Which strength of fluoride in toothpaste is most effective?

Tooth decay (caries) is a widespread disease, affecting billions of people worldwide. Fluoride has long been used to prevent decay, through a variety of different methods including toothpaste, water, milk, mouthrinses, tooth gels and varnish. Regular toothbrushing is recommended to prevent decay and other oral diseases, and toothbrushing for 2 minutes twice daily with a fluoride toothpaste is generally recommended. The typical strength of regular or family toothpaste is around 1000 to 1500 parts per million (ppm) fluoride, but many other strengths are available worldwide. There is no minimum fluoride concentration, but the maximum permissible fluoride concentration for a toothpaste varies according to age and country. Higher concentrations are rarely available over the counter, and are classed as a prescription‐only medicine. Stronger fluoride toothpaste may offer greater protection against decay but also increases the risk of fluorosis (enamel defects) in developing teeth. This is an update of the Cochrane Review first published in 2010. Continue reading

Xylitol in toothpaste may prevent tooth decay, but there is no evidence that xylitol in sweets and chewing gum has an effect

Xylitol

Tooth decay is a common disease affecting up to 90% of children and most adults worldwide. It impacts on quality of life and can be the reason for thousands of children needing dental treatment under general anaesthetic in hospital. However, it can easily be prevented and treated by good oral health habits such as brushing teeth regularly with toothpaste that contains fluoride and cutting down on sugary food and drinks. If left undisturbed, the unhelpful bacteria in the mouth – which cause decay – multiply and stick to the surfaces of teeth producing a sticky film. Then, when sugar is eaten or drank, the bad bacteria in the film are able to make acid resulting in tooth decay. Xylitol is a natural sweetener, which is equally as sweet as normal sugar (sucrose). As well as providing an alternative to sugar, it has other properties that are thought to help prevent tooth decay, such as increasing the production of saliva and reducing the growth of bad bacteria in the mouth so that less acid is produced. In humans, xylitol is known to cause possible side effects such as bloating, wind and diarrhoea. Continue reading

Triclosan / copolymer containing toothpastes for oral health

ToothpasteGum disease and dental decay are the main reasons for tooth loss. Plaque (a film of bacteria) can build up on the teeth, leading to swelling and redness of the gums (gingivitis) which if left untreated can develop into a more serious form of gum disease (periodontitis). Periodontitis can cause pain, eating difficulties and tooth loss. The build up of plaque can also cause teeth to decay. Adding an effective and safe antibacterial ingredient to toothpastes could be an easy and low-cost answer to these problems. Continue reading

New Oral Health Group Podcast

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c Liam Dunn, published under Creative Commons licence

Did you know? There are now a range of Cochrane podcasts available on the Cochrane Library.

The latest Oral Health Group podcast is by the University of Manchester’s Lucy O’Malley, who gives the lowdown on her review: Primary school interventions for preventing caries. Follow the link to listen in and hear the findings!

Other available Oral Health Group podcasts include:

Follow the links to read the Cochrane Summary, and then click “Podcast” on the bottom right of the page to listen.

New publications from the Oral Health Group in Issue 5 of the Cochrane Library for 2013

The latest edition of The Cochrane Library is out today, and features 1 new review and 3 new protocols from the Cochrane Oral Health Group. Follow the links to read more!

Children ToothbrushesNew Review:
Primary school-based behavioural interventions for preventing caries
Anna M Cooper, Lucy A O’Malley, Sarah N Elison, Rosemary Armstrong, Girvan Burnside, Pauline Adair, Lindsey Dugdill, Cynthia Pine

This review considers the clinical effects of school based interventions aimed at changing behaviour related to toothbrushing and the frequency of consumption of sugary food and drink. Are programmes aimed at making lasting changes to toothbrushing habits and reducing sugary food and drink consumption in 4-12 year olds effective?

Four clinical trials were included in the review. Three of these showed that there was less dental plaque in the children who had received the programme, and one small study showed there was less tooth decay when children had undergone the educational intervention. However, more high quality research is needed.

New protocol:
Dental cavity liners for Class I and Class II resin-based composite restorations
Andrew B Schenkel, Ivy Peltz, Analia Veitz-Keenan

This review will be undertaken by a team from the College of Dentistry at the University of New York. It will assess the effects of using dental cavity liners in the placement of restorations.

New protocol:
Oral health educational interventions for nursing home staff and residents
Martina Albrecht (nee Bunge), Ramona Kupfer, Daniel Reissmann, Burkhard Haastert, Ingrid Mühlhauser, Sascha Köpke

This new review will assess the effects of educational interventions to improve the oral and dental health of nursing home residents. These interventions could include training programmes for staff or for the residents in oral hygiene, oral care practice, diet and skills training.

New protocol:Triclosan/copolymer containing toothpastes for oral health
Philip Riley, Thomas Lamont

This review will assess the effects (i.e. including both the efficacy and safety) of triclosan/copolymer containing fluoride toothpastes, compared to fluoride toothpastes, for the long-term control of tooth decay, plaque and gingivitis in children and adults.

Other highlights of Issue 5 of the Cochrane Library include: