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The effect of toothpaste with reduced concentration of fluoride-containing sodium trimetaphosphate and polyols on initial enamel erosion

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Clinical Oral Investigations Aims and scope Submit manuscript

Abstract

Objectives

This in vitro study evaluated the efficacy of toothpaste containing fluoride (F), sodium trimetaphosphate (TMP), and xylitol and erythritol (XE) to inhibit or repair initial enamel erosion lesions.

Materials and methods

Bovine enamel blocks (n = 120) were selected according to surface hardness (SH) and randomly divided into 5 experimental groups (n = 24 blocks/group): Placebo (no F, TMP, XE); 1100 ppm F; 16% xylitol + 4% erythritol (XE); 200 ppm F + 0.2% TMP (200 ppm F/TMP); and 200 ppm F + 0.2% TMP + 16% xylitol + 4% erythritol (200 ppm F/TMP/XE). The sound and softened blocks were immersed in toothpaste slurry in human saliva for 2 min. The blocks were then submitted to 4 erosive challenges in citric acid (0.75%, pH 3.5), each challenge for 1 min, with stirring. The SH of the blocks was determined after treatment (t) and after the 4 erosive challenges. In addition, the precipitates were analyzed by scanning electron microscopy (SEM). Variables were submitted to a two-way repeated-measures analysis of variance followed by a Student–Newman–Keuls test (p < 0.05).

Results

Toothpaste containing 200 ppm F/TMP/XE led to the highest protective and repair effect compared to the other groups (p < 0.001). The protective and repair effect was XE > 200 ppm F/TMP > 1100 ppm F > placebo (p < 0.001). All groups produced precipitates with a thicker layer for XE and TMP groups.

Conclusions

Toothpaste containing 200 ppm F, TMP, and polyols demonstrated a superior protective and repair effect in initial enamel erosive lesions in vitro.

Clinical relevance

Toothpaste containing F and polyols could be an advantage in patients affected by dental erosion, due to its higher preventive potential, mainly in individuals who frequently drink acidic beverages. However, future studies are needed to confirm these results.

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Acknowledgements

We would like to thank the National Council for Technological and Scientific Development–Brazil (CNPq, grant number 133158/2019-5) for the master’s scholarship received by the first author; the State of São Paulo Research Foundation–Brazil (FAPESP, grant number 2018/21082-9) for the Scientific Initiation scholarship received by the fourth author; the Coordination for the Improvement of Higher Education Personnel–Brazil (CAPES, grant number 88881.068437/2014–2001) for financial support under the coordination of the second author; and Dr. Wayne Gundry from Xlear Incorporation (American Fork, UT, USA) for manufacturing the toothpastes.

Funding

The work was supported by the master’s scholarship received by the first author from the National Council for Technological and Scientific Development–Brazil (CNPq, grant number 133158/2019–5); the Scientific Initiation scholarship from the State of São Paulo Research Foundation–Brazil (FAPESP, grant number 2018/21082–9) received by the fourth author; and financial support from the Coordination for the Improvement of Higher Education Personnel–Brazil (CAPES, grant number 88881.068437/2014–2001) under the coordination of the second author.

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Authors and Affiliations

  1. Department of Preventive and Restorative Dentistry, School of Dentistry, São Paulo State University (Unesp), Araçatuba, São Paulo, Brazil

    Priscila Toninatto Alves de Toledo, Alberto Carlos Botazzo Delbem & Amanda Eliane Sakamoto

  2. Feinberg School of Medicine, Northwestern University, Ann and Robert Lurie Children’s Hospital, 420 E Superior St, Chicago, IL, 60611, USA

    Mark Lloyd Cannon

  3. Department of Diagnosis and Surgery, School of Dentistry, São Paulo State University (Unesp), Araçatuba, São Paulo, Brazil

    Denise Pedrini

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Contributions

Priscila Toninatto Alves de Toledo and Amanda Eliane Sakamoto participated in the study design, performed the laboratory experiments, organized the data for statistical analysis, and contributed to the preparation of the manuscript. Mark Lloyd Cannon participated in validation, investigation, data curation, formal analysis, writing—review and editing. Alberto Carlos Botazzo Delbem conceived the study idea, funding acquisition, organized the data for statistical analysis, and contributed to the preparation of the manuscript. Denise Pedrini conceived the study idea, participated in the study design, supervised the laboratory experiments, organized the data for statistical analysis, and contributed to the preparation of the manuscript. All authors performed the revision and approval of the final version of the manuscript.

Corresponding author

Correspondence to Denise Pedrini.

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Ethics approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the Institutional Review Board and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed consent

Informed consent was obtained from all individuals participating in the study.

Conflict of interest

The author Alberto Carlos Botazzo Delbem declares that he has a patent request in Brazil (INPI—BR 10 2020 022701 7) for “Dental Composition and Process of Obtaining it”. The authors Priscila Toninatto Alves de Toledo, Mark Lloyd Cannon, Amanda Eliane Sakamoto, and Denise Pedrini declare that they have no conflict of interest.

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de Toledo, P.T.A., Delbem, A.C.B., Cannon, M.L. et al. The effect of toothpaste with reduced concentration of fluoride-containing sodium trimetaphosphate and polyols on initial enamel erosion. Clin Oral Invest 26, 7243–7252 (2022). https://doi.org/10.1007/s00784-022-04684-7

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