oral disease
Dental caries
Fluoride dentifrice during remineralization
Dentin hypersensitivity
Inflammation
Calculus formation
Oral malodor/reduction of VSCs
Considerations for the pediatric patient
Birth to first tooth eruption
Eruption of first tooth
2-5 year old
Purposes and uses for Mouthrinses
Before professional treatment
Self-care
Some types of mouthrinses
fluoride
Chlorhexidine (CHX)
Triclosan
Phenolic-Related Essential Oils
Which agent is the most effective antimicrobial and antigingivitis agent available for clinical use?
A) Chlorhexidine
B) Fluoride
C) Triclosan
D) Phenolic-related essential oils
A) Chlorhexidine is the correct answer.
Chlorhexidine is the most effective antimicrobial and antigingivitis agent available for clinical use.
Factors to Teach the Patient
Significance of ADA product acceptance seal
Ask DHCP about oral care products
Avoid impulse buying of dental products
Understand relationship between compliance and expected outcomes
Acid-forming
Acidogenic
chemical that is bacteriostatic or bactericidal
antimicrobial agent
a substance that causes contraction or shrinkage and arrests discharges
astringent
a chemical taht is used for therpeutic reasons
chemotherapeutic agent
treatment of disease by means of chemical substance or pharmaceutical agents
chemotherapy
Chlorohexidine
CHX
a substance with a high molecular weight that results from chemically combining two or more monomers
Co-polymer
the benefits of a product or procedure that lead to intended results such as reduction in gingivitis
Efficacy
substance contained in a product (such as in a dentifrice) to retain moisture and prevent hardening upon exposure to air
Hemuctant
activity relating to motions of fluids or the forces that produce or affect much motions; opposite of hydrostatic
hydrokinetic activity
a chemical that impacts the immunoinflammatory process causing either exacerbation or reduction.
inflammatory mediator
the ability of an agent to bind to the pellicle, tooth surface, and soft tissue and be released over an extended period of time with the retention of its potency
substantivity
process whereby the joint action of separate agents is greater than the sum of their effects taken separately
synergism
coordinated action; acting jointly; for example, one drug might enhance the effect of another drug
syngeristic effect
a chemical with therapeutic properties that is delivered by rinsing or irrigation device
therapeutic rinse
What is the primary agent that has shown efficacy in reducing gingival inflammation?
Triclosan
What is the most effective agent in commercial dentifrices for the reduction of dentin hypersensitivity?
5% potassium nitrate
Dentifrices shown to help inhibit supragingival calculus may contain
Pyrophosphate salts
Zinc salts (zinc chloride and zinc citrate)
Sodium hexametaphosphate
Triclosan/copolymer
What are preventive and therapeutic benefits of dentifrices?
prevention of dental caries
remineralization of early noncavitated dental caries
reduction of biofilm formation
reduction of gingivitis/inflammation
reduction of dentin hypersensitivity
reduction of supragingival calculus formation
Cosmetic effects of dentifrices
removal of extrinsic stain
reduciton of oral malodor (halitosis)
Substances used in detergents
sodium lauryl sulfate USP
sodium N-lauryl sarcosinate
Substances used in abrasives
Calcium carbonate
Phosphate salts
Hydrated aluminum oxide
Silica, silicates, and dehydrated silica gels
Types of binders used
Mineral colloids
Natural gums
Seaweed colloids
Synthetic celluloses
Substances used in humectants
xylitol
glycerol
sorbitol
substances used in preservatives
alcohol
benzoates
dichlorinated phenols
substances used in flavoring agents
zylitol
glycerol
sorbitol
Active components of dentifrices benefit in what areas?
anti-caries
anti-biofilm/anti-gingivitis
anti-calculus
anti-oral malodor (halitosis)
anti-sensitivity
How do you apply toothpaste for children less than two years old?
smear" toothpaste
For ages 2-5 years old, how do you apply toothpaste?
pea-sized
Classifications of mouthrinses
preventive
cosmetic
therpeutic
Functions of Chemotherapeutic Agents
Remineralization
Antimicrobial
Astringent
Anodyne
Buffering
Deodorizing
Oxygenating
Preventive and Therpeutic Agents of Mouthrinses
Fluoride
Chlorhexidine (CHX)
Triclosan
Phenolic-related essential oils
Quaternary ammonium compounds
Oxygenating agents
Oxidizing agents
What is the most effective antimicrobial and antigingivitis agent available for clinical use
CHX
What % solution is available in the US?
0.12%
What bacteria does it reduce?
Mutans streptocci
A cationic bisbiguanide with broad antibiacterial activity
CHX
Bisphenol and nonionic antimicrobial agent
Triclosan
What disrupts cell walls and inhibit bacterial enzymes
phenolic-related essential oils
Rupture the cell wall and alter the cytoplasm
Quaternary ammonium compounds
Alters bacterial cell membrane increasing permeability
oxygenating agents
neutralization of volatile sulfur compounds that contribute to oral malador
oxidizing agent
Characteristics of an Effective Chemotherapeutic Agent
Nontoxic
no or limited absorption
substantivity
bacterial specificity
low induced drug resistance
What are some inactive ingredients
water
alcohol
flavoring
Oldest consumer protection agency in the US federal government
Officially began in 1906 with the passage of the Pure Food and Drug Act
FDA
Purpose of FDA
regulates drugs, equipments, and devices
Clinical trial with small sample population (20-80)
Pre-clinical Phase I
Clinical trial with a larger sample population (100-200) who have disease or condition that the product is designed to treat
Pre-clinical Phase II
Clinical trial with a larger sample population (1,000 to 3,000) who have a disease or condition to test efficacy, monitor side effects, and identify treatment parameters
Pre-clinical Phase III
Clinical trials on products that are already approved and on the market
Pre-clinical Phase IV
What has promoted safety and effectiveness of dental products for over 125 years?
ADA
What is the Seal Program?
Listing of all ADA sealed products
What is the purpose of the Seal Program?
-to help the public and dental professionals make informed decisions about consumer dentla products
-To study and evaluate products for safety and efficacy, when used as directed
-To inform members of the dental team and the public about the safety and ef
What information is required for the ADA acceptance process?
-complete ingredient listing
-objective data from clinical and lab studies on product safety and effectiveness
-compliance with specific product category
-evidence of good manufacturing processes
How long is the acceptance good for?
5 years
What does the Seal Statement tell the consumer?
what specific claims have been reviewed and approved, and indicates why the particular product was accepted