salicylates and Tooth-Discoloration

This randomized, single center, examiner-blind, controlled, parallel-group, 6-month clinical study compared the antiplaque/antigingivitis potential of an essential oil (EO) versus a 0.07% cetylpyridinium chloride (CPC)-containing mouthrinse. A 5% hydroalcohol solution was included as a control group.. 354 healthy volunteers (18-71 years of age) were enrolled in this clinical trial; 338 subjects completed the study. At baseline, 1-, 3-, and 6-month visits, subjects received an oral examination, gingivitis (MGI), gingival bleeding (BI) and plaque assessments (PI). Following randomization, subjects received a prophylaxis and began brushing twice daily with the provided fluoride toothpaste and rinsing twice daily with 20 mL of the assigned mouthrinse for 30 seconds.. All rinses were well tolerated by the subjects, with the exception of extrinsic tooth stain complaints in 13 subjects in the CPC group between the 3- and 6-month exams. Statistically significant reductions in gingivitis, bleeding and plaque were observed for both EO and CPC at all post-baseline time-points when compared to the negative control. At 6 months MGI and PI were reduced by 42.6% and 42.0% for EO and by 17.1% and 13.9% respectively, for CPC vs. control. When compared to CPC, EO was statistically significantly superior at all post-baseline time-points. EO showed increasing reductions in MGI of 10.5%, 20.3% and 30.7% as well as reductions in PI of 12.7%, 23.7% and 32.6% at 1, 3 and 6 months, respectively. When analyzing the number of healthy sites (MGI scores of 0 or 1), the beneficial effect of the EO-containing mouthrinse is 45.8% greater than using a CPC-containing mouthrinse and 59.8% greater than placebo.

Topics: Adolescent; Adult; Aged; Anti-Infective Agents, Local; Cetylpyridinium; Dental Plaque; Dental Plaque Index; Drug Combinations; Female; Follow-Up Studies; Gingival Hemorrhage; Gingivitis; Humans; Male; Middle Aged; Mouthwashes; Oils, Volatile; Periodontal Index; Placebos; Salicylates; Single-Blind Method; Terpenes; Tooth Discoloration; Young Adult

A major cause of tooth discoloration may be sealer remnants in the chamber. The objective of this study was to evaluate, longitudinally, coronal discoloration from four sealers. Extracted premolars were sectioned in the coronal third of the root. The chamber contents were removed and instrumentation was via the canal. The following sealers were bulk introduced into the chamber: AH26, Kerr Pulp Canal Sealer, Roths 801 (nonstaining), and Sealapex. The apical access was sealed with white sticky wax. Teeth were maintained in a moist environment at 37 degrees C. Initial (immediate pretreatment) digital images of the teeth were made for base line comparison. Subsequent images were at 1-, 3-, 9-, and 12-month intervals. Then images were mixed and descriptively evaluated blindly by trained evaluators. Discoloration was induced by the four sealers, with slight to moderate visible changes that increased through 12 months. There was slightly more discoloration with AH26 and Kerr Pulp Canal Sealer. In conclusion discoloration induced by the endodontic sealers produced slight to moderate and generally progressive discoloration over 12 months.

Topics: Bicuspid; Bismuth; Calcium Hydroxide; Dental Pulp Cavity; Drug Combinations; Epoxy Resins; Follow-Up Studies; Humans; Humidity; Image Processing, Computer-Assisted; Longitudinal Studies; Methenamine; Root Canal Filling Materials; Salicylates; Silver; Single-Blind Method; Temperature; Titanium; Tooth Crown; Tooth Discoloration; Zinc Oxide-Eugenol Cement

The adjunctive use of antimicrobial mouthrinses to help control supragingival plaque and gingivitis has been shown to contribute significantly to patients' daily oral hygiene regimens. This controlled clinical study used an observer-blind, randomized, cross-over design in a 4-day plaque regrowth model to determine the relative efficacies of an essential oil-containing mouthrinse (Listerine Antiseptic) and an amine fluoride/stannous fluoride-containing mouthrinse (Meridol) in inhibiting the development of supragingival plaque. A 0.1% chlorhexidine mouthrinse (Chlorhexamed-Fluid) was used as a positive control, and a 5% hydroalcohol solution was used as a negative control. Dosing for each of the test mouthrinses was based on the manufacturers' label directions. Because the volume and rinse time for each of the test mouthrinses were different, each test mouthrinse had its own negative control group. On day 1 of each test period, subjects received an oral soft and hard tissue examination and a dental prophylaxis to remove all plaque, calculus, and extrinsic stain. Starting the same day, subjects refrained from all mechanical oral hygiene procedures for the next 4 days and rinsed 2x daily under supervision with their randomly-assigned mouthrinse. On day 5, each subject received a plaque assessment as well as an oral examination to assess side effects. Each test period was separated by a 2-week washout period. 23 volunteers with a median age of 26 years completed the study. Compared to the respective placebos, the median percent plaque reductions at 5 days were 23.0%, 12.2%, and 38.2% for the essential oil, amine/stannous fluoride, and chlorhexidine rinses, respectively. The plaque reductions seen in the essential oil and chlorhexidine rinse groups were statistically significant (p < 0.001), while the plaque reduction in the amine/stannous fluoride rinse group was not statistically significant (p > 0.05). Additionally, the essential oil rinse was significantly more effective (p < 0.001) than the amine/stannous fluoride rinse in inhibiting plaque accumulation in this clinical model.

Topics: Adult; Amines; Anti-Infective Agents; Anti-Infective Agents, Local; Chlorhexidine; Cross-Over Studies; Dental Plaque; Dental Plaque Index; Dental Prophylaxis; Drug Combinations; Female; Humans; Male; Mouthwashes; Placebos; Salicylates; Single-Blind Method; Terpenes; Tin Fluorides; Tooth Discoloration

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 essential oil/phenolic rinse product may cause staining was investigated. The rinses studied were the anti-adhesive alone and combined with 0.02% chlorhexidine and the essential oil/phenolic rinse. These were positioned against a positive control rise, 0.2% chlorhexidine, and a negative control rinse, water. The study was a single blind 5-treatment, randomised Latin square cross-over design, incorporating balance for carry-over effects. 15 volunteers participated and on Day 1 of each study period were rendered stain free by scaling and polishing of the teeth. Oral hygiene was suspended and 8 x per day subjects rinsed under supervision, firstly with the allocated formulation and then with 10 ml of warm black tea. On Day 4, tooth and tongue staining was scored by area and intensity (colour). A washout period of at least 3 1/2 days was permitted between treatment periods when oral hygiene was resumed. Before the study and during washouts, volunteers practised tongue brushing. Tooth and tongue staining was significantly increased with 0.2% chlorhexidine compared to the essential oil/phenolic rinse which in turn was significantly increased compared to the other 3 rinses. The antiadhesive/chlorhexidine rinse produced no more staining than the anti-adhesive or water rise. However, the parallel plaque regrowth study suggests this inhibition of staining resulted from the vitiation of the chlorhexidine activity by the antiadhesive. The methodology would appear a simple and quick way of assessing the propensity of mouthrinses to cause extrinsic staining.

Topics: Anti-Infective Agents, Local; Chlorhexidine; Color; Cross-Over Studies; Dental Plaque; Dental Prophylaxis; Dental Scaling; Drug Combinations; Humans; Male; Mouthwashes; Oils, Volatile; Oral Hygiene; Phenols; Polyethylene Glycols; Polymethacrylic Acids; Salicylates; Single-Blind Method; Surface-Active Agents; Tea; Terpenes; Tongue; Tooth Discoloration; Water

A 6-month double-blind, controlled clinical study was completed with 124 healthy adult subjects to determine the efficacy of 2 mouthrinses, Listerine (LA) and Peridex (PX), used as supplements to regular oral hygiene measures in reducing supragingival dental plaque and gingivitis. Following screening examinations for entry levels of existing gingivitis and plaque, baseline gingival and plaque area indices, extrinsic tooth stain, supragingival calculus, bleeding and soft tissue condition were recorded. All subjects then received a complete dental prophylaxis to remove plaque, calculus and extrinsic stain. Subjects were randomly assigned to 1 of 3 groups and performed supervised rinses twice daily for 30 s in addition to their normal oral hygiene, for 6 months. All indices were again evaluated at 3 and 6 months. After 6 months, LA and PX significantly (p less than 0.001) inhibited development of plaque by 36.1% and 50.3%, respectively, and the development of gingivitis by 35.9% and 30.5%, respectively, compared to a hydroalcohol control. PX was more effective in inhibiting plaque and both mouthrinses appeared to be equally effective in inhibiting gingivitis. LA patients did not develop significant levels of stain or supragingival calculus at 6 months, compared to baseline or control. PX patients developed significant levels of extrinsic stain and supragingival calculus compared to baseline and control. Though PX was more effective than LA in the control of plaque, this study indicates that both LA and PX were effective agents in a regimen for the control of plaque and gingivitis.

Topics: Adult; Chlorhexidine; Dental Calculus; Dental Plaque; Dental Plaque Index; Double-Blind Method; Drug Combinations; Female; Gingivitis; Humans; Male; Middle Aged; Mouthwashes; Periodontal Index; Salicylates; Terpenes; Tooth Discoloration

A 6-month double-blind, controlled clinical study was conducted on 107 healthy adult subjects to determine the efficacy of a mouthrinse used as a supplement to regular oral hygiene measures on supragingival dental plaque and gingivitis. 115 healthy adult patients were recruited for the study. Following screening examinations for minimal entry levels of existing gingivitis and plaque in patients with a minimum of 20 sound natural teeth, extrinsic tooth stain, gingivitis and plaque index scores were recorded. Soft tissues were evaluated. All subjects then received a complete dental prophylaxis, removing plaque, calculus and extrinsic stain. Utilizing their normal oral hygiene, subjects began a regimen of rinsing with 20 ml of the randomly assigned rinse, twice daily for 30 s for 6 months. 7 days after prophylaxis, gingivitis was again scored (baseline 2). Soft tissue, gingivitis, plaque area and extrinsic stain were evaluated again at 3 and 6 months. Results demonstrated that after 6 months, listerine produced a 34% inhibition of both plaque and of gingivitis compared to a hydroalcohol control (p less than 0.001).

Topics: Adolescent; Adult; Dental Plaque; Dental Plaque Index; Double-Blind Method; Drug Combinations; Female; Gingivitis; Humans; Male; Middle Aged; Mouthwashes; Periodontal Index; Salicylates; Terpenes; Tooth Discoloration

The aim of this study was to assess, in vitro, the color of teeth exposed to different mouthrinses for a prolonged period.. Bovine teeth were distributed in four groups: control, alcohol-containing mouthrinse (Listerine(®)), alcohol-free mouthrinse (Oral-B(®)) and chlorhexidine mouthrinse (Periogard(®)). The teeth were submitted to two cycles of staining and artificial aging. Color evaluation was performed with a digital spectrophotometer at the beginning of the experiment and after every cycle. Color changes were characterised using the system defined by the Comission Internationale de L'Eclairage (CIE L*, a*, b*). Data were analysed using the ANOVA and Tukey's post hoc test.. After the two cycles of staining and artificial aging, ΔE, ΔL and Δb from the alcohol-containing mouthrinse showed statistically significant differences when compared to the other groups. The ΔE values of the Listerine(®) group after the two cycles were greater than 3.7, indicating a visually perceptible color change.. The teeth exposed to the alcohol-containing mouthwash Listerine(®) were the only ones that presented a clinically perceptible color change.. A blue-colored alcohol-containing mouthwash was shown to be capable of causing dental color change after a prolonged period of exposure. Special care must be taken when choosing and prescribing the prolonged use of the same mouthwash.

Topics: Animals; Anti-Infective Agents, Local; Cattle; Cetylpyridinium; Chlorhexidine; Color; Dental Enamel; Drug Combinations; Ethanol; Hot Temperature; Humidity; Mouthwashes; Salicylates; Solvents; Spectrophotometry; Terpenes; Time Factors; Tooth Crown; Tooth Discoloration; Ultraviolet Rays

The aim of this study was to use the Zurich polyspecies biofilm model to compare the antimicrobial effects of chlorhexidine mouth rinses available on the Swiss market. As positive and negative controls, aqueous 0.15% CHX solution and water were used, respectively. In addition, Listerine® without CHX was tested. Biofilms in batch culture were grown in 24- well polystyrene tissue culture plates on hydroxyapatite discs in 70% mixed (1:1 diluted) unstimulated saliva and 30% complex culture medium. During the 64.5-hour culturing period, the biofilms were exposed to the test solutions for 1 minute twice a day on two subsequent days. Thereafter, the biofilms were dip-washed 3 times in physiological NaCl. Following the last exposure, the incubation of biofilms was continued for another 16 h. They were then harvested at 64.5 h. The dispersed biofilms were plated on 2 agar media. After incubation, colonies (CFU) were counted. All solutions containing CHX as well as Listerine ® significantly reduced the number of microorganisms in biofilms. According to their efficacy, the mouth rinses were classified into 2 groups. The two Curasept ADS solutions, Parodentosan, and the Listerine® mouth rinse reduced the number of total CFU by 3 log10 steps. This seems sufficient for a long-lasting prophylactic application. The two PlakOut® mouth rinses and the CHX control fell into the other group, where the number of CFU was reduced by 7 log10 steps. These mouth rinses are predestined for short-term therapeutic use. However, reversible side effects must be taken into account. It has thus far not been possible to formulate CHX products with effective ADS (Anti Discoloration System) additives without reducing antimicrobial activity.

Topics: Analysis of Variance; Anti-Infective Agents, Local; Biofilms; Chlorhexidine; Colony Count, Microbial; Dental Plaque; Drug Combinations; Humans; Mouthwashes; Salicylates; Saliva; Statistics, Nonparametric; Terpenes; Tooth Discoloration

A major cause of tooth discoloration is sealer remnants in the pulp chamber after root canal treatment. The purpose of this study was to assess coronal distribution and color changes of four commonly used sealers placed in the pulp chamber after 2 yr. Fifty extracted premolars were cross-sectioned in the coronal third of the root. The chamber contents were removed, and instrumentation was via the canal; then freshly mixed sealer was placed in each chamber. Sealers evaluated were: AH 26, Kerr Pulp Canal Sealer, Roth 801, and Sealapex. The apical access was sealed with white sticky wax, and the tooth was maintained in a moist environment at 37 degrees C for 2 yr. Teeth were split longitudinally, and digital images of the exposed dentin were made, scrambled, and evaluated blindly by trained evaluators for color changes and for presence of sealer in dentin. There was no measurable penetration of sealer into dentin for all groups and no dentin discoloration occurred. The sealers displayed marked discoloration. At 2 yr, the sealers discolored and remained confined primarily to the pulp chamber.

Topics: Bismuth; Calcium Hydroxide; Dentin; Dentin Permeability; Drug Combinations; Epoxy Resins; Humans; Random Allocation; Root Canal Filling Materials; Salicylates; Silver; Titanium; Tooth Crown; Tooth Discoloration; Zinc Oxide-Eugenol Cement

Extrinsic staining of teeth is a side-effect of some antiseptic mouthrinses. However, few of the many rinse products available to the general public have been investigated for their propensity to cause staining. Dietary factors play an aetiological role in staining and have been used in vitro to study and compare the activity of rinses. The aim of this study was to assess rinse products for staining in vitro and, through the staining reaction, to compare the activity of products containing the same ingredients. Perspex blocks, with or without saliva pretreatment, were soaked in rinses for 2 min, washed and placed in a standard tea solution for 60 min and then the optical density (OD) read on a spectrophotometer. The cycle was repeated 10 times for saliva and 17 times for no saliva specimens or until the maximum OD was exceeded. A series of three separate experiments was performed by this method. The maximum OD was not exceeded by any product before seven passages and therefore data were compared at six passages. For most products OD increased with saliva pretreatment. Some cetylpyridinium chloride (CPC) rinses stained comparably to a chlorhexidine rinse. CPC rinses, most of which contained the same concentration of the antiseptic, varied considerably in their propensity to induce staining and one was little different to water controls. A 0.1% chlorhexidine rinse stained slightly more than a 0.2%. A phenolic/essential oil product produced some staining but zinc, triclosan and other essential oil rinses did not stain.(ABSTRACT TRUNCATED AT 250 WORDS)

Topics: Analysis of Variance; Anti-Infective Agents, Local; Cetylpyridinium; Chlorhexidine; Drug Combinations; Drug Synergism; Food Coloring Agents; Hexetidine; Materials Testing; Methylmethacrylate; Methylmethacrylates; Models, Structural; Mouthwashes; Oils, Volatile; Phenols; Salicylates; Saliva; Spectrophotometry; Tea; Terpenes; Tooth Discoloration; Triclosan; Zinc Compounds

Topics: Bismuth; Humans; Organometallic Compounds; Salicylates; Stomatitis; Tooth Discoloration