Business Use Mechanical & Chemical Plaque Removal: Understanding the Different Efficacies for Patient Education
Ohio Dental Hygienists Association Total Development Weekend May 31, 2019 Business Use
Dr. Cyndee Stegeman EdD, RDH, RD, CDE, FAND Procter & Gamble Crest + Oral B Scientific Relations Manager [email protected] Business Use Evolution of Toothpaste – Fluoride Systems
Caries (fluoride)
Caries + Sensitivity Caries + Cosmetic Caries + Antibacterial
Multi-Benefit Business Use Focus: Gingival Health Business Use Why toothpaste matters…
❖ Manual brushing removes 42% of plaque biofilm ❖ Average brushing is 46 seconds ❖ Only 10% of patients adhere to correct brushing methods. ❖ Toothpaste with SnF offers comprehensive benefits
J of Clinical Dentistry, 2017
5 Business Use Therapeutic Dentifrices Monographs regulate OTC dentifrices
Monograph Active Ingredients Mode of Action Examples
Sodium Fluoride Aquafresh Extreme Clean Sub-surface Anti-caries Monofluorophosphate Remineralization Colgate Cavity Protection Stannous Fluoride Crest Gum Detoxify
Anti-plaque Triclosan Bactericidal Colgate Total Anti-gingivitis Stannous Fluoride Bacteriostatic Crest Gum Detoxify
Strontium Chloride Dentinal Occludes Tubules Original Sensodyne Potassium Nitrate Hypersensitivity Numbs the Nerve Sensodyne Stannous Fluoride Crest Gum Detoxify
US Federal Food, Drug, & Cosmetic Act. Accessed 1/4/2019, US FDA Monograph System. Accessed 1/4/2019, US Food & Drug Administration Business Use
Smart Phone Stannous Fluoride ❖ Caries Control ❖ Phone Calls ❖ Anti-Gingivitis ❖ Text Messages ❖ Sensitivity Relief ❖ E-mail ❖ Plaque Control ❖ Take Pictures & Video ❖ Calculus Control ❖ Surf the Internet ❖ Whitening ❖ Store/Listen to Music & Movies ❖ Fresh Breath ❖ GPS ❖ Protection Against Acid Erosion ❖ Flashlight Business Use
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What makes Stannous different?
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Actions Benefits Net Effect
⎢ Slows acid damage
⎢ Kills and slows bacteria Anti-Cavity Anti-Erosion ⎢ Helps occlude dentin Anti-Sensitivity Anti-Gingivitis ⎢ Blocks harmful toxins 12 Business Use 13 Business Use Targeting the Microbe/Host Interaction Business Use Stain Mitigating Factors
Hydrogen Peroxide Bleaches surface stains
Zinc Citrate, Silica Also inhibits the formation of calculus and plaque Business Use In VITRO DATA COMPARING TO SENSODYNE STANNOUS FLUORIDE TOOTHPASTE DEMONSTRATED THAT CREST STABILIZED STANNOUS FLUORIDE TOOTH PASTE DELIVERS:
▪ Greater deposition
▪ Greater tubule protection after a mechanical and acid resistance challenge
Sensodyne Crest® stabilized Control‡ stannous Fluoride¶ stannous fluoride‡‡
After treatment
After Mechanical Challenge
After Acid Challenge
Crest Stabilized Stannous Fluoride toothpaste demonstrated better tubule occlusion efficiency and durability
* With twice daily brushing † P&G calculation based on Nielsen US reported sales for year ending w/o 8/10/2013 ‡ Colgate® Cavity Protection toothpaste †† Crest® PRO-HEALTH™ toothpaste ¶ Sensodyne® Repair & Protect toothpaste ** Zsiska M, White DJ. Dentinal tubule occlusion with stannous fluoride dentifrices. J Dent Res 2014; 93 (Spec Iss A): Abstract 579. Business Use Crest Gum and Sensitivity
16 Business Use Titanium Implants Business Use
Mucositis Two weeks of good oral hygiene
Source: Dr. Amit Patel BDS MSc MclinDent RCSEng, UK Business Use Proper formulation is critical to deliver all the benefits of stannous fluoride Stabilize Make Sn+2 Sn+2 bioavailable
Make the Sn+2 Mitigate the stain of And stain mitigator bioavailable Sn+2 compatible for long-term stability Business Use Stannous Fluoride
Extremely complex chemistry: SnF2 • It’s not on Wikipedia +2 -… + - SnF2 → Sn and F just like NaCl →Na and Cl Right? WRONG!!!
F-
Sn+2 20 Business Use
SnF2 forms complexes with all ionic and polar species in the formulation
- SnF + F SnF[Gluconate] 2 SnF3 - SnF3 Sn[Glconate] SnF+ SnO(OH)2 SnO2 Sn:Silica Sn[Gluconate][polyphosphate] N! Sn+2 Zn+2 Sn[Polyphosphates] 21 22 Business Use Stannous Fluoride
• Binds to toxins (e.g., lipopolysaccharides) • Blocks endotoxins’ reactivity with toll-like receptors • Blunts inflammatory destruction to reduce/prevent gingivitis Business Use
Manual Toothbrushes Business Use CrissCross Bristles
CrissCross bristles Angled bristles Oral-B – The only brush with Cross Action bristles angled at 16° to actively penetrate deep between teeth
Removes up to 99% of plaque in hard-to reach areas Business Use
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Oscillating-Rotating-Pulsating Technology “Round for a Reason”
Professionally inspired small, round designed, to follow tooth anatomy and morphology Business Use
27 Business Use Power Brushes Oscillating move back and forth at a regular speed Pulsating a regular throbbing sensation Business Use Handle + 8 Brush Head Refills for Improved Patient-Based Solutions Business Use Whitening Strip with Light Technology
30 Business Use Business Use Business Use dentalcare.com structure – Professional Education