An analysis of nine toothpastes found that none of them protects the enamel or prevents erosive wear. Scientists emphasize the importance of diet and treatment by a dentist. Credit: Samira Helena João-Souza
The increasing prevalence of tooth erosion and dentin hypersensitivity has led to the appearance of more toothpastes that claim to treat these problems. While there was no such toothpaste 20 years ago, today, many of those brands are available.
However, a study conducted at the University of Bern in Switzerland with the participation of a researcher supported by a grant from the São Paulo Research Foundation showed that none of the nine toothpastes analyzed was capable of attenuating the loss of enamel surface, a key factor in tooth erosion and dentine hypersensitivity.
"Research has shown that exposed dentine with open tubules causes hypersensitivity and erosion is one of the causes of dentine exposure. That is why in our study we analyzed toothpastes that claim to be anti-aerosol and / or desensitizing, "said Samira Helena João-Souza, PhD in the Faculty of Dentistry of the University of São Paulo (FO-USP) in Brazil and first author of the article.
According to the article, published in Scientific Reports all toothpastes tested caused different amounts of enamel surface loss, and none of the toothpastes provided protection against erosion and abrasion of the enamel . The authors of the study emphasized that these toothpastes have utility, but that they should be used as a complement, not as a treatment, strictly speaking. According to João-Souza, at least three factors are required: treatment prescribed by a dentist, use of an adequate toothpaste and a change in lifestyle, especially diet.
"Dental erosion is multifactorial, it has to do with brushing, and above all, with diet, and food and beverages are becoming increasingly acidic as a result of industrial processing," he said.
The researcher emphasizes that dental erosion is a chronic loss of dental hard tissue caused by acid without bacterial involvement, unlike the related caries bacteria. When it is associated with mechanical action, such as brushing, it produces erosive wear. In these situations, patients often experience discomfort when they drink or eat something cold, hot or sweet.
"They come to the clinic complaining that they have cavities, but in reality, the problem is caused by exposure to dentin due to brushing with [a] very abrasive toothpaste, for example, combined with the frequent consumption of large quantities of acidic foods and drinks, "said Professor Ana Cecília Corrêa Aranha, supervisor of João-Souza and co-author of the article.
In our clinical work, we see patients with this problem in the cervical region between [the] gums and teeth. The enamel in this region is thinner and more susceptible to the problem, "he added.
Scientists tested eight anti-erosive and / or desensitizing toothpastes and a control toothpaste, all available in pharmacies and pharmacies in Brazil or Europe.The research simulated the effect of brushing once a day with exposure to an acid solution for five consecutive days in the tooth enamel.The study used human premolars donated for scientific research purposes, artificial saliva, and an automatic planing machine.
"We use a microhardness test to calculate the enamel loss due to brushing with the toothpastes tested. The chemical analysis consisted in measuring the pH of the toothpaste and the levels of tin, calcium, phosphate and fluorine, "explained João-Souza, who analyzed the abrasive particles contained in the toothpastes, measured their size and test the wettability, a measure of the ease with which the toothpaste mixed with artificial saliva could spread on the surface of the tooth.
"During the brushing with these toothpastes mixed with artificial saliva, we discovered that the properties of the toothpastes were different, so we decided to expand the scope of the analysis to include chemical and physical factors. This [broadening] made the study more complete, "said João-Souza.
All the toothpastes analyzed caused the progressive loss of the tooth surface during the five-day period." None of them was better than the others. The indication will depend on each case. The test showed that some [toothpastes] caused less surface loss than others, but all resembled control toothpaste [for] this criterion. Statistically, all were similar, although numerically, there were differences, "said Aranha.
" We are now working on other studies related to dentin to think about the possibilities, since none of these toothpastes was found capable of preventing the dental erosion or dentin hypersensitivity, which is cause for concern. "
The researchers plan to begin a more specific in vivo study that will also include pain assessments.
Samira Helena João-Souza et al. Chemical and physical factors of the desensitizing and / or anti-erosive tooth creams associated with less erosive tooth wear, Scientific Reports (2017). DOI: 10.1038 / s41598-017-18154-8