Blackberries for antimicrobial agent!??!

Antimicrobial effects of blackberry extract target periodontopathogens. Journal of Periodontal Research. 2013
Blackberry extract(BBE) was tested for its antibacterial properties against 10 different oral bacteria.  This study demonstrated that  BBE reduced the metabolic activity of bacteria while exerting minimal effect on harmless oral bacteria.

Philips Sonicare AirFloss

Sonicare AirFloss is developed to provide an alternative to traditional flossing.  With a quick burst, microdroplets of water are accelerated by pressurized air to disturb and remove plaque in between teeth.  Philips, the manufacturer, claims that AirFloss can clean between all teeth in 60 seconds.  Unlike the traditional oral irrigators, AirFloss is portable, and rechargeable.   

Research Article: 

Comparison of two power interdental cleaning devices on the reduction of gingivitis. Journal of Clinical Dentistry. 2012

This study compared Waterpik Water Floss and Sonicare AirFloss.  Both devices demonstrated significant reduction in gingivitis and bleeding on probing.  However, the test group used Waterpik showed significant improvement in overall gingivitis reduction than AirFloss.  Waterpik also was twice as effective for the lingual legion.  

The effect of different interdental cleaning devices on gingival bleeding. Journal of International Academy of Periodontology. 2011
This study compared the effectiveness of an oral irrigator and waxed dental floss on gingival bleeding.  The daily use of an oral irrigator was significantly more effective in reducing gingival bleeding than waxed dental floss.

This video shows the Airfloss microburst in slow motion.  The microburst removes the plaque biofilm substitute between two teeth on a typodont in one burst.

Oraqix (lidocaine and prilocaine gel) 2.5%/2.5%

Oraqix is a needle-free anesthetic system that can be used for scaling and root planing procedure.  It is a combination of lidocaine and prilocaine and its unique thermosetting system to deliver pain relief.  Oraqix is delivered using a blunt metal tip inserted into pockets in liquid form.  Once administered, it thickens at body temperature into an elastic gel.  Onset time is 30 seconds and it lasts about 20 minutes.  

Link to Oraqix

Quantification and analysis of pain in nonsurgical scaling and/or root planing. Journal of the American Dental Association. 2004  This study demonstrated effectiveness of Oraqix in pain control during scaling and root planing procedure.  

The anesthetic onset and duration of a new lidocaine/prilocaine gel intra-pocket anesthetic(Oraqix) for periodontal scaling/root planing. Journal of Clinical Periodontology. 2001

This study concluded that Oraqix provides anesthesia after 30 seconds once its applied, and it lasted about 17 to 20 minutes.  Also it was noted that there were no reports of numbness of tongue, lip, or cheek as well as any adverse local reactions in the oral mucosa.  

PreviDent 5000 Fluoride Toothpaste

Link to Colgate

PreviDent5000 is a prescription fluoride toothpaste that is formulated with 1.1% sodium fluoride.  It is recommended for patients with high caries risk, restorative treatments, and orthodontic decalicification.  Patient will be instructed to brush with the toothpaste for 2 minute before bed.  I do recommend patients to spit out the toothpaste but not to rinse with water to maximize the benefit of using fluoride toothpaste.  

Reversal of primary root caries using dentifrices containing 5,000 and 1,100 ppm fluoride. Caries Research. 2001
This study compared the ability of two toothpastes containing sodium fluoride.  One has 5,000 ppm fluoride (Prevident 5000) and other one has 1,100 ppm fluoride.  Average over the counter toothpastes has 1,100 ppm fluoride concentration.  The study found that the toothpaste containing 5,000 ppm fluoride worked better than 1,1000 ppm toothpaste in remineralizing the root caries lesions.

Sensodyne Toothpaste

Sensodyne is a toothpaste recommended to treat dental sensitivity.  Daily use of the toothpaste controls dentin hypersensitivity caused by cold, hot, acidic, sweet and other triggers.  Dentin hypersensitivity defined as 'a short, sharp pain arising from exposed dentin in response to stimuli which cannot be ascribed to any other form of dental defect or pathology'*.  Sensodyne is formulated with potassium Nitrate and sodium fluoride (1150 ppm).  

Link to Sensodyne

A comparative evaluation of the efficacy of two novel desensitizing dentifrices. International Journal of Dentistry. 2012 

This study compared two commercially available toothpastes that are used to treat dentin hypersensitivity.  Both Sensodyne and Colgate Sensitive Pro-Relief significantly reduced the cold and tactile sensitivity. 

*Addy M. Dentine Hypersensitivity. New perspectives on an old problem. Int Dent J (2002) 52; 367-375

Chlorhexidine (Gluconate Oral Rinse, 0.12%)

Chlorhexidine is commonly used as an adjunctive therapy along with Scaling and Root Planing procedure.  The microbial effect of the rinse decreases the bacterial loads in the mouth while reducing gingival inflammation.  The common side effects caused by using Chlorhexidine are temporary loss of taste, teeth staining and increased supragingival calculus build-up.  

Adjunctive effect of chlorhexidine antiseptics in mechanical periodontal treatment: first results of a preliminary case studies. International Journal of Dental Hygiene. 2012
This study supports the use of Chlorhexidine rinse in conjunction with the mechanical periodontal therapy.  Overal pocket depths were decreased in both patient groups whether they used the rinse or not.  However, bleeding on probing and total bacterial counts were significantly lower in patients used chlorhexidine rinse.

Rinsing with alcohol-free or alcohol-based chlorhexidine solutions after periodontal surgery. Swedish Dental Journal. 2012
This study concluded that both the alcohol-free and alcohol-based chlorhexidine rinse showed the same plaque inhibitory effect in periodontal patients after periodontal surgery.

GumChucks: a new and fun way to floss!

GumChucks resemble nunchucks and they are equipped with disposable floss tips that is a 3/4inch long.  Making "C" shape to wrap the floss around teeth would be so much easier with this tool.  It would be ideal for patients with limited dexterity, especially for the children! 

Link to GumChucks website

GUM EasyThread Floss

 This is a cool product that is designed to make flossing around braces, bridges, and implants easy.  I was more familiar with Oral-B Super Floss which I think works great but I thought Oral-B could have done better job with packaging/dispensing of floss.  15 pre-cut Super Floss is packaged in one.  When I tried to pull one floss out of a package, (1) all the flosses come out, tangled up together, (2) it gets tangled in the package so I can't even take one out.  So I would end up open the whole package just to get a single floss out.  I used it because it worked good when I had braces but it was pretty annoying.  

GUM EasyThread Floss seemed to be an organized version of Oral-B Super Floss to me.  EasyThread Floss is rolled in a dispenser so it reduces tangles.  Both ends of floss have stiff threader sections so it would be easier to floss with clean/un-used section of the floss.  

As for the patient compliance level, the following study examined which flossing aid patients prefer; between regular finger floss and Flosser.  While there were no significant difference in plaque removal in both the method but patients preferred the flossing aid slightly over finger flossing.  
Evaluating the efficacy of a new flossing aid. Journal of Clinical Periodontology. 1993

Remineralization: ACP (Amorphous Calcium Phosphate)

Amorphous calcium phosphate (ACP) is an inorganic amorphous calcium phosphate technology made by combining soluble slats of calcium and phosphorous.  ACP is a reactive and soluble calcium phosphate compound.  ACP rapidly releases calcium and phosphate ions to convert to apatite and remineralize tooth structure.  ACP has been shown in studies to decrease dentin permeability by 78%, thereby reducing sensitivity.  Also, ACP has been shown to restore enamel luster and enhance fluoride delivery.  ACP is found in Age Defying Toothpaste by Arm and Hammer.  Premier offers ACP in its Enamel Pro prophy paste with fluoride, Enamel Pro Sodium Fluoride Varnish, and Enamel Pro 1.23% Non-Acidulated Fluoride Gel.  Discus offers Relief ACP Oral Gel with the addition of sodium fluoride and potassium nitrate.  The fluoride-added formulas precipitate hydroxyapitite, occluding dentinal tubules.  From RDH Magazine.

Gelato Perio Maintenance Rinse, 0.63% stannous fluoride

Link to Keystone Industries

Gelato Perio Rinse is manufactured by Keystone industries and contains 0.63% stannous fluoride.  It is designed to prevent dental caries while strengthening and protecting root surfaces.  The rinse is alcohol-free, gluten-free, and color additives-free! 

Research Article:
The effect of a dentifrice and mouth rinse combination containing amine fluoride/stannous fluoride on plaque and gingivitis: a 6-month field study. Journal of Clinical Periodontology. 2005
This study compared stannous fluoride rinse and sodium fluoride rinse on plaque formation and gingivitis.  After 6 month of use, both rinses reduced the plaque scores and bleeding scores.  Overal staining was more pronounced on patients who used stannous rinse than sodium fluoride rinse.

Crest Pro-Health Multi-Protection Rinse

Crest Pro-Health Multi-Protection mouthrinse contains sodium fluoride 0.0219% and an anti-microbial agent, cetylpyridinium chloride (CPC).  This product does not contain alcohol which is beneficial to use in patients with dry mouth.  While CPC is effective in reducing gingivitis, causing extrinsic staining of teeth is one of the known side effects of using this product.

Here is the link to a news video clip reporting consumer complaints of their teeth turning brown after using Crest Pro-Health rinse.

Link to Crest ProHealth

Research Article:
Antimicrobial efficacy of 0.05% cetylpyridinium chloride mouthrinses. Letters in Applied Microbiology. 2013
This study shows the reduction of supragingival plaque and plaque-associated gingivitis after using a CPC containing mouthrinse.

The staining potential of various currently marketed mouthrinses. The Journal of Clinical Dentistry. 2013
This study demonstrated that regular use of Crest Pro-Health rinse increased the extrinsic stain accumulation after six weeks.

Xylimelts

Xylimelts is used to treat xerostomia.  Clinical studies suggest that the benefit of xylitol are greatest when there is a continuous concentration of xylitol presents in the mouth.  Xylimelts adheres to oral tissue and releases effective concentrations of xylitol over time.  It stimulates the saliva flow while moisturizes and coats the mouth.  It can be used before bed or during day time.  This product is manufactured by a local company, OralHealth, in Bellevue, Washington.  The company also makes CankerMelts to treat Canker Sore.  


Link to OraHealth Website

Xylimelts Brochure
Xylitol information for Dental Professionals
     This is an educational website for information about the benefits of xylitol.

Research Article:
XyliMelts time-release adhering discs for night-time oral dryness. International Journal of Dental Hygiene. 2012

Oral-B Electric Toothbrushes

Link to Oral B website

Oral-B power brush uses oscillating-rotating technology allowing to brush-head to change directions and remove plaque.  Oral-B Professional Precision 5000 Series also incorporated Triple pressure control technology which supports gentle brushing habits.  Indication lights and change in pulsation alert users to stop aggressive brushing.  


Efficacy of an electric toothbrush on plaque control compared to two manual toothbrushes. International Dental Journal. 2011 The result of this study showed no evidence of statistically significant difference in plaque control between electric toothbrush and manual brushes.  What I noticed from reading this article was that chosen study subjects were dental students. (and they knew how to brush their teeth with manual brushes!)

Evaluation of a new multi-directional power toothbrush versus a marketed sonic toothbrush on plaque and gingivitis efficacy. American Journal of Dentistry. 2012  This study compares plaque removal level between the use of multi-directional power toothbrush (Oral B product) and a sonic toothbrush (Sonicare).  This study was published by Procter & Gamble which also owns Oral-B company.  The conclusion of study could had been affected to support the interests of the company.

Plaque removal efficacy of power and manual toothbrushes: a comparative study. Clinical Oral Investigations. 2010 Power toothbrush was more effective in removing plaque than manual toothbrushes.

BreathRX

Link to BreathRx.com
BreathRx system is designed to treat halitosis by eliminating bad breathe and decreasing bacterial growth in the mouth.  The system includes toothpaste, tongue spray and scraper, and mouth rinse.  BreathRx is alcohol-free and contains xylitol.  

Comparative effects of various commercially available mouthrinse formulations on oral malodour. Oral Diseases. 2010
In this study, five over the counter mouthrinse products were compared and BreathRx had a moderate effectt on halitosis control when it was compared to other products.  This study concluded that a low dose chlorhexidine rinse (0.025%) produced the best result in halitosis control.

Interdental Brush

Let's face it, most patients hate flossing. If I can somehow convince patients to floss 3-4 times a week, I am a happy camper!!  Reasons for not flossing are varies from finger flossing cut off circulation on their fingers and turn them blue to don't know how to floss even though I demonstrate it at every visit.  So I try to suggest other interproximal cleaning aids to help them clean out plaque and food debris between the teeth. Interdental brushes are one of the many interproximal cleaning aids available that I often recommend and I have been getting good feedback from my patients.  I was worried about its ability to remove plaque as compared to regular waxed floss but it seemed to work well when I see returning patients at their 6 months visit.  One of the important thing is to make sure that patient uses a proper size brush head. If the brush head is much smaller or larger than the interproximal spaces, it won't do the job.  Interdental brushes can also be used around orthodontic brackets, under wires and around implants.  

Interproximal gingivitis and plaque reduction by four interdental products. Journal of Clinical Dentistry. 2006
This study compared four different interdental cleaning aids on removing plaque and reducing gingivitis.  All cleaning aids did comparably well in removing plaque and tools used include, Glide floss, Butler flossers, GUM Go-Betweens, and GUM Soft-Picks.