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Mohd Masood

Lecture Outline
Dentifrices
Ideal requirements for dentifrices
Dentifrices contents
Recent development in toothpaste

Mouthwash

Lecture Outcomes
Upon completion of this course students

would be able to
Discuss different methods of chemical plaque

control
Components of toothpaste and mouthwash

Methods of Plaque
Control:
Mechanical Plaque Control Methods.
Chemical Plaque Control Methods.

Chemical Plaque Control


Agents
Dentifrices/ Toothpastes
Mouth Rinses

TOOTHPASTE /
DENTIFRICES

Toothpaste called as dentifrice, is an inclusive term used to


describe
powder, paste or gel, used with a toothbrush to aid in the
removal of
plaque, biofilm, materia alba, and stain from teeth and soft
tissue.

PURPOSE
Cleaning
Polishing
Removal of stains
Reduce incidence of tooth decay

Ideal requisites
Should decrease plaque & gingivitis
Prevent pathogenic growth
Should prevent development of resistant bacteria
Should be biocompatible
Should not stain teeth or alter taste
Should have good retentive properties
Should be economic

Toothpaste Contents
Abrasives (20%-40%)
Binders (2%)
Humectants (20%-40%)
Detergents (1%-2%)
Flavoring agent (2%)
Sweetening agents (2%)
Colouring agent (2%)
Preservatives (<1%)
Water (20%-40%)

Abrasive
Functions of Abrasive
Also called as polishing agent
Solid, insoluble particles
Removes debris and residual strain from teeth
Mild abrasive action
Removes stained pellicle, restores natural luster,
enhances enamel whiteness
Examples of Abrasives:
Aluminium oxide
Calcium pyrophosphate
Carbonates like sodium bicarbonate, calcium carbonate
silicas

Binde
rs

Functions of Binder
To provide consistency and shape.
Keep the solid phase properly suspended in the liquid phase .
Prevent the toothpaste from drying out.
Contribute to the creamy consistency of the toothpaste and

hence, control the viscosity.


Provide body to the dentrifice, especially after extrusion from
the tube onto the toothbrush.

Examples of Binders:

Water soluble agents

Alginates, Sodium carboxy methyl cellulose etc


Water insoluble agents

Colloidal silica, Magnesium aluminium salts etc

Humecta
nts
Functions of humectants
Used in toothpaste to prevent loss of water and

subsequent hardening of the product upon exposure to


air.
Reduces the loss of moisture from tooth paste

Affect taste perception

Examples:
Glycerine
Sorbitol
Polyethylene glycol
Mannitol
Propylene glycol

Detergents/
surfactants
Function
Produce foam and aid in the removal of

debris.
Emulsifies flavoring agents.
Antimicrobial property
High level may cause mucosal irritation.
May react with other toothpaste components.

Examples:
Sodium Lauryl Sulfate
Sodium N-Lauryl Sarcosinate
Polyethylene glycol (PEG)

Sweeteners and
Flavors
Functions
Render the product pleasant to use & leaves a
fresh taste in mouth after use
Sweeteners: sodium saccharin, sorbitol,
mannitol, xylitol
Flavors: improve taste of toothpaste
Examples

peppermint,
spearmint,
wintergreen,
menthol,
cinnamon

Preservatives and
Solvents
Function of Preservatives:
prevent the growth of micro organisms such as mold and

bacteria in the toothpaste.


Non-irritating
Compatible with other ingredients

Examples:
alcohols,
sodium benzoate,
dichlorinated phenols

Function of Solvents:
dissolves the ingredients and allows them to be mixed.
Water is the most common solvent used.

Fluoride
Function:
Increases resistance to enamel solubility.
Restricted usage level (for adults it must be within

1000 to 1450 ppm and for children not more than


1000ppm)

Examples:
Sodium fluoride
Sodium monofluorophosphate
Stannous fluoride

Therapeutic
Agents

Anti-caries agents:
sodium fluoride and sodium monofluorophosphate
Anti-plaque:
Sodium Lauryl Sulphate, Triclosane, Zinc and Stannous ions
Anticalculus agents (crystal growth inhibitors)
Pyrophosphate, Zn citrate, Zn chloride
Desensitizing agents
Sodium fluoride, potassium nitrate
Anti-dentin hypersensitivity:
Potassium salts
Whitening agents:
Papain, Dimethicone
Anti bacterial agents
Triclosan, delmopinol, metallic ions & Zn-citrate trihydrate

Recent developments in
dentifrices

Tooth paste for children


Natural tooth paste (herbal)
Whitening tooth paste
Breath freshening tooth paste
Sodium bicarbonate tooth paste

TRICLOSAN
Phenol derivative
Is synthetic and ionic
Used as a topical antimicrobial agent
Broad spectrum of action including both gram
positive and gram negative bacteria
It also includes mycobacterium spores and
Candida species

MECHANISM OF ACTION
TRICLOSAN

ACT ON CYTOPLASMIC MEMBRANE

INDUCE LEAKAGE OF CELLULAR


CONSTITUENTS

BACTERIOLYSIS

Triclosan
Triclosan is included in tooth paste to reduce

plaque formation
Used along with Zinc citrate or co-polymer
Gantrez to enhance its retention within the
oral cavity
Triclosan delay plaque formation
It inhibits formation of prostaglandins &
leukotrienes there by reduces the chance of
inflammation

METALLIC IONS
eg:

Zn & Cu ions

MECHANISM OF ACTION
It reduces the glycolytic activity in bacteria

&delays bacterial growth

QUARTERNARY AMMONIUM
COMPOUNDS
Cationic antiseptics & surface active

agents
Effective against gram positive organisms

MECHANISM OF ACTION
Positively charged molecule reacts with

negatively
charged
cell
membrane
phosphates and thereby disrupts the
bacterial cell wall structure
Eg: Benzanthonium chloride,

Benzalleonium
cetylpyredinium

chloride and

SANGUINARINE
It is a benzophenanthredine alkaloid
It is most effective against gram ve

organisms

ANTIBIOTICS
Vancomycin, erythromycin, Natamycin and

Kanamycin
Due to bacterial resistance problems the
use of antibiotics has been reduced

CHLORHEXIDINE
GLUCONATE(0.2%)
It is a cationic bisbiguanide
Effective against gram +ve, gram ve

organisms, fungi, yeasts and viruses


Exhibit antiplaque & antibacterial
properties

MECHANISM OF
ACTION
Antiplaque action of chlorhexidine

Prevents pellicle formation by blocking acidic


groups on salivary glycoproteins thereby reducing
glycoprotein adsorption on to the tooth surface
Prevents adsorption of bacterial cell wall on to the
tooth surface
Prevents binding of mature plaques

Bacteriostatic at low concentrations


Bacterial cell wall(-ve charge)
Reacts with +ve charged chlorhexidine
molecule
Integrity of cell membrane altered
CHX binds to inner membrane phospholipids &
increase
permeability
Vital elements leak out & this effect is
reversible

Bacteriocidal action
increased concentration of chlorhexidine
Progressive greater damage to membrane
Larger molecular weight compounds lost
Coagulation and precipitation of cytoplasm
Free CHX molecule enter the cell & coagulates
proteins
Vital cell activity ceases
cell death

ADVERSE EFFECTS OF
CHLORHEXIDINE
Brownish staining of tooth or restorations
Loss of taste sensation
Rarely hypersensitivity to chlorhexidine

has been reported


Stenosis of parotid duct has also been
reported

Enzymes
Enzymes has been used as active agents

in antiplaque preparations
It is due to the fact that enzymes would be
able to breakdown already formed matrix
some plaques and calculus
Some are proteolytic and have bactericidal
action
eg:Mucinase, mutanase, dextranase etc

DELMOPINOL
Inhibits plaque growth and reduces gingivitis

Mechanism of action
Interfere with plaque matrix formation & also reduces

bacterial adherence
It causes weak binding of plaque to tooth, thus aiding
in easy removal of plaque by mechanical procedures
It is therefore indicated as a pre brushing mouth
rinse

Adverse effect of
delmopinol
Staining of tooth & tongue
Taste disturbances
Mucosal soreness & erosion

Essential Oil Rinse


Reduces plaque 2o-35% and gingivitis reduction of 25-

35%
Essential Oil Preparation Contains:
Thymol
Eucalyptol
Menthol
Methyl Salicylate
Alcohol (up to 24% depending on the preparation)

Questions