Dental products

Dental products

Dental products are used to maintain the dental and oral hygienic condition in a human being.

There are numerous inorganic compounds used in the preparation of dental products like fluoride salts, calcium salts etc. They are mainly used to prevent the dental problems like dental caries, gingivitis and bad breath. Dental products included anitcaries, cleaning agents, desensitizing agents, polishing agent, oral antiseptic and astringents.

What are the problems related to tooth?

• Bad breath
• Tooth decay
• Gum problems
• Oral cancer
• Mouth sores
• Tooth erosion
• Tooth sensitivity
• Tooth aches
• Unattractive smile

A large numbers of inorganic chemicals and their preparations are known which find their application in the practice of dental care and oral disorders. As they come in contact with the human body, they are regarded like other drugs and pharmaceuticals.

Dental products include:

1. Anti caries agent: Sodium Fluoride
2. Desensitizing agents: Zinc chloride
3. Dentifrices: Calcium carbonate

Dental Caries

Dental caries or tooth decay is a disease of the teeth caused by the action of acid mostly lactic acid obtained by the action of certain microorganism on fermentable carbohydrates. Acid produced by bacterial metabolism of fermenting carbohydrates act on the teeth, produce lesions or a cavity where bacteria get localized and dental caries takes place. This disease is characterized by decalcification of tooth along with the bad smell of the mouth.

Two specific groups of bacteria found in the mouth that are responsible for dental caries:

1. Mutans streptococci (Streptococcus mutans)
2. Lactobacilli

Mechanism of formation of dental caries

For caries to develop, three factors must occur at the same time:

• A susceptible tooth
• Diet rich in fermentable carbohydrates
• Specific bacteria (regardless of other factors, caries cannot occur without bacteria)

METHODS TO CONTROL CARIES

1. Chemical measures
2. Nutritional measures
3. Mechanical measures

Chemical measures include:

I. Substances which alter tooth surface or tooth structure:

Chemicals falling into this categories Include:

• Fluorides
• Iodides
• Bisbiguanides
• Silver nitrates
• Zinc chloride and potassium ferrocyanates

II. Substances which interfere with carbohydrate degradation through enzymatic alteration

• Includes:-

1. Vitamin K
2. Sarcoside

• Vitamin K

– Vit. K was found to prevent acid formation in incubated mixtures of glucose and saliva

• Sarcoside

– Sodium-N-lauryl sarcosinate & sodium dehydroacetate were promising enzyme inhibitors or antienzymes. They have the ability to reduce the solubility of powdered enamel

III. Substances which interfere with bacterial growth and metabolism:

Includes:-

• Urea and ammonium compounds
• Chlorophyll
• Nitrofurans
• Antibiotics
• Caries vaccines

Nutritional measures include:

The chief nutritional measures advocated for the control of dental caries is restriction of refined carbohydrate intake. Other measures include

–    Avoiding sugar that retains of teeth surface

–    Avoiding sugar in between meals

–    Eating of phosphate diets

Mechanical measures include:

This refers to procedures specifically designed for and aimed at removal of plaque from tooth surface methods for cleaning tooth mechanically are:

1. Prophylaxis by dentist
2. Tooth brushing
3. Mouth rinsing
4. Use of dental floss or tooth picks
5. Incorporation of detergents foods in diet
6. Pit and fissure sealants

To prevent the dental caries and to maintain the oral hygienic many substances are used like ammoniated toothpaste, urea-containing powders, and antibiotic containing mixtures and anti- enzyme compounds but however these compounds have their own advantages and limitation according to the council on dental therapeutics.

A currently accepted and documented approach to prevent caries is administration of fluoride either internally or topically to the teeth.

Role of fluorides:

To prevent caries, most accepted and documented theories are based on the usage of fluoride either internally or externally.

–    Fluorides are found in soils rich in fluorspar,cryolite,and other minerals.

–    Fluoride is a mineral found throughout the earth’s crust and widely distributed in nature.

–    Fluoride is the ionic form of the element fluorine

–    Sources: Small amounts: Fruits, vegetables, cereals.

–    Rich amounts: Sea foods and tea leaves, Fluoridated Salt / Milk

–    Topical agents: Toothpaste

–    According to WHO: Water is the chief Source of Fluoride ions

Distribution of Fluorides:

Teeth and skeleton have the highest concentrations of fluoride. –Due to the affinity of fluoride to calcium.

Fluoride content of teeth increases rapidly during early mineralization periods and continues to increase with age, but at a lower rate

Metabolism of fluoride ions:

When taken internally, fluoride in solution or in rapidly soluble salts is absorbed almost completely from the GIT. The absorbed fluoride is partially deposited in the bone or developing teeth, remaining excreted by kidneys.

Careful analysis of teeth has shown that the concentration of fluoride is greater in the surface layer of enamel in both erupted and unerupted teeth. Thus fluoride uptake from tissue fluids is limited to external surface. The deposited fluoride on the surface of the teeth does not allow the action of acids or enzyme in producing lesions. Before studying the theories, let us study the role of fluoride in teeth

Presence of fluoride ions in teeth

Fluoride: identified as one of the elements present in dental hard tissues.

• Fluoride ion is “calcium –seeking”
• Apatite: the principal mineral of skeletal tissues. Crystallized form of calcium phosphate: Ca10(PO4)6(X)2. If:

‘X’ is OH hydroxyapatite

‘X’is F fluoroapatite : more regular

Fluoride Concentration in Teeth

• It is estimated that substitution of only 10% of hydroxyl groups in enamel apatite by fluoride, renders the enamel maximally resistant to caries
• Concentration of fluoride is higher:

–    On the surface enamel compared to the deeper layer,

–    In permanent teeth compared to decalcified teeth formed under the same circumstances

The possible theories are for preventing dental caries by fluoride ions:

1: Fluoride were incorporated into tooth structure: Increased resistance to acid attack by the following mechanism

1. a) Fluorapatite forms more compact and regular crystals than hydroxyapatite (Fluoride favours formation of fluorapatite, a more acid – resistant apatite than hydroxyapatite) and present in less surface area for the action of acids
2. b) Higher concentration of fluoride on outer enamel can protect against acid attack

2: Fluoride influence the solubility rate: Calcium and fluoride ions released from the apatite during initial dissolution forms Calcium Fluoride (CaF2) on the surface of the fluorapatite hence reducing it solubility.

3: Fluoride catalyses stable apatitic phase: Fluoride ions replace carbonate ions in the apatite structure. Apatite crystals with low carbonate contents are more stable and are less soluble compared to those with high carbonate ion content.

4: Fluoride favors remineralization of early carious lesions

• Plaque fluid contains fluoride. At decreased pH the fluoride level increased.Enhance remineralization of enamel by facilitating the re-precipitation of calcium and phosphate ions into the enamel fluoroapatite.
• Greater concentration of fluoride released from the dissolved enamel or already present on the plaque, the more will remineralization be favored and carious process be slowed. Use of topical fluoride raises the fluoride level of tooth surface and underlying tissues to a level expected to protect against caries.

5: Effect on acid production:

Fluoride  inhibits  enolase  and  ATP-ase  activity  (Embden-Meyerhof  pathway  in  bacterial metabolism) in oral streptococci hence reduce acid production.

Fluoride can bind more effectively to positively charged areas on the apatite crystal than can the bacteria.

Adversely affects the uptake of glucose by bacteria into the cells and subsequently lactic acid formation.

Further prevent the synthesis of glycogen

6: Fluoride affects the morphology of the teeth making them more self- cleansing

Fluoride administered during tooth formation may result in shallower and wider fissures, more rounded cusps thus reducing the number and size of sites where food and plaque could accumulate.

7: Different agents with specific effects: For example: Stannous ions in SnF2may affects surface wettability and reduce plaque formation because of its high solubility.

The  mechanism  of  action  by which  fluoride  inhibits  the  caries  formation  is  still  to  be completely analyzed.

Fluoride therapy:

Systemic: water fluoridation

Topical: Fluoridated tooth paste/tablets

Systemic: water fluoridation: Fluoride ions are present in food and ground water. But in some places the ground water does not contain fluoride ion. So municipal people add fluoride ion to the drinking water. This process is known as fluoridation. In case if too much of fluoride is present in tissue fluids it leads to mottling of teeth (dental fluorosis). This usually occurs in those areas where the drinking water has more than 2ppm of fluoride.

Fluoridated Milk – Milk is used as an instrument for fluoride administration. – Fluoridated milk was found to be as effective as fluoridated water in reducing dental caries.

Fluoridated Salt – Use salt as a vehicle for fluoride in the diet. – Salt is about 2/3 as effective as the water.

Topical: Fluoridated tooth paste/tablets:

Fluoride Tablets – Ingestion daily beginning at 5 – 9 years: permanent teeth can still be significantly protected from caries.

Prenatal Fluoride Supplement – Fluorides supplements are not recommended for adults, especially pregnant women, for reducing dental caries. The concentration of fluoride that reaches the fetus is generally lower than that in the maternal blood. Infants exposed will have higher plasma, skeletal and developing enamel fluoride levels.

Anti caries agent:

 Anticaries are those inorganic compounds used to prevent the dental caries. The official inorganic compounds used as Anticaries agent is: Sodium fluoride

Monograph analysis of sodium fluoride.

Sodium Fluoride

Molecular formula: NaF

Mol. Wt: 41.9

Standards: Sodium Fluoride contains not less than 98.5 per cent and not more than 100.5 per cent of NaF, calculated on the dried basis.

Description. A white powder or colourless crystals.

Synonyms: Floridine; sodium monofluoride; disodium difluoride; natrium fluoride; Florocid

Physico chemical properties:

• Sodium fluoride is soluble in water.
• Noncombustible.
• Corrosive to aluminum

Method of Preparation:

NaF is prepared by neutralizing hydrofluoric acid using sodium hydroxide

Chemical reaction:

HF + NaOH → NaF + H2O

Hypersensitivity by definition: A state of being excessively sensitive to a substance

• DENTINHYPERSENSITIVITY is characterized by short sharp pain arising from exposed dentin in response to stimuli mainly thermal, evaporative, tactile, osmotic or chemical—that cannot be ascribed to any other dental defect or disease.
• Dentine hypersensitivity is sensation felt when the nerves inside the dentin are exposed to the environment

Effect of sensitivity

• The sensation can range from irritation all the way to intense, shooting pain.
• This sensitivity can be caused by several factors, including, decaying teeth or exposed tooth roots.

Desensitizing agents

• Desensitizing agents are used to treat the sensitive of dentin towards too hot or cold condition

The inorganic compound used as desensitizing agents are zinc eugenol cement

Chemical Composition:

• Zinc oxide: 69.0%
• White Rosin: 29.3%
• Zinc acetate: 1%
• Zinc sterate: 0.7%
• Liquid eugenol: 85%

Classification of zinc eugenol cement: Type I ZOE: For temporary cementation Type II ZOE: Permanent cementation

Type III ZOE: Temporary filling and thermal base

Type IV ZOE:  Cavity liners

• It is available in the form of Powder/liquid/paste

Storage: Store in a suitable container

Medicinal uses:

• Temporary cementation
• Permanent cementation
• Pulp capping agent
• Cavity liners

Dentifrices: –

Used to clean the accessible surface of the teeth and the adjacent gums

–    Also called as cleaning agents

–    Applied with the fingers or tooth brush

–    Mainly used for destaining the teeth

–    Inorganic compound used is calcium carbonate

The different types of dentifrices

Cleaning agent or dentifrices: They are the material used to clean the teeth and adjacent gums by abrasive property and the rubbing force. They are applied either by fingers or toothbrush. Dentifrice are applied as tooth powder or tooth paste, some of the useful substances used as dentifrices for providing the oral hygienic condition are fluoride, calcium salts, phosphate salts, etc.

Dentifrices containing polishing agent:

Dentifrices should not only have the property of cleaning teeth but also should remove the stains on the teeth so that it looks white, this can be possible only if the dentifrices are containing the polishing agent in its preparation. The official product used as polishing agent is pumice, a substance of volcanic origin mainly containing silicates of aluminum, potassium and sodium.

Dentifrices containing desensitizing agent: They are the dental products that reduce the sensitivity of the teeth towards heat and cold. Therefore some desensitizing agents are used in dental preparation.

The mechanism of action of these agents may be due to local anaesthetics. Examples of these agents are calcium chloride

Oral  antiseptics  and  astringent:  For  maintaining  the  oral  hygienic  some  inorganic compounds are used for their antiseptic or astringent activity.

For examples:

1. Hydrogen per oxide, I.P.: 3% is used as antiseptic
2. Sodium per borate: 2% is used as tooth powder or as mouthwash.
3. Magnesium peroxide: Rarely used as bleaching agent.
4. Ammonical silver nitrate solution: used as astringent.
5. Zinc oxide: used as cement and fillers.

The general requirements for a dentifrice as follows:

• Should be capable of cleaning the teeth
• Leave a pleasant, cool and refreshing sensation in the mouth
• Harmless, nontoxic, non-irritant
• Maintain its flow properties
• Easy to pack and use
• Abrasive character should be of standard limit

Monograph of calcium carbonate Name:

Calcium carbonate Chemical formula: CaCO3

Molecular weight: 100.09 g/mol

Properties of calcium carbonate:

Description: A fine, white, microcrystalline powder. odorless

Solubility: Slightly soluble in water, freely soluble mineral acid with liberation of carbon di oxide gas.

Standards: Calcium Carbonate contains not less than 98.0 per cent and not more than 100.5 per cent of CaCO3, calculated on the dried basis

Synonyms: Precipitated Chalk

Method of Preparation:

Calcium carbonate is prepared from calcium oxide. Water is added to give calcium hydroxide, and carbon dioxide is passed through this solution to precipitate the desired calcium carbonate, referred to in the industry as precipitated calcium carbonate

Chemical reactions: CaO + H2O → Ca(OH)2

Ca(OH)2 + CO2 → CaCO3

Storage: Store protected from moisture

Medicinal uses:

• Dentifrices
• Calcium Supplement

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