John K. Peterson

Effectiveness of an Acidulated Phosphate Fluoride-Pumice Prophylactic Paste: A Two-Year Report

The cariostatic potentiality of an acidulated phosphate fluoride-pumice prophylactic paste was tested on children in grades 5 through 7 in a fluoridated community and in a nonfluoridated community. Measurements of effectiveness were made by one examiner without the use of radiographs; a second examiner made the measurements with and without the use of radiographs. The only significant differences (<0.05) were found in the nonfluoridated community.

Clinical Science Influence of Alkaline pH on the Effectiveness of Sodium Fluoride Dentifrices

Two similar sodium fluoride dentifrices, one neutral and one alkaline, were compared to a placebo for clinical effectiveness in reducing caries. The neutral dentifrice contained 35% less soluble fluoride than the alkaline dentifrice. Both fluoride dentifrices were significantly effective but were not different from each other.

Relative caries-inhibiting value of sodium silicofluoride and sodium fluoride.

M ASSLER* has reported that a saturated (0.9 per cent) sodium silicofluoride solution is a great deal more effective than sodium fluoride in making tooth enamel resistant to acids in vitro. The Section of Dental Health of the Minnesota Department of Health, with the assistance of the University of Minnesota School of Dentistry, the Minnesota Dental Foundation, and the Health Council, P.T.A., and school personnel of Mound, Minnesota, began in April, 1953, a clinical experiment in the Mound schools to measure the possible value of sodium silicofluoride as a caries-preventive measure. A total of 610 children in Grades 3 through 7 received treatments in 1953 in the 3 different projects of the program. Each received a detailed dental examination (with the use of a portable dental chair, operating light, explorer, and an anterior and two posterior bite-wing roentgenograms), a prophylaxis, and a varying number of 0.9 per cent sodium silicofluoride and 2 per cent sodium fluoride topical treatments depending on which of the three projects they were in. Children in Projects I received 4 treatments of sodium silicofluoride on one side of the mouth and 4 of sodium fluoride on the other. A clerk designated, by marking alternately, which side of the mouth was to be treated with each solution. Each child carried to the operator a slip on which this information was marked. Children in Project II received 2 sodium silicofluoride treatments on one side of the mouth and nothing on the other side. Children in Project III received 1 treatment of sodium silicofluoride on one side and 4 treatments of sodium fluoride on the other side of the mouth. Each treatment consisted of isolating the teeth on one side of the mouth by a cotton roll on the lower lingual and a continuous cotton roll on the upper and lower buccal, both held in place with a cotton-roll holder. The teeth were then dried thoroughly with compressed air and saturated with the designated solution. A mouth prop was used on the buccal to hold the cotton roll above the upper teeth during the 4-minute treatment. The multiple-chair technique developed by the U.S. Public Health Service was used. Most treatments were completed in 4 consecutive days, although a few children had skipped days and a few had more than 1 treatment in 1 day.

THE CURRENT STATUS OF THERAPEUTIC DENTIFRICES

Dentifrice sales now total more than 250 million dollars a year in this country. Each one percent is worth 2 % million dollars in sales. Before the American Dental Association Council of Dental Therapeutics’ initial recognition of the anticaries properties of a dentifrice, the extent of each manufacturer’s share of the market was largely determined by the size and success of its advertising campaign. The manufacturers actually had a formula telling them how much needed to be spent on advertising in order to get and hold a certain percentage of the market. At the time Crest6 was recognized with a Group B classification in 1960, it had 12% of the market, compared to 23% for Gleem@ and 35% for Colgate @. Crest sales then rapidly climbed to 35 percent. I do not know how much more Crest spent on advertising, but the company’s sales increased by more than 50 million dollars a year in a very short time. I suspect that Crest has an even larger share of the market now. We in Dentistry and Dental Public Health have been caught in a peculiar dilemma. We want to recommend to our patients and communities the best available dentifrice (indeed, we are morally obligated to do so). And yet, those of us in public health, particularly, are extremely reluctant or even forbidden to recommend a specific brand name. We should be more comfortable if we could recommend a type of dentifrice and know that all brands of this type have similar effectiveness. Perhaps that day is now a t hand, a t least as far as stannous fluoride dentifrices are concerned. Most dentifrice tests have been with those formulated with the hope of inhibiting caries. Most of my discussion will be concerned with these. However, there are reports (and some additional rumors) of dentifrices designed to inhibit plaque and calculus formation, as well as others purported to relieve hypersensitive teeth.