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Business Plan

DENTAL TREATMENT CORPORATION (DTC)

A. INTRODUCTION
1. THE COMPANY
2. DENTAL TREATMENT OBJECTIVES
3. DENTAL DISEASE
B. THE MARKET FOR DISEASE TREATMENT
1. AT-RISK POPULATIONS
2. MARKET SEGMENTS
3. PRODUCT DELIVERY VEHICLES
A. DENTAL TREATMENTS VARNISHES, SPECIAL
TREATMENTS AND RINSES, ETC.
B. ORAL HYGIENE PRODUCTS CONTAINING SPECIAL
EXTRACTS
C. OTHER FOODS PREPARED FOODS
4. COMPETITIVE PRODUCTS FOR DISEASE CONTROL
C. ANTI-DISEASE AGENTS
1. VEGETABLE EXTRACTS
2. SPECIAL CHEMICALS (SC)
D. PRODUCT DEVELOPMENT
1. VEGETABLE EXTRACTS
2. SPECIAL CHEMICAL PRODUCTS
3. COMBINATION TREATMENTS
E. STRATEGIC PARTNERS
1. FAMOUS UNIVERSITY
2. CONSUMER PRODUCT COMPANIES
F. MANAGEMENT
G. FINANCIAL PROJECTIONS
APPENDIX A MARKET SEGMENTS AND ECONOMIC IMPACT
FIGURE A1: DISEASE TREATMENT BY INCOME AND AGE
FIGURES A2- A5: EFFECT OF NEW DISEASE TREATMENTS
BY PATIENT AGE
APPENDIX B. - OTHER RELATED PRODUCTS
TOOTHPASTE
MOUTHWASH

A. INTRODUCTION
1. The Company
DTC is a Washington corporation founded to develop and bring to market
products that will substantially reduce the incidence of dental caries throughout
the world.
DTCs core technology includes special chemicals (SC) and vegetable extracts
developed at the laboratory of Dr. Walter Smith at FAMOUS UNIVERSITY. Products
based on these will be integrated with patient education and food-based
remedies to provide the broadest benefit to the most people at the lowest cost.
Dr. Smith has developed the science behind these products with the support of
Dental Treatment Service (DTS).

2. Dental Treatment Service (DTS) Objectives


The objectives of DTSs scientific program are:

To foster the development and deployment of technologies that decrease


the burden of dental disease in society and to apply these technologies for
treating other mucosal diseases with similar etiology.

To profitably exploit the results of its R&D program and to reinvest those
profits in broadening its contributions to public health.

To build and sustain a reputation for DTS as an innovator in healthcare and


medicine in selected markets.

3. Dental Caries
Dental Caries, tooth cavities to the public, is found in virtually every human
population on earth. It is a slow-onset disease caused primarily by a small group
of bacteria. The predominant species associated with dental caries is
Streptococcus mutans (S. mutans, which is part of the normal flora in the mouth.
It is harmless until it reaches high concentrations in the plaque near the tooth
surface and is then fed carbohydrate or simple sugars. Metabolism of these
substrates elicits the secretion of lactic acid that attacks the mineral component
in the tooths structure resulting in dental cavities/caries. Diet, the ecology of
the mouth, and the resistance of the host all influence the development of caries.
The disease can be mitigated in infected individuals by changes in any of these
factors.
Caries is a good first choice for DTS studies because this slow-onset disease is
well understood and no cure has yet been delivered to date. Dental caries is
caused primarily by a common oral bacterium, Streptococcus mutans . When S.
mutans finds conditions that favor it over other oral flora, it will increase its
numbers relative to other organisms. When this occurs within dental plaque at
the tooth surface it creates conditions that lead to caries. When the host

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subsequently consumes products that contain simple sugars the S. mutans


converts them to lactic acid that erodes the tooths surface and subsurface.
Infants are normally free of infection until their first teeth appear. They are most
often exposed to S. mutans from their mother who carries the organism in her
mouth.. Poor oral hygiene and high sugar diets exacerbate the infection
contributing to tooth damage in children through the teenage years. In the US
the infection often abates in early adulthood as diet and eating habits change.
However the organism remains part of the oral ecosystem and damage from the
disease accumulates slowly into middle age. The costs of caries treatment grows
in middle age due to the increase in restorative surgery, which continues as long
as people have teeth. Thus, ironically, the general improvement in dental care
and increase in longevity has made caries a new disease of the elderly.
Caries does not occur uniformly around the world, nor uniformly across
socioeconomic classes within a population. In the US it is a major cost burden for
the Public Health Service, in part because less affluent people have diets higher
in refined sugars that selectively encourage growth of S. mutans. There are also
segments of the population served by the PHS, such as Native Americans, that
resist preventative dental care for cultural reasons. Paradoxically, in the less
developed nations, caries is found most in the affluent because it is they who can
afford to buy refined sugar products while the poorer people eat more basic foods
that contain less of them.

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B. THE MARKET FOR CARIES TREATMENT


The combined markets for all the DTC anti-caries agents are about $550 million,
about equally divided between vegetable and chemical active ingredients. About
half the US population is currently at risk for caries, spread across all ages.
These data are summarized in Table 1 below.
Table 1: Anti-Caries Market Potential by Age and Treatment
Summary of
anti-caries
user segments

No of
customers

% at risk

% using
herbs

% using SC

(millions)

Potential
Revenues
$ millions

Children under 6
years old

20,020

37%

13%

6%

34,486

Children between
6 and 18

42,852

56%

36%

9%

133,740

Mothers

58,343

65%

41%

6%

154,909

Other adults

103,957

65%

37%

5%

242,484

Elderly

31,702

21%

13%

2%

25,660

All groups

256,874

56%

33%

5%

591,278

The expected users are weighted more heavily toward the low-income groups.
This may be an advantage for the vegetable formulations, which can be delivered
as lower cost confections, over the more expensive SC treatments. Additionally,
the appeal of natural products has high value in markets made up largely of
people with discretionary income. These data and conclusions are shown in
Appendix A, Figure A1, Caries Treatment by Income and Age.
Because caries is a slow-onset disease, the effects and full benefits of new
treatments and prophylaxes will be delayed by some years. Much of the current
dental expense goes for treating cumulative damage that has accumulated over
many years. We estimate that the health improvements from new products will

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lag their introduction and use by 5-10 years. However, once these new habits
are adopted the benefits also accumulate over long periods as shown in
Appendix A, Figure A2.
Five years after acceptance of the new caries prevention products the annual
dental expense per patient is expected to drop by 15%, or $10 Billion/year from
of the current rate of $60 Billion/year. After ten years the US dental expense
should be about half of present levels, representing a savings of $30 Billion per
year. These projected savings are summarized in Appendix A, Figure A3 A5.

1. At-Risk Populations
The population groups in the United States for whom caries treatments are most
beneficial are:

Low Socioeconomic Groups often receive services from public health


agencies who want treatments at a reasonable cost that can be applied to
large numbers of people economically.

High Risk Groups from certain segments of the population, such as Native
Americans, may have greater caries problems for cultural reasons.
These groups are also reliant to some extent on public health services for
dental care.

Children up to age 18 have high incidence of caries. They tend to eat


frequently and like high-sugar foods. Their oral hygiene is often
lackadaisical.

Mothers are the primary source of transmission of S. mutans to their


children. Eliminating S. mutans in the mothers could be a highly desirable
approach for eliminating the disease.

The Elderly are experiencing an increase in caries for numerous reasons.


They have accumulated damage and subsequent restorations that need
repair or replacement. They may have receding gingiva providing
exposed dentin that is a haven for the infection. They may also have
decreased or more viscous saliva production. This is a growing market
because only recently have people 65 years and older retained their teeth.
This group will become an major consumer of dental services at the babyboomers reach 65 and older.

High Socioeconomic Group parents want the latest and greatest for
their offspring.

In developed countries outside the US the caries distribution is similar


to our domestic market, modified by their local dietary habits.

In less developed countries where refined sugar products are expensive


or unavailable caries is more often found in high socioeconomic groups
that can afford sugar.

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2. Market Segments
Children up to 12 years old Treatment can begin once the child gets
teeth.
a. The characteristics of this segment are:

They like sweets.


Certain segments see dentist on regular basis.
Have a strong immune defense system.
Often are treated with antibiotics for common diseases.

Children 12 to 18 This group has many of the characteristics of the


younger children, with some additional factors related to personal care and
grooming.
a. Characteristics of this segment:

Like sweets but interest drops as they age.


See a dentist regularly.
They have a strong immune defense system.
Are less frequently treated with antibiotics.
Focus more on grooming and cleanliness.
Less influenced by parents.

Mothers are often responsible for transmission of the disease to their


children so they are considered separately from the adults as a whole. In a
great many cases, permanent elimination of S. mutans from the mother may
have a large future beneficial effect on the oral health of their children. This
would require killing of most of the S. mutans followed by repetitive treatment
with an S.M. inhibitor to curb re-colonization.
This would be done through a more stringent treatment by the dentist to start
this improvement spiral. This in turn would be followed by treatment with
toothpaste or rinses to sustain the resulting healthy plaque. It is believed
that mothers would be more likely to invest in the dentists caries prophylaxis
because of the extra protection that affords their children.
Advances in dental care have resulted in the Elderly keeping their teeth
longer. At the same time many of them experience lower volumes of saliva or
more viscous saliva. These conditions create an environment more favorable
to pathogenic bacteria, resulting in increased caries.
a. Characteristics of this segment:

Reduced saliva production due to aging.


Medications that cause dry mouth sometimes resulting in the
ingestion of hard candies to stimulate saliva production.

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Poor taste and diminished interest in sweets.


Dietetic restrictions associated with health issues.
Less robust immune defense system.

Low Socioeconomic Society needs to be reached with the inexpensive


products that can be sold over-the-counter either as potions or in common
food products.
a. Characteristics of this segment:

Limited disposable income.


Do not see dentists regularly.
Poor diet usually high in fat and sugar.
Limited medical attention.

APPENDIX A, Figure A1, Caries Treatment by Income and Age, describes the
size of each population segment and estimates the potential use of the most
promising caries treatments for each.

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3. Product Delivery Vehicles


These treatments might be delivered in any of a variety of professional or
consumer products. The best choices for each treatment modality are:

a. Dental treatments varnishes, special treatments and rinses, etc.


Products such as special chemicals will probably be applied in a
manner that keeps the active agent in the treated area for a prescribed
period of time in a controlled environment. These will only be applied
by dental professionals, and will not be formulated as additives to
consumer products.

b. Oral hygiene products containing vegetable extracts


These natural materials can be incorporated in a variety of consumer
products that where duration of exposure is not critical. Because the
unit cost of the treatment is low they are suitable for repeated use
under varying and uncontrolled conditions. Some common vehicles
that might incorporate these treatments are:

Hard candy also to stimulate saliva


Toothpaste
Mouth wash
Drinks (e.g., teas, soft drinks)
Chewing gum
Sweet foods sweetened cereals, pastries
Breath mints

c. Other foods prepared foods


Another possibility is to engineer fruits to deliver the special chemical.
While these would take many years to develop, this approach has
tremendous potential because it could:

treat the S. mutans


get people to eat more fruit
eliminate downstream processing costs.

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4. Competitive Products for Caries Control


There are many other products on the market that contribute to a reduction in
caries. They include mechanical devices and chemical treatments that
cumulatively have led to substantial reduction in caries over the last 20 years.
The products most commonly used are described in detail in Appendix B. The
entire list includes:

Toothpaste
Toothbrushes including electric and sonic.
Floss
Mouthwashes & rinses (OTC)
Chlorohexidine (Prescription)
Fluoride treatments

C. DTCS ANTI-CARIES AGENTS


1. Vegetable Extracts
Vegetable treatments look most attractive due to their simplicity, low regulatory
requirements, perceived ease of formulation, worldwide potential use, good
margins and perceived general effectiveness. The first vegetable products could
be put on the market within 2 years. Hurdles to be overcome are proving in-vivo
efficacy to attract distribution and support from the community, development of
the right product forms, scaling up production to satisfy the anticipated demand
and protecting the intellectual property to prevent direct competitors.
The strongest claims were that the product promotes or supports xxxx
health, and all of those labels contained the disclaimer, in bold type: This
product has not been evaluated by the FDA. This product is not
intended to diagnose, treat, cure or prevent any disease. There were
few ways, other than package design, to differentiate brands for any product.
Even purity claims were generally absent, although the store personnel had
opinions about some companies.
The market is highly fragmented, with no company having as much as 10%
share. The store gave blocks of shelf space to many brands. Twinlab, Solaray,
Solgar, Natures Plus, Source Naturals, Carlson, Countrylife, Natureslife, NOW and
Natures Way each had about 4 x 6 ft of shelf en bloc. The salespeople claimed
that some brands had better quality control than others, and some ran tests for
pesticides. Unsolicited she mentioned that as a common problem with herbs
from China.
There is little competitive advantage to be gained from taking common (or even
uncommon) herbs and putting them in a consumer product unless you can make
strong claims of efficacy that others cannot. Claiming that a toothpaste reduces
cavities means little because all of them say that. Saying that we stop the decay
process would, on the other hand, get peoples attention in a different way.

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That means to succeed a company must either have a monopoly on the raw
material supply, or patent the particular ingredients. When the raw material is
widely available, as it is in DTCs case, the commercial viability of vegetable
remedies depends on purifying, identifying and patenting the key active
ingredients.
The steps in creating value for the vegetable products are as follows:
a.
b.
c.
d.
e.
f.
g.

Establish natural herb sources


Demonstrate activity in laboratory
Isolate and identify active components
File patents
Formulate into products
Prove product efficacy
Complete safety testing

For a product with me-too claims to reduce cavities, the estimated time-tomarket from this point in the development cycle is about 2 years.
If claims are to made for eliminating S. mutans and prevention of caries the
following additional development steps are required.
h.
i.
j.
k.
l.

Confirm market opportunity


Set up (pilot) manufacturing
Establish distribution channels
Obtain regulatory approval after proof of efficacy
Market rollout (with partners)

The time-to-market for this product version is about 5 years.

2. Special chemicals (SC)


The best use of special chemical treatments will be for curing established
infections. They will have a longer, more expensive development process and will
require regulatory approval before they can be sold. Initially these treatments
will be administered by dental professionals.
In the long-term SCs have potential for delivering a caries cure to third world
countries by engineering them into everyday foods such as bananas, apples, rice,
corn, but the technology to do this is still a long way from being practical.
The estimated time-to-market for chemical treatments is:

If applied by the dentist: 5 years


If applied by the patients 7 years
If incorporated in foods greater than 10 years

D. PRODUCT DEVELOPMENT

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1. Vegetable Extracts
This opportunity is based on DTS obtaining the rights to research done by Dr.
Smith on discovering natural products with cariostatic activity. Dr. Smith has
logically selected a group of 200 herbs for screening which are known in Rural
traditional medicine as having anti-infectious activity. This activity includes both
direct attacks on bacteria and yeasts and indirect stimulation of the immune
system to protect against microbial attack. Some of them have been tested for
anti-cancer uses by a company in San Diego, which is farming the best
candidates.
Thanks to Dr. Smiths test the evaluation of some of these vegetable extracts is
well advanced, and one of them, called SC1, has shown promising anti-caries
activity. Based on this work a company has formulated an experimental
toothpaste containing SC1 and has shown that the anti-bacterial activity was
stable for six months at room temperature.
If we pursue the vegetable approach there are several steps that must be taken
to evolve this science into a business.
unique
-

identify the active ingredients and determining if they are


optimize the formulation
seek patent coverage of anything new
secure sources of raw materials
establish efficacy and determine dosage
obtain the necessary regulatory approval

These are included below in Figure P1 - Vegetable Product Production Flow Chart.
PRODUCT CLAIMS
DTC;s initial R&D goals are to find a formulation that is proven to selectively kill
the major cariogenic bacteria. This would allow DTC to claim greater efficacy
than current anti-caries products. This differentiation is important and valuable
in the Companys competitive business environment.

2. Special chemical Products


Special chemicals (SC) are the most elegant and potentially the best long-term
solution because they stop existing infections. If they are applied in a longlasting lacquer coating the may also prevent future infections. The method of
delivery can be modified to match the culture and wealth of the infected
community. In addition, their development path is also better defined than that
for vegetables.
a. There are no topical chemical products produced or marketed today, so
there are no current products that can exemplify a product such as special
chemical (SC) treatment for caries. There are only a few chemical products
on the market today and they are provided as injectibles.

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b. Producing SC on a large scale is a difficult and expensive process. The


sterilization procedures, equipment, monitoring, etc are very expensive
and difficult to do on a routine basis. In addition, worldwide capacity for
large scale production is very limited and at a cost of $200-300 million to
build such facilities, companies are reluctant to add capacity.
c. The purification of SC is a standard process regulated by the FDA. Basically
it consists of passing the cell and media soup through a series of columns
followed by virus purification procedures.
d. Since SC will be expensive to produce and somewhat limited in supply, the
probable product concept for them is:
SC would be a product used in special cases of caries infection and
applied by the dentist. It would be produced and supplied to dentist
as a frozen concentrate.
The dentist would use this concentrate to make up dilute solutions
for treatment. These treatment solutions could be prepared weekly
and kept refrigerated.

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E. STRATEGIC PARTNERS
1. FAMOUS UNIVERSITY

To help its research results become products to benefit the society. To do this,
the university will assist business ventures in a best effort mode.
In return, the university will seek a return for its support of its research. This
can take the form of an up front licensing fee (and royalties) from profitable
licensees or some other arrangements for start-up organizations. Recently the
university adopted a policy to take an equity position in start up companies in
exchange for licensing fees.
The university allows its employees to take part in a start-up as founding
scientists, board members and consultants. Founders shares in the company
are allowed for university employees if approved by a committee to review
conflict of interest.

2. CONSUMER PRODUCT COMPANIES


F. MANAGEMENT
G. FINANCIAL PROJECTIONS

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APPENDIX A MARKET SEGMENTS AND ECONOMIC IMPACT


Notes to Tables and Figures
Because caries is a slow-onset disease, the effects of new treatments and
prophylaxes will be delayed by some years. Much of the current dental expense
goes for treating cumulative damage that has accumulated over many years. We
estimate that the health improvements from new products will lag their
introduction and use by 5-10 years. However, once these new habits are
adopted the benefits also accumulate over long periods.

Assumptions:
Figure A1: Caries Treatment by Income and Age
a. In low income groups oral hygiene is worse, so the fraction of people at
risk in those populations is higher than the average.
b. Mothers are more aware of the need for dental care because of their
concern for their childrens health. Therefore mothers will be more
frequent users of treatments than other adults.
c. Low income groups will use proportionately more inexpensive OTC
products to reduce caries than more affluent people.
d. Higher income groups will be substantially greater buyers of premium
dentist-applied caries treatments.
e. Children and the elderly will prefer vegetable candies to toothpaste and
rinses. Adults will have the opposite preference.

Figures A2- A5: Effect of New Caries Treatments by Patient Age


a. Within 10 years after treatment is widely adopted:
1. The first populations to see benefits will be the older children who began
treatment when young. They will require noticeably fewer basic
restorations.
2. The second major reduction in basic restoration costs will be seen in young
adults who began treatment while in their teens and had accumulated only
moderate amounts of caries damage that did not progress very much after
that.
3. Older adults who began treatment as young adults will see reductions in
basic restoration of old tooth damage. Many fewer will progress to need
major restorations.
b. Within 20 years after treatment adoption:

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4. These anti-caries products will be in routine use.


5. Diagnostic testing will be reduced for all ages. Treatment will be
automatic.
6. Preventive treatment will be more directed toward periodontal disease,
which will have lower incidence of occurrence.
7. There will be large reductions in all restorations, particularly in older
children and young adults who will not have accumulated any damage
once they started using the products.
8. Older adults who have been using the treatments for a long time will have
far fewer restorations and periodontal disease.
9. Dental expense in the elderly, who began using the treatments in middle
age, will be reduced. However this lower expense/patient will be offset by
increases in longevity and the higher proportion of seniors who retain their
teeth.

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APPENDIX B. - OTHER DENTAL PRODUCTS


TOOTHPASTE
For the Dental Treatment Service business plan, toothpaste is both a competitive
product in attacking the cavity problem as well as a potential means for delivery
of natural vegetable products. For these reasons, this study was conducted to
better understand the toothpaste market.
TOOTHPASTE MARKET
The worldwide toothpaste market is about $5 billion in retail sales. The United
States market in 1999 was $1.7 billion and is expected to grow to $2 billion by
2003. The 1999 figure of $ 1.7 billion is up 4% from 1998 figures.
The top 5 brands of toothpaste in terms of market share for 1999 in dollar sales
are as follows:
BRAND
Colgate
Crest
Aquafresh
Metadent
Arm & Hammer
Other
Total

COMPANY
Colgate-Palmolive
Proctor & Gamble
SmithKline
Beecham
CheesebroughPonds
Church & Dwight

SALES (millions)
$475
444
181
136
71
393
1,700

PERCENT (%)
28
26
11
8
4
23
100

Colgate and Crest saw sales growth from 1998 of 5.3% and 8.7% respectively. I
could not find figures for other toothpaste brands.
The toothpaste market has seen a shift over the last 10 years from standard
toothpaste products to premium products that provide tartar control, whitening,
gels, desensitizing, antibacterial and all natural ingredients. This has segmented
the market and provided the consumer an array of products for specific needs.
This has been good for toothpaste sales and, as shown above, sales are on the
rise. As a further example of this growth, the largest segment of this premium
category, the whitening segment, has seen sales growth since 1996 of 159%.
Projections are that toothpaste sales will continue to increase as producers
introduce more and more specialty products. Therefore, research and
development in the toothpaste business is very aggressive. New, active
components for these specialty products are in demand. As an
example, competitors are looking for materials that will compete with
Colgates new Total containing triclosan. This could be a good
opportunity for vegetable based antibacterials particularly for the all
natural segment.

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TOOTHPASTE COMPOSITION
Toothpaste is composed of several ingredients, each of which provides a
functional important component to the finished product in its effort to fight
cavities and periodontal disease. Below are the various functional component
categories with examples of the chemicals used.
1. ABRASIVES & POLISHING AGENTS
Abrasives are added to toothpaste to remove debris, plaque and bacteria
from the tooth surface. Polishing agents are added to polish the tooth
surface and improve appearance. Often these are the same component.
Materials used in toothpaste for these purposes include calcium
carbonate, sodium bicarbonate (baking soda), dicalcium phosphate,
sodium metaphosphate hydrated aluminum, silica, and sodium
pyrophosphate. Natural toothpaste use baking soda or sea salt. Many of
these compounds including baking soda have the added feature of
neutralizing acids that are produced by cavity forming bacteria.
2. ANTIBACTERIALS AND CAVITY FIGHTERS
These are components added to toothpaste to kill oral bacteria and to
reduce the formation of cavities. The leading substance added to
toothpaste to do this is fluoride. It is the most effective material as an
antibacterial and cavity preventor. It functions topically by inhibiting the
growth and acid formation of the bacteria. It functions systemically by
becoming part of the tooth enamel making it more resistant to
demineralization. It is a proven substance for cavity prevention and is
used widely in most toothpastes. It is added as sodium fluoride, stannous
fluoride and sodium monofluorophosphate.
Other compounds that fall into this category include sodium
dehydroacetate, zinc citrate, sodium lauryl sarcosinate, Neem, tea tree oil,
xylitol, chlorine dioxide, myrrh resin, mastic gum, thymol, eugenol,
eucalyptal, Echinacea, goldenseal and other natural plant extracts. A
recent antibacterial added to toothpaste is triclosan, a broad antibacterial
found in soaps. Triclosan is found in a new toothpaste introduced by
Colgate called Total.
3. HUMECTANTS
Humectants are materials added to toothpaste to keep it moist. They
include compounds like propylene glycol, glycerin, and sorbitol.
4. SWEETENERS & FLAVORS
These are added to improve the flavor of toothpaste. There are many such
substances added to toothpaste for this purpose. A few examples are
saccharin, sorbitol, peppermint, spearmint, wintergreen, cherry, cinnamon,
fennel, ginger, anise, as well as various natural extracts and oils.
5. EMULSIFIERS, STABILIZERS, & FLOW-AGENTS
Subatances in this category provide stability, smoothness and consistency
to toothpaste. They are sodium hydroxide, cellulose gums, hydrated silica,
carrageenan, and gum tragacanth.
6. DESENSITIZERS

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Desensitizers are substances added to toothpaste to make the teeth less


sensitive to conditions such as hot, cold, acid, base, etc. Common
compounds used in toothpaste for this purpose include potassium nitrate,
sodium citrate, and strontium.
7. BINDERS
Binders help hold the toothpaste formulation together. Some examples are
sodium alginate, bentonite, and carrageenan.
8. SUDSERS & DETERGENTS
These are added to toothpaste for foaming and cleaning. A common
substance used for this is sodium lauryl sulfate (SLS). Natural toothpastes
replace SLS with xylitol.
9. LUBRICANTS
Lubricants help toothpaste flow smoothly from the tube and over the
teeth. Glycerin is the most widely used compound for this purpose.
10. COLOR
Artificial colors are used to color most toothpastes. Titanium dioxide is
added to make the paste opaque and white. Natural colors are used in
natural toothpastes and include annatto as well as fruit and vegetable
extracts.
11. PRESERVATIVES
Preservatives are added to toothpaste to provide extended shelf life to the
product. Common preservatives include p-hydroxybenzoate, methyl
paraben, citric acid, and natural extracts.

PREMIUM PRODUCTS (SOME EXAMPLES)


The newest product in this category is Colgates Total containing the
antibacterial triclosan. This is a broad spectrum antibacterial that has been used
in antibacterial soaps. To use this in their toothpaste, Colgate had to conduct
several trials and get FDA approval. Triclosan is a somewhat controversial
compound in that many experts warn that its use will only promote strains of
microbes that will develop resistance to this antibiotic. Market analysts project
that competitors will be introducing similar toothpastes with antibacterial
additives.
Gel toothpaste are not new, but were one of the first products to separate
themselves from the standard products. Gel toothpastes are offered by all of the
major toothpaste producers and are generally promoted as a breath freshenesr.
The Aquafresh brand is one that exemplifies this. Mixtures of gels and white
toothpaste are also available in unique tubes to deliver both to your toothbrush.
Whitening toothpaste is another premium category that has seen excellent sales
growth over the last 6 years. All major toothpaste producers provide whitening
formulations in there produce lines. Whitening is promoted through the action of
baking soda as an abrasive stain remover coupled with hydrogen peroxide. These
products only remove stains from the surface of the teeth and do not penetrate
the surface.

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Toothpastes are offered that desensitize your teeth to hot, cold, acid, base, etc. A
line of such products is offered by Block Drug Company, Inc. under the brand
name Sensodyne. The desensitizing is done through the use of nitrate
compounds in the toothpaste formulation. Combinations of desensitizing and
whitening or gel formulations are available.
Enamelon is a toothpaste introduced in 1998 by a startup company called
Enamelon, Inc. This product addresses the issue of repairing cavities
through remineralization. The company offers a toothpaste that contains
fluoride and proprietary formulations of calcium and phosphate ions such that the
saliva concentration of these ions is enhanced to promote repair through
remineralization of decay sites. Some of this technology was developed within
the company and some was licensed from the American Dental Association
Health Foundation. The product and the company are doing very well. They are in
the process of offering other toothpaste and dental care products.
A new product from Arm & Hammer addresses nighttime breath. This
toothpaste contains zinc citrate that is to inhibit the growth of oral microbe
overnight thus preventing nighttime breath.
All natural toothpastes are another premium category that is growing well. There
are numerous products on the market from a variety of marketers including Toms
of Maine as well as foreign producers. These products usually contain fluoride,
baking soda, peroxide and various natural extracts. Vegetable extracts are
promoted heavily by this market segment. A product called Enamel Saver
markets a sodium lauryl sulfate free toothpaste that contains xylitol in its place.
One natural toothpaste offers a product containing aloe vera that is suppose to
promote healing of gum and mouth sores.
A unique product is offered by a company named Body Electric of Colville, WA.
Their product is called Pristine. This is a tooth cleaning oil made from coldpressed essential oils of mint and almonds which are known for their antibacterial
properties. It does not contain any fluoride, abrasives, foaming agents,
sweeteners, emulsifiers or preservatives.
There are many toothpastes offered on the market, but most fit within
these categories. The flow of such products is expected to continue as
consumers become more educated on dental disease.

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MOUTHWASH
A. MARKET
Sales of mouthwash in 1999 were $677million. This was up from 1998 by 3.8%.
The top 5 leading brands were:
BRAND
Listerine
Private Label
Scope
Plax
Act
Other
Total

SALES
(millions)
$293
133
111
38
19
83
677

The mouthwash market has been growing but not a t the rate of that of
toothbrushes and toothpaste.
B. MOUTHWASH COMPOSITION
Mouthwashes contain fewer functional components than toothpaste, but they do
have some important key ingredients.
All mouthwashes contain some form of antiseptic or antibacterial. Over the
counter products usually contain alcohol, cetylpridinium chloride or methyl
salicylate as an antiseptic. They may also contain sodium fluoride. Prescription
mouthwash contains the antibacterial chlorohexidine.
Additional functional components in mouthwash are flavorings and colors.
Common flavorings include sweetness as saccharin, mint, spearmint,
peppermint, thymol, eucalyptol and vegetable extracts.
C. PRODUCTS
Mouthwash products generally fall into one of three categories based on the
market they are addressing. These three categories or market needs are breath
freshening, teeth whitening and dental hygiene.
In the category of breath freshening, mouthwash is marketed to people seeking a
treatment for bad breath. Listerine and Scope are examples of products that
address this market. These products contain antiseptics to kill bad breath forming
bacteria and a heavy dose of flavoring to temporarily cover bad breath. Research
has shown that mouthwashes have an immediate effect on bad breath but long
term they are not effective in eliminating the problem.
The mouthwash whitening market is relatively new. Products in this category are
SuperSmile mouthwash and products made by Polident. These products
contain antiseptics and flavorings but also contain baking soda and peroxide to
enhance teeth whitening. Their effectiveness is unproven.
Mouthwashes that attempt to improve dental hygiene are of greatest interest to
DTS and its business plan. There are several products on the market that claim to
remove plaque, kill oral bacteria, reduce gingivitis and improve overall oral

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health. PLAX is a mouthwash that is designed for used before brushing to loosen
plaque for easier removal on brushing. No information could be found on its
special active ingredients. Listerine and other major marketers of mouthwash
make a tartar control product that is suppose to reduce the formation of tooth
tartar when used regularly. Several natural mouthwashes are sold that contain an
array of natural substances such as vitamin C, vitamin E, Aloe vera, witch hazel,
tea tree oil (oil form the tree Melaleuca alternitolia) and numerous vegetable
extracts. These are claimed to kill bacteria, improve healing, reduce cavities and
reduce gum disease. As an example, natural products such as these are available
for companies like Toms of Maine.
A few unique antibacterial products are ANTI-OXIDANT and ClosysII.
ANTIOXIDANT is a mouthwash marketed as an immune system supplement to
boost the immune system to prevent gum disease. It contains vitamin C&E,
coenzyme Q, alpha lipoic acid, grape seed extract, selenium, Aloe vera, and a
proprietary delivery system. Its effectiveness is unproven. Closys II is a
mouthwash that contains chlorine dioxide as an antibacterial. Product claims are
that chlorine dioxide is more effective than other antibacterials.
To complete the review of mouthwash products, there are several products
marketed that are alcohol free and/or saccharin free. There are also
mouthwashes that are two phases to get the desired effect.
In general, OTC mouthwashes have been shown to have little effect on controlling
plaque and oral bacteria and they are no substitute for brushing. The one
positive in mouthwash is fluoride. A mouthwash that contains fluoride has been
shown to be effective in enhancing the protective effects of fluoride in
toothpaste.

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