Susan M Hooper

A randomised in situ trial, measuring the anti-erosive properties of a stannous-containing sodium fluoride dentifrice compared with a sodium fluoride/potassium nitrate dentifrice

OBJECTIVES To determine if a stabilised, stannous-containing sodium fluoride dentifrice provides greater enamel protection in situ against intraoral dietary erosive challenges compared with a sodium fluoride/potassium nitrate dentifrice. METHODS A single-centre, investigator blind, randomised, supervised, two-treatment, non-brushing, four-period crossover in situ study was undertaken, with each test period being 15 days. Thirty-five healthy adult subjects were recruited to participate in the study, which included four erosive acid challenges per day. Subjects were randomised to product treatment, which included either: (1) a stannous-containing sodium fluoride dentifrice (Oral-B(®) Pro-Expert Sensitive) or (2) a sodium fluoride/potassium nitrate dentifrice (Sensodyne(®) Pronamel(®) ). Each study subject wore an intraoral appliance retaining two sterilised, polished human enamel samples for 6 hours/day. Subjects swished with an allocated dentifrice slurry twice a day and with 250 ml of orange juice for 10 minutes (25 ml/minute over a 10-minute period) four times per day. The primary and secondary outcomes for this study were enamel loss measured using contact profilometry at days 15 and 5, respectively, using parametric analysis methods. RESULTS At day 15, a 38% lower enamel loss (P < 0.0001) was observed, with estimated medians of 2.03 μm (SE 0.247) and 3.30 μm (SE 0.379), in favour of the stannous-containing dentifrice. At day 5, specimens treated with the stannous-containing sodium fluoride dentifrice demonstrated 25% less enamel loss than those treated with the sodium fluoride/potassium nitrate dentifrice. Treatment differences at day 5 were also statistically significant (P < 0.05), with estimated medians of 1.37 μm (SE 0.177) and 1.83 μm (SE 0.223), respectively. CONCLUSIONS Results of this in situ study suggest the stabilised, stannous-containing sodium fluoride dentifrice could be used to provide significantly greater protection to enamel from erosive acid challenge compared with that provided by conventional fluoride-containing products.

The erosive effects of saliva following chewing gum on enamel and dentine: an ex vivo study

Objectives The primary objective was to determine the erosive effect of expectorated saliva, following chewing acidic gum, on enamel and dentine samples, using a non-acidic gum as a negative control. Secondary objectives were to determine the effect of brushing enamel and dentine samples and the effect of individual saliva pH and buffering.Design A single-centre, single-blind, placebo-controlled, two-way crossover study.Setting A clinical trial, involving healthy participants, undertaken at Bristol Dental School and Hospital.Methods Eight healthy participants expectorated saliva onto prepared enamel and dentine samples while chewing gum (strawberry flavoured acidic gum [active] or peppermint flavoured non-acidic gum [control]). Half of the enamel and dentine samples were brushed before measurement by contact profilometry.Main outcome measures Mean enamel and dentine erosion, with and without brushing and the relationship to salivary buffering.Results At 10 days, mean depth of surface loss from dentine samples (95% CI), following chewing of acid-containing gum and subsequent brushing, was −11.34 μm (2.22 μm) and from un-brushed dentine samples was −11.02 μm (1.71 μm). No significant erosion was noted for other groups.Conclusions Frequent chewers of acid-containing gums are susceptible to dentine erosion even in the presence of good salivary buffering. Enamel erosion was insignificant within the time constraints of the present study but warrants further investigation.

A randomised clinical study to measure the anti-erosion benefits of a stannous-containing sodium fluoride dentifrice

Background: To compare the enamel protection efficacy of stannous-containing sodium fluoride and sodium monofluorophosphate (MFP)/triclosan dentifrices marketed in India in an in situ erosion model with acidic challenge. Materials and Methods: This randomised and controlled, in situ, supervised, double-blind clinical trial employed a two-treatment, four-period crossover design, wherein subjects wore an appliance fitted with human enamel samples 6 h/day during each 10 day treatment period and swished twice daily with their assigned dentifrice slurry: Oral-B ® Pro-Health (maximum 1,000 ppm F as sodium fluoride with stannous chloride) or Colgate ® Strong Teeth with Cavity Protection (maximum 1,000 F as sodium MFP and triclosan). Subjects swished with 250 ml of orange juice over a 10 min period after each treatment and twice daily for the acidic erosive challenge. Enamel samples were measured for tooth surface loss using contact profilometry at baseline and day 10. Results: A total of 34 subjects were randomised to treatment; 32 subjects completed the final visit. Baseline profilometry measurements of the specimen surfaces were near zero within ± 0.3 μm, and no statistically significant difference (P > 0.48) on average was observed between the two test dentifrices. At day 10, the stannous-containing dentifrice demonstrated 88% less erosion (P < 0.0001) relative to the MFP/triclosan dentifrice. Estimated medians (95% confidence intervals) were 0.21 μm (0.17, 0.25) for the stannous-containing dentifrice versus 1.66 μm (1.39, 1.99) for the MFP/triclosan dentifrice. Both dentifrices were well-tolerated. Conclusions: Compared with MFP/triclosan toothpaste, a stabilised stannous-containing sodium fluoride dentifrice gave statistically significantly greater protection against tooth enamel surface loss in situ following repeated acid erosive challenge.