ORAL CARE

Zenaida B. Soriano,MS

Senior ASEAN Expert

Cosmetics

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ORAL CARE PRODUCTS

1. Toothbrush

2. Dentifrice

3. Oral Rinses

ORAL ENVIRONMENT

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ORAL ENVIRONMENT

TeethGingiva / MucosaSaliva

PlaqueTartar

CariesPeriodontal Disease

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ORAL ENVIRONMENTTEETH

Enamel – hard, white outer covering surrounding the crown of the tooth. Consists of inorganic substances, calcium and phosphate.

Cementum – thin, bone-like material covering the root. Also consists of inorganic substances.

Dentin – a yellow bone-line material under the enamel Provides support Forms bulk of tooth Composed of collagen (20%) and calcium phosphate (75%)

Pulp – soft tissue in the center of the crown and root Contains nerves, blood vessels and lymph vessels Produces dentin Provides nourishment for tooth Functions as a sensory signal of injury

Pellicle – thin salivary film covering the tooth composed of proteins and lipids

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Figure 1: Diagrammatic Sketch of the Tooth and Periodontal Tissue

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Figure 2: The Palatal Surface of the Upper Jaw

A diagrammatic representation of palatal surface of the upper jaw, with a full complement of permanent teeth

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Figure 3: The Maxillary Teeth

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Figure 4: The Mandibular Teeth

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Figure 5: The Deciduous Teeth

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Figure 6: The Permanent Teeth

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Table 1: Approximate Age of Tooth Eruption

AGE AT ERUPTION

6 months7 1/2 months

7 months9 months

12-14 months16-18 months20-24 months

6-7 years6-8 years7-9 years9-12 years

10-12 years10-12 years11-13 years17-21 years Third molars

TOOTH

Cuspids First bicuspids Second bicuspids Second molars

Permanent teeth First molars Central incisors Lateral incisors

Upper lateral incisors First molars Cuspids Second Molars

Deciduous teeth Lower central incisors Upper central incisors Lower lateral incisors

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ORAL ENVIRONMENTGINGIVA / MUCOSA

Gingiva – dense fibrous tissue surrounding necks of teeth Covered by a smooth mucous membrane which bleeds easily when

penetrated Also called “periodontal tissue” or “gums”

Oral mucosa – “mucous membrane” lining the mouth

Peridontium - attachment apparatus consisting of Gingiva Cementum Periodontal ligament Jawbone Oral mucosa

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ORAL ENVIRONMENTSALIVA

A complex fluid secreted by salivary glands containing water, mucin, proteins, salts and enzymes.

Functions: aids in digestion lubricates both hard and soft tissues buffers cariogenic acids forms the pellicle provides minerals for repairing enamel / cementum

(remineralization) delivers antimicrobial agents (immunoglobulins, enzymes, etc.)

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ORAL ENVIRONMENTPLAQUE

Soft sticky, invisible film constantly forming in your mouth. Covers teeth and gums.

Oral mucosa cells Saliva Bacteria

Can be removed by brushing and flossing.

Gram + cocci Gram + rods Gram – anaerobes(healthy mouth) (gingivitis)

Formation / progression influenced by: Diet Host immune system Oral environment

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Inhibition of Plaque Accumulation

Measures Proposed

Increase in Total Numbers

Increase in Specific Bacterial

PopulationsInterbacterial

Adhesion

1. Keep tooth clean, free of pellicle, e.g., by toothbrushing

1. Use broad-spectrum anti-bacterial agents

Introduce specific measures, e.g.,

vaccines

Apply Ca2+ antagonists; destroy matrix, e.g., with proteolytic enzymes

2. Interfere with bacterial attachment mechanisms, e.g.,

with Ca2+ antagonists2. Remove mechanically with toothbrush, floss, etc.

3. Attack dextran and other adhesive bacterial secretions, e.g., with dextranases

4. Alter surface of tooth by physical-chemical means

Increase in Microbial Population

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ORAL ENVIRONMENTTARTAR

Calcification (crystallization of minerals) on the surface of the tooth formed mainly in the presence of plaque.

Rough surface promotes further growth of plaque Stains easily (yellow / brown) Most prevalent near salivary glands and around necks and roots of teeth Removed only by dentist

Tartar Control Agents (Pyrophosphate) Acts as crystal “poisons” to stop formation Easily degraded by oral enzymes / stabilized by fluoride and Gantrez.

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ORAL ENVIRONMENTCARIES

A progressively destructive, infectious disease resulting in: Demineralization of enamel / cementum Bacterial penetration to pulp Formation of macroscopic activity

Caries promotion Caries reductiondietary carbohydrate increased salivary flowreduced salivary flow reduced plaquecariogenic bacteria fluoride

Sound enamelplaque acid prod

mineral loss

salivaacid neutralization

mineral gain(fluoride)

Lesions

Cavity

COMPOSITION & CHEMISTRY OF DENTIFRICES

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COMPOSITION & CHEMISTRY OF DENTIFRICES

DENTIFRICE:A dentifrice is a substance used with a toothbrush for the purpose of cleaning the accessible surfaces of the teeth (American Dental Association)

TOOTHPASTE:

Toothpaste is a colloidal suspension of a mixture of ingredients that must be carefully balanced in order to provide an efficacious, safe, and consumer friendly product

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TOOTHPASTE INGREDIENTS

Abrasive Binder Humectant Sweetener Flavor Surfactant

Active Ingredients

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ABRASIVE

Function: Cleaning and polishing

Characteristics: Solid, insoluble particles Abrasive Potential for fluoride interaction

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ABRASIVE

Types :

Silica Phosphate Salts – ie “Dical” Carbonates – ie Calcium Carbonate or Chalk Others

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Radioactive Dentin Abrasion Method

This procedure involves the use of accelerated toothbrushing apparatus and dentin section that contain radioactive phosphorous. The ADA standard was set at 100, which corresponds to RDA value of 475.

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Figure 7: In-vitro Abrasion Studies, RDA

This photograph shows a two-brush model abrasion machine, which is used in in vitro dentifrice abrasion studies.

Source: Stallard, Richard E. A Textbook of Preventive Dentistry (Second Edition).

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Comparative Abrasiveness of some Commercially Available Dentifrices as Determined by a Radioactive Dentin Procedure

Source: Stallard, Richard E. A Textbook of Preventive Dentistry (Second Edition).

DENTIFRICE MANUFACTURER PRINCIPAL ABRASIVE

ABRASIVITY INDEX

Sensodyne Block Drug Co. Silica 157Vote Bristol-Myers Co. Silica 134Plus White Plus Bishop Industries, Inc. Dicalcium Phosphate (anhydrous) 132Plus White Bishop Industries, Inc. Dicalcium Phosphate (anhydrous) 110Gleem II Procter and Gamble Co. Calcium Pyrophosphate 106Macleans (old formulation) Beecham Products, Inc. Calcium Carbonate 93Crest (Mint and Regular) Procter and Gamble Co. Calcium Pyrophosphate 88Close-Up Lever Brothers Co. Silica 87

Pearl Drops Carter-Wallace, Inc.Alumina and Dicalcium Phosphate (dihydrate) 72

Macleans (new formulation) Beecham Products, Inc. Dicalcium Phosphate (dihydrate) 68Ultra Brite Colgate-Palmolive Co. Dicalcium Phosphate (dihydrate) 64Colgate with MFP Colgate-Palmolive Co. Insoluble Sodium Metaphosphate 51Pepsodent Lever Brothers Co. Dicalcium Phosphate (dihydrate) 26

Thermodent Chas. Pfizer and Co.Magnesium Carbonate (basic) and Calcium Carbonate 24

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BINDER

Function:Used to stabilize toothpaste formulations to prevent separation of the liquid and solid phases

Characteristics:Can be natural or synthetic

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BINDER

Types:

Natural Polymers Carboxymethyl Cellulose (CMC) Carrageenans Xanthan Gum

Synthetic Polymers Others

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HUMECTANT

Function: Used in toothpaste to prevent loss of water and

subsequent hardening of the product upon exposure to air

Characteristics: Affect taste perception Proper usage level produce a clear translucent toothpaste

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HUMECTANT

Types:

Glycerine Sorbitol Polyethylene Glycol Xylitol Propylene Glycol

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SWEETENER

Types:

Sodium Saccharin Sodium Cyclamate Acesulfame K

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SWEETENER

Function: An important part of toothpaste flavoring system

Characteristics: Government regulations

Non-cariogenic

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FLAVOR

Function: Improve taste of toothpaste

Characteristics:

One of the most important factors for consumer

A mixture of flavoring agents

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FLAVOR

Types:

Minty Fruity Medicinal Cinnamon

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Oral products have a unique and specialized flavor requirements. To be successful in oral products, a flavor must:

Have a pleasant taste while brushing Leave a pleasant taste in your mouth after

brushing Be compatible with the base

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All factors being roughly equal – “mouthfeel” appearance, perceived therapeutic attributes, etc. – the consumer will look to flavor as the determinant in selecting a product for use day after day and year after year.

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SURFACTANT

Function: Produce foam and aid in the removal of debris

Emulsifies flavoring agents

Characteristics:

May react with other toothpaste components

High level may cause mucosal irritation

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SURFACTANT

Types:

Sodium Lauryl Sulfate Sodium N-Lauroyl Sarcosinate Sodium Dodecyl Benzene Sulfonate PEG Oil

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FLUORIDE ACTIVES

Function: Increase resistance to enamel solubility

Characteristics:

Regulated by Government

Restricted usage level

Soluble fluoride ion is essential for activity

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FLUORIDE ACTIVES

Types:

Sodium Fluoride NaF

Sodium Monofluorophosphate MFP

Stannous Fluoride SnF2

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Anticaries Dentifrices: FDA Tentative Final Monograph

Package size limitation

Identity (labeling)

Indications

WarningsDirections

Aids in the prevention of dental caries or cavities or decay (as deemed appropriate by the manufacturer); misleading statements not permitted

"Adults and children 2 years of age and older; brush teeth thoroughly at least once daily or as directed by a dentist. Children under 6 years of age should be supervised in the use of this product." Also for stannous fluoride dentifrices, "This product may produce surface staining of the teeth. Adequate toothbrushing may prevent these stains which are not harmful or permanent and may be removed by your dentist."

None required for dentifrices

Anticaries active agents (category I)

Package shall not contain more than 260 mg total fluorine per package

Contains established name of drug; identifies product as "anticavity", "fluoride", "dentifrice", or "toothpaste", as appropriate

Sodium fluoride, 0.22%Sodium monofluorophosphate, 0.76%Stannous fluoride, 0.4%

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OTHER ACTIVES

Tartar PolyphosphatesZinc Citrate

Plaque / Gingivitis TriclosanSnF2Chlorhexidine

Zinc Citrate

Desensitizer Potassium Nitrate

Whitening Calcium PeroxideHydrogen Peroxide

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TYPICAL COMPOSITION

Ingredients Weight %

Humectants 60 – 20

Water 0 – 50

Binders 0 – 12

Abrasive 18 – 50

Flavor 0.5 – 2.0

Sweetener 0.2 – 1.0

Surfactant 0.5 – 2.0

Fluoride 0.2 – 1.2

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U.S. FORMULA COMPARISONIngredients Colgate P&G Unilever SKB

Humectants Glycerin Glycerin Glycerin GlycerinSorbitol Sorbitol Sorbitol SorbitolPEG PEG PEG PEG

Binders CMC Xanthan CMC CMCCarrageenan Carbopol CarrageenanXanthan

Abrasive Silica Silica Silica PCCDical SilicaPCC

Flavor Mint Mint Mint MintSweetener Saccharin Saccharin Saccharin SaccharinSurfactant SLS SLS SLS SLSFluoride NaF NaF NaF MFP

MFP SnF2 MFPSnF2

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TOOTHPASTE CONSIDERATIONS

Safety Efficacy Consumer Friendly

Pleasing taste Ease of use Pleasing appearance

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PRODUCT CRITERIA

Minimum one year shelf life Easily dispensable Compatible with the package Efficacious Safe

MOUTHWASHES or ORAL RINSES

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Ingredients of Dentifrices and Oral Rinses

Dentrifrice Oral RinseTherapeutic agent(s) Therapeutic agent(s)

Abrasive -Surfactant(s) Surfactant(s)Humectant(s) Humectant(s)Flavor Flavor

- Ethanol

Thickener(s) -Coloring ColoringWater Water

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Mouthwash ComponentsIngredient Function

Alcohol

Adds bite and freshness. Enhances flavor impact. Helps solubilize some flavor components. Contributes to cleansing action and antibacterial activity.

Flavor

Makes mouthwash pleasant to use. Adds a refreshing, cool quality to oral cavity immediately and for some time after use. Makes breath temporarily pleasant by imposing a pleasant note over breath aroma. Some flavors exert significant antibacterial effect.

HumectantAdds "body" to product, inhibits crystallization around closure.

Surfactant

Used for solubilization of flavor. Provides foaming action. Assists removal of oral debris by lowering surface tension. Can be antibacterial. (Selection is critical in antibacterial mouthwashes; must be compatible with antibacterial active.)

Water Major vehicle to carry other ingredients.

Special ingredients: Antibacterial agent To enhance antibacterial efficacy.

Astringent salts Can interact with proteins of saliva and oral mucosa. Chlorophyllins For topical deodorization. Fluoride Anticaries agent.

Thank You