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Effectiveness of a new dentifrice with baking soda and peroxide in removing extrinsic stain and whitening teeth
Abstract
The primary purpose of this randomized, controlled, six-week clinical trial was to determine the effectiveness and safety of a new whitening dentifrice in removing extrinsic tooth stain and whitening teeth. An additional two-week exploratory study was conducted to determine whether the whitening or stain-prevention activity of the dentifrice would persist following cessation of use.
In the first study (Phase I), one-hundred and forty-six qualifying subjects were randomly assigned to either a sodium bicarbonate whitening dentifrice group (Arm & Hammer Advance White Extreme Whitening Baking Soda and Peroxide Toothpaste) or a silica-based negative control dentifrice group, and brushed twice daily with their assigned dentifrice for six weeks. Tooth shade on the labial surfaces of the eight incisors was assessed using a Vita Classic shade guide, and extrinsic tooth stain was scored using a Modified Lobene Stain Index (MLSI) at baseline, week 4, and week 6. In Phase II (after the week 6 examination), volunteers from the Arm & Hammer whitening dentifrice group were randomly assigned to continue using the whitening dentifrice or to use the negative control dentifrice twice daily for two weeks. The six-week shade and stain index scores served as the baseline for this exploratory phase and were rescored after two weeks.
The whitening dentifrice group had statistically significant (p < 0.0001) mean shade score reductions of 1.82 and 2.57 from baseline to weeks 4 and 6, respectively. For the same periods, the negative control dentifrice group was virtually unchanged from baseline. For tooth stain, the MLSI total mean scores for the whitening dentifrice group showed statistically significant (p < 0.0001) decreases from baseline of 1.42 (41.6%) and 2.11 (61.6%) at weeks 4 and 6, respectively. In contrast, the negative control dentifrice group had a MLSI reduction of 0.07 at week 4 and a 0.06 increase at week 6. Between-group analyses using baseline-adjusted ANCOVA showed the whitening dentifrice to be statistically significantly more effective (p < 0.0001) than the negative control for shade and tooth stain reductions for all index comparisons. Compared to the six-week (baseline) scores, subjects who continued to use the whitening dentifrice for the additional two weeks experienced statistically significant (p < 0.0001) further mean reductions of 0.88 in shade score and 0.46 in MLSI score, while subjects who switched to the negative control dentifrice experienced smaller, statistically significant (p < 0.05) reductions of 0.34 in shade score and 0.13 in total MLSI score.
The Arm & Hammer whitening dentifrice tested in this study is effective for removing extrinsic tooth stain and whitening teeth. While the results also suggest that this dentifrice may have stain-prevention activity that persists following cessation of product use, such activity would need to be confirmed with further studies.
... Sodium bicarbonate, also known as baking soda, is widely used for nearly 100 years as an abrasive in a variety of cleaning products. Its stain and plaque removal ability, despite its low abrasivity, suggest chemical as well as physical mechanisms for its stain removal action leading to more cleaning power with minimal abrasion (17,18). Low tooth structure abrasion, safety, biocompatibility, low cost and buffering and antibacterial properties made it one of the most economical, yet efficient, abrasive particularly for use in dental products such as dentifrices and mouth rinses (17)(18)(19)(20). ...
... Its stain and plaque removal ability, despite its low abrasivity, suggest chemical as well as physical mechanisms for its stain removal action leading to more cleaning power with minimal abrasion (17,18). Low tooth structure abrasion, safety, biocompatibility, low cost and buffering and antibacterial properties made it one of the most economical, yet efficient, abrasive particularly for use in dental products such as dentifrices and mouth rinses (17)(18)(19)(20). It has shown 10 times more abrasion-cleaning power than calcium phosphate as the gold standard for mechanical cleaning (18). ...
... However, the abrasive capacity and stain removing efficacy of the polishing pastes and powders vary greatly, which may result in diverse tooth wear and cleaning power (19,23). In the present study, we compared the iron induced stain removing potential of polishing with pumice powder for 30 s as a traditional in-office polishing material with a solely mechanical action, and sodium bicarbonate as a product acting both mechanically and chemically on the discolored labial surface of primary anterior teeth (13,17). We used spectrophotometry to assess the tooth color and its alterations following discoloration and stain removal. ...
... In relation to daily brushing frequency, most studies [20][21][22][23][24] reported that using toothpaste twice a day increased tooth whitening, but two studies indicated that patients who brushed three times a day were more likely to have whiter teeth. In addition, the follow-up period ranged from 5 days to 8 weeks, with the most common period being 4 weeks (six studies). ...
... In the four studies that evaluated tooth color change using the VITA shade guide, all studies [20,[22][23][24] reported that bleaching dentifrices were effective for tooth whitening when compared with regular dentifrices (p < 0.05). However, Gerlach et al. [20] found differences between the groups only in the evaluation period following 4 weeks of dentifrice use. ...
... However, Isaacs et al. [21], Kakar et al. [22], and Ghassemi et al. [23] observed that the presence of 1.0% hydrogen peroxide in the chemical formulation of dentifrices caused tooth coloration changes when compared with nonwhitening toothpastes. ese findings agreed with those obtained by Sharma et al. [17] who demonstrated the bleaching potential of these dentifrices and concluded that the presence of hydrogen peroxide was able to significantly interfere with dental chromatic alterations over a brushing period of 2 to 6 weeks. ...
A systematic review was performed to evaluate whether whitening toothpastes promote tooth whitening when compared to the use of conventional (nonbleaching) dentifrices. This review was registered at PROSPERO (CRD42017065132) and is based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses. Electronic systematic searches of PubMed/MEDLINE, Scopus, and the Cochrane Library were conducted for published articles. Only randomized clinical trials in adults that compared the use of so-called whitening dentifrices to the use of nonwhitening dentifrices were selected. The outcome was tooth color change. Twenty-two articles from 703 data sources met the eligibility criteria. After title and abstract screening, 16 studies remained, after which a further five studies were excluded. In total, nine studies were qualitatively analyzed. Significant differences in tooth color change were found between the groups using whitening dentifrices and those using nonwhitening dentifrices. Within the limitations of this study, the evidence from this systematic review suggests that bleaching dentifrices have potential in tooth whitening. However, although many whitening dentifrices have been introduced into the dental market for bleaching treatments, it is important to analyze tooth surface and color changes when performing home bleaching.
... The longevity and esthetic appearance of toothcolored restorations depend on the color stainability of the material. [6][7][8][9][10][11] Intrinsic discoloration occurs due to change in the material itself. Extrinsic discoloration occurs due to absorption of surrounding stains by the material. ...
... Each specimen was subjected to 90 brushing cycles, 2 minutes for each cycle (180 minutes for each specimen) simulating one month of toothbrushing (3 cycles/ day). [8][9][10] Using the PTS machine, the pressure on each specimen was standardized to 30 g subjected by the toothbrush bristles on the specimen surface with machine base rotation speed of 7 cycles per minute. After brushing procedure, specimens were cleaned in an ultrasonic tank for 10 minutes and then air dried. ...
Statement of problem: Surface finishing and polishing techniques have a mechanical impact on ceramic-polymer surfaces that can eventually affect the surface roughness and color. Expected changes, after being subjected to aging procedures, necessitates adopting a finishing and polishing protocol to enhance their impaired optical properties. The purpose of this in vitro study was to assess the effect of two different polishing techniques on the surface roughness and color stability of two CAD/CAM ceramic-polymer materials compared to CAD/CAM glass ceramic material before and after being subjected to chemical and mechanical aging procedures. Materials and Methods: Fourty-two discs were constructed from CAD\CAM esthetic blocks. Lithium disilicate CAD/CAM glass ceramics as control (n=14), ceramic-polymer hybrid materials, Lava Ultimate (n=14) and Vita Enamic (n=14) were studied. Discs in each group were divided into equal subgroups (n=7) according to the polishing technique employed. One subgroup was polished following the manufacturer's recommendations (mnf) and the other was polished by brush and paste protocol(B/P). Mechanical and chemical aging procedures were performed for each subgroup. The surface roughness and color of each specimen were measured before and after all interventions and aging procedures. Surface topography (Ra) was evaluated using contact stylus profilometer and the average Ra values (μm) were calculated. Laboratory UV Spectrophotometer was used to measure color parameters (a*,b*,L*). Color differences (ΔΕ) and surface roughness (Ra) data were analysed using two-way (ANOVA). Results: There was no significant difference in surface roughness values between the two techniques after polishing. After mechanical aging, (mnf) technique showed significantly higher surface roughness than (B/P) except for Vita Enamic. After chemical aging, the two polishing techniques showed no significant difference in mean color change (ΔE) values with all ceramic types. Conclusion: The brush/paste polishing protocol produced comparable surface smoothness to the manufacturer's protocol for glass and polymer ceramics. Color change is material compositional microstructure dependent.
... Data were meta-analyzed with the inverse variance method and random effects model. To metaanalyze data generated using the Vita Classical shade guide, the SD data of Ghassemi and others 22 was used to calculate r to obtain the SD of the difference for Ghassemi and others. 13 In the presence of high heterogeneity, sensitivity analysis was undertaken using the ''leave-one-out'' method to identify the role of each individual study on the final effect size measure. ...
... Operative Dentistry One study assessed color change using the Vita 3D Master shade guide and found no significant influence of the type of dentifrice. 10 On the other hand, color change assessed using the Vita Classical shade guide, when meta-analyzed (three studies 13,22,50 involving 1322 participants), generated a mean 1.80 whiter shade tab, favoring the WD (Table 1). Heterogeneity was rated high, and risk of bias was rated serious due to concerns regarding the randomization process and potential deviations from intended interventions. ...
Whitening dentifrices (WDs) are widespread and accessible worldwide, claiming to whiten teeth. Therefore, this systematic review aimed to assess the extrinsic stain removal (ESR), the whitening potential, and the adverse effects of WDs. Randomized controlled trials comparing WDs with regular dentifrices (RDs) and other home-based whitening products were searched at NCBI-PubMed, Cochrane-CENTRAL, EBSCO-Host, and clinicaltrials.gov. The studies were screened and had data extracted by two independent researchers. Eligible studies presented outcomes of ESR, color change, and adverse effects, with no restriction of publication date. Data were meta-analyzed using RevMan 5.3, and the level of evidence was rated according to GRADE criteria. Eleven studies (n=1962) assessed reduction of stain area and intensity through Lobene Stain index, with a mean difference (MD) of −0.33 ([−0.41;−0.25]; p=0.00001) and −0.34 ([−0.44;−0.25]; p=0.00001), respectively. When the modified Lobene Stain index was used (six studies; n=2576), MD was −0.42 ([−0.58;−0.25]; p=0.00001) and −0.30 ([−0.39;−0.21]; p=0.00001), respectively. Mean color change through shade guide tabs (three studies; n=1322) was −1.80 ([−2.33;−1.26]; p=0.00001). All differences were in favor of the WDs, which also produced a risk of adverse effects (RR=1.74; [1.20, 2.52]; p=0.003; four studies; n=1322). The comparison of WDs with paint-on gel (two studies; n=58) yielded similar efficacy and adverse effects ( p>0.05), whereas the comparison of WDs with white strips (two studies; n=87) yielded higher efficacy of the latter ( p=0.00001) and similar adverse effects ( p=0.52). The quality of evidence varied from low to moderate. WDs are more effective in reducing extrinsic stain and producing a whitening-like effect in teeth than RDs, although they also produce more adverse effects. Whitening efficacy of WDs is similar to paint-on gel and lower than white strips. Higher-quality evidence demands larger, well-conducted, independent studies.
... [4] Biochemically, fluoride dentifrices can be considered colloidal suspensions that have an important action in reducing demineralization and enhancing re-mineralization of dental hard tissues and also act as a cleaning agent. [5][6][7][8] The cleaning action is mainly promoted by the abrasive particles, which are insoluble minerals designed to disorganize the bacterial biofilm, removing microorganisms and stains, giving a whitened appearance. [6,9,10] The most common abrasive particles used in dentifrice formulations are softened silica (hydrated silica), chalk (calcium carbonate), and baking soda (sodium bicarbonate). ...
... In fact, a positive effect on tooth whitening can be reached after 2 weeks of dentifrice use, remaining stable for up to 12 weeks. [7,27] Thus, there is still a need for studies to evaluate whitener dentifrices' influence on esthetic composite resin restoration roughness over a short period. ...
Objectives:
The present study verified the influence of whitening dentifrices on the surface roughness of a nanohybrid composite resin.
Materials and methods:
Thirty-two specimens were prepared with Filtek™ Z350 XT (3M/ESPE) and randomly divided into four groups (n = 08) that were subjected to brushing simulation equivalent to the period of 1 month. The groups assessed were a control group with distilled water (G1), Colgate Total 12 Professional Clean (G2), Sensodyne Extra Whitener Extra Fresh (G3), and Colgate Luminous White (G4). A sequence of 90 cycles was performed for all the samples. The initial roughness of each group was analyzed by the Surface Roughness Tester (TR 200-TIME Group Inc., CA, USA). After the brushing period, the final roughness was measured, and the results were statistically analyzed using nonparametric Kruskal-Wallis and Dunn tests for intergroup roughness comparison in the time factor. For intragroup and "Δ Final - Initial" comparisons, the Wilcoxon test and (one-way) ANOVA were, respectively, performed (α = 0.05).
Results:
The roughness mean values before and after brushing showed no statistically significant difference when the different dentifrices were used. None of the dentifrices analyzed increased significantly the nanohybrid composite resin surface roughness in a 1 month of tooth brushing simulation.
Conclusions:
These results suggest that no hazardous effect on the roughness of nanohybrid composite resin can be expected when whitening dentifrices are used for a short period. Similar studies should be conducted to analyze other esthetic composite materials.
... Además, los autores sugieren más estudios que confirmen estos resultados. 40 También se han realizado estudios para comparar la eficacia de este tipo productos blanqueadores (enjuagues y pastas dentales), pero han sido tan variados los tipos de diseño de ensayos, que hacen que las comparaciones directas sean difíciles, sobre todo porque hay varias formas de medir el color resultante, y no hay consenso de opinión en este campo. 41 Incluso hasta se han comparado con la eficacia de tratamientos de blanqueamientos ambulatorios, 42 lo cual dista mucho de la realidad. ...
Resumen Introducción: En torno al blanqueamiento dental existen muchas afirmaciones con poco soporte científico, tales como: los blanqueamientos son ácidos, dañan el esmalte, se utilizan férulas, hay restricción en dieta y en la gestación, con límite mínimo de edad para su uso, entre otros. Para la odontología es de suma importancia que toda afirmación se realice responsablemente con una evidencia científica para entregar lo mejor de cada tratamiento a los pacientes. Objetivo: Conocer las posibles indicaciones del blanqueamiento dental en niños y adolescentes, modalidades, los efectos sobre los tejidos blandos y duros, así como
... We judge that any distance formula (ΔE ab , ΔE 00 ) or index formula (ΔWI D ) will lead to nearly the same conclusions of the whitening effect in terms of perceptibility as long as the measurements in the CIELAB system point to increased lightness (ΔL*) and decreased yellowness (Δb*) of the teeth. These clinically significant tooth color change results for the enzymes and peroxides toothpastes comply with related research results for the peroxide toothpastes [23][24][25][26][27][28][29]. Differently than results from this study and the complying researches, some authors [30,31] claim that the concentration of peroxide in whitening toothpastes is low and that, in combination with short exposure time, cannot provide the internal whitening effect. ...
Objectives
To assess the whitening efficiency and patient satisfaction after usage of commercially available toothpastes with the different whitening ingredients.Materials and methodsThis randomized controlled trial study comprised 161 participants who were randomly divided into eight groups based on used whitening or control/conventional toothpaste (Colgate Max Expert White [CMEW], n = 20; Signal Daily White [SDW], n = 20; Himalaya Sparkly White Herbalis [HSWH], n = 20; Signal White System [SWS], n = 20; Rembrandt Deeply White + Peroxide [RDWP], n = 20; Splat Extreme White [SEW], n = 20; Splat White Plus [SWP], n = 21; and Kalodont Multi Repair [control], n = 20). Tooth color and color change were evaluated using a spectrophotometer (CIELAB coordinates, ΔEab*, ΔE00, whiteness index change [ΔWID]). Measurements were performed at baseline, 30 days and 60 days after the beginning of treatment, and 30 days after completing treatment – follow-up. Side effects and satisfaction with the whitening outcome were reported throughout the questionnaire.ResultsThe results for ΔL*, Δa*, and Δb* showed an increase in lightness and decrease in yellowness for all tested whitening toothpastes compared to the control group after 30 days of use (p ≤ 0.05). Also, significant tooth color difference (ΔEab*, ΔE00) and whiteness index change (ΔWID) were recorded for all tested whitening toothpastes 30 days and 60 days from the beginning of use (p ≤ 0.05). Toothpaste containing a combination of urea peroxide and enzyme ingredients (SEW) demonstrated the highest and the longest whitening effect.Conclusions
Whitening toothpastes can show perceptibly whitening effect after a short time of usage, but without a long-lasting impact.Clinical relevanceToothpaste containing a combination of enzymes and peroxides showed the best whitening performance compared to those containing only enzymes, peroxides, or abrasives.Trial registrationClinicalTrials.gov: NCT04460755
... Baik Hidrogen Peroksida maupun Carbamide Peroksida menunjukkan efek pemutihan konsisten yang sama dalam penelitian klinis selama dua tahun [8]. Sodium Bicarbonate yang populer disebut Baking Soda ternyata memiliki efek memutihkan gigi yang signifikan dibanding kelompok kontrol non perlakuan dalam sebuah uji klinis dalam waktu 6 minggu dengan 146 sampel pasien [9]. ...
Indonesian society began to make appearance as a primary need. Appearance becomes important for middle and upper social classes which reaches 60-70% in Indonesia. Researchers are trying to find a combination formula of two teeth whitening ingredients (Baking Soda and Peroxide). The study uses an experimental method, which is to make a dental gel with variety of gradient constituent formulas, including F1, F2, F3, F4, and F5. F5 is the most optimal formula with best stability test results among other. F5 with Peroxide concentration of 30% had teeth whitening activity of 38% by two months in vitro test on adult teeth samples. Abstrak Masyarakat Indonesia mulai menjadikan penampilan sebagai kebutuhan primer. Penampilan menjadi hal penting pada lingkaran sosial kelas menengah dan atas yang jumlahnya mencapai 60-70% di Indonesia. Peneliti mencoba menemukan formula kombinasi dua bahan pemutih gigi (Baking Soda dan Peroksida). Penelitian ini menggunakan metode eksperimental, yaitu membuat formulasi gel gigi dengan berbagai variasi gradien konstituen formula, meliputi F1, F2, F3, F4, dan F5. Formula F5 merupakan formula yang paling optimal dengan hasil uji kestabilan terbaik. F5 dengan konsentrasi Peroxide 30% memiliki aktivitas pemutihan gigi sebesar 38% dalam dua bulan uji in vitro pada sampel gigi dewasa Kata-kata kunci: Formulasi, Baking soda, Peroksida, Pemutihan gigi 1. Pendahuluan Estetika gigi yang terutama sangat tergantung pada warna menjadi perhatian utama dalam praktek dokter gigi. Selain perawatan kulit, wajah, rambut yang sudah banyak dilakukan, perawatan gigi menjadi poin penting karena berhubungan dengan kualitas senyum dan tingkat kepercayaan diri ketika berinteraksi dengan orang lain. Selfie dengan kamera smartphone telah menjadi budaya millenial dan gigi mendapat peran penting dalam kualitas ekspresi wajah dalam kegiatan tersebut [1]. Berdasarkan pengamatan di online shop, apotek dan klinik dental, peneliti menemukan komposisi bahan pemutih pada
... Some studies stated that the new dentifrices containing baking soda, peroxide, amorphous calcium phosphate ("active calcium") and tetrasodium pyrophosphate were effective whitening agents (24)(25)(26). Experimental dentifrices claimed to have some effectiveness with new contents such as in enzymatic dentifrices containing lactoperoxidase and carbamide peroxide (27), dual silica system and dentifrices containing sodium hexametaphosphate (10,28,29). However, objective measurements did not show effectiveness in a trial carried out with hydroxyapatite and calcium peroxide for removal of extrinsic stains (30). ...
There is an increased accessibility of over-the-counter (OTC) whitening agents with very little data in the literature regarding their effectiveness. This review was done to determine their effectiveness of the predominant OTC whitening agents from 2006 until 2018 where a comparison of each agent was made with a placebo, no treatment or with other OTC whitening agents. The major categories of OTC whitening agents such as dentifrices, whitening strips and paint on gels. Dentist prescribed bleaching applied at home and in-office bleaching studies and studies that demonstrated whitening products to participants were excluded. Articles were searched for in the databases of Medline (Ovid), PubMed, the Cochrane Library and Cochrane Central Register of Controlled Trials. Twenty-four articles were included in the systematic review and the quality of studies was determined by the GRADE (Grading of Recommendations, Assessment, Development and Evaluations) ranking criteria. Compared to other OTC, strips are reported to be effective. Two studies determined whitening strips to be effective. Whitening strips have been shown to be effective when compared with placebos and other OTC whitening agents. Dentifrices are effective in changing the shade of the tooth “by removing extrinsic stains” when compared to a placebo and non-whitening dentifrices, but they are not as effective in comparison to whitening strips. There is a lack of evidence with regards to the effectiveness of paint-on gels. While there is some evidence that OTC can alter shade in the short term, there is a need for better-designed studies.
... This can affect the general health and ability of an individual to participate fully in society, fulfilling roles as family members, friends, co-workers, and other roles requiring interaction with others. 3,4 Tooth color is determined by intrinsic and extrinsic coloration. 5,6 Intrinsic tooth color is related to the light scattering and adsorption properties of the enamel and dentin. ...
Aim and objectives
To compare the effectiveness of the stain removing property of the whitening toothpastes (silica [Colgate Visible White], silica, papain and bromelain [Whitospark], and silica and calcium carbonate [Snowdent] containing toothpastes) on extrinsic dental stains and to assess the lasting of tooth whitening effect produced by the whitening toothpastes.
Materials and methods
It is a randomized, concurrent parallel arm, non-invasive, controlled trial designed to compare the effectiveness of the whitening toothpastes on reducing extrinsic dental stains. Parametric t-test was used.
Results
A statistically significant difference can be seen between Groups A and B, Groups B and C, and Groups B and D. Maximum mean and percentage reduction was found in Group B at the end of the second month in stain extent and intensity. A statistically significant difference was seen between subgroups B1 and B2. Maximum mean and percentage reduction was found in subgroup B1 at the end of the fourth month in stain extent and intensity.
Conclusion
Silica, papain, and bromelain containing toothpastes (Whitospark) show effectiveness on reducing extrinsic dental stains.
... The observer angle was set at 2°, and the device was adjusted to a small reading area. 24,25 The color of each specimen was measured twice: After staining (M1) and after treatment (M2). The results of the color measurements were quantified with regard to the three coordinate values (L*, a*, and b*) as established by the CIE, which locate the color of an object in a three-dimensional (3D) color space. ...
Aim: The purpose of this in vitro study was to evaluate the color and microhardness of teeth subjected to different overthe- counter (OTC) whitening products in association or not with 10% carbamide peroxide (10% CP). Materials and methods: Enamel-dentin specimens (n = 210) were obtained from bovine incisors and stained. Half of the specimens were then subjected to daily cycles of staining (5 minutes), 10% CP bleaching (8 hours) in association with OTC products, and artificial saliva storage until complete 24 hours, for 2 weeks; the other half was subjected to daily cycles of staining, OTC treatment, and storage in artificial saliva for 12 weeks. The specimens were divided into 14 groups according to the OTC: CP-Water and Water (deionized water); CP-Listerine and Listerine (whitening mouth rinse); CP-Brushing and Brushing (mechanical brushing); CP-Colgate and Colgate (conventional toothpaste), CP-ColgateW and ColgateW, CP-OralBW and OralBW, and CP-CloseUpW and CloseUpW (whitening toothpaste). After staining and whitening, color and microhardness were measured. Data were submitted to analysis of variance (ANOVA) and the Tukey's test for multiple comparisons for color analysis and the paired t-test for microhardness analysis. Results: The CP and CloseUpW groups had the largest color change (ΔE00). The teeth treated with Colgate increased significantly in microhardness after whitening. Conclusion: The association of 10% CP with OTC whitening agents did not increase the whitening effect or microhardness. The OTC agents containing hydrogen peroxide and abrasives had a similar effect to one another but were not as effective as the CP groups and the subgroup brushed only with blue covarine toothpaste. Clinical significance: The current study provides information about the mechanism of OTC whitening products. None of the whitening agents evaluated damaged the enamel when used according to the manufacturers' instructions. The use of toothpaste containing hydrogen peroxide or abrasives cannot provide a whitening effect similar to at-home bleaching, and this does not improve with the association with 10% CP. However, toothpaste containing blue covarine has a satisfactory whitening effect immediately after brushing.
... The majority of studies have provided that, the effect of whitening dentifrices on the surface roughness of composites occur after a long period of use, ranging from 6 months to 1 year, [8,10,20]. In fact, the effect of whitening can be reached after 2 weeks of dentifrice use, remaining stable for up to 3 months [21,22]. Some studies have proved that continues use of whitening dentifrices results in severe tooth wear, and the dentin is eroded [23,24]. ...
... Additional considerations include the avoidance of interactions between active ingredients and the need to maintain activity for the duration of the product's shelf- life. 4 Sodium bicarbonate (baking soda) has been included as an abra- sive component in whitening dentifrices for many years, [5][6][7][8][9][10] typically at levels between 20% and 60%. A new formulation has been devel- oped, Arm & Hammer ™ Truly Radiant ™ Clean & Fresh toothpaste (Church & Dwight Co., Inc., Ewing, NJ USA), that contains 10% baking soda making the base less salty tasting for consumers and allowing for the use of new flavor ingredients. ...
Objectives:
This randomized, prospective clinical trial was conducted to determine the safety and effectiveness of a new whitening dentifrice formulation in comparison to that of both a negative and a positive control dentifrice.
Methods:
Seventy-nine qualifying subjects were randomly assigned to either the new whitening dentifrice (Arm & Hammer® Truly Radiant™ Clean & Fresh Toothpaste), a positive control whitening dentifrice (Crest® 3-D White® Radiant Mint Toothpaste), or a negative control regular dentifrice (Colgate® Cavity Protection Toothpaste). The subjects brushed with their assigned dentifrice for two minutes, twice daily, for five days. Extrinsic tooth stain was assessed using a Modified Lobene Stain Index (MLSI) at baseline and after five days of product use.
Results:
All entering subjects completed the study. There were no significant differences (p > 0.05) in stain among the three groups at baseline. The Arm & Hammer Truly Radiant and positive control groups had statistically significant (p < 0.001) mean composite MLSI reduction scores of 13.2% and 7.8%, respectively, from baseline to day five. The negative control dentifrice group was virtually unchanged during this period. Intergroup comparisons showed the Truly Radiant group to have significantly greater stain removal (p < 0.0001) scores than the negative control. The Truly Radiant group also had greater stain removal than the positive control, though the differences were not statistically significant.
Conclusions:
This study demonstrates that five-days' use of Arm & Hammer Truly Radiant Clean & Fresh dentifrice was significantly more effective in stain removal than a regular (non-whitening) dentifrice and comparable in effectiveness to a whitening dentifrice positive control.
... The Lobene Stain Index was used to score the amount of stains on specimens in the current study. This index is widely used for the assessment of stainability of composite resins, and its reliability has been confirmed in many previous studies (30)(31)(32)(33)(34)(35). However, this measure is subjective and may be considered a limitation of the current study. ...
Background:
Color change is one major drawback of tooth-colored resin-based restorations.
Objectives:
This study aimed to assess the color stability of three commonly used resin-based restorative materials upon exposure to tea and coffee.
Materials and Methods:
Discs were fabricated from Spectrum TPH (Dentsply/Caulk), Denfil (Vericom), and Filtek Z250 (3 M) microhybrid composites and immersed in coffee and tea solutions for two hours on the first day and the whole of the second, third, and fourth days. The color was assessed visually and recorded using the Lobene Stain Index after each period of immersion. The color change of the three composite resins was compared using the Kruskal-Wallis test, Mann-Whitney U test, and Friedman test. The level of significance was set at 0.05. The Cohen’s Kappa was also calculated to assess inter-rater agreement.
Results:
The three composite resins showed statistically significant color changes after four days of immersion in a coffee solution (P = 0.014), but their color change in the tea solution was not significant (P > 0.05). A comparison of color changes in the composites after one (two hours) and four days of immersion in tea and coffee solutions revealed a significant difference in color changes between Spectrum TPH and the other two composites (P < 0.001).
Conclusions:
The three microhybrid composites used in this study showed variable color stability upon exposure to a coffee solution. The color stability of Spectrum TPH was inferior to that of Denfil and Filtek Z250.
... The Lobene Stain Index was used to score the amount of stains on specimens in the current study. This index is widely used for the assessment of stainability of composite resins, and its reliability has been confirmed in many previous studies (30)(31)(32)(33)(34)(35). However, this measure is subjective and may be considered a limitation of the current study. ...
... Accordingly, dentifrices, due to their ease of use and low cost, have been used as vehicles for whitening agents. Some in vitro studies attest the effectiveness Declaration of Interests: The authors certify that they have no commercial or associative interest that represents a conflict of interest in connection with the manuscript. of whitening dentifrices 4,5,6 and some published clinical trials demonstrate greater effectiveness of one or another product. 7,8,9,10,11 In general, these studies have argued that whitening dentifrices may reduce or significantly inhibit the extrinsic staining of natural teeth compared to control dentifrices. ...
The aim of this clinical study was to evaluate tooth color changes (ΔE) and tooth sensitivity (TS) associated with whitening dentifrices. Sixty participants were selected according to inclusion and exclusion criteria and then allocated to three groups (n = 20): Colgate Luminous White (G1), Close Up White Now (G2) and Sorriso dentifrice (G3-control). The participants were instructed to use only the provided dentifrice and toothbrush in standardized oral hygiene procedures for 4 weeks. ΔE was assessed by spectrophotometry (CIELab System) whereas TS was determined by a visual analog scale at baseline and weekly using four assessment points. The data were analyzed by two-way ANOVA and Tukey’s post-hoc test and Friedman test (α = 0.05). ΔE (baseline-assessment point 4) showed no significant difference (p>0.05) across the groups: G1 (ΔE = 5.1), G2 (ΔE = 6.8), and G3 (ΔE = 4.4). Δb (baseline-assessment point 4) was significantly different (p < 0.05) in G2 (3.8) when compared to G1 (-0.2) and G3 (0.3). There was no significant difference (p > 0.05) in TS at baseline. Both the control and whitening dentifrices caused similar tooth color changes (ΔE). There was no significant TS during the study period.
... This is at odds with the behavior of non-whitening toothpaste controls, more common-ly seen in stain reduction studies in which there has been either little reduction or even a slight increase in extrinsic stain during the duration of the study. [5][6][7][8] Although the reason for the activity of the negative control in the current study is not clear, it should be noted that even with this apparent activity both whitening regimens were significantly more effective than the control at each time interval. ...
• Objective: This randomized, controlled clinical trial was conducted to assess the extrinsic stain reduction achieved by brushing with a whitening dentifrice and powered toothbrush, and to determine whether the addition of a whitening booster paste to this regimen would enhance its stain reducing effectiveness. • Methods: Sixty qualifying subjects were randomly assigned either to Regimen One, a whitening dentifrice (Arm & Hammer® Truly Radiant™ [TR] toothpaste] and powered toothbrush (Arm & Hammer® Truly Radiant™ [TR] Extra Whitening Spinbrush™); Regimen Two, the dentifrice and powered toothbrush with the addition of a whitening booster; or Regimen Three, a negative control (Colgate® Cavity Protection toothpaste and an ADA standard manual brush). They were instructed in the use of their assigned products and then brushed unsupervised at home for two minutes, twice daily, for 14 days. Extrinsic tooth stain was assessed at baseline and after two, five, and 14 days using a Modified Lobene Stain Index (MLSI) with Lobene inclusion criteria of ≥:1.5. • Results: All three treatment groups had statistically significant (p < 0.0001) mean total MLSI reductions from baseline at each time point, in a time-dependent manner. Day 14 reductions were 22.2% for Colgate Cavity Protection, 29.1% for Regimen One, and 34.4% for Regimen Two. Reductions for Regimen One and Regimen Two were significantly greater compared to Regimen Three, the negative control, at each time period (p < 0.01), and those for Regimen Two were significantly greater compared to Regimen One on days 2 and 14 (p < 0.05) and directionally more effective on day 5 (p = 0.0673). • Conclusion: The combination of Truly Radiant toothpaste and Truly Radiant Spinbrush provides safe and effective stain removal that can be further enhanced by the addition of the whitening booster.
... Após 6 semanas de estudo, o dentifrício clareador testado mostrou-se efetivo em remover manchas dentárias extrínsecas e no clareamento dos dentes e em prevenir manchamento dentário por até 2 semanas. 169 A remoção de manchas intrínsecas é difícil de ser atingida pela utilização de dentifrícios, visto que tanto os agentes mecânicos como os químicos limitam-se à remoção de manchamentos superficiais. Apesar de o clareamento à base de peróxidos ser um método estabelecido, a sua utilização no dentifrício é limitada. ...
Objective
To evaluate the whiteness index (WID) and surface roughness (Ra) of bovine enamel after simulated tooth brushing with different commercial and experimental whitening dentifrices.
Materials and Methods
Cylindrical enamel bovine specimens were acid etched, stained, and divided in nine groups (n = 8): Colgate® Optic White®, Crest® Baking Soda and Peroxide, Arm and Hammer® Advanced White™ Extreme Whitening, Rembrandt® Deeply White® + Peroxide, Close up® White Attraction Natural Glow, Hinode Prowhite, and experimental dentifrice containing papain (PP), bromelain (PB), or papain and bromelain (PPB). Ra and WID were obtained initially and after 600, 1200, and 3,600 cycles of simulated tooth brushing. Data were analyzed using two‐way analysis of variance test (α = 0.05).
Results
Ra was significantly influenced by both dentifrice (p = 0.043) and period of tooth‐brushing simulation (p < 0.001). Except for PP and PPB, all groups showed a statistically significant increase in Ra after simulated tooth brushing. After staining and brushing, none of the materials tested increased the initial WID.
Conclusions
The effect of commercial whitening dentifrices may be related to their high abrasiveness. Experimental formulations tested provided a similar effect without undesired wear of enamel. Whitening dentifrices only act through an abrasive effect rather than bleaching the tooth structures. When used, special care must be taken for avoid undesired wear of enamel. Experimental dentifrices provided similar removal of extrinsic stains without undesired abrasiveness; however, this effect may be due to the use of less aggressive abrasives in their formulations.
Objective:
The aim of this systematic review was to assess the effect of a whitening dentifrice (WDF) relative to a regular dentifrice (RDF) on the reduction of natural extrinsic tooth surface discoloration (ETD).
Materials and methods:
The MEDLINE-PubMed, Cochrane-CENTRAL and EBSCO-Dentistry and Oral Sciences databases were searched, up to April 2017. The inclusion criteria were as follows:(randomized)controlled clinical trials, healthy subjects ≥18 years of age, studies comparing WDF with RDF, a follow-up period of at least 6 weeks and studies scoring ETD as the stain area/extent, stain intensity or a composite score. Studies using an induced staining model were excluded.
Results:
Independent screening of 851 unique papers resulted in 21 eligible publications, which included 32 comparisons. The descriptive analysis illustrated that the majority of comparisons showed a significant effect on ETD, in favour of WDF over RDF. The meta-analysis substantiated this observation and revealed that the difference of means (diffM) comparing WDF and RDF was a reduction for stain area of -0.44 [(95% CI: -0.55; -0.339) (P<.00001)] according to the original Lobene Stain Index; this result is in favour of the WDF. For the modified Lobene Stain Index, the diffM was -0.41 [(95% CI: -0.71; -0.10) (P=.009)]. For overall stain intensity, the diffM was -0.35 [(95% CI: -0.44; -0.25) (P<.00001)], and the composite score was -0.39 [(95% CI: -0.57; -0.21) (P<.0001)] and -0.54 [(95% CI: -0.66; -0.43) (P<.00001)]. Subgroup analysis differentiating between products that contained added chemical antidiscoloration agents showed a similar pattern.
Conclusion:
In this review, nearly all dentifrices that are specifically formulated for tooth whitening were shown to have a beneficial effect in reducing ETD, irrespective of whether or not a chemical discoloration agent was added.
An eight-week, double-blind, parallel and unsupervised clinical study was conducted to compare the ability of two dentifrices, Arm & Hammer Dental Care toothpaste and Crest toothpaste, to prevent the formation of stain induced by the twice daily use of 0.12% chlorhexidine gluconate (Peridex). Stain formation was evaluated through the use of a new index (Modified Stain Index) designed to selectively detect stain of the proximal and facial surfaces of the anterior teeth. Examinations of stain formation were conducted at two-week intervals for a total of eight weeks. The results indicated equivalent stain prevention benefits for Arm & Hammer Dental Care and Crest when evaluated during eight weeks of chlorhexidine therapy. The modified stain index was shown to be valuable for discriminating location and intensity of early stain formation.
The main purpose of this laboratory study was to determine the tooth whitening effect of a baking soda dentifrice containing stabilized 1% hydrogen peroxide following repeated applications to intrinsically stained teeth. Additional objectives were to investigate (1) the influence of tooth surface curvature and moisture on color measurements, (2) preliminary treatment parameters using 1% hydrogen peroxide solution, and (3) the relationship between Vita shade guide standards and instrumental color readings. Human tooth specimens with intrinsic stain were specially prepared and measured for color (L*a*b*) by means of diffuse reflectance spectrophotometry. Specimens were measured under wet and dry conditions with natural and flattened enamel surfaces. A preliminary test was conducted with 1% H2O2 solution to establish tooth whitening versus treatment time. Then, new tooth specimens were treated repeatedly with slurries of silica, baking soda, or baking soda/peroxide dentifrices at 30-minute intervals, and color measurements were taken under both wet and dry conditions after 4, 8, 16 and 24 hours. L*a*b* color measurements of the Vita shade guide teeth were also made in order to relate laboratory color changes to clinical effects. The parameter testing results showed that flattening the enamel surface had no effect on tooth color, but the teeth rapidly became lighter and less yellow upon air-drying. The 1% H2O2 solution caused both a significant decrease in yellow (b*) and an increase in lightness (L*). Since the reduction for b* occurred more rapidly and to a greater extent than the L* factor, the b* component may be the more important indicator of tooth whitening by bleaching. Compared to the silica and baking soda dentifrices, the baking soda/peroxide dentifrice significantly decreased the yellow color (b*) of the teeth after 8 or more hours of topical treatment. The instrumental color readings of the Vita Shade guide teeth showed that the color differences between the standards were not linear or consistent, and their accuracy for assessing clinical changes in tooth whiteness is questionable.
The increasing emphasis on dental aesthetics has made tooth whitening an important function of a dentifrice. This laboratory study investigated the whitening effect of toothbrushing with sodium bicarbonate-based dentifrices compared with standard dentifrices that do not contain sodium bicarbonate. Six dentifrices and a distilled water control were tested for their ability to whiten teeth with intrinsic stain. The dentifrices contained different abrasive systems: (1) 45% NaHCO3; (2) 65% NaHCO3 (Arm and Hammer Dental Care); (3) 94% NaHCO3; (4) 94% NaHCO3 + 1.5% H2O2; (5) silica (Crest Regular Toothpaste); and (6) dicalcium phosphate (Colgate Regular Toothpaste). After a thorough rubber cup cleaning with a pumice slurry, the intrinsic color of the test teeth with a Vita shade of A3 or darker was measured with a spectrophotometer using the standard L*a*b* color scale. Measurements were taken on a total of 12 teeth per test dentifrice before treatment, and after 30, 60, 90 and 120 minutes of mechanical toothbrushing. No changes in L* (lightness/brightness) or a* (red-green hue) occurred, but significant differences in b* (yellow-blue hue) were observed over time. Compared to baseline tooth color, all four sodium bicarbonate-based dentifrices were significantly effective in removing the yellow intrinsic tooth stain, while the water control, silica dentifrice, and dicalcium phosphate dentifrice demonstrated no significant change. Between-group comparisons showed that the four dentifrices containing sodium bicarbonate were significantly more effective than the water and dicalcium phosphate dentifrice groups. The commercial dentifrice containing 65% sodium bicarbonate was also more effective than the commercial silica dentifrice. Although continued toothbrushing from 30 to 120 minutes resulted in additional stain removal, most of the tooth whitening by the sodium bicarbonate-based dentifrices occurred in the first 30 minutes of brushing. In the studies conducted, dentifrices containing high concentrations of sodium bicarbonate were more effective at removing intrinsic tooth stain than dentifrices that do not contain sodium bicarbonate.
The effect of twice-daily brushing with one of three different dentifrices (Arm & Hammer Dental Care, Arm & Hammer Dental Care Extra Whitening, Crest) on stain removal and tooth whitening was examined in 115 volunteers over a period of 12 weeks. The facial surfaces of 12 anterior teeth were assessed for stain using a published, modified version of a standard stain index. Whiteness was measured on teeth 8 and 9 using a single Vita Lumin-Vaccum Shade Guide for consistency. At baseline, the mean facial stain scores were significantly higher (p < 0.05-0.01) for both Arm & Hammer dentifrices than for Crest. In addition, the tooth shades, as indicated by the stain guide, specifically the b* values representing yellowness, were quantified using a Minolta spectrophotometer. Arm & Hammer Dental Care Extra Whitening formula was found to be significantly better than Crest at removing naturally occurring extrinsic stain. The difference between Arm & Hammer Dental Care Extra Whitening and Crest became significant (p < 0.01) after two weeks of use, and remained intact during the balance of the study, achieving p values of 0.0002 for at least one of the three assessed parameters (total stain, proximal, and facial) at weeks 4 and 12. The study also found that Arm & Hammer Dental Care produced a significant increase in tooth whiteness by week 12, whereas Crest showed no such increase at any time during the study. These results suggest that the two Arm & Hammer Baking Soda products are more effective in reducing stain and increasing whiteness than the standard silica-based dentifrice. Their effectiveness is not related to abrasivity since they are less abrasive to tooth enamel than the silica-based product tested.
To evaluate a modified tooth stain index and determine the effect of dietary factors on stain formation.
At baseline, 182 adult volunteers were given a full oral prophylaxis followed by stain assessment using a modification of the Lobene index. This involved assigning separate scores to the mesial (M) and distal (D) sites of each tooth, in addition to the standard gingival area (G) and tooth body (B). For each site, stain intensity and areas were scored. The sum of (intensity X area) scores was calculated for all sites (GBMD-value) and for the gingival and body sites only (GB-value). The subjects used a standard abrasive dentifrice and a soft toothbrush for 6 weeks.
Stain was reassessed and the average increase in GBMD-value was 20.9 (sd=9.9) (buccal aspect) and 29.9 (sd=18.0) (lingual aspect). The corresponding GB-values were 4.4 (sd=4.8) and 12.5 (sd=10.2). The coefficients of variation of the GBMD index values were consistently lower than those of the GB values. Smoking and tea-drinking were found to be the only significant (p<0.001) factors investigated for stain formation.
It is concluded that the modified index may well be advantageous to its conventional counterpart because sites with most visible stain are assessed separately and because it may also offer higher discriminatory power due to a lower coefficient of variation.
The objective of this clinical investigation was to evaluate the effectiveness in removing existing extrinsic tooth stains of a sodium bicarbonate (baking soda), dual-phase dentifrice containing calcium and phosphate (Test Dentifrice), when compared to a commercial hydrated silica dentifrice (Control Dentifrice), during a six-week period of normal, unsupervised use.
This investigation was a double-blind comparison of two equivalent, parallel groups of subjects assigned to use different dentifrices for six weeks. A total of 108 adult male and female subjects qualified for the trial based on the presence of existing extrinsic tooth stains and other inclusion/exclusion criteria. The two groups were balanced for gender, tobacco use, and extrinsic tooth stain scores, and randomly assigned the Test or Control dentifrices. All subjects were instructed to brush their teeth twice daily using only the dentifrice and toothbrush provided, and to refrain from using any other oral hygiene products for the duration of the study. Although product usage was unsupervised after the baseline visit, subjects maintained a treatment diary, and product consumption was monitored to estimate compliance. Oral soft and hard tissue and extrinsic stain assessments (Modified Lobene Stain Index) for each subject were conducted at baseline and after two, four, and six weeks of product use.
A total of 107 subjects complied with the protocol and completed the six-week study. Compared to baseline, at the two-, four-, and six-week examinations the Test Dentifrice group had statistically significant reductions in extrinsic tooth stain. In contrast, the Control Dentifrice group did not attain significant reductions from baseline at any of the exams. At both the four-week and six-week examinations, the Test Dentifrice group had significantly lower levels of extrinsic tooth stain than the Control Dentifrice group.
A sodium bicarbonate, dual-phase dentifrice containing calcium and phosphate demonstrated statisically significant efficacy in removing naturally acquired, extrinsic tooth stain, and was significantly more effective for stain removal than a commercially available, hydrated silica dentifrice.