Advances in Dental Research, Vol 9, 304-311, Copyright © 1995 by International & American Associations for Dental Research
Role of models in assessing new agents for caries prevention--non-fluoride systems
A. J. Roberts
Unilever Dental Research, Port Sunlight Laboratory, Bebington, Wirral, UK.
While fluoride is an effective anti-caries agent, the search for more
effective alternative therapies continues. A wide range of non-fluoride
anti-caries agents has been postulated, and this paper reviews some of the
pre-clinical models that have been utilized in their evaluation and some of
the pitfalls that must be avoided. Using data on the potential anti-caries
efficacy of phosphopeptides obtained from casein, the caution that must be
applied in extrapolating laboratory data to predict clinical performance is
discussed. Evaluation strategies that focus on only one potential mode of
action (e.g., inhibition of demineralization) may overestimate the true
clinical efficacy which may arise from a combination of two or more effects
(e.g., inhibition of demineralization and stimulation of remineralization).
Although laboratory and in situ data predict anti-caries efficacy for
sodium trimetaphosphate in combination with fluoride, this was not found in
three-year clinical trials. A possible reason for this, the lack of
suitable calibration methods, is discussed. Finally, some comments on the
appropriateness of laboratory evaluation strategies are made.
