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Oral Care Products

In document HSDM_guide2010_2011 (Page 59-62)

Toothpastes

Most toothpaste currently on the market is a combination of an abrasive, a foaming agent, and 1 or more therapeutic agents.

- Abrasives - Abrasives give toothpaste its cleaning power. They polish teeth by removing stains and plaque.

 Silica or hydrated silica

 Sodium bicarbonate

 Others: aluminum oxide, dicalcium phosphate, calcium carbonate - Foaming agents (surfactants/ detergents)

 Sodium lauryl sulfate – can be irritating to people with aphthous ulcers. Several brands make a toothpaste without this ingredient.

 Sodium methyl cocoyl taurate – alternative to sodium lauryl sulfate found in Sensodyne.

- Therapeutic agents

 Fluoride - Fluoride incorporates itself into tooth enamel making teeth more resistant to acid and inhibiting the ability of bacteria to produce acid.

 Stannous Fluoride – Tin fluoride was used in the first fluoride toothpaste because it could be used with the most common abrasive at the time (calcium phosphate). It also has antibacterial effect; however, it is believed that it also stains teeth gray.

 Sodium Fluoride – NaF is a commonly used fluoride, but can‘t be used with calcium based abrasives. This is not a problem now with the wide variety of abrasives available.

 Sodium Monofluorophosphate – Originally developed to avoid infringing on Crest patent for Stannous Fluoride. It can be used with calcium based abrasives.

 Desensitizing agents

 Potassium Nitrate – block pain transmission between nerve cells

 Strontium Chloride – block dentin tubules

 Anti-Tartar agents - remove calcium and magnesium from the saliva, so they can't deposit on teeth. Pyrophosphates do not remove tartar.

 Tetrasodium Pyrophosphate and other Pyrophosphates

 Antimicrobial agents - kill or stop the growth of bacteria in dental plaque

 Tricolsan – bactericidal compound found in Colgate Total.

 Zinc Citrate or Zinc Chloride – bacteriostatic compound found in some toothpaste.

 Whitening agents –

 Sodium carbonate peroxide – Breaks down into hydrogen peroxide. It is added to

"peroxide" toothpastes as a whitener and antibacterial agent.

 Hydrogen peroxide – oxidizing agent that removes stains (oxidizing reaction).

 Citroxane –a compound of Rembrandt toothpaste that disrupts stain through the combined action of papain, citrate and aluminum oxide. Papain is a proteolytic enzyme that is thought to whiten by dissolving the proteinaceous component of the stain. Citrate is added to enhance the activity of papain. Aluminum oxide is a mild abrasive

 Sodium hexametaphosphate – functions as a sequesterant / chelating agent to prevent tarter formation and staining. Used in Crest Pro-Health toothpaste.

60 Mouth Rinses

- Alcohol

- Therapeutic Agents

 Fluoride – typically sodium fluoride

 Antimicrobial agents -

 Chlorhexidine gluconate – bacteriostatic antiseptic for gram positive and some gram negative microbes. Used in mouth rinses: Peridex and PerioGard.

 Cetylpyridinium Chloride – antiseptic used in some mouth rinses to prevent plaque and reduce gingivitis. However, it has been shown to cause brown stains between teeth.

 Thymol

 Salivary enzymes - lysozyme, lactoferrin, glucose oxidase, and lactoperoxidase

 Anesthetics - menthol

Selected Brands and Products:

This list is not all inclusive. It is intended to be a sampling of several common or unique products available.

Keep in mind that this industry changes very fast and what may be here one day is off the market the next.

Also, many products with a particular name come in a variety of forms (eg Prevident 5000 toothpaste, Prevident rinse, Prevident 5000 varnish, etc)

Type Brand Product Notes

Toothpaste Colgate Total - Contains 0.30% Triclosan

- Contains 0.243% sodium fluoride (1094 ppm F ion)

Colgate Sensitive

- Contains 5% potassium nitrate

- Contains 0.45% stannous fluoride (1125 ppm F ion) Colgate Simply White - Contains hydrogen peroxide and abrasives

- Contains 0.243% sodium fluoride (1094 ppm F ion)

Colgate Prevident 5000 - Prescription needed

- Contains sodium fluoride (5000ppm F ion) Crest

(Proctor & Gamble)

Pro-Health - Polyfluorite system which is the combination of stannous fluoride with sodium hexametaphosphate

Crest

(Proctor & Gamble)

Sensitivity - Contains 5% potassium nitrate

- Contains 0.15% sodium fluoride (675 ppm F ion) Crest

(Proctor & Gamble)

Vivid White - Contains hydrated silica abrasive and sodium hexametaphosphate

- Contains 0.243% sodium fluoride (1094 ppm F ion) Rembrandt

(Johnson & Johnson)

Naturals - No foaming agent (sodium lauryl sulfate)

- Claim to have flavor derived from natural sources Aquafresh

(GlaxoSmithKline)

Sensitive Maximum Strength

- Contains 5% potassium nitrate

- Contains 0.15% sodium fluoride (675 ppm F ion) Sensodyne

(GlaxoSmithKline)

Original - Contains sodium methyl cocoyl taurate (foaming agent alternative)

Biotene Oral Balance Toothpaste - No foaming agent (sodium lauryl sulfate)

- Contains: lactoperoxidase, glucose oxidase, and lysozyme Tom‘s of Maine Natural with Propolis

and Myrrh

- This product contains no fluoride, but be careful because other products from this brand may have fluoride Mouth Chattem ACT - Contains 0.5% sodium fluoride (220 ppm ion)

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Rinse

Colgate Fluorigard - Contains 0.5% sodium fluoride (220 ppm F ion) Colgate Prevident 5000 - Contains sodium fluoride (2000ppm F ion)

Crest Pro-Health - Contains Cetylpyridinium Chloride

- May cause staining of teeth

Johnson & Johnson Listerine - Contains Ethanol (solvent), Thymol (antiseptic), and menthol (local anesthetic)

Biotene Oral Balance Mouth Rinse - Contains lysozyme, lactoferrin, glucose oxidase, and lactoperoxidase

Colgate Periogard - Prescription needed

- Contains 0.12% chlorhexidine gluconate

3M Peridex - Prescription needed

- Contains 0.12% chlorhexidine gluconate Fluoride:

Gel/ Foam/

Varnish

Colgate Prevident 5000 Gel - Prescription needed

- Contains 1.1% sodium fluoride (5000ppm F ion)

Colgate Phos-Flur Gel - Prescription needed

- 1.1% acidulated phosphate fluoride gel

Colgate Gel-Kam - OTC topical gel

- Contains 0.4% stannous fluoride (1000 ppm F ion)

Colgate Prevident 5000

Varnish

- In Office

- 5% sodium fluoride (22,600ppm F ion)

Colgate Duraphat Varnish - In Office

- 5% sodium fluoride (22,600ppm F ion)

Oral B Minute Foam/ Gel - In Office

- Acidulated phosphate fluoride (17,690ppm F ion)

Oral B Neutra Foam - In Office

- 2% Sodium fluoride

Medicom DuraFlor - In Office

- 5% sodium fluoride (22,600ppm F ion)

Whitening Crest White Strips - In Office formulations: Professional 6.5% hydrogen peroxide, Supreme 14% hydrogen peroxide - Retail formulations also available

Denture Crest Fixodent - Denture adhesive

Other OraPharma Arrestin - Minocycline microspheres

- Used in treatment of some avulsed teeth and as a locally acting antibiotic in periodontal disease

PharmaScience Fluor-a-day tablets - Prescription needed

- Sodium fluoride tablets available as 0.25mg, 0.50mg, 1mg

Orajel Maximum Strength

Gel

- Used for canker sores - Contains benzocaine

MGI Salagen - Prescription needed

- Contains 5 mg pilocarine - cholinergic salivary stimulatant

Calculating Fluoride Content

(% Stannous Fluoride) * (0.25) = % F ion (% F ion) * (104) = F ppm

(% Sodium Fluoride) * (0.45) = % F ion (% F ion) * (104) = F ppm

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In document HSDM_guide2010_2011 (Page 59-62)