John Moran

• University of Bristol

Objectives: To determine the ability of eight denture cleansers to remove and inhibit tea-stain build-up on acrylic resin. Materials and methods: In the stain removal study, Perspex(®) (cast heat polymerised resin) specimens previously soaked in saliva were stained using multiple exposures of chlorhexidine and tea solutions. Specimens were expos...

This study compared the staining potential of two experimental amine fluoride/stannous fluoride mouth rinses (A and B), a phenolic/essential oil rinse (C) and a negative control, water, rinse (D). The study was a single centre, randomized, single-blind, four treatment crossover study design among healthy participants. Prior to each study period, pa...

Formulations of commercially available denture cleaners vary widely. Unfortunately, comparative data to suggest which products are the most effective can become invalid as newer products are introduced or formulations are changed. The aim of this in vitro study was to measure the stain removal properties of four currently available denture cleaners...

Extrinsic stain and other deposits need to be removed to keep good oral health and to maintain an aesthetic and odour free prosthesis. OBJECTIVES: this in vitro investigation was carried out to evaluate the ability of eight commercial denture cleansers to remove and inhibit tea stain build up on acrylic resin material. METHODS: In the stain removal...

Toothpastes are thought to be of benefit to cleaning teeth but may also have the potential for soft tissue damage at least on the cellular level by inclusion of detergents in their formulation. The aim of this study was to observe the in vitro response of oral mucosa like cells to toothpaste detergents. TERT-1 keratinocytes were exposed to varying...

Certainly we have amassed considerable knowledge on chemical plaque control and the literature on the subject is now enormous. There are, however, still large gaps in our knowledge, particularly in relation to the long-term benefits of mouthrinsing as an adjunct to normal oral hygiene procedures. Equally disappointing is the failure to develop alte...

Delmopinol is a third-generation anti-plaque agent used as a mouthwash to reduce plaque and alleviate gingivitis. To create an overview of the anti-plaque efficacy of 0.2% delmopinol as an adjunct to normal oral hygiene measures by meta-analysis of completed clinical trials. Eight double-blind, parallel-group studies were identified. Study duration...

A single-centre, randomized single-blind parallel study was undertaken to compare staining seen with three brushing regimens and to determine subject perception of side effects such as staining and effects on taste. This 6-week parallel study used 157 volunteers who were randomized into one of three treatment groups: (i) brushing in the morning and...

Accurate and reproducible assessment of extrinsic staining is pivotal to determining efficacy of some tooth whitening oral hygiene products. The aim of this study was: (1) to produce a stain shade guide to aid the in vitro and in vivo stain assessment (2) to assess intra- and inter-examiner reproducibility of stain assessment using the stain shade...

The use of specific antimicrobial agents in toothpastes may help reduce plaque and gingivitis. There would also appear to be some value in formulating products that contain combinations of such agents that may potentiate any activity present. The aims of this exploratory and pragmatic study were twofold: (1) Exploratory: to compare the effects on p...

Chemicals which have a direct effect at inhibiting or reducing bacterial adherence to tooth surfaces may subsequently inhibit plaque growth and reduce gingival inflammation. This study investigated whether two anti-adherent systems could inhibit plaque re-growth in the mouth when rinsed as a solution or as a toothpaste slurry. A total of 21 subject...

Tooth staining is a common side effect of chlorhexidine mouth rinses and caused by the interaction of the di-cationic antiseptic with dietary chromogens. A product is now available, which claims an anti-discolouration system (ADS) with one clinical study in support. This study in vitro aims to determine whether two ADS rinses do or do not bind diet...

Two single centre, randomized single-blind, crossover studies were performed, to compare the effect of a test toothpaste with a conventional fluoride paste in the inhibition and removal of extrinsic dental stain promoted by repeated chlorhexidine/tea rinses. These studies used 24 subjects in each of two separate clinical trials. On the Friday befor...

A single centre, randomised single-blind, three-way crossover study was performed, to compare the effect of an experimental test toothpaste with a commercially available whitening toothpaste and water control at inhibiting extrinsic stain promoted by repeated chlorhexidine/tea rinses. This study used 23 subjects. During the week before the study th...

There is growing evidence that the new generation of electric toothbrushes are more effective than manual toothbrushes. The primary aim of these studies was to compare, as an indication of the stage of development, the plaque removal properties of a prototype battery powered toothbrush with an established product. A secondary aim was to utilise the...

A single-center, single-blind, two-way crossover study was performed to compare the effects of an electric powered toothbrush with a conventional manual toothbrush at removing chlorhexidine/tea tooth staining. This study used 24 subjects. During the week before the study, the subjects received a prophylaxis to remove all staining, plaque and calcul...

Toothbrushing with toothpaste is the most widely used method of home dental care for the populations of the Western world. The traditional role of toothpaste is primarily cosmetic, in aiding the cleaning of teeth and producing fresh breath. Today, however, formulations contain ingredients which may also help oral health by way of reducing dental pl...

The market for whitening toothpastes in the UK is burgeoning at present, but little has been published about the modes of action or efficacy of such pastes. Much is known about how the individual ingredients work, but toothpaste formulations are complex and there is potential for interaction. Studies have been undertaken to compare the efficacy of...

Zinc-citrate-containing toothpastes have previously been suggested to be of value at inhibiting plaque and gingival inflammation. Present formulations have included triclosan which is thought to contribute major antibacterial/antiplaque effects. Alternative antimicrobial agents and other ingredients such as oils could help to produce equally effect...

Triclosan containing toothpastes have been noted for their potential to inhibit plaque and gingival inflammation. The aim of this study was to determine whether a toothpaste containing triclosan and an enhanced fluoride system would inhibit de novo plaque formation beyond that of a non-triclosan, conventional fluoride toothpaste. This study used a...

Toothpastes and mouthrinses containing triclosan have been shown to be of some value at inhibiting both plaque and gingivitis. However much improved activity can be obtained by the addition of other chemicals which increase substantivity or antimicrobial activity. The present study was designed to determine whether a new mouthwash formulation conta...

Quaternary ammonium compounds constitute a large group of antibacterial chemicals with a potential for inhibiting plaque and gingivitis. One compound, benzalkonium chloride (BC), may be of value, although there is a dearth of evidence to support efficacy. The aim of this study was to measure the ability of 2 BC mouthrinses (0.05% and 0.1%) to inhib...

Non-steroidal anti-inflammatory drugs (NSAIDs) have been widely used to reduce the inflammation and pain in patients suffering from arthritis. There is a possible use for these drugs in the treatment of inflammation associated with periodontitis. However, the propensity of NSAIDs to cause serious side effects, including gastrointestinal bleeding, h...

Most people in industrialized countries use oral hygiene products. When an oral health benefit is expected, it is important that sufficient scientific evidence exist to support such claims. Ideally, data should be cumulative derived from studies in vitro and in vivo. The data should be available to the profession for evaluation by publication in re...

Acidified sodium chlorite (ASC) is recognised as a highly potent, broad spectrum antimicrobial system that has been successfully developed for uses in veterinary, food processing and medical device fields. The current studies aimed to investigate the persistence of antimicrobial action and plaque inhibitory properties of 3 ASC mouthrinses by compar...

The adjunctive use of antiplaque mouthrinses with normal oral hygiene procedures may produce a significant beneficial effect on gingival health. At present, numerous products are available with various claims for efficacy. Although for many of these products, well-controlled studies have been carried out comparing the products, against a negative c...

There are a large number of mouthrinse products available to the general public for use as adjuncts to oral hygiene. Many have not been evaluated and relatively few comparisons of products have been made. This study compared 4 mouthrinse products containing cetylpyridinium chloride (CPC), chlorhexidine, C31G, or triclosan with saline rinse included...

Delmopinol is a morpholinoethanol derivative which, in mouthrinses used in the absence of normal oral hygiene, has been shown effective in the inhibition of plaque and gingivitis. The aim of this study was to determine the adjunctive oral hygiene benefits and safety of delmopinol rinses when used alongside normal toothcleaning. This 6-month home us...

Chlorhexidine is a well-established agent used for the control of supragingival plaque but is not without disadvantages, such as tooth staining, which limits its clinical applications to short-term use. This clinical trial studied the clinical effectiveness and stain-forming potential of chlorhexidine in a chewing gum base. Subjects (151) were scre...

Staining of teeth and mucous membranes is a well-known side-effect with chlorhexidine mouthrinses in which dietary chromogens play an important rôle. The purpose of this study was to determine whether a co-polymer anti-adhesive agent would prevent staining by a low concentration chlorhexidine solution. Additionally, the possibility that an essentia...

The inhibition of bacterial attachment to the tooth surface is one possible approach to plaque control. This study evaluated in vivo the plaque inhibitory action of a novel copolymer reported to have considerable antiadhesive properties in vitro. The study was a single blind, 5-treatment, randomised Latin square crossover design, incorporating bala...

Much has been written on the subject of extrinsic tooth discoloration, but, except when the pigment is intentionally applied, the etiologies and mechanisms are poorly understood. Extrinsic stains have been classified as non-metallic or metallic. The pigment usually lies not on or in the dental tissues, but in surface deposits, particularly the acqu...

For various clinical indications, oxidising agents have been used in dentistry for many years. Little is known, however, of their antibacterial activity and their ability to inhibit plaque formation. In this study, 2 mouthrinses containing peroxyborate (Bocasan) and peroxycarbonate (Kavosan) were compared alongside a negative control saline rinse a...

The aim of this study was to determine the value of screening studies to assess the efficacy of antiseptic mouthrinse products relative to proven products. The products tested were 6 antiseptic mouthrinses available in France. 4 contained chlorhexidine (Eludril, Hibident, Parodex and Prexidine) with Hibident considered the positive control. 1 produ...

The mere incorporation of an active ingredient in an oral hygiene product does not necessarily guarantee efficacy. As new formulations appear, it would seem prudent to at least screen for activity by comparison with an established product. The aim of this study was to compare a new 0.12% chlorhexidine containing rinse with a well researched 0.2% ch...

. The aim of this study was to determine the value of screening studies to assess the efficacy of antiseptic mouthrinse products relative to proven products. The products tested were 6 antiseptic mouthrinses available in France. 4 contained chlorhexidine (Eludril Hibident, Parodex and Prexidine) with Hibident considered the positive control. 1 prod...

This investigation was undertaken to evaluate cross-linked human type I collagen, with and without added metronidazole, when used as a barrier membrane in the guided tissue regeneration (GTR) principle of treatment for periodontal disease. 16 patients suffering from moderate to severe periodontitis with 78 bilaterally matched periodontal defects un...

The effects of 0.1% and 0.2% delmopinol mouthwashes on supragingival plaque flora were investigated in a 6-month home-use study. 141 subjects were studied from whom plaque was collected at baseline. 12. 24 and 36 weeks. Overall, there were no consistent effects on microscopic or total counts. However, there was a significant reduction in the propor...

This study was undertaken to evaluate freeze-dried cross-linked human type I collagen when used as a barrier membrane for guided tissue regeneration (GTR) in periodontal surgery. 14 patients with radiographic evidence of bone loss and residual pocketing of > 6 mm on bilaterally matched sites were given preliminary scaling, polishing and oral hygien...

Recent studies have suggested that a sonic electric toothbrush is more effective than a manual brush at removing extrinsic dental stain. There have been few studies of the comparative stain removal properties of different electric brushes. The study reported here was conducted to compare the efficacy of the sonic toothbrush (Sonicare) with an oscil...

This study was a first stage evaluation of the plaque inhibitory properties of an experimental cetylpyridinium chloride (CPC)/essential oil mouthrinse. The study was a formulation, not ingredient, evaluation and comparisons were made with established mouthrinse products. The 5 rinses tested were: the experimental formulation; a triclosan/copolymer...

A previous clinical screening study demonstrated that a cetylpyridinium chloride (CPC) essential oil mouthrinse inhibited plaque regrowth to a significantly greater extent than a negative control or a triclosan/copolymer rinse when used without toothbrushing. The purpose of this study was to evaluate the same ingredient combination as a pre-brushin...

The effects of 1% chlorhexidine and 1% chlorhexidine/fluoride dentifrices on supragingival plaque flora were investigated in a 6-month home-usage study. 146 subjects were studied from whom plaque around 6 teeth was collected at baseline, 6 weeks and 24 weeks. Total anaerobic counts were reduced at 6 and 24 weeks in both active groups compared to co...

Research and development has been aimed towards the development of toothpastes for oral hygiene and gingival health benefits. The most effective antiplaque agent to date, chlorhexidine, is difficult to formulate into active toothpaste products. Despite some encouraging findings for experimental chlorhexidine toothpastes, there are to date no commer...

Antimicrobial agents included in graft material for use in guided tissue regeneration of periodontally diseased tissue may be of value in combating infection, but may also alter the properties of the membrane material and exert an effect upon the host immune response. Metronidazole, niridazole and tinidazole were added to a cross-linked freeze-drie...

Delmopinol has been considered as a potential agent for the chemical control of plaque. The aims of these studies were to measure the effects of a 0.2% delmopinol hydrochloride mouthrinse on (1) plaque reformation and (2) salivary bacterial counts. Comparisons were made with a 0.2% chlorhexidine rinse and a placebo rinse. A group of 12 male volunte...

There is a continuing search for ingredients to enhance the chemical plaque inhibitory action of oral hygiene products. Sanguinarine, other natural extracts and triclosan have already been used in products. The aim of this study was to evaluate a number of triclosan and natural product rinses for effects on plaque regrowth. In particular, the influ...

This study investigated the effects of root planing and/or the placement of acrylic strips containing chlorhexidine, metronidazole or tetracycline on the composition and antimicrobial susceptibility of the subgingival flora in chronic periodontitis. 101 periodontal pockets from 73 patients were entered into 6 treatment groups which were, chlorhexid...

A NUMBER OF MOUTHWASH PRODUCTS containing cetylpyridinium chloride (CPC) are available. Data for individual products are limited, although overall the antiseptic has been shown to reduce plaque. Results for gingivitis reductions by CPC have been equivocal. This study was an active/placebo parallel group design to evaluate the use of a CPC mouthrins...

Chlorhexidine and phenolic mouthrinses have attracted considerable interest as adjuncts to oral hygiene. The aim of this study was to compare two well known proprietary mouthrinse products for their effects on plaque regrowth, the development of gingivitis and the formation of toothstaining. The study was a single-blind, randomized, placebo-control...

An herbal/bicarbonate toothpaste has received some attention from the public and profession following a number of studies which have reported beneficial effects of the paste on both plaque and gingivitis. The present study, one of several ongoing clinical trials, evaluated the toothpaste in mouthrinse form using a 19-day, no oral hygiene, triple-cr...

A number of commercially prepared chlorhexidine mouthrinses which are now available are formulated at concentrations lower than the more usual 0.2%. This study compared 0.12% and 0.1% chlorhexidine mouthrinses for effects on plaque regrowth and gingivitis, using a two 19-day period single-operator blind-crossover study design on 14 healthy human vo...

Discolouration of the teeth, tongue and dental restorative materials associated with the use of cationic antiseptics is still the limiting factor in long-term usage of antiplaque agents such as chlorhexidine. Oxidising agents have been used successfully to remove dental stain in animals, but products and regimens have not been evaluated in humans....

Taurolin, a synthetic antimicrobial agent, has been suggested to be of potential value as an inhibitor of dental plaque. Although data on the antibacterial activity of Taurolin are available there is a dearth of information for effects on oral bacterial isolates and antibacterial activity in the mouth. This study assessed the in vivo and in vitro a...

A Taurolin solution has been shown previously to possess antibacterial activity, not only by a bactericidal effect but also by reducing bacterial surface adherence. Such mechanisms may contribute to reduction in dental plaque in the mouth, however this remains to be determined. The present study assessed whether a Taurolin rinse could firstly effec...

Gingival crevice fluid (GCF) was collected from inflamed sites in 20 patients before and 6 weeks after treatment. Levels of IgG to human collagen Type I were measured in the GCF and autologous serum using an enzyme-linked immunosorbent assay and compared with levels in control sera. IgG antibody to collagen was detected in GCF at significantly (P l...

Evidence to date has demonstrated the potential value of acrylic strips to deliver antimicrobial compounds into periodontal pockets. The present study was designed to evaluate further the therapeutic effect of antimicrobial acrylic strips in the management of chronic periodontitis. A total of 101 pockets in 69 patients were randomly treated with (1...

Many toothpastes have been formulated over recent years to contain antimicrobial compounds with the aim of preventing or reducing plaque, calculus, gingival inflammation or dental caries. For many, if not all of these toothpastes, it has yet to be proven whether they are significantly better at reducing plaque and gingivitis than conventional tooth...

A CPC-detergent formulation in a foam vehicle, was compared with a fluoride toothpaste for its ability to prevent plaque and gingivitis over a period of 12 days. Whilst refraining from all other oral hygiene procedures, the foam or toothpaste was applied to the teeth in fluoride application trays, in a group of 14 volunteers. At days 8 and 12 of th...

A single-blind crossover study was used to compare the ability of a 0.2% chlorhexidine mouthrinse (Corsodyl) with a sanguinarine-zinc mouthrinse (Veadent) to inhibit plaque and gingivitis. 14 volunteers starting with plaque-free mouths and optimal gingival health, rinsed with the preparations over two 19-day periods whilst refraining from all other...

Local antimicrobial therapy has been considered for use in the treatment of chronic periodontal disease. This study evaluated chlorhexidine, metronidazole, and tetracycline delivered into periodontal pockets in an acrylic resin vehicle and compared the results with root planed and untreated sites over a three-month follow-up period. One site per pa...

Both past and presently available toothpastes contain potential antimicrobial agents which could have a beneficial effect in the prevention of plaque and gingivitis. If these preparations were to be effective clinically, some effect on salivary bacteria would also be expected. This cross-over study measured salivary bacterial counts and the presenc...

Commercial toothpastes have been suggested as a possible means of conveying antimicrobials to the mouth with the desired aim of reducing plaque accumulation and thus improving gingival health. This study measured the ability of a number of commercial toothpastes to inhibit oral microorganisms by determining minimum inhibitory concentrations (MICs)...

Few studies have reported the maximum potential of surfaces to adsorb the cationic antiseptics and few comparisons between antiseptics have been carried out. The purpose of this investigation was to measure the maximum uptake of alexidine, cetyl pyridinium chloride, chlorhexidine gluconate and chlorhexidine acetate to polymethylmethacrylate and by...

Clinical and in vitro studies have implicated dietary components as major aetiological factors in staining of teeth and acrylic materials associated with chlorhexidine use, a local side effect not unique to this antiseptic. These experiments studied the precipitation and surface staining reactions of the cationic antiseptics alexidine, cetyl pyridi...

The phenomenon of surface adsorption appears fundamental to the antiplaque activity of the cationic antiseptics. Moreover, reaction with chromogenic material is relevant to the local side effect of staining. The purpose of this investigation was to determine how such local reactions affect the antibacterial activity of some of these antiseptics. Th...

This study measured plaque accumulation on anterior teeth after topical or mouth rinse application of 0.2% chlorhexidine gluconate. Compared with water plaque scores were highly significantly reduced. There was no significant difference in plaque scores between topical application or mouth rinsing. The importance of locally adsorbed chlorhexidine i...

Evidence suggests that brushing with a toothpaste may slow plaque reformation over 24 h. This study measured the effect of toothpaste alone on plaque regrowth over a 96 h period and compared the effect with water and the known antiplaque agent chlorhexidine. At 9 a.m. at the beginning of 7,4-day no oral hygiene periods, 10 volunteers were scaled an...

A dietary aetiology for tooth staining associated with the use of chlorhexidine has been postulated. The time related activity of chlorhexidine would therefore suggest that evening rinsing would result in less staining than morning rinsing. This study measured tooth and tongue staining and plaque accumulation in a group of 18 volunteers, rinsing on...