Advances in Dental Research, Vol 9, 127-128, Copyright © 1995 by International & American Associations for Dental Research
The value of anti-caries and anti-plaque dentifrices at a community level
K. W. Stephen
Department of Adult Dental Care, University of Glasgow Dental School, Scotland.
Although dentifrices (in a modern sense) were first introduced at the turn
of the century, it was not until the advent of fluoride-containing
compounds that any of therapeutic value was produced. In the early post-war
years, formulation compatibility difficulties occurred, with the result
that none was demonstrated to have clinically proven efficacy until
stannous fluoride was successfully incorporated in the "Crest" formulation
of 1955. Thereafter, sodium monofluorophosphate (SMFP) appeared, to be
followed by organic and acid-phosphate fluoride preparations, most of which
were shown to produce clinical benefit over placebo controls. Since the
late 1970's, however, such studies have been deemed unethical in many
countries in view of the almost universal availability of efficacious
fluoride dentifrices. While an NaF formulation was the first to be tested
(albeit unsuccessfully) by Bibby (1945), there was a considerable time
period before the arrival of both stable and effective silica-based systems
in the early 1980's. Results of studies have varied, but the largest ever
double-blind NaF/SMFP head-to-head dentifrice trial yet published (Stephen
et al., 1994) has indicated a 6.4% significant benefit in favor of NaF (in
silica) over SMFP. With respect to the effect of dentifrice fluoride
levels, above 1000 ppm dose-response caries reductions have been obtained,
but the efficacy of preparations containing 500 ppm F or less has yet to be
demonstrated. In relation to root caries, Jensen and Kohout (1988) reported
a 41.4% DFS significant reduction in subjects who used a NaF/silica
dentifrice at 1100 ppm F, over a one-year period.
