A new in vitro study has provided valuable insights into the impact of various toothpaste types on enamel and dentine, offering key implications for managing and preventing erosive tooth wear. The study, published in BMC Oral Health, evaluated whitening, fluoride-containing, and fluoride-free toothpastes, revealing notable differences in how they influence dental surfaces.
Key Findings on Toothpaste Effects
The research highlighted that whitening toothpastes can exacerbate dental erosion by increasing the surface roughness of both enamel and dentine. This effect may worsen tooth wear over time. In contrast, the effectiveness of fluoride-free toothpastes varied significantly depending on their active ingredients. Some fluoride-free formulations offered minimal protection against erosive damage, suggesting that not all such toothpastes are equally effective.
The global increase in erosion lesions has led researchers to investigate effective toothpaste formulations that can protect tooth surfaces from acid attacks. However, there is still no consensus on which toothpaste ingredients provide the best defense against erosive tooth wear. This uncertainty emphasizes the need for further research in this field. To address this gap, researchers Betül Kübra Kurucu Karadeniz and Emel Karaman from Turkey examined how different toothpaste formulations prevent enamel and dentine erosion.
Research Methodology
The study utilized 90 recently extracted bovine incisors, which were prepared by separating the crowns and roots and grinding them flat to create smooth enamel and dentine surfaces. These specimens were then divided into six groups, each using a different toothpaste formula:
- Curaprox Enzycal Zero Fluoride (fluoride-free)
- Colgate Total 12 (1450 ppm NaF)
- Splat Biocalcium (fluoride-free, Nano-HAP)
- Colgate ProRelief (1450 ppm NaF, arginine)
- Sensodyne Repair and Protection (1450 ppm NaF, novamin)
- Opalescence Whitening (1100 ppm NaF)
The specimens were exposed to a demineralizing solution for two minutes followed by artificial saliva for 60 minutes, repeated four times daily for five days. Brushing with a charged toothbrush was done at the start and end of each erosive cycle. Surface roughness was measured on the fifth day using a 3D profilometer, and comparisons were made using the Wilcoxon test to identify changes in roughness levels following treatment.
Results and Insights
The study revealed the following key outcomes:
Opalescence Whitening and Curaprox Enzycal Zero Fluoride significantly increased surface roughness in both enamel and dentine compared to baseline levels. These groups exhibited the roughest surfaces, with the exception of Colgate ProRelief.
Sensodyne Repair and Protection produced the smoothest enamel surfaces, suggesting a strong protective effect on enamel.
Colgate Total 12 led to the smoothest dentine surfaces, showing its effectiveness in protecting dentine from erosion.
Enamel samples in the Opalescence Whitening group exhibited a greater increase in surface roughness compared to dentine samples, indicating that whitening formulations are more damaging to enamel than to dentine.
Conclusions and Implications
The study concluded that whitening toothpastes, in general, increase both enamel and dentine surface roughness, with enamel showing significantly more damage. Toothpastes containing fluoride, fluoride combined with novamin, and fluoride combined with arginine were found to be effective in preventing dental erosion. However, the protective effects of fluoride-free toothpastes varied depending on their active ingredients.
Additionally, toothpastes containing Nano-Hydroxyapatite (Nano-HAP) showed potential in preventing erosive tooth wear, even without fluoride. Despite this, fluoride remains the most reliable and effective ingredient for combating dental erosion. Nano-HAP-containing toothpastes may serve as a viable alternative for patients who cannot or choose not to use fluoride.
This study underscores the importance of carefully selecting toothpaste based on its active ingredients to protect against tooth wear. Further research is needed to confirm these findings and provide clearer guidelines for optimal toothpaste formulations.
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