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Relationship between toothpastes properties and patient-reported discomfort: crossover study

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Abstract

Objectives

This study aims to correlate patient-reported reactions with in vitro analyses of the pH, abrasive quality, and cytotoxicity of four toothpastes.

Materials and Methods

One hundred twenty-one patients received non-identified samples of toothpaste to be used for 6 days and answered a questionnaire about their sensations. In vitro analysis: the pH of toothpastes was measured with a pH meter. The abrasivity of toothpastes was evaluated against composite resin specimens (n = 10). A toothbrushing machine was used to simulate wear, which was indirectly measured by mass loss using a scale. Cell culture media conditioned with toothpaste were used to assess the cytotoxicity. Confluent cells were kept in contact with the conditioned media or control for 24 h. The cell viability was measured using the 3-(bromide, 4,5-dimethylthiazol-2yl)-2,5-diphenyltetrazolium (MTT)-reduction assay. The obtained data on the pH, weight loss, and cell viability were compared by ANOVA/Tukey’s tests (p < 0.05).

Results

With the exception of the bleaching effect paste, the Oral B® paste produced the highest frequencies of irritation reports, tooth sensitivity, taste discomfort, and texture discomfort in the clinical study; patients also reported rougher teeth, soft tissue peeling, dry mouth, thrush, tingling, and taste changes in response to this paste. The in vitro analysis demonstrated that Oral B® had the lowest pH, the highest abrasivity, and produced the lowest cell viability (p < 0.01).

Conclusion

Results suggest that low pH toothpastes that are highly abrasive and cytotoxic may cause undesirable reactions in patients.

Clinical relevance

Toothpaste’s properties should be well known for indication to patient therefore minimizing discomfort reports.

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References

  1. Fine DH, Furgang D, Markowitz K, Sreenivasan PK, Klimpel K, De Vizio W (2006) The antimicrobial effect of a triclosan/copolymer dentifrice on oral microorganisms in vivo. J Am Dent Assoc 137(10):1406–1413

    Article  PubMed  Google Scholar 

  2. Ozaki F, Pannuti CM, Imbronito AV, Pessotti W, Saraiva L, de Freitas NM, Ferrari G, Cabral VN (2006) Efficacy of a herbal toothpaste on patients with established gingivitis—a randomized controlled trial. Braz Oral Res 20(2):172–177

    Article  PubMed  Google Scholar 

  3. Cury JA (2002) Dentifrícios: como escolher e como indicar. In: Associação Paulista dos Cirurgiões-Dentistas Odontologia São Paulo: Artes Médicas–Divisão Odontológica

  4. Cury JA, Francisco SB, Simoes GS, Del Bel Cury AA, Tabchoury CP (2003) Effect of a calcium carbonate-based dentifrice on enamel demineralization in situ. Caries Res 37(3):194–199

    Article  PubMed  Google Scholar 

  5. Davies R, Scully C, Preston AJ (2010) Dentifrices—an update. Med Oral Patol Oral Cir bucal 15(6):e976–982

    Article  PubMed  Google Scholar 

  6. Gaffar A, Scherl D, Afflitto J, Coleman EJ (1995) The effect of triclosan on mediators of gingival inflammation. J Clin Periodontol 22(6):480–484

    Article  PubMed  Google Scholar 

  7. Herlofson BB, Barkvoll P (1996) The effect of two toothpaste detergents on the frequency of recurrent aphthous ulcers. Acta Odontol Scand 54(3):150–153

    Article  PubMed  Google Scholar 

  8. Moore C, Addy M, Moran J (2008) Toothpaste detergents: a potential source of oral soft tissue damage? Int J Dent Hyg 6(3):193–198. doi:10.1111/j.1601-5037.2008.00307.x

    Article  PubMed  Google Scholar 

  9. Ersoy M, Tanalp J, Ozel E, Cengizlier R, Soyman M (2008) The allergy of toothpaste: a case report. Allergol Immunopathol 36(6):368–370

    Article  Google Scholar 

  10. Isaac-Renton M, Li MK, Parsons LM (2015) Cinnamon spice and everything not nice: many features of intraoral allergy to cinnamic aldehyde. Dermat Contact, Atopic, Occupational, drug 26(3):116–121. doi:10.1097/DER.0000000000000112

    Google Scholar 

  11. Lawrence LM, Farquharson A, Brown RS, Vatanka HO (2013) Oral tissue irritants in toothpaste: a case report. J Clin Pediatr Dent 38(1):75–78

    Article  PubMed  Google Scholar 

  12. Camargo SE, Joias RP, Santana-Melo GF, Ferreira LT, El Achkar VN, Rode Sde M (2014) Conventional and whitening toothpastes: cytotoxicity, genotoxicity and effect on the enamel surface. Am J Dent 27(6):307–311

    PubMed  Google Scholar 

  13. Cvikl B, Lussi A, Gruber R (2015) The in vitro impact of toothpaste extracts on cell viability. Eur J Oral Sci 123(3):179–185. doi:10.1111/eos.12177

    Article  PubMed  Google Scholar 

  14. Gerckens B, Eisinger G, Kaden P, Kruger W (1991) Comparative studies of toothpastes and toothpaste ingredients in biological systems: 1. Can various toothpastes be differentiated by relative biological effectiveness in cell culture studies? Oralprophylaxe/Herausgeber, Verein fur Zahnhygiene eV 13(2):55–60

    Google Scholar 

  15. Torrado A, Valiente M, Zhang W, Li Y, Munoz CA (2005) Cytotoxicity of a new toothpaste based on an ion exchange resin mixture. Am J Dent 18(4):267–269

    PubMed  Google Scholar 

  16. Guo LW, Wu Q, Green B, Nolen G, Shi L, Losurdo J, Deng H, Bauer S, Fang JL, Ning B (2012) Cytotoxicity and inhibitory effects of low-concentration triclosan on adipogenic differentiation of human mesenchymal stem cells. Toxicol Appl Pharmacol 262(2):117–123. doi:10.1016/j.taap.2012.04.024

    Article  PubMed  Google Scholar 

  17. Buma R, Maeda T, Kamei M, Kourai H (2006) Pathogenic bacteria carried by companion animals and their susceptibility to antibacterial agents. Biocontrol Sci 11(1):1–9

    Article  PubMed  Google Scholar 

  18. Newbrun E (1989) Cariology, vol 9. Quintessence, Chicago, IL

    Google Scholar 

  19. Skaare A, Kjaerheim V, Barkvoll P, Rolla G (1997) Skin reactions and irritation potential of four commercial toothpastes. Acta Odontol Scand 55(2):133–136

    Article  PubMed  Google Scholar 

  20. Lee AY, Yoo SH, Oh JG, Kim YG (2000) 2 cases of allergic contact cheilitis from sodium lauryl sulfate in toothpaste. Contact Dermatitis 42(2):111

    PubMed  Google Scholar 

  21. Barkvoll P, Rolla G (1989) Possible effects of sodium lauryl sulfate (SLS) on the oral mucosa. J Dent Res 68 (−):991

  22. Baer PN (1992) Toothpaste allergies. J Clin Pediatr Dent 16(3):230–231

    PubMed  Google Scholar 

  23. Herlofson BB, Barkvoll P (1994) Sodium lauryl sulfate and recurrent aphthous ulcers. A preliminary study. Acta Odontol Scand 52(5):257–259

    Article  PubMed  Google Scholar 

  24. Chahine L, Sempson N, Wagoner C (1997) The effect of sodium lauryl sulfate on recurrent aphthous ulcers: a clinical study. Compend Contin Educ Dent 18(12):1238–1240

    PubMed  Google Scholar 

  25. Addy M, Hunter ML (2003) Can tooth brushing damage your health? Effects on oral and dental tissues. Int Dent J 53(Suppl 3):177–186

    Article  PubMed  Google Scholar 

  26. DeLattre VF (1999) Factors contributing to adverse soft tissue reactions due to the use of tartar control toothpastes: report of a case and literature review. J Periodontol 70(7):803–807. doi:10.1902/jop.1999.70.7.803

    Article  PubMed  Google Scholar 

  27. Macdonald E, North A, Maggio B, Sufi F, Mason S, Moore C, Addy M, West NX (2010) Clinical study investigating abrasive effects of three toothpastes and water in an in situ model. J Dent 38(6):509–516. doi:10.1016/j.jdent.2010.03.007

    Article  PubMed  Google Scholar 

  28. Schemehorn BR, Moore MH, Putt MS (2011) Abrasion, polishing, and stain removal characteristics of various commercial dentifrices in vitro. J Clin Dent 22(1):11–18

    PubMed  Google Scholar 

  29. Redmalm G (1986) Dentifrice abrasivity. The use of laser light for determination of the abrasive properties of different silicas. An In vitro Study Swedish Dent J 10(6):243–250

    Google Scholar 

  30. Davis WB, Winter PJ (1976) Measurement in vitro of enamel abrasion by dentifrice. J Dent Res 55(6):970–975

    Article  PubMed  Google Scholar 

  31. Bergstrom J, Eliasson S (1988) Cervical abrasion in relation to toothbrushing and periodontal health. Scand J Dent Res 96(5):405–411

    PubMed  Google Scholar 

  32. Ashmore H, Van Abbe NJ, Wilson SJ (1972) The measurement in vitro of dentine abrasion by toothpaste. Br Dent J 133(2):60–66

    Article  PubMed  Google Scholar 

  33. Voronets J, Lussi A (2010) Thickness of softened human enamel removed by toothbrush abrasion: an in vitro study. Clin Oral Investig 14(3):251–256. doi:10.1007/s00784-009-0288-y

    Article  PubMed  Google Scholar 

  34. Teixeira EC, Thompson JL, Piascik JR, Thompson JY (2005) In vitro toothbrush-dentifrice abrasion of two restorative composites. Journal of esthetic and restorative dentistry: Official Publication of the American Academy of Esthetic Dentistry [et al.] 17 (3):172–180; discussion 181–172

  35. Kanter J, Koski RE, Martin D (1982) The relationship of weight loss to surface roughness of composite resins from simulated toothbrushing. J Prosthet Dent 47(5):505–513

    Article  PubMed  Google Scholar 

  36. Giles A, Claydon NC, Addy M, Hughes N, Sufi F, West NX (2009) Clinical in situ study investigating abrasive effects of two commercially available toothpastes. J Oral Rehabil 36(7):498–507. doi:10.1111/j.1365-2842.2009.01965.x

    Article  PubMed  Google Scholar 

  37. Thomassewski MHD, Santos FA, Wambier DS (2009) Desgaste dos cimentos de ionômero de vidro indicados para tratamento restaurador atraumático após escovação simulada. Rev Odontol UNESP (Online) 38 (−):12–19

  38. Ruano R, Jaeger RG, Jaeger MM (2000) Effect of a ceramic and a non-ceramic hydroxyapatite on cell growth and procollagen synthesis of cultured human gingival fibroblasts. J Periodontol 71(4):540–545. doi:10.1902/jop.2000.71.4.540

    Article  PubMed  Google Scholar 

  39. ASTM (1992) Annual Book of ASTM Standards: Medical Devices. American Society for Testing and Materials, West Conshohocken USA

    Google Scholar 

  40. Mosmann T (1983) Rapid colorimetric assay for cellular growth and survival: application to proliferation and cytotoxicity assays. J Immunol Methods 65(1–2):55–63

    Article  PubMed  Google Scholar 

  41. Freshney RI (2010) Database of misidentified cell lines. Int J Can J Int Cancer 126(1):302. doi:10.1002/ijc.24998

    Article  Google Scholar 

  42. Kielbassa AM, Gillmann L, Zantner C, Meyer-Lueckel H, Hellwig E, Schulte-Monting J (2005) Profilometric and microradiographic studies on the effects of toothpaste and acidic gel abrasivity on sound and demineralized bovine dental enamel. Caries Res 39(5):380–386. doi:10.1159/000086844

    Article  PubMed  Google Scholar 

  43. Hilgenberg SP, Pinto SC, Farago PV, Santos FA, Wambier DS (2011) Physical-chemical characteristics of whitening toothpaste and evaluation of its effects on enamel roughness. Braz Oral Res 25(4):288–294

    Article  PubMed  Google Scholar 

  44. Cardoso CA, Levy FM, Peres-Buzalaf C, Buzalaf MA (2015) Dentifrice pH but not consistency may affect fluoride uptake in plaque. J Dent 43(2):219–224. doi:10.1016/j.jdent.2014.12.003

    Article  PubMed  Google Scholar 

  45. Motta LG, Motta RG, Bastazini Filho O, Velmovstky L, Fraga RC (2002) Total fluoride and pH of some dentrifices in Rio de Janeiro. Rev Bras Odontol 59(2):136–138

    Google Scholar 

  46. Andrade Junior ACC, Andrade MRTC, Machado WAS, Fischer RG (1998) In vitro study of dentifrice abrasivity. Rev Odontol Univ Sao Paulo 12(3):231–236

    Article  Google Scholar 

  47. Schlueter N, Klimek J, Ganss C (2014) Effect of a chitosan additive to a Sn2+-containing toothpaste on its anti-erosive/anti-abrasive efficacy—a controlled randomised in situ trial. Clin Oral Investig 18(1):107–115. doi:10.1007/s00784-013-0941-3

    Article  PubMed  Google Scholar 

  48. Seong J, Macdonald E, Newcombe RG, Davies M, Jones SB, Johnson S, West NX (2013) In situ randomised trial to investigate the occluding properties of two desensitising toothpastes on dentine after subsequent acid challenge. Clin Oral Investiga 17(1):195–203. doi:10.1007/s00784-012-0683-7

    Article  Google Scholar 

  49. Johannsen G, Tellefsen G, Johannsen A, Liljeborg A (2013) The importance of measuring toothpaste abrasivity in both a quantitative and qualitative way. Acta Odontol Scand 71(3–4):508–517. doi:10.3109/00016357.2012.696693

    Article  PubMed  PubMed Central  Google Scholar 

  50. Liljeborg A, Tellefsen G, Johannsen G (2010) The use of a profilometer for both quantitative and qualitative measurements of toothpaste abrasivity. Int J Dent Hyg 8(3):237–243. doi:10.1111/j.1601-5037.2009.00433.x

    PubMed  Google Scholar 

  51. Tellefsen G, Liljeborg A, Johannsen A, Johannsen G (2011) The role of the toothbrush in the abrasion process. Int J Dent Hyg 9(4):284–290. doi:10.1111/j.1601-5037.2011.00505.x

    Article  PubMed  Google Scholar 

  52. Vicentini BC, Braga SR, Sobral MA (2007) The measurement in vitro of dentine abrasion by toothpastes. Int Dent J 57(5):314–318

    Article  PubMed  Google Scholar 

  53. Redmalm G, Ryden H (1984) Dentifrice abrasivity. The use of laser light and supplemental techniques for characterizing toothpastes containing different abrasives. An In vitro Study Swedish Dent J 8(2):57–66

    Google Scholar 

  54. Joiner A (2010) Whitening toothpastes: a review of the literature. J Dent 38(Suppl 2):e17–24. doi:10.1016/j.jdent.2010.05.017

    Article  PubMed  Google Scholar 

  55. Navada R, Kumari H, Le S, Zhang J (2008) Oral malodor reduction from a zinc-containing toothpaste. J Clin Dent 19(2):69–73

    PubMed  Google Scholar 

  56. Herro E, Jacob SE (2010) Mentha piperita (peppermint). Dermat Contact, Atopic, Occupational, Drug 21(6):327–329

    Google Scholar 

  57. Herlofson BB, Barkvoll P (1996) Oral mucosal desquamation caused by two toothpaste detergents in an experimental model. Eur J Oral Sci 104(1):21–26

    Article  PubMed  Google Scholar 

  58. Neppelberg E, Costea DE, Vintermyr OK, Johannessen AC (2007) Dual effects of sodium lauryl sulphate on human oral epithelial structure. Exp Dermatol 16(7):574–579. doi:10.1111/j.1600-0625.2007.00567.x

    Article  PubMed  Google Scholar 

  59. Ghapanchi J, Kamali F, Moattari A, Poorshahidi S, Shahin E, Rezazadeh F, Khorshidi H, Jamshidi S (2015) In vitro comparison of cytotoxic and antibacterial effects of 16 commercial toothpastes. J Int Oral Health: JIOH 7(3):39–43

    PubMed  PubMed Central  Google Scholar 

  60. Aykut-Yetkiner A, Attin T, Wiegand A (2014) Prevention of dentine erosion by brushing with anti-erosive toothpastes. J Dent 42(7):856–861. doi:10.1016/j.jdent.2014.03.011

    Article  PubMed  Google Scholar 

  61. Dzakovich JJ, Oslak RR (2013) In vitro reproduction of incisal/occlusal cupping/cratering. J Prosthet Dent 109(6):384–391. doi:10.1016/S0022-3913(13)60324-8

    Article  PubMed  Google Scholar 

  62. Franzo D, Philpotts CJ, Cox TF, Joiner A (2010) The effect of toothpaste concentration on enamel and dentine wear in vitro. J Dent 38(12):974–979. doi:10.1016/j.jdent.2010.08.010

    Article  PubMed  Google Scholar 

  63. Wiegand A, Burkhard JP, Eggmann F, Attin T (2013) Brushing force of manual and sonic toothbrushes affects dental hard tissue abrasion. Clin Oral Investig 17(3):815–822. doi:10.1007/s00784-012-0788-z

    Article  PubMed  Google Scholar 

  64. Tsutsui T, Tanaka Y, Ushimura A, Ide T, Matsumura M, Barrett JC (1997) In vitro cytotoxicity of diverse preparations used in dental practice to human gingival keratinocytes. Toxicol In vitro: an Int J published in Assoc with BIBRA 11(4):393–398

    Article  Google Scholar 

  65. Norton JN, Rylander LA, Richards JL (1995) In vitro oral mucosa irritation testing with human cell cultures. Toxicol In vitro: an Int J published in Assoc with BIBRA 9(1):67–74

    Article  Google Scholar 

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Acknowledgments

The authors would like to thank Colgate-Palmolive for the toothpastes donation. This study was supported by the authors and received no specific grant from any funding agency in the public, commercial, or not-for-profit sectors. Also, this study did not have any perceived and the authors declare that they have no conflict of interest.

Ethical standards

This study was approved by the Ethical Committee in Research of the Ibirapuera University (protocol 367 763). All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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Authors and Affiliations

  1. Master Degree Program, School of Dentistry, Ibirapuera University, Chácara Flora, São Paulo, Brazil

    Mariana Bruno, Maria Stella N. A. Moreira & Fernanda Calabró Calheiros

  2. School of Dentistry, University of São Paulo, São Paulo, Brazil

    Fernando Taddeo, Igor Studart Medeiros & Márcia Martins Marques

  3. Master Degree Program, School of Dentistry, Santo Amaro University, São Paulo, Brazil

    Letícia Cristina Cidreira Boaro

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  1. Mariana Bruno
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  2. Fernando Taddeo
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  3. Igor Studart Medeiros
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  4. Letícia Cristina Cidreira Boaro
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  5. Maria Stella N. A. Moreira
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  6. Márcia Martins Marques
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  7. Fernanda Calabró Calheiros
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Correspondence to Fernanda Calabró Calheiros.

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Bruno, M., Taddeo, F., Medeiros, I.S. et al. Relationship between toothpastes properties and patient-reported discomfort: crossover study. Clin Oral Invest 20, 485–494 (2016). https://doi.org/10.1007/s00784-015-1539-8

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