Fluoride-Containing Toothpastes Available in Two European Countries

PEDIATRIC DENTAL JOURNAL 16(2): 187–195, 2006 187

Short Communication Fluoride-containing toothpastes available in two European countries

Fusao Nishikawara*1,2, Yoshiaki Nomura*1,2, Yoh Tamaki*1,2,3, Seiko Katsumura*4, Yoshinobu Asada*5 and Nobuhiro Hanada*2

*1 Department of Preventive Dentistry and Public Health, Tsurumi University School of Dental Medicine 2-1-3 Tsurumi, Tsurumi-ku, Yokohama 230-8501, JAPAN *2 Department of Oral Health, National Institute of Public Health 2-3-6 Minami, Wako, Saitama 351-0197, JAPAN *3 Division of Oral Health, Department of Health Science, Kanagawa Dental College 82 Inaoka-cho, Yokosuka, Kanagawa 238-8580, JAPAN *4 Department of Anatomy, Tsurumi University School of Dental Medicine 2-1-3 Tsurumi, Tsurumi-ku, Yokohama 230-8501, JAPAN *5 Department of Pediatric Dentistry, Tsurumi University School of Dental Medicine 2-1-3 Tsurumi, Tsurumi-ku, Yokohama 230-8501, JAPAN

Abstract The caries-preventive effect of fluoride is well known. The Key words widespread use of fluoride-containing toothpastes and mouthrinses has been Fluoride, recommended to reduce dental caries. Many kinds of fluoride-containing Prevention of dental caries, toothpastes are available in Japan. The aim of this study was to investigate the Toothpastes current status of fluoride-containing toothpastes on the market in two European countries. Fluoride-containing toothpastes were purchased from retail outlets in Cardiff, United Kingdom, and Frankfurt, Germany. The ingredients labels were studied to determine the type and concentration of fluoride. Most of the toothpastes contained sodium fluoride (56.4%); some contained monofluoroacetic sodium (31.7%), stearyl trihydroxyethyl propylenediamine dihydrofluoride (1.0%), aluminium fluoride (1.0%), stannous fluoride (2.0%), or amine fluoride (5.0%). The concentration of fluoride in these products ranged from 800 to 1,500 ppm.

The effectiveness of fluoride for the prevention of prevention of dental caries3). dental caries has been clearly established. There Many kinds of fluoride-containing toothpastes are several methods for the application of fluoride, are available throughout the world. In Japan, 87% of including water fluoridation, varnishes, and several the toothpastes currently on the market contain some other commercially available professional and self- form of fluoride4). A review indicated that between applied products. In Japan, according to the water 20% and 40% of toothpastes contain fluoride as an quality standards of the Japan Waterworks Law, the anticaries agent. Moreover, it has been suggested fluoride concentration of tap water should be kept at that fluoride-containing toothpastes may also have a level not exceeding 0.8 ppm. However, in fact, the an anti-caries effect in children5,6). Because many concentration of fluoride in the public water supply toothpastes containing fluoride are available in in most districts of Japan has been reported to be Europe, we carried out a field survey to gain a less than 0.1 ppm1,2). The World Health Organization better understanding of the market sales of these (WHO) recommends a concentration of 0.5 to products in two countries. We visited pharmacies, 1.0 ppm of fluoride in the drinking water for the supermarkets, general shops, and kiosks in Cardiff and Frankfurt, from which we purchased many Received on March 24, 2006 toothpastes. The products obtained are shown in Accepted on July 31, 2006 Table 1a–b. A total of 52 and 49 fluoride-containing

187 188 Nishikawara, F., Nomura, Y., Tamaki, Y. et al.

Table 1a The toothpastes purchased in Cardiff, United Kingdom that contained fluoride Fluoride Country of Company Product name Ingredients concentration production (ppm) aqua, sorbitol, hydrated silicate, cellulose, sodium citrate, sodium lauryl sulfate, disodium phosphate, sodium phosphate, aroma, sodium Boots Whitening — 1,090 carboxymethylcellulose, zinc citrate, sodium fluoride, sodium saccharide, clorofene bromide, dye The Boots Co. sorbitol, aqua, cellulose, caprylic acid/capric acid triglyceride, hydrated silicate, sodium tripolyphosphate, xylitol, sodium citrate, PEG1600, Boots Advanced — aroma, sodium carboxymethylcellulose, sodium lauryl sulfate, citric 1,450 Stainguard System acid, sodium fluoride, sodium saccharide, sodium sulfate, sodium hydrate, dye aqua, aluminium hydroxide, sorbitol, calcium levofolinate dihydrate, glycerin, aroma, sodium carboxymethylcellulose, monofluoroacetic Carter Products Ltd. Pearl Drops Toothpolish — 1,000 sodium phosphate, polysorbic acid 20, sodium saccharide, methylparaben, menthol sorbitol, aqua, hydrated silicate, glycerin, tetrapotassium pyrophosphate, Carter-Wallace Ltd. Pearl Drops Smokers — sodium lauryl sulfate, tetrasodium pyrophosphate, PEG600, aroma, — sodium carboxymethylcellulose, sodium saccharide, sodium fluoride, dye sodium bicarbonate, aqua, glycerin, sodium saccharide, PEG400, Arm & Hammer Dental USA sarcosine sodium, aroma, sodium carboxymethylcellulose, sodium 1,100 Care Original lauryl sulfate, sodium fluoride sorbitol, silicic acid anhydride, aqua, glycerin, alumina, aroma, sodium Arm & Hammer P.M. Church & Dwight USA lauryl sulfate, sodium carboxymethylcellulose, monofluoroacetic sodium 1,320 Night-Time Protection Co. Inc. phosphate, zinc citrate, sodium saccharide sodium bicarbonate, aqua, glycerin, alumina, tetrasodium Arm & Hammer pyrophosphate, aroma, PEG400, sodium lauroyl sarcosinate, sodium USA 1,100 Extra Whitening lauryl sulfate, sodium saccharide, monofluoroacetic sodium phosphate, sodium carboxymethylcellulose, sodium lauryl sulfate calcium hydrogen phosphate dihydrate, glycerin, sorbitol, sodium Colgate fluoride, sodium carboxymethylcellulose, monofluoroacetic sodium UK 1,450 Cavity Protection phosphate, PEG600, sodium lauryl sulfate, saccharin sodium, tetrasodium pyrophosphate, aroma, aqua purificate calcium carbonate, aqua, sorbitol, sodium lauryl sulfate, monofluoroacetic sodium phosphate, PEG600, aroma, carrageenan, Colgate UK sodium carboxymethylcellulose, sodium silicate, sodium saccharide, 1,450 Herbal methylparaben, propylparaben, tee-tree extract, sage extract, eugenol, mirrh extract, chamomilla extract, dye sorbitol, aqua, hydrated silicate, PEG600, sodium lauryl sulfate, aroma, Colgate UK sodium carboxymethylcellulose, cocamidopropyl betaine, sodium 1,450 Fresh Confidence fluoride, sodium saccharide, triclosan, glycerin, dye sorbitol, aqua, hydrated silicate, glycerin, PEG600, sodium lauryl Colgate UK sulfate, aroma, sodium carboxymethylcellulose, sodium fluoride, sodium 1,450 Triple Cool Stripe saccharide, dye glycerin, hydrated silicate, sodium bicarbonate, propylene glycol, aqua, sodium tripolyphosphate, tetrasodium pyrophosphate, sodium lauryl Colgate UK sulfate, monofluoroacetic sodium phosphate, aroma, calcium peroxide, 1,450 Sensation Deep Clean carrageenan, sodium carboxymethylcellulose, sodium hydrate, sodium saccharide, dye aqua, hydrated silicate, sorbitol, glycerin, tetrasodium pyrophosphate, Colgate poly methyl vinyl ether/maleic acid copolymer, aroma, sodium lauryl UK 1,450 Colgate-Palmolive Whitening sulfate, titanium dioxide, sodium carboxymethylcellulose, carrageenan, UK sodium fluoride, sodium hydrate, sodium saccharide aqua, hydrated silicate, sorbitol, glycerin, PEG600, tetrasodium Colgate pyrophosphate, poly methyl vinyl ether/maleic acid copolymer, sodium Anti-Tartar with UK 1,100 lauryl sulfate, aroma, sodium carboxymethylcellulose, sodium hydrate, Whitening carrageenan, sodium saccharide, sodium fluoride, dye poly methyl vinyl ether/maleic acid copolymer, hydrated silicate, Colgate glycerin, sorbitol, sodium lauryl sulfate, sodium fluoride, aroma, sodium UK 1,450 Total carboxymethylcellulose, titanium dioxide, sodium saccharide, carrageenan, sodium hydrate, aqua FLUORIDE TOOTHPASTES IN EUROPE 189

poly methyl vinyl ether/maleic acid copolymer, hydrated silicate, glycerin, sorbitol, sodium lauryl sulfate, aroma, sodium Colgate UK carboxymethylcellulose, sodium fluoride, titanium dioxide, sodium 1,450 Total Fresh Stripe saccharide, carrageenan, sodium hydrate, hydrated silicate, aluminium potassium sulfate, aqua, dye aqua, hydrated silicate, sorbitol, glycerin, poly methyl vinyl ether/maleic acid copolymer, sodium lauryl sulfate, aroma, sodium Colgate UK carboxymethylcellulose, sodium hydrate, sodium fluoride, triclosan, 1,450 Total Plus Whitening carrageenan, sodium saccharide, hydrated silicate, aluminium potassium sulfate, dye aqua, calcium carbonate, sorbitol, glycerin, hydrated silicate, sodium lauryl sulfate, aroma, sodium carboxymethylcellulose, monofluoroacetic Ultrabrite — 1,000 sodium phosphate, tetrasodium pyrophosphate, sodium saccharide, methylparaben, propylparaben calcium hydrogen phosphate dihydrate, glycerin, alumina, sorbitol, Rembrandt aqua, sodium citrate, cocamidopropyl betaine, aroma, monofluoroacetic USA 1,200 Extra Whitening sodium phosphate, sodium lauryl sulfate, papain, citric acid, sodium saccharide, methylparaben, dye Den-Mat calcium hydrogen phosphate, aqua, glycerin, sorbitol, alumina, Rembrandt Plus cocamidopropyl betaine, aroma, zinc citrate, monofluoroacetic sodium USA 1,200 Superior Whitening phosphate, carrageenan, papain, citric acid, calcium peroxide, sodium saccharide, methylparaben calcium carbonate, aqua, sorbitol, glycerin, zeolite, hydrated silicate, sodium lauryl sulfate, aroma, titanium dioxide, sodium Clinomyn E.C. De Witt & Co. — carboxymethylcellulose, monofluoroacetic sodium phosphate, trisodium 1,000 Smokers Toothpaste phosphate, methyl polysiloxane, sodium saccharide, methylparaben, propylparaben aqua, sorbitol, hydrated silicate, PEG1600, sodium lauryl sulfate, Mentadent — monofluoroacetic sodium phosphate, zinc citrate, sodium 1,450 SR carboxymethylcellulose, sodium saccharide, dye aqua, sorbitol, hydrated silicate, PEG1600, sodium lauryl sulfate, Mentadent P Elida Faberge Ltd. France monofluoroacetic sodium phosphate, aroma, sodium 1,000 Original Flavour carboxymethylcellulose, sodium saccharide, dye aqua, sorbitol, hydrated silicate, PEG1600, sodium lauryl sulfate, Signal — aroma, sodium fluoride, sodium saccharide, sodium 1,450 Family Protection carboxymethylcellulose, calcium gluconate, dye aqua, hydrated silicate, sorbitol, glycerin, PEG300, sodium lauryl Aquafresh UK sulfate, aroma, xanthan gum, titanium dioxide, carrageenan, sodium 1,350 Fresh & Minty fluoride, sodium saccharide, dye aqua, hydrated silicate, sorbitol, glycerin, PEG300, sodium lauryl Aquafresh UK sulfate, aroma, xanthan gum, titanium dioxide, carrageenan, sodium 1,350 Mild & Minty fluoride, sodium saccharide, dye aqua, hydrated silicate, sorbitol, glycerin, PEG300, sodium lauryl Aquafresh UK sulfate, aroma, xanthan gum, titanium dioxide, carrageenan, sodium 1,350 Multi Active fluoride, triclosan, sodium saccharide, dye aqua, hydrated silicate, sorbitol, glycerin, sodium tripolyphosphate, Aquafresh PEG300, sodium lauryl sulfate, aroma, titanium dioxide, UK 1,100 ,Whitening polyvinylpyrrolidon, xanthan gum, sodium hydrate, sodium saccharideםMulti-Action sodium fluoride, dye aqua, hydrated silicate, sorbitol, glycerin, PEG300, sodium lauryl Macleans UK sulfate, aroma, titanium dioxide, xanthan gum, carrageenin, sodium 1,350 Fresh Mint fluoride, sodium saccharide aqua, hydrated silicate, sorbitol, glycerin, sodium tripolyphosphate, Macleans — PEG300, titanium dioxide, sodium lauryl sulfate, aroma, xanthan gum, 1,100 Whitening Glaxo Smith Kline sodium hydrate, sodium fluoride, sodium saccharide aqua, hydrated silicate, sorbitol, glycerin, sodium tripolyphosphate, Macleans — PEG300, sodium lauryl sulfate, aroma, xanthan gum, sodium hydrate, 1,100 ICE Whitening Gel sodium fluoride, sodium saccharide, dye glycerin, sorbitol, xanthan gum, silicon dioxide, silicic acid anhydride, Macleans — sodium methyl coco taurine, titanium dioxide, methylparaben, 1,040 Sensitive propylparaben, aqua, sodium fluoride, sodium saccharide, aroma 190 Nishikawara, F., Nomura, Y., Tamaki, Y. et al.

aqua, sorbitol, glycerin, silicic acid anhydride, sodium Sensodyne F carboxymethylcellulose, sodium lauryl sulfate, colloidal silica, — 1,450 Total Care peppermint oil, titanium dioxide, sodium fluoride, sodium saccharide, spearmint oil, dye, levomenthol sorbitol, glycerin, silica gel, aqua, sodium methyl coco taurine, sodium Sensodyne Gel carboxymethylcellulose, colloidal silica gel, peppermint oil, sodium — 1,400 Total Care fluoride, spearmint oil, sodium saccharide, levomenthol, sodium hydrate, dye aqua, sorbitol, hydrated silicate, glycerin, tetrasodium pyrophosphate, Sensodyne cocamidopropyl betaine, potassium hydroxide, silicic acid anhydride, — 1,400 Gentle Whitening sodium carboxymethylcellulose, aroma, sodium fluoride, sodium saccharide, dye aqua, sorbitol, calcium carbonate, PEG300, synthetic sodium magnesium silicate, hydrated silicate, sodium lauryl sulfate, aroma, Smith Kline Macleans — sodium carboxymethylcellulose, monofluoroacetic sodium phosphate, 1,050 Beecham Complete Care triclosan, sodium saccharide, calcium glycerophosphate, sodium hydrate, sodium fluoride, dye aqua, calcium levofolinate dihydrate, glycerin, sorbitol, xylitol, peppermint oil, xanthan gum, sodium lauryl sulfate, monofluoroacetic Janina International Opale sodium phosphate, tetrasodium pyrophosphate, titanium dioxide, zinc — 1,500 Ltd. Whitening Toothpaste chloride, sodium saccharide, bromelain, sodium bicarbonate, triclosan, sodium hydrate, urea peroxide, sodium persulfate, papain, methylparaben aqua, sorbitol, hydrated silicate, glycerin, tetrasodium pyrophosphate, PEG300, tetrasodium pyrophosphate, disodium pyrophosphate, sodium Crest Germany lauryl sulfate, aroma, carboxy vinyl polymer, didasic potassium 1,450 Tartar Control phosphate, sodium fluoride, sodium phosphate, sodium saccharide, xanthan gum, dye silicic acid anhydride, aqua, sorbitol, glycerin, PEG300, tetrasodium pyrophosphate, sodium bicarbonate, sodium lauryl sulfate, PEG200, Procter & Gamble Crest Germany PEG70, aroma, carnauba wax, sodium carboxymethylcellulose, citric 1,450 UK Extra Whitening acid, sodium sorbate, sodium benzoate, sodium fluoride, sodium saccharide, titanium dioxide, dye aqua, hydrated silicate, sorbitol, glycerin, PEG300, sodium lauryl sulfate, tetrasodium pyrophosphate, tetrasodium pyrophosphate, Crest Germany disodium pyrophosphate, aroma, carboxy vinyl polymer, sodium 1,450 Complete carboxymethylcellulose, sodium fluoride, sodium saccharide, triclosan, xanthan gum, dye aqua, sorbitol, hydrated silicate, xylitol, glycerin, sodium Beverly Hills Formula tripolyphosphate, sodium lauryl sulfate, sodium bicarbonate, PEG1600, Natural & White Breath Ireland 1,000 aroma, sodium carboxymethylcellulose, monofluoroacetic sodium Confidence phosphate, triclosan, sodium saccharide, calcium glycerophosphate, dye aqua, sorbitol, hydrated silicate, xylitol, glycerin, sodium Beverly Hills Formula tripolyphosphate, sodium lauryl sulfate, sodium bicarbonate, PEG1600, EU 1,000 Plus aroma, sodium carboxymethylcellulose, monofluoroacetic sodiumםEnamel Purity Laboratories phosphate, sodium saccharide, triclosan, calcium glycerophosphate, dye aqua, sorbitol, hydrated silicate, xylitol, glycerin, sodium Beverly Hills Formula tripolyphosphate, sodium bicarbonate, sodium lauryl sulfate, PEG1600, Natural & White Total EU 1,000 aroma, sodium carboxymethylcellulose, monofluoroacetic sodium Protection phosphate, sodium saccharide, triclosan, calcium glycerophosphate, dye Beverly Hills Formula aqua, sorbitol, hydrated silicate, xylitol, potassium citrate, glycerin, Natural & White Ireland sodium tripolyphosphate, sodium bicarbonate, sodium lauryl sulfate, 1,000 Sensitive aroma, monofluoroacetic sodium phosphate, sodium saccharide, dye aqua, glycerin, hydrated silicate, sorbitol, propylene glycol, sodium lauryl sulfate, disodium hydrogen phosphate, xanthan gum, aroma, Theramed Perfect Germany jojoba oil, disodium azacyclo heptane diphosphonate, trisodium 1,450 Extra Fresh phosphate, zinc sulfate, cocamidopropyl betaine, sodium fluoride, Schwarzkopf & sodium saccharide, titanium dioxide, methylparaben, dye Henkel aqua, glycerin, hydrated silicate, sorbitol, propylene glycol, sodium lauryl sulfate, xanthan gum, aroma, alumina, jojoba oil, disodium Theramed Perfect Germany azacyclo heptane diphosphonate, trisodium phosphate, disodium 1,450 Extra Whiten hydrogen phosphate, cocamidopropyl betaine, sodium fluoride, sodium saccharide, methylparaben, dye FLUORIDE TOOTHPASTES IN EUROPE 191

aqua, sorbitol, hydrated silicate, sodium lauryl sulfate, PEG1600, sodium fluoride, sodium bicarbonate, aroma, sodium Just Greaqt Varue — 1,050 carboxymethylcellulose, monofluoroacetic sodium phosphate, triclosan, sodium saccharide, calcium glycerophosphate, dye aqua, hydrated silicate, sorbitol, propylene glycol, urea, PEG1600, Totalcare — sodium lauryl sulfate, aroma, xanthan gum, sodium fluoride, triclosan, 1,450 Fresh Mint sodium saccharide, dye aqua, sorbitol, hydrated silicate, sodium lauryl sulfate, PEG1600, Totalcare sodium bicarbonate, aroma, sodium carboxymethylcellulose, — 1,050 Coolmint Stripe monofluoroacetic sodium phosphate, triclosan, sodium saccharide, Superdrug Stores calcium glycerophosphate, dye PLC aqua, sorbitol, potassium tripolyphosphate, propylene glycol, hydrated Sensitive silicate, silicic acid anhydride, PEG1600, sodium lauryl sulfate, aroma, — 1,450 Whitening pineapple extract, sodium saccharide, potassium thiocyanate, xanthan gum, citric acid, sodium fluoride, sodium methyl paraben, dye aqua, sorbitol, hydrated silicate, potassium citrate, propylene glycol, Sensitive — urea, sodium lauryl sulfate, sodium monofluorophosphate, PEG1600, 1,450 f sodium carboxymethylcellulose, aroma, sodium saccharide, dye aqua, sorbitol, hydrated silicate, sodium bicarbonate, sodium Totalcare — tripolyphosphate, sodium lauryl sulfate, aroma, sodium 1,450 Whitening carboxymethylcellulose, sodium fluoride, triclosan, sodium saccharide, dye — indicates the undocumented country of production or concentration of fluoride.

toothpastes were obtained in Cardiff and Frankfurt, able toothpastes in Japan is restricted to less than respectively. The concentration of fluoride in these 1,000 ppm. In contrast, the fluoride concentration products ranged from 800 ppm to 1,500 ppm. of the toothpastes collected in this survey varied Among the 101 products purchased in this study, between 800 and 1,500 ppm. The difference in the 16 contained triclosan and two contained chlor- fluoride concentration in saliva is depended on the hexidine gluconate, both of which may be effective fluoride concentration of the toothpaste used daily12). as antimicrobial agents. A total of 99 products Biesbrock et al. carried out a randomized, double- contained sodium saccharin and 90 contained blind control trial among 657 children, aged from sorbitol as a sweetening agent. There are no marked 9 to 12 years, who used one of three different differences in the ingredients of the toothpastes toothpastes, the fluoride concentrations of which collected in the two countries; however, some were 0 ppm, 500 ppm, or 1,450 ppm13). The results products were found to contain zinc chloride, zinc indicated that the difference in DMF after 9 or 12 lactate, or zinc citrate for the prevention of halitosis. months were statistically significant for the products In Europe, water fluoridation has not been which contained 500 ppm and 1,450 ppm of fluoride universally implemented, and fluoride is provided when compared to the control group. However, the via mouthrinses, toothpastes, fluoride-containing salt difference was not significant between the products and tablet contains fluoride. In 2000, the DMF index containing 500 ppm and 1,450 ppm of fluoride. In of caries prevalence was 2.2 in Greece, 0.6 in the contrast, Bartizek et al. carried out a meta-analysis Netherlands, and 0.9 in Switzerland. In all of these for the effects of toothpastes containing 1,700 ppm, three countries, the DMF index was lower than the 2,200 ppm, and 2,800 ppm, compared to toothpaste 2.4 reported for Japan in 19997). About the two cities containing 1,100 ppm14). The results indicated that that we reported in this study, the DMF index was the products containing 2,800 ppm of fluoride were 1.33 in Wales and 1.33 in Germany in 2000/20018,9). effective when compared to toothpaste containing It has been reported that topical fluorides (varnishes, 1,100 ppm; however, the differences between the gels, and mouthrinses), used in addition to fluoride- products containing 1,700 ppm and 2,200 ppm of containing toothpaste, achieve a modest reduction in fluoride were not significant when compared to the caries compared to a fluoride-containing toothpaste toothpaste containing 1,100 ppm. used alone10), and that intensive fluoridation is These results indicated that the fluoride concen- effective in preventing enamel and dentine caries11). tration of toothpastes recommended for children The concentration of fluoride in commercially avail- might be need to be at least 500 ppm. But the risk of 192 Nishikawara, F., Nomura, Y., Tamaki, Y. et al.

Table 1b The toothpastes purchased in Frankfurt, Germany that contained fluoride Fluoride Country of Company Product name Ingredients concentration production (ppm) aqua, hydrated silicate, sorbitol, PEG1600, sodium Lacalut carboxymethylcellulose, silica, aroma, cocamidopropyl betaine, — — Fluor aluminum lactate, amine fluoride, propylene glycol, sodium fluoride, titanium dioxide, sodium saccharide, chlorhexidine gluconate

Arcam GmbH aqua, sorbitol, aluminium hydroxide, hydrated silicate, silica, polyoxyethylene polyoxypropylene glycol (150E.O.) (30P.O.), sodium Lacalut lauryl sulfate, hydroxyethylcellulose, aroma, aluminum lactate, titanium — — Aktiv dioxide, allantoin, sodium fluoride, sodium saccharide, aluminium fluoride, amine fluoride, propylene glycol, chlorhexidine gluconate, bisabolol aqua, sorbitol, hydrated silicate, glycerin, cocamidopropyl betaine, Sensodyne F — potassium chloride, zinc citrate, sodium carboxymethylcellulose, silica, 1,400 VorbeugungםSchutz aroma, sodium saccharide, sodium fluoride, trisodium phosphate, dye aqua, sorbitol, hydrated silicate, glycerin, potassium pyrophosphate, Sensodyne Block Drug — cocamidopropyl betaine, potassium chloride, silica, sodium 1,400 Dental Weiss Company Inc. carboxymethylcellulose, aroma, sodium fluoride, sodium saccharide, dye aqua, sorbitol, hydrated silicate, glycerin, cocamidopropyl betaine, Sensodyne potassium chloride, silica, zinc citrate, sodium carboxymethylcellulose, — 1,400 Z aroma, dye, sodium saccharide, sodium fluoride, tocopherol acetate, trisodium phosphate, panthenol, citric acid, butylated hydroxyanisole calcium hydrogen phosphate, hydrated silicate, glycerin, sorbitol, Colgate PEG600, sodium lauryl sulfate, sodium carboxymethylcellulose, aroma, EEC — Karies-Schutz sodium monofluorophosphate, tetrasodium pyrophosphate, sodium saccharide, sodium fluoride sorbitol, aqua, hydrated silicate, glycerin, PEG600, sodium lauryl Colgate EEC sulfate, aroma, sodium carboxymethylcellulose, sodium fluoride, sodium — Fresh Gel saccharide, dye aqua, hydrated silicate, sorbitol, glycerin, PEG600, sodium lauryl Colgate sulfate, sodium carboxymethylcellulose, aroma, sodium fluoride, sodium — — Dentagard saccharide, chamomilla extract, peppermint oil, mirrh extract, sage extract, dye aqua, hydrated silicate, glycerin, sorbitol, poly methyl vinyl Colgate-Palmolive ether/maleic acid copolymer, sodium lauryl sulfate, aroma, sodium Colgate — carboxymethylcellulose, sodium hydrate, sodium fluoride, carrageenan, 1,450 Total Fresh Stripe sodium saccharide, triclosan, hydrated silicate, aluminium potassium sulfate, dye sorbitol, aqua, hydrated silicate, PEG600, sodium lauryl sulfate, aroma, Colgate — sodium carboxymethylcellulose, cocamidopropyl betaine, sodium 1,450 Fresh Confidence fluoride, sodium saccharide, triclosan, glycerin glycerin, sodium bicarbonate, aqua, hydrated silicate, sodium lauryl Colgate — sulfate, sodium carboxymethylcellulose, aroma, sodium saccharide, 1,100 Merfluan sodium fluoride, titanium dioxide aqua, hydrated silicate, glycerin, sorbitol, zinc citrate, sodium lauryl Colgate — sulfate, aroma, sodium carboxymethylcellulose, sodium 1,000 PerioGard Plus monofluorophosphate, sodium hydrate, sodium saccharide, dye aqua, glycerin, sodium metaphosphate, ethylene/vinyl acetate copolymer, silica, xylitol, cocamidopropyl betaine, propylene glycol, Pearls & Dents stearyl tri-hydroxyethyl propylenediamine dihydrofluoride, chamomilla Dr. Liebe Nachf. — 1,200 Multiplex-Zahncreme extract, alcohol denat, panthenol, bisabolol, sodium fluoride, hydroxyethylcellulose, titanium dioxide, sodium benzoate, sodium saccharide, menthol, anethole, eucalyptol, aroma aqua, sorbitol, hydrated silicate, PEG1600, sodium lauryl sulfate, tin Mentadent C — pyrophosphate, aroma, sodium fluoride, zinc citrate, sodium — Intensive carboxymethylcellulose, sodium saccharide, dye aqua, sorbitol, hydrated silicate, PEG1600, sodium lauryl sulfate, tin Mentadent C — pyrophosphate, aroma, sodium fluoride, zinc citrate, sodium — Sensitive carboxymethylcellulose, sodium saccharide, dye Elida Faberge aqua, sorbitol, hydrated silicate, PEG1600, sodium lauryl sulfate, Signal — aroma, sodium fluoride, sodium carboxymethylcellulose, sodium — Kariesschutz saccharide, dye FLUORIDE TOOTHPASTES IN EUROPE 193

sorbitol, aqua, hydrated silicate, PEG1600, sodium lauryl sulfate, Signal — aroma, sodium fluoride, sodium carboxymethylcellulose, sodium — Sport-Gel saccharide, dye calcium carbonate, sorbitol, aqua, calcium hydrogen phosphate, propylene glycol, aluminum silicate, sodium lauryl sulfate, silica, Clinomint E.C. De Witt & Co. — sodium carboxymethylcellulose, sodium monofluorophosphate, aroma, 1,000 Zahnpastar fur Raucher sodium saccharide, titanium dioxide, menthol, methyl polysiloxane, methylparaben, propylparaben sorbitol, hydrated silicate, aqua, PEG1600, sodium lauryl sulfate, Oral B — aroma, stannous fluorid, sodium carboxymethylcellulose, sodium 1,090 Advantage saccharide, tin pyrophosphate, sodium hydrate, dye aqua, sorbitol, hydrated silicate, polyoxyethylene stearyl ethers, glycerin, carrageenan, aroma, titanium dioxide, disodium hydrogen Oral B — phosphate, sodium fluoride, citric acid, sodium benzoate, sodium 1,000 Gillette Gruppe Zendium Classic saccharide, potassium thiocyanate, glucose oxidase, amidoglycosidase, Deutshland GmbH lactoperoxidase aqua, sorbitol, hydrated silicate, polyoxyethylene stearyl ethers, glycerin, carrageenan, aroma, titanium dioxide, disodium hydrogen Oral B — phosphate, sodium fluoride, citric acid, sodium benzoate, sodium 1,090 Zendium Friscmint saccharide, potassium thiocyanate, glucose oxidase, amidoglycosidase, lactoperoxidase sorbitol, aqua, calcium hydrogen phosphate dihydrate, calcium hydrogen phosphate, propylene glycol, polyoxyethylene castor oil, titanium dioxide, sodium carboxymethylcellulose, aroma, sodium Aronal — cocoyl ethyl ester sulfonate, sodium monofluorophosphate, 1,000 Forte cocamidopropyl betaine, sodium saccharide, retinyl palmitate, citric acid, lecithin, ascorbyl palmitate, tocopherol, polyaminopropyl biguanide Elmex aqua, hydrated silicate, sorbitol, sodium hydroxyethylcellulose, amine — 1,250 Kariesschutz fluoride, aroma, titanium dioxide, sodium saccharide GABA GmbH Elmex aqua, sorbitol, hydrated silicate, sodium hydroxyethylcellulose, amine — 1,250 Mentholfrei fluoride, titanium dioxide, aroma, sodium saccharide aqua, sorbitol, polyethylene powder, hydrated silicate, sodium Elmex — hydroxyethylcellulose, amine fluoride, silica silylate, aroma, titanium 800 Sensitive dioxide, sodium saccharide, potassium hydrate aqua, sorbitol, hydrated silicate, silica silylate, hydroxyethylcellulose, Meridol castor oil polyethoxylated hydrogenated, cocamidopropyl betaine, — 1,400 Zahnpasta aroma, sodium gluconate, PEG4-stearamide, amine fluoride, stannous fluorid, sodium saccharide, potassium hydrate, dye aqua, hydrated silicate, sorbitol, glycerin, PEG300, sodium lauryl Odol-med 3 — sulfate, aroma, sodium fluoride, titanium dioxide, xanthan gum, 1,350 Mint carrageenan, sodium saccharide, dye aqua, hydrated silicate, sorbitol, glycerin, pentasodium triphosphate, Odol-med 3 — PEG300, sodium lauryl sulfate, aroma, titanium dioxide, xanthan gum, 1,100 Samt Weiss sodium fluoride, sodium saccharide, sodium hydrate, dye aqua, glycerin, hydrated silicate, sorbitol, PEG300, sodium lauryl Odol-med 3 — sulfate, aroma, titanium dioxide, sodium fluoride, triclosan, xanthan 1,350 40 plus Glaxo Smith Kline gum, carrageenan, sodium saccharide, dye sodium bicarbonate, aqua, glycerin, cocamidopropyl betaine, ethanol, Parodontax rhatany extract, peppermint oil, mentha oil, echinacea extract, mirrh — 1,400 Mit Fluorid extract, chamomilla extract, sage extract, sodium fluoride, xanthan gum, sodium saccharide, dye calcium carbonate, aqua, sorbitol, glycerin, hydrated silicate, aroma, sodium carboxymethylcellulose, sodium lauroyl sarcosinate, sodium Settima — 1,350 monofluorophosphate, calcium glycerophosphate, allantoin, sodium saccharide, sodium hexametaphosphate, methylparaben, dye aqua, glycerin, hydrated silicate, xylitol, PEG300, xanthan gum, sodium Dr. Best lauryl sulfate, aroma, panthenol, titanium dioxide, tocopheryl acetate, — — Vital Komplex niacinamide, sodium fluoride, zinc chloride, polyvinylpyrrolidon, sodium saccharide, dye calcium carbonate, aqua, sorbitol, glycerin, hydrated silicate, aroma, sodium carboxymethylcellulose, titanium dioxide, sodium lauryl sulfate, Dr. Best Smith Kline — sodium lauroyl sarcosinate, sodium monofluorophosphate, calcium — Vital Komplex Beecham glycerophosphate, allantoin, sodium saccharide, sodium hexametaphosphate, methylparaben 194 Nishikawara, F., Nomura, Y., Tamaki, Y. et al.

aqua, calcium hydrogen phosphate dihydrate, glycerin, silica, propylene Duromed glycol, isopropyl alcohol, sorbitol, ethanol, sodium lauryl sulfate, Die Kraft des indischen Germany aroma, sodium monofluorophosphate, polyvinylpyrrolidon, melia — Neembaums azadirachta, sodium carboxymethylcellulose, sodium cocoyl ethyl ester sulfonate, sodium saccharide, dye aqua, sorbitol, glycerin, calcium pyrophosphate, hydrated silicate, aluminium hydroxide, calcium hydrogen phosphate, aroma, PEG600, Perl Weiss Das UK sodium lauryl sulfate, sodium monofluorophosphate, sodium — Schonheits Zahnweiss Mumauer carboxymethylcellulose, trisodium phosphate, sodium phosphate, Markenvertrieb sodium saccharide, dye GmbH sorbitol, aqua, hydrated silicate, glycerin, silica, sodium Perl Weiss extra hexametaphosphate, sodium lauryl sulfate, PEG600, aroma, sodium UK — Das Raucher Zahnweiss monofluorophosphate, sodium carboxymethylcellulose, sodium saccharide, dye calcium hydrogen phosphate, glycerin, aqua, alumina, sorbitol, sodium Rembrandt acid citrate, cocamidopropyl betaine, aroma, sodium USA — Original monofluorophosphate, papain, sodium lauryl sulfate, carrageenan, citric acid, sodium saccharide, methylparaben, dye calcium hydrogen phosphate, glycerin, alumina, sorbitol, aqua, sodium Medipharma Rembrandt acid citrate, cocamidopropyl betaine, aroma, sodium USA — Homburg GmbH Minzgeschmack monofluorophosphate, sodium lauryl sulfate, papain, carrageenan, citric acid, sodium saccharide, methylparaben, dye calcium hydrogen phosphate, glycerin, sorbitol, aqua, alumina, Rembrandt potassium nitrate, sodium lauryl sulfate, aroma, guar gum, sodium USA — Minzgeschmack monofluorophosphate, sodium saccharide, papain, methylparaben, citric acid, dye aqua, calcium hydrogen phosphate dihydrate, glycerin, sorbitol, silica, sodium lauryl sulfate, sodium carboxymethylcellulose, isopropyl Salviagalen F alcohol, sodium cocoyl ethyl ester sulfonate, methylparaben, Madaus AG — — mit Fluorid propylparaben, sodium saccharide, sodium monofluorophosphate, bisabolol, thymol, cloves oil, fennel oil, peppermint oil, spearmint oil, sage extract, aroma, dye calcium carbonate, glycerin, aqua, sodium bicarbonate, cocamidopropyl betaine, aroma, peppermint oil, silica, sodium methyl coco taurine, One Drop Only Nur Tropfen — trisodium citrate, sodium monofluorophosphate, calcium hydrogen — GmbH Medizinisches Konzentrat phosphate, sodium saccharide, tea tree oil, bisabolol, sodium fluoride, methylparaben, propylparaben, dye Blend-a-med aqua, glycerin, hydrated silicate, xanthan gum, sodium lauryl sulfate, — 1,450 Classic sodium fluoride, sodium saccharide, zinc lactate, dye sorbitol, aqua, hydrated silicate, trisodium phosphate, sodium lauryl Blend-a-med — sulfate, aroma, carboxy vinyl polymer, sodium fluoride, sodium 1,450 Procter & Gamble Kariosan phosphate, sodium saccharide, xanthan gum, dye sorbitol, aqua, hydrated silicate, potassium pyrophosphate, sodium Blendax — lauryl sulfate, aroma, sodium pyrophosphate, xanthan gum, carboxy 1,450 Anti-Belag vinyl polymer, sodium fluoride, sodium saccharide, glycerin, dye aqua, sorbitol, hydrated silicate, glycerin, potassium nitrate, PEG300, Procter & Gamble trisodium phosphate, sodium lauryl sulfate, aroma, carboxy vinyl Dentril — — GmbH polymer, sodium fluoride, sodium phosphate, sodium saccharide, xanthan gum, methylparaben, propylparaben, dye aqua, hydrated silicate, sorbitol, propylene glycol, pentasodium AS-dent triphosphate, sodium lauryl sulfate, potassium pyrophosphate, aroma, — 1,430 Zahnweiss alumina, sodium carboxymethylcellulose, sodium fluoride, sodium saccharide, dye Schlecker aqua, hydrated silicate, sorbitol, propylene glycol, sodium lauryl sulfate, AS-dent sodium carboxymethylcellulose, aroma, sodium fluoride, chamomilla — 1,430 Krauter extract, sage extract, mirrh extract, bisabolol, sodium saccharide, sodium cocoyl ethyl ester sulfonate, dye aqua, xylitol, silica, mineral salt, propylene glycol, glycerin, sodium Emser — lauryl sulfate, sodium carboxymethylcellulose, sodium — Salzig-Minzig monofluorophosphate, titanium dioxide, aroma Siemens & Co xylitol, silica, aqua, glycerin, propylene glycol, PEG400, SAL EMS, Emser — sodium carboxymethylcellulose, sodium lauryl sulfate, sodium — Minzig-Frisch monofluorophosphate, dye, aroma — indicates the undocumented country of production or concentration of fluoride. FLUORIDE TOOTHPASTES IN EUROPE 195

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