Oral mucosal desquamation of pre- and post-menopausal women. A comparison of response to sodium lauryl sulphate in toothpastes

Plaque control and reduction of gingivitis: The evidence for dentifrices

This paper focuses on plaque control and the management of gingivitis in adults and summarizes the evidence of commercially available dentifrices as gathered from existing systematic reviews. Three internet sources were used to search for appropriate papers (up to and including February 2017). The search strategy was designed to include any systematic review published on dentifrices that also included an evaluation of plaque and gingivitis scores. Characteristics of the individual reviews, such as methodological aspects, quantitative data and conclusions, were extracted. The potential risk of bias was estimated and the acquired evidence was graded. Independent screening of 205 unique reviews resulted in 10 published and eligible systematic reviews. One publication evaluated the mechanical contribution of dentifrice to plaque removal. Eight papers were identified that evaluated the efficacy of a proposed single active ingredients, of which two reviewed more than one potentially active ingredient. One study compared two active ingredients. This meta‐review appraised the current state of evidence and found that toothbrushing with a standard fluoride dentifrice does not provide an added effect for the mechanical removal of dental plaque. Evidence suggests that compared with a standard dentifrice, those containing triclosan or stannous fluoride have benefits with respect to gingival health and control of dental plaque.

Oral mucosal peeling related to dentifrices and mouthwashes: A systematic review

Background

The aim of this systematic review was to summarise the clinical information available about oral mucosal peeling (OMP) and to explore its aetiopathogenic association with dentifrices and mouthwashes.

Material and Methods

PICOS outline: Population: subjects diagnosed clinically and/or pathologically. Intervention: exposition to oral hygiene products. Comparisons: patients using products at different concentrations. Outcomes: clinicopathological outcomes (primary) and oral epithelial desquamation (secondary) after use. Study design: any. Exclusion criteria: reports on secondary or unpublished data, in vitro studies. Data were independently extracted by two reviewers.

Results

Fifteen reports were selected from 410 identified. Descriptive studies mainly showed low bias risk, experimental studies mostly an “unclear risk”. Dentifrices or mouthwashes were linked to OMP, with an unknown origin in 5 subjects. Sodium lauryl-sulphate (SLS) was behind this disorder in 21 subjects, tartar-control dentifrices in 2, and flavouring agents in 1 case. Desquamation extension was linked to SLS concentration. Most cases were painless, leaving normal mucosa after desquamation. Tartar-control dentifrices caused ulcerations more frequently.

Conclusions

OMP management should consider differential diagnosis with oral desquamative lesions, particularly desquamative gingivitis, with a guided clinical interview together with pathological confirmation while discouraging the use of the product responsible for OMP.

Key words:Systematic review, oral mucosal peeling, dentifrices, sodium lauryl-sulphate, oral hygiene products.

In vivo evaluation of fluoride and sodium lauryl sulphate in toothpaste on buccal epithelial cells toxicity

OBJECTIVES

The present study addresses the effect of fluoride and sodium lauryl sulphate content of toothpaste on oral epithelial cells in vivo conditions.

SUBJECTS AND METHOD

Forty volunteers were assigned into two experimental groups, each of them applying the different brand of toothpaste. Every group has been using three different types of toothpaste (non-fluoride and non-SLS, fluoride and non-SLS, and the fluoride and SLS) of the same brand for 6 months, each for 2 months. The buccal epithelial cells were sampled at baseline and 30, 60, 90, 120, 150 and 180 days after the beginning of the research. Effect on DNA damage was analyzed by micronucleus assay Results: After 60 days of use, for both tested kinds of toothpaste with fluoride and without SLS, all studied parameters were not significantly different from the results obtained at the time when the participants used a non-fluoride toothpaste. While, after 60 days of use, for one kind of toothpaste with SLS and fluoride, was observed significantly higher incidence of pyknotic cells (2.20 ± 0.95, 0.00 ± 0.00 vs. 0.05 ± 0.22, respectively; p = .001), cells with karyorrhexis (2.35 ± 1.14, 0.85 ± 0.93 vs. 0.40 ± 0.68, respectively; p = .001), and nuclear buds (1.35 ± 0.68, 0.45 ± 0.51 vs. 0.45 ± 0.60, respectively; p = .001), compared to toothpastes of the same brand with fluoride and without SLS, and without fluoride and without SLS, for the same period.

CONCLUSIONS

Based on the results, can be concluded that there is no fluorine-dependent cytotoxic or genotoxic effect, while SLS dentifrice increases the number of nuclear morphological changes in buccal epithelial cells.

Characterization and in vitro estrogenicity of orthodontic adhesive particulates produced by simulated debonding

OBJECTIVE

To investigate the structure and composition of ground orthodontic adhesive particulates produced under simulated clinical conditions and assess their estrogenic action in vitro.

MATERIALS AND METHODS

A chemically cured and a light-cured adhesive were included in the study. Specimens were prepared by simulating bonding procedures, covering the bracket base surface with cellulose films to detach the full set material. The adhesives prepared under this method were grounded in glass chambers with an 8-fluted tungsten carbide on a high-speed handpiece; a new bur and different chamber was used for each adhesive sample and grindings were performed on different days to avoid contamination of the room. The adhesive particulates produced were subjected to FT-IR spectroscopy for the molecular characterization of particles; scanning electron microscopy for the morphologic condition and structure; and X-ray microanalysis for the elemental composition of the particles. Amounts of the ground adhesives were immersed in saline for 1 month at 37 degrees C. Eluents from solution of the two adhesives were added to media of an estrogen-responsive cell line derived from human breast adenocarcinoma (MCF-7), to assess the estrogenicity. Positive (estradiol and bisphenol-A) and negative (saline) controls were used; all assays were repeated four times and the results were averaged. Estrogenicity data were analyzed with one-way ANOVA and the Tukey test at the .05 level of significance.

RESULTS

The study of the composition of particles revealed compounds related to monomers with no major differences noted. Significant structural alterations were observed between the materials studied, with the chemically cured adhesive having larger particles. The ground samples contained Si, Na and Al apparently deriving from fillers, whereas large Ba fillers were identified only in the chemically cured group, whereas no distinct molecular variation was noted between the set material and its corresponding particulate form. Both chemically cured and light-cured adhesives exhibited an estrogenic action through induction of the proliferation rate of MCF-7 cells (160% and 128%, respectively, compared to control).

SIGNIFICANCE

Apart from the potentially hazardous action of adhesive particulate aerosol produced by grinding, composite resin particulates may act as endocrinological disruptors.

Microarray analysis of bisphenol A-induced changes in gene expression in human oral epithelial cells

Bisphenol A (BPA) is a common ingredient in dental materials. However, its potential adverse effects on the oral cavity are unknown. The purpose of this study is to identify the genes responding to BPA in a human oral epithelial cell line using DNA microarray. Of the 10,368 genes examined, changes in mRNA levels were detected in seven genes: five were up-regulated and two were down-regulated. The expression levels of the calcium channel, voltage-dependent, L-type, alpha 1C subunit (CACNA1C), cell death activator CIDE-3 (CIDE-3), haptoglobin-related protein (HPR), importin 4 (IPO4), and POU domain, class 2 and transcription factor 3 (POU2F3) were significantly up-regulated in the cells exposed to 100 mM BPA. The spermatogenesis-associated, serine-rich 2 (SPATS2) and HSPC049 protein (HSPC049) were significantly down-regulated. The detailed knowledge of the changes in gene expression obtained using microarray technology will provide a basis for further elucidating the molecular mechanisms of the toxic effects of BPA in the oral cavity.

Organotypic human oral tissue models for toxicological studies

Three-dimensional models of the human oral epithelia have been developed to test the irritation of oral-care products and to provide systems to study the pathology of the oral cavity. The in vitro tissue models, cultured using normal oral epithelial cells and serum free medium, adopt a buccal or gingival phenotype. The buccal tissue (designated ORL-200) is 8-12 cell layers thick and non-cornified; the gingival tissue (designated GIN-100) is 9-13 layers thick and cornified at the apical surface. The tissues express cytokeratins 13 and 14 similar to their corresponding native oral tissues. The MTT viability assay was used to assess inter-lot and intra-lot reproducibility. The MTT average intra-lot coefficient of variation (CV) was less than 10% for both tissues and the time required to reduce tissue viability by 50% (ET-50) following application of 1% Triton-X 100 averaged 1.02+/-0.33 h (n=26) and 7.97+/-0.80 h (n=14) for the buccal and gingival tissues, respectively. The utility of the buccal tissue for irritation studies was examined by testing prototype dentifrice formulations and commercially available products including mouthwashes, toothpastes, and oral cleansers. Use of the MTT ET-50 assay and cytokine release clearly differentiated between the formulations and the oral care products. In conclusion, the oral tissue models represent highly reproducible, non-animal means to screen the irritation potential of newly developed oral care products and should be useful to study the innate immunity, biology, and pathology of the oral mucosa.

A study to assess the efficacy of a new detergent free, whitening dentifrice in vivo using QLF planimetric analysis

OBJECTIVE

To determine the effects of a detergent-free, whitening dentifrice using an in vivo plaque regrowth model with the novel application of QLF as a planimetric analysis tool.

METHOD

A total of 20 subjects took part in a double blind, single-centre, crossover study in which slurry rinses were the only form of plaque control over a 5-day period. Following a washout and prophylaxis the subjects used 2 daily rinses in the absence of all other plaque control methods. Subjects returned to the clinic on the afternoon of day 5 when plaque was disclosed and assessed by the plaque index and area using both a photographic and novel fluorescent planimetric technique. A further 9-day washout was carried out and the rinse period repeated to ensure that each subject had used both experimental and comparator slurries.

RESULTS

Twenty subjects completed the trial. The test product showed a significant inhibition of plaque re-growth (16.9%) compared with a fluoride-matched comparator using the Turesky index (P < 0.0001), the photographic planimetric technique (17.5%) (P < 0.0001) and the novel QLF technique (18.4%) (P < 0.0001).

CONCLUSION

The results confirm that plaque inhibition capability of a detergent-free whitening dentifrice is at least as effective as a fluoride matched comparator. QLF is a promising tool for disclosed plaque quantification.

A study to assess the effects of a new detergent-free, olive oil formulation dentifrice in vitro and in vivo

OBJECTIVE

To determine the effects of a detergent-free dentifrice containing olive oil using in vitro microbiological tests and an in vivo plaque re-growth model.

METHOD

A total of 20 subjects took part in a double blind, single-centre, crossover study in which slurry rinses were the only form of plaque control over a 5-day period. Following a washout and prophylaxis the subjects used 2x daily rinses in the absence of all other plaque control methods. Subjects returned to the clinic on the afternoon of day 5 when plaque was disclosed and assessed by plaque index and area. A further 9-day washout was carried out and the rinse period repeated to ensure that each subject had used both experimental and control slurries. In vitro microbiological experiments were conducted to examine the effects of olive oil alone and in the new dentifrice on bacterial growth and adhesion.

RESULTS

20 subjects completed the trial. The olive oil product showed a significant inhibition of plaque re-growth (17.2%) compared with a fluoride-matched control using the Turesky index (p<0.0001) and also using the planimetric technique (22.0%) (p<0.0001). Significant decreases in bacterial growth and adhesion (measured as total viable count) were detected in the presence of olive oil and the new dentifrice.

CONCLUSION

The results suggest that the experimental olive oil containing paste has potential value in the inhibition of plaque.

The effect of a sodium lauryl sulfate-free dentifrice on patients with recurrent oral ulceration

OBJECTIVE

Sodium lauryl sulphate (SLS) is the most commonly used detergent in dentifrices. Recent reports have suggested that it may exacerbate conditions with compromised epithelial integrity. The aim of this study was to compare the effect of an SLS-free dentifrice and an SLS-containing dentifrice on recurrent oral ulceration (ROU).

DESIGN

A double-blind crossover clinical trial was carried out during which subjects used an SLS dentifrice for 8 weeks and an SLS-free dentifrice for 8 weeks. Each phase was preceded by a 2-week washout period.

SETTING

A UK dental teaching hospital.

SUBJECTS AND METHODS

Forty-seven subjects completed the trial. They were all in the age range 10-62 years, had regularly recurrent oral ulceration reporting at least one to two ulcers per month and had normal levels of vitamin B12, ferritin and folate.

MAIN OUTCOME MEASURES

The trial phases were compared for the following ulcer parameters--number of ulcer days, total pain scores, number of ulcer episodes, and number of ulcers. Additional parameters compared were the number of ulcers per episode, ulcer duration, total pain per episode and ulcer size.

RESULTS

None of the ulcer parameters measured was significantly affected by the use of the SLS-free dentifrice as compared with the SLS dentifrice.

CONCLUSION

SLS-free dentifrice had no significant effect on ulcer pattern in the ROU study group.