Toothpaste Technologies - Semmelweis Egyetem Toothpaste Technologies A Short History of Toothpaste...

Toothpaste Technologies
A Short History of Toothpaste
500 BC Toothpowders used by ancient Greeks
400 AD Romans added astringents and other “therapeutics“ to the
abrasives ( chrushed bones ) - the start of "formulation„
1892 Dr W Sheffield – “Cream Dentrifice” in collapsible tube
1900-1950s Improvements in aesthetics were made including foaming,
flavouring and sweetening and replacement of toothpowders with
toothpastes
1955 P&G launched first mass market Fluoride toothpaste
1985 P&G launched the first mass market Tartar Control
toothpaste
1990s P&G, Colgate, Lever, SKB etc. launched anti-microbial,
Triclosan-containing toothpastes

Statement of FDI (International Dental Association) and WHO
 Widespread use of fluoride toothpaste*
 Preventive dental education
 Availability of regular dental visits
Main reasons for caries reduction in the
industrialized western countries:
* toothpaste consumption at proper dental hygiene:
12 tubes/person/year
in Hungary: ~ 2,4 tube/person/year
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Fluoride toothpaste is the most frequently used topical fluoride agent
Modified from the World Health Organization, 1994
Estimate of the numbers of people in the world using various types of fluoride
therapy.
CLINICAL
TOPICALS MOUTHRINSES DROPS/TABLETS SALT
FLUORIDATION
WATER FLUORIDATION FLUORIDATED
TOOTHPASTE
0 10
0
20
0
30
0
40
0
500 MILLION
S
20
20
20
40
210
450

Current understanding of fluoride action:
predominant caries inhibitory effect of
fluoride is the topical, posteruptive effect
inhibition of demineralization enhancement of remineralization fluoride incorporation into the enamel
J.M. ten Cate, J.B. Featherstone: Fluoride in Dentistry, Munksgaard, 1996
posteruptively important
during the tooth development (little effect)

Fluoride dentrifice should be used daily for
toothcleaning to control development and
progression of dental caries lesion
at all ages, but young children should be
supervised
enamel caries
root caries
50 % reduction 67 % reduction

European Academy of Pediatric Dentistry ( EADP) 2000
Age Fluoride
conc
(ppm)
Frequency of
brushing
daily
Amount of toothpaste
6 mont -2year
low F
toothpaste
max 500 ppm
1x small, film layer
2 – 6 year max. 500 2 x small pea size - or nail
Above 6 year 1000-1450 2 x 1/3 – 1/2 brush head
* Oulis, Raadal, OuMartens. Guidelines on the use of fluoride in children: an EAPD policy document.
European Journal of Pediatric Dentistry;1/2000: 7-12

Use of fluoride toothpaste
Recommendations*
Age group
Fluoride concentration (ppm)
Daily use Amount to be used
6 month-2years 500 ppm twice Pea- size
2 – 6 years 1000 (+) ppm twice Pea- size
6 years and overl 1000-1450 twice 1-2 cm
European Archives of PEDIATRIC DENTISTRY
Fluoride Symposium EAPD F guidelines
Volume 10 (Issue 3) Sept. 2009

Transformation of active - inactive lesion
effect of 3 month active oral hygiene
Textbook of Clinical Cariology
Thylstrup & Fejerskov
Munksgaard 1999

Typical Toothpaste Composition
Humectants
34%
Water
34%
Actives
5%
Binder
1%
Surfactant
2%
Buffers
2%
Flavour
1% Colourants
1%
Abrasives
20%

Acives
5%
Anti-cavity e.g. Fluoride salts
Tartar control e.g.
Pyrophosphate
Antimicrobial e.g. Triclosan,
CPC, Zinc salts, Stannous salts
Ingredients : Actives

Fluoride in Toothpaste – Mode of Action
Ca
P P
P
P P
P
P
P
Ca
Ca Ca
Ca
Ca
Ca
Ca Ca
Ca
Ca10(PO4)6(OH)2
Saliva
Free fluoride promotes
from dentifrice retention / formation

Role of Fluoride • Enhance the remineralization process
• Decrease enamel solubility
17

More free fluoride
Faster More
Enamel Fluoride uptake
Smaller initial lesions
Less clinical caries
NaF

Healthy tooth enamel before bacteria acid attack
Demineralized enamel- bacteria acid breaks tooth enamel down
Remineralized enamel- fluoride and minerals in saliva build tooth enamel up
F- F- F-
20
Fluoride Rebuilds Enamel Every Time You Brush

Fluorides
Nátriumfluorid Nátrium
monofluorofoszfát Ónfluorid Aminfluorid

Type of Fluoride Toothpaste
Sodium Fluoride (NaF) blend-a-med EXPERT Enamel Protection, blend-a-
med EXPERT Gums Protection, blend-a-med EXPERT
Sensitive, Oral-B Sensitive, Colgate Total, Sensodyne
F, Odol Med 3, Signal, Parodontax,
,
Sodium Monofluorophosphate
(SMFP) (Na 2 FPO
3 )
Aronal, several Colgate variants (Cavity Protection,
Sensitive)
Stannous Fluoride (SnF 2 ) blend-a-med EXPERT Gums Protection, Meridol,
Amine fluoride (AmF)
(primarily in Europe)
Elmex orange, Meridol
Aluminium Fluoride (AlF3) Lacalut Active

Are all Fluorides The Same?
NaF
Na 2 FPO
3
(SMFP)
SnF 2
AmF AlF 3
Stops de-mineralization
 



Enhances re-
mineralization





Mechanism
creates F-
apatite
creates F-
apatite
creates F-
apatite
creates F-
apatite
No data
Fluoride delivered directly or
chemically changed to release
F -
directly Hydrolysis
(enzyme
action)
directly Indirect
(complex
reaction)
directly
Anti-bacterial properties
none none 

none
Anti hypersensitivity
properties
none
none 
none none

Sodium Fluoride (NaF) - Results
NaF results in better cavity protection than SMFP 2
A v e r a g
e %
c a r i e s r e d
u c t i o
n v s p
l a c e b
o
0
10
20
30
40
50
NaF SMFP
2 Stookey,G. et al: A Critical Review of the Relative Anticaries Efficacy of Sodium Fluoride and
Sodium Monofluorophosphate Dentifrices. Caries Res 1993;27(4):337-60.

Nachnani J Dent Res 2008 87 (Spec Issue B) Abstract 2864
* p

Common agents used for plaque and gingivitis in global toothpaste
SF= Stannous Fluoride
CHX = Chlorhexidine
CPC = Cetylpyridinium chloride
SF T
T
SF T T CHX
CPC
T = Triclosan
T

Abrasives
20%
Removes stain, increases
“solidity”
e.g. Silica, Alumina, Calcium
Carbonate etc. (not baking
soda)
Ingredients : Abrasives

 Silica – Mechanism of Action
 Particles of silica move with bristles of toothbrush
 Particles penetrate the protein layer (pellicle) in which extrinsic stain is located
 Brushing action drags the silica particles across the enamel and remove the stained pellicle
 Abrasivness/Cleaning Effects depends on silica level
 (grittyness)

 Enamel Safe Stain Removal
 Hand brush acrylic lenses with toothpaste for 2-4 minutes
 When held up to light scratching may be seen if toothpaste is
abrasive
Abrasive Whitening
toothpaste (alumina)
Complete 7

 Active Ingre

Toothpaste Technologies - Semmelweis Egyetem Toothpaste Technologies A Short History of Toothpaste...

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