REVIEW ON DENTAL CARE PREPARATION

www.wjpr.net Vol 9, Issue 7, 2020.

Mangulkar. World Journal of Pharmaceutical Research

236

REVIEW ON DENTAL CARE PREPARATION

Dr. Shubham Mangulkar*

Pharmacist, Bhandegaon Tq. Darwha, Yavatmal, Maharastra India.

ABSTRACT

In General Overview, We discussed about dentifrices, type of

dentifrices, formulation, evaluation and it recent treads. There have

been many dentifrices product over the years, many focusing on

marketing strategies to sell Product, such as offering whitening

capabilities. The most essential dentifrices recommended by dentist are

toothpaste which is used in conjunction with toothpaste to help remove

food debris and dental plaque. Dentifrices are the product which is

used to maintain the oral hygiene such as freshness of mouth and avoid

hygiene can be maintained throughout the day by using various dental

preparations. In that all formulation will studied. In that article we

included some point i.e. Classification of dental care preparation, and their formulation and

advantage. In that include development of desenti.

1. INTRODUCTION

A dentifrice is a substance used with a toothbrush for the purpose of cleaning the accessible

surfaces of the teeth. Maintenance of teeth clean and in good health is essential and also

important for everyone. This can be achieved by using various dental care preparations or

dentifrices. Dentifrices are the preparations used for cleaning the surface of teeth and them

shiny and to preserve the health of the teeth and gums. These preparations may also expected

to help inhibit the formation of unpleasant odours and freshen the breath. Regular use of

dentifrices helps to prevent occurrence of tooth decay. A good dental health increases the

possibility of good general health. Dentifrices can be either simple cleansing dentifrices or

also be therapeutic dentifrices. Therapeutic dentifrices are basically cleansing preparations

containing, additionally, some drugs or chemicals which decrease the occurrence of dental

caries to help in control of periodontal disease. These are achieved by the bactericidal,

bacteriostatic, enzyme inhibiting or acid- neutralizing qualities of the drugs or chemicals

World Journal of Pharmaceutical Research SJIF Impact Factor 8.084

Volume 9, Issue 7, 236-261. Review Article ISSN 2277– 7105

Article Received on

01 May 2020,

Revised on 22 May 2020,

Accepted on 11 June 2020,

DOI: 10.20959/wjpr20207-17292

*Corresponding Author

Dr. Shubham Mangulkar

Pharmacist, Bhandegaon Tq.

Darwha, Yavatmal,

Maharastra India.



237

used. Therapeutic dentifrices containing stannous fluoride are widely used products both

dental caries and periodontal disease can be traced to the formulation of bacterial plaque on

the Exterior surface of the teeth.

1.1 Need and importance of a toothpaste/dentifrice

The major requirements of oral preparations, especially toothpastes, have been summarized

on many occasions in the past. For toothpaste, these requirements were:

a) When used properly, with an efficient toothbrush, it should clean the teeth adequately, that

is, remove food debris, plaque and stains.

b) It should leave the mouth with a fresh, clean sensation.

c) Its cost should be such as to encourage regular and frequent use by all.

d) It should be harmless, pleasant and convenient to use

e) It should be capable of being packed economically and should be stable in storage during

its commercial shelf-life.

f) It should conform to accepted standards in terms of it’s abrasively to enamel and dentine.

Claims should be substantiated by properly conducted clinical trials. These requirements

remain valid today, with perhaps only the priority and emphasis placed on any individual

point being changed.

g) To achieve this it is necessary to have a high solid suspension in a stable viscous form and

therefore gelling agents or thickening polymers have to be incorporated.

h) To prevent it from drying out it also becomes necessary to add humectants to the system.

Finally, colours and preservatives are also added, creating a complex matrix of ingredients

which can be classified as 'simple' cosmetic toothpaste.

2. Classification of Dental Care Preparations

Table No. 01.



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3. Toothpaste

Toothpaste is a colloidal suspension of a mixture of ingredients that must be carefully

balanced in order to provide an efficacious, safe, and consumer friendly product. Dentifrices

are oral preparation meant for application on the teeth to provide cleansing action. They may

also be used for certain therapeutic purposes in order to maintain dental hygiene. Tooth paste

is the most population from of dentifrices. They include the following ingredient, which

determined their quality and efficacy.

Ingredients used in toothpastes

A. Cleansing and polishing agents

B. Surfactants

C. Humectants

D. Gelling agents

E. Sweetening agents

F. Flavors

G. Minor ingredients

H. Fluoride and other active ingredients

A] Cleaning and polishing agents (abrasives)

Abrasives or polishing agent are used to polish the teeth and to remove food debris adhering

to the surface of the teeth. They constitute about 20-50 % of total formulation. Clearly the

main purpose of the cleaning and polishing agent is to remove any adhering layer on the

teeth, and the material normally considered are given below.

a) Dental Grade Silica’s (SiO2)

In a relatively short period of time silica has generally become the abrasive of choice because

it offers great flexibility to the formulator. It can be produced to a high state of purity giving

excellent compatibility with therapeutic additives and flavours. Varying the particle size can

alter the finished product abrasivity. Clear gels can be formulated by carefully matching the

refractive indices of silica used with the liquid phase of the toothpaste. Silica can also give

additional thickening properties to the dental cream if extremely fine particle sizes are used

(silica thickeners). When used in toothpastes, silica is generally incorporated at levels

between 10 and 30%.

b) Di-Calcium phosphate dihydrate (CaHPO4-2H2O)

DCPD is one of the most commonly used dental cream abrasives, perhaps because it gives



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good flavor stability. It is normally white in colour and gives toothpaste which generally does

not require additional whitening agents.

The main drawback is that it is only fully compatible with sodium monofluorophosphate as

the fluoride source because of the presence of free calcium ions. Formulating with other

therapeutic fluoride sources does not appear to have been successful. The abrasive is usually

formulated at levels between 40% and 50% to give relatively dense toothpaste.

c) Calcium carbonate (CaCO3)

Calcium carbonate is probably one of the most commonly used dental cream abrasives.

Precipitated calcium carbonate (chalk) is available with a white or off-white colour and both

particle size and crystalline form can be varied, depending upon its conditions of

manufacture. As a result of its structure and calcium content, precipitated calcium carbonate

is incompatible with sodium fluoride, but is stable with the less reactive sodium

monofluorophosphate. Calcium carbonate is also used at levels between 30% and 50% to

give a relatively dense paste.

d) Sodium bicarbonate or baking soda (NaHCO3)

Sodium bicarbonate has a unique 'salty' mouth-feel that tends to polarize consumers, many

finding it attractive possibly due to its heritage as a cleaner/deodorizer. It is a very mild

abrasive, usually used at a 5-30% level, in combination with other abrasives such as silica or

calcium carbonate to achieve the required cleaning action.

e) Hydrated alumina Al2O3 • 3H2O or Al (OH)3

It has good compatibility with sodium monofluorophosphate and other ingredients added to

give a therapeutic benefit. The abrasive is usually formulated at levels between 40% and 50%

to give a relatively dense paste. Hydrated alumina is relatively inert, cost-effective, and

available as a white amorphous solid.

f) Other abrasives

Insoluble sodium met phosphate (IMP) (NaPO3)x, is available as a free-flowing white

powder, with moderate abrasivity and good compatibility with flavour oils, sodium

monofluorophosphate and ionic fluoride sources (stannous and sodium fluorides). It is now

only used in extremely limited amounts. Calcium pyrophosphate (CPP), Ca2P2O7, was the

original abrasive purposely developed for its compatibility with stannous fluoride to give the

first commercially available therapeutic dentifrice containing fluoride.



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B] Surfactants

Surfactants are used in the toothpaste to aid in the penetration of the surface film on the tooth

by lowering the surface tension. They also provide the secondary benefits of providing foam

to suspend and remove the debris, and the subjective perception of toothpaste performance.

They often have better foaming properties, and are more compatible with other ingredients

since their pH range is essentially neutral. They are also available with a higher degree of

purity that can eliminate some of the bitter flavour components that affect taste. In general,

surfactants are used at a concentration of around 1-2% by weight in the dental cream.

Sodium lauryl sulphate (SLS)

This has been the main surfactant of choice, used in nearly all toothpaste brands. However,

while alternative surfactants have been considered, and will continue to be looked at and

developed, none is in widespread use since all have some disadvantages compared to SLS.

C] Humectants

Humectants are used to prevent the paste from drying out and hardening to an unacceptable

level. At the same time they give shine and some plasticity to the paste. Generally only two

major humectants are considered for use in toothpaste, often in combination with small

amounts of additional minor humectants. Humectant concentration in the formulation 20-

40%.

a) Glycerin [CH2OHCHOHCH2OH]

Glycerin is still the humectant used in greatest bulk quantity in toothpaste. It is one of the best

humectants, producing a shiny, glossy product. It is stable; non-toxic, available from both

synthetic and natural sources, and provides a useful sweetening function to the paste.

b) Sorbitol [CH2OH(CHOH)4CH2OH]

Sorbitol syrup (approximately 70%) is also extensively used throughout the industry and is

sometimes considered superior to glycerin depending upon the formulation. It also imparts

sweetness, and is a stable humectant. Sorbitol 70 – It consist 70% w/v concentration of

sorbitol solution.

c) Propylene Glycol (CH3CHOHCH2OH) and Polyethylene Glycol (CH2OH (CHOH)

nCH2OH)

Propylene glycol and polyethylene glycol are not normally used as the sole humectant in a

paste since they are more expensive and, in the case of propylene glycol, can impart a slightly

bitter taste. They are more generally used in relatively small amounts in combination with



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either glycerin or sorbitol. The amount of humectant in any formula obviously has to be

adjusted depending upon the other constituents of the formula (especially abrasive nature),

but generally the total humectant loading is in the range 10-30% by weight.

d) Xylitol (CH2OH (CHOH)3CH2OH)

Xylitol is a polyol equivalent of sorbitol, but with a five-carbon chain instead of six. Like

sorbitol it is a naturally occurring material with a relative sweetness equal to sugar. Currently

its high cost and limited availability restrict its use.

D] Gelling agents

Gelling or binding agents are hydrophilic (water-loving) colloids which disperse and swell in

the water phase of the toothpaste and are necessary to maintain the integral stability of the

paste and prevent separation into component phases. They are probably the most widely

variable components of toothpaste and the choice of gelling agent can greatly influence the

dispensability of the paste in the mouth, the generation of foam and, above all, the release of

the flavor components. Some formulations have combinations of gelling agents in order to

achieve the desired consumer preferences.

a) Sodium Carboxymethyl Cellulose CMC.

Carboxymethylcellulose is one of the preferred gelling agents for use in toothpaste. It can be

manufactured to a high state of purity and tailor-made for an individual requirement by

varying the degree of substitution on the cellulose chain. This can give flexibility in terms of

solubility, elasticity and some increased stability in the presence of electrolytes.

b) Carrageenan

It is a purified colloid, consisting of a mixture of sulfated polysaccharides and, as with all

natural products; it can be of variable quality, which could cause a problem for any

formulator. Therefore, it is standardized either by repeated blending, or dilution with variable

amounts of inert material. Some flexibility in the gelling properties of carrageenan can be

achieved by controlling the cations present by ion exchange. Miscellaneous gelling agent.

c) Xanthan

This is a polysaccharide produced by fermentation technology. It offer excellent properties

for use in toothpaste since it gives a highly structured gel, relatively easily broken down when

sheared, but which recovers rapidly. It is relatively insensitive to electrolytes and heat, but

unfortunately it is generally incompatible with cellulosic materials because of contaminating

enzymes that degrade cellulose.



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d) Hydroxyl ethyl cellulose HEC

This is occasionally used as an alternative to Carboxymethyl Cellulose (CMC), especially

when a greater electrolyte tolerance is required. Synthetic polymers. Cross linked acrylic

acid polymers have become more intensively used in the past decade because of their useful

thickening and suspending properties combined with their inertness and their stability to heat

and ageing.

e) Clays

Colloidal clays, either natural processed bentonites or synthetic clays, have been used as

binding agents because of their thixotropic properties. Depending upon the rest of the formula

components (e.g. abrasive, amount of free water), the level of gelling agent added to a paste

can vary from 0.5% to 2.0% by weight.

E] Sweetening agents

These are important for product acceptance, since the final product must be neither too sweet

nor too bitter. These ingredients must always be considered in partnership with the flavour

because of their combined impact. Sodium saccharin. This is the sweetening agent in widest

commercial use, and is generally used at a level between 0.05% and 0.5% by weight.

F] Flavours

Flavours are probably the most crucial part of toothpaste because of consumer preferences.

The flavour is a blend of many suitable oils, with peppermint and spearmint being the major

base components. These are nearly always fortified with other components such as thymol,

Anatole, menthol (to give a pleasant cooling effect), eugenol (clove oil), cinnamon,

eucalyptol, aniseed, and wintergreen (to give a medicinal effect). In addition, because the

flavour is a mixture of sparingly soluble organic oils, its interactions with the other dentifrice

components are often unpredictable and unexpected. Taste and stability can be influenced

greatly by both the other components of the dental cream, e.g. free water content, or

absorption by the abrasive (perhaps to the surface), and also by the physical properties of the

dental cream, e.g. pH, viscosity etc., Depending upon the formulation, e.g. the abrasive nature

and level, the gelling agent used and the presence of therapeutic ingredients which may

impact taste perception, the flavour level may vary from around 0.5% to 1.5% by weight.

G] Minor ingredients

a) Titanium Dioxide TiO2- Titanium dioxide may be added to give additional whiteness and

brilliance to the paste.



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b) Colours can be an integral part of the aspect of any toothpaste that may influence

consumer preference and purchase intent. The EEC Cosmetics Directive (Annex IV) lists

the permitted colours and only a small amount is necessary to create a large impact,

<0.01% by weight.

c) pH regulators. Occasionally buffering systems need to be added to the dental cream to

adjust the pH of the final finished product.

d) Sparkles. A recent introduction in the marketplace is the addition of small reflective mica

particles to coloured transparent gel products. This gives toothpaste the appearance of

containing 'sparkles' and is especially aimed at younger children.

H] Fluoride and other 'active' ingredients

The earliest fluoride dentifrices contained sodium fluoride. However, the fluoride was

biologically unavailable because the calcium in the dentifrice abrasive bound the fluoride and

thus inactivated it. Although a number of dentifrices containing fluoride are on the market,

not all provide available fluoride because the abrasive systems that some dentifrices contain

inactivate the fluoride. Therefore, the product may contain as much fluoride as any other

dentifrice but it is not available. Also, if the product has a short shelf life, it will be

ineffective if poor marketing gets it to the consumer too late. [2] [12]

Classification of Toothpaste

Table No. 02.

A) Therapeutic Toothpaste - 1) Fluorinated Toothpaste

B) Plaque Gingivitis Prevention Toothpaste – 1) Anti Calculus Toothpaste

2) Desensitizing Toothpaste

3) Fresh breath Toothpaste.

C) Cosmetic Toothpaste - 1) Whitening or Bleaching Toothpaste

Advantage

a) Delivers active ingredient such as fluoride or xylitol to help prevent tooth and gum

disease.

b) Recent advance in toothpaste enable high efficacy of oral health delivery.

c) Desensitizing toothpaste.

d) Whitening toothpaste.



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Disadvantages

a) Extended consumption of large volumes of fluorinated toothpaste can result in fluorosis.

Triclosan, an active ingredient in many types of toothpaste can combine with chlorine in

tap water to form chloroform which is a human carcinogen.

b) Incompatible with sodium fluoride, which is used as anticaries agent.

c) It may alter the taste of the final formulation when used in high concentration.

d) It may Expensive.

A good tooth paste should have following characteristics –

a) It must clean the dental surface properly without any scratches.

b) Consistency should be such that it can be easily squeezed out of the tube to Spread on the

brush, but should not penetrate in to the brush.

c) The consistency should remain constant in wide range of temperature during Shelf life.

d) It should be non-toxic and should not sensitize buccal membrane.

e) It should not interact with the container material.

f) It should have pleasant taste and odour.

g) It should have good appearance.[2] [12]

Examples of toothpaste

Marketed products –

i.e. Colgate Maxfresh, Colgate Sensitive, Colgate Maxwhite etc.

Brands of commercial toothpaste in India

a) Colgate-Colgate Palmotive Ltd.

b) Close-up-Hindustan Unilever Ltd.

c) Sensodyne-GlaxoSmithKline.

4. TOOTH POWDERS

Tooth powders are oldest and simplest preparations. Over the years their market share has

been reduced due to popularity of pastes, but steel they have a considerable market share. The

main problems encountered with powders are Floating of powder in air during

manufacturing. Formation of cake on storage. Ingredients in less quantity are mixed first and

are mixed with remaining contents. Flavour can spray or Adsorbed first on to polishing agent.

This mix is screened before filling into hopper.



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Evaluation test

1) Abrasiveness test

2) Particle size

3) Cleansing test

4) PH of product

5) Limit test of arsenic and lead

6) Volatile matter and moisture

Composition

Tooth powders contain the following ingredients-

a) Abrasives

b) Surfactants or detergents

c) Sweetening agents

d) Flavoring agents

e) Colouring agents

f) Detergents or other foaming agents

a) Abrasives - calcium carbonate, tricalcium phosphate, insoluble sodium met phosphate

b) Soaps - Prepared from selected fatty acids, they are white and tasteless unsuitable soaps

with strong odour and soapy taste are not used. Example: sodium palmitate.

c) Detergent – The proportion of detergent will depend on its solubility and on the amount

foam desired in the product. Example: sodium lauryl sulphate.

d) Flavoring agents –Tooth powders are usually flavored with essential oils. Flavoring oils

includes peppermint oil, spearmint oil, clove oil, cinnamon oil, anise oil.

e) Sweetening agents – Sodium saccharin is the most commonly used.

Packaging of tooth powders

Tooth powders are generally packed into metals cans with a dispensing top closed with either

metallic or plastic cap. Cans are generally made of tin plated or chemically treated steel. This

can be coated with a suitable lacquer. Now a day’s tooth powder is also packed in plastic

containers. Abrasives are used in manufacturing of tooth powders are similar to that of tooth

pastes. Though lighter calcium carbonate is used in tooth paste but in tooth powders heavier

grade calcium carbonate is used. Other ingredients are similar to that of tooth paste.[13]



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General procedure for manufacture

This is done by simple mixing .First ingredients of small quantity are premixed and then

mixed with other ingredients. Ribbon type or agitator type of mixer are used. Flavour can be

sprayed on to the bulk or can be premixed with part of some abrasive.[3]

Examples of toothpowder

Marketed products

i.e. Colgate, Vico, Dabarlal

Dental care products

Effervescent Polident Denture Cleansers

Nonabrasive cleaning and antibacterial Action in a soaking solution with oxidizing agents

and detergents to remove food particles, stains and bacteria. Cleaning action is available in

variants for 3 minutes, overnight and stain removing whitening and for partials.

Fig. No. 01.

Polident Dentu-Paste and Dentu-Gel Denture Cleansers

Mechanical cleaning with a brush using these denture cleansers containing detergents and

oxidizing agents.

Fig No. 02.



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Polident Fresh Cleanse Denture Foam

Denture Cleansing foam provides nonabrasive mechanical cleaning and antibacterial action

and stain removal with detergents and a long lasting flavor.

Fig No. 03.

5. MOUTHWASH

Mouthwashes are the solutions intended for cleaning, refreshing and deodorizing mouth and

also may be used as therapeutic acids in treatment of gingival/mucosal diseases. Mouthwash

is a liquid which is held in the mouth passively or swilled around the mouth by contraction of

perioral muscles or movement of the head, and may be gargled, where the head is titled back

and the liquid bubbled at the back of the mouth.

All mouthwashes are liquids usually in the dominantly aqueous form but many products may

be prepared in the solid/liquid concentrations which are diluted with water just for use.

Alcohol/glycerol concentrations have all been described as mouthwashes/preparations.

Mouthwashes come in a variety of compositions, many claiming to kill bacteria that make up

plaque Or to freshen breath. In their basic form, they are usually recommended to be used

after brushing but some manufacturers recommend pre-brush rinsing. Dental research has

recommended that mouthwash should be used as an aid to brushing rather than a

replacement, because the sticky resistant nature of plaque prevents it from being actively

removed by chemicals alone, and physical detachment of the sticky proteins is required. The

amount of the different component in mouthwash varies from product to product. Some

practically have the same composition as toothpaste. Distinct from toothpaste most mouth

rinses contain alcohol, as a preservative and semi-active ingredient.

The amount of alcohol is usually ranging from 18-26 %.



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Anti-cavity Mouthwash

Table No. 03.

Ingredient Total %

Alcohol 5

Glycerin 7.5

Sorbitol 7.5

Plutonic F127 1

Pluronic F108 1

Na Saccharin 0.02

NaF

Flavour 0.08

Water to make 100

A Good Mouthwash Should have the Following Characters

Good and quick antiseptic action at the dilution it is used.

Attractive flavor to impart an odour to the mouth.

Sweet taste

Not much Expensive.

Non-irritant to mouth and mucous membrane.

Non-toxic.

Classification of Mouthwash

a) Astringent mouthwash

b) Antiseptic Mouthwash

c) Buffered Mouthwash

d) Deodorizing Mouthwash

e) Therapeutic Mouthwash

a) Astringent Mouthwash

These shrink and protect the inflamed oral mucosa and also serve the purpose of flocculating

and precipitating protein aqueous material so that it can be removed by flushing.

Ingredient-dil. HCL, ZnCl2, ZnSo4, CHCL3, Water

Used- It use for removal of proteinaceous debris form and Stomatitis.

b) Antiseptic Mouthwash

These are mouthwashes that contain antiseptic compounds and are intended for use to remove

or destroy bacteria that are normally found large in oral cavity.



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Hence, these may be used in following conditions:

Before and after tooth extraction –

Glossitis

Infections-gingivo-stomatitis

Phenolic compounds – Phenol, β-napthol, thymol, hexyl resorcinol, hexachlorophene other

antibacterial compounds– Benzoic acid, potassium chlorate, boric acid, tyrothcycin &

Grnicidin.

Action Of Ingredient - hexyl

Resorcinol – Antiseptic

Glycerin – Sweetening Agent and Weak Antiseptics

Clove Oil- Flavoring Agent, Counter irritant and analgesics

Ethyl Alcohol – Increase Solubility of hexyl resorcinol

Water – Vehicle

Ascorbic Acid - Antioxidant, Reducing Agent.

c) Buffered Mouthwash

These are mouthwashes alkaline in nature & are helpful in reducing stringy saliva & making

mucous less viscid and also help to liquefy the viscid mucous in the mouth by dispersion of

proteins.

Active Ingredient

Nacl –Make solution iso-osmatic

NaHCO3 – Render the mucous less viscous and reduces stringy saliva and mucous by

dispersion of Protein.

Peppermint Oil - Flavorings agent

Chloroform Water – Flavoring and Preservative agent.

Uses - As Mouthwash When these is string and thick mucous in mouth, oral hygiene

infection.

d) Deodorizing Mouthwash

Deodorize mean remove or conceal an unpleasant smell.

Add 1cup of mouthwash to the dispenser along with your preferred detergent and run your

regular wash cycle. Bye bye, dirty sock smell.



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Ingredient use

Alcohol, Benzydamine (analgesics), Edible oil, Essential oil, Phenol, Chloroform Water

(Flavoring and Preservative), Eucalyptus (Fresh smell and cooling taste), Methyl salicylate

(antiseptic and anti-inflammatory ) , Thymol (antiseptic), Menthol (Local anesthetic).

Use - Remove Unpleasant Taste in Mouth.

e) Therapeutic Mouthwash

This is available for control of dental caries, bacterial plaque and gingivitis. Mouthwash does

not have a therapeutic effect on sub gingival periodontopathic microorganisms because they

do not penetrate sub-gingival.

Preparation of Mouthwashes

a) Antiseptic or Antibacterial substances

b) Astringents

c) Deodorizing Agent

d) Drug Extract

e) Flavors

f) Surfactant

g) Sweeteners

h) Colorants

i) Vehicle

a) Antiseptics Substance

These are the active constituents of most of the mouthwashes. Various substances are

available to select a suitable antiseptic for incorporating in a mouthwash. The choice of

specific antiseptic is made according to the need and matching with other ingredients.

Substances normally used are:

Phenol and Derivatives- Phenol (0.1-1%)

Beta-Naphthol (0.3-0.5%)

Thymol (0.1%), Chlorothymol (0.05-0.1%).

Quaternary Ammonium Compound – Acetyl Pyridinium Chloride, Citric acid.

Essential Oil – Cinnamon Oil, Cassia oil, Clove Oil, Eucalyptus Oil.

Miscellaneous Antibacterial Compound – Formalin, Boric acid, Benzoic acid.



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b) Astringent

Astringents are being used in mouthwashes from a long time. Astringents are incorporated in

mouthwashes for following various actions:

To Shrink and protect inflated mucous surfaces.

To Precipitates proteins of saliva.

To diminish accumulated mucous secretions by precipitation.

Example

Zinc Chloride

Zink Sulphate

Zinc Acetate

Aluminum Sulphate.

c) Deodorizing Agent

It is not only the bacterial growth on food particles in the mouth, but several other factors, to

cause of bad breathe. Pathological conditions of oral cavity, teeth, throat, gastrointestinal

tract, the lungs and nasal passage may cause bad breath. However, a local measure can be

taken to achieve, deodorizing effect in mouth.

Ex. Quaternary Ammonium Compounds.

d) Drug Extract

Several extracts have found use in mouthwashes. They can act as astringents, stimulants or

flavoring agents. Extracts which are suggested to use are tinctures of myrrh, an oleo gum-

resin obtained from the stem of commiphoramolmol.

e) Flavors

Peppermint oil, Menthol, Thymol, Aniseed oil, Clove oil, Eucalyptus oil are widely used

Flavoring agent available for incorporating in mouthwashes.

f) Surfactant

Occasionally surfactants are incorporated in mouthwashes to have wetting, or detergent, or

solubilizing effects. To keep all the ingredients, particularly when water content is more, in

solution sometimes solubilizing agents may be required. Tweens or other compatible

surfactants can be used.



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g) Sweeteners

Sugar is not used as Sweetener in mouthwashes. Saccharine, or other synthetic sweetener

extract can used for this purpose.

h) Colours

Mouthwash are often coloured with vegetable dyes. The useful dyes are: Saffron, Carmine,

Phloxine, erythrosine. They do not have effect on other ingredient & on their action.

i) Vehicle

This is very important ingredient as all the constituent have to be kept to in solution in the

vehicle Alcohol alone or in combination with water is the widely used solvent.

Advantage of Mouthwashes

Can boost your oral health.

May prevent plaque from building up.

Rinses with fluoride can help prevent cavities.

Fluoride protects against tooth decay.

Mouthwash can help you target plaque.

Prevents dry mouth.

Disadvantage of Mouthwashes

Some mouth rinses contain high levels of alcohol- ranging from 18 to 26 percent.

This may produce burning in the cheeks, teeth and gums.

Packaging and Storage

Container – Fluted plastic screw caps colourless bottle are use unless protection from is

necessary.

Storage - Store at room temperature, Always from Sunlight, Keep out of reach of

children.

Evaluation Test

1) Antiseptic Properties

2) In-Vitro Antiseptic properties

3) In Vivo Antiseptics Properties

4) Stability test.



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Example of Mouthwashes

Marketed example

a) Antiseptics – Phenolic Mouthwash

b) Analgesics - Lidocaine hydrochloride

c) Bacterial (Cosmetic) - Fluoride

Official example

a) Chlorhexidine Mouthwash

b) Benzydamine HCL Mouthwash

c) Sodium Mouthwash.

6. SOLID AND LIQUID PREPARATION

Though these preparations are not much popular, but still they exist in the market and have

limited use for tooth cleaning purpose. Solid dental preparations are basically a tooth powder

suspended in a soap case and converted to solid shapes. The abrasive materials vary from 50-

80%and the soap is about 20-50%. They also contain flavours, sweeteners and occasionally

colours.

The soap and calcium carbonate are mixed along with glycerin and other additives and then

milled and mixed with some water, if necessary, to form a soft mass. Then they are made into

bars, stick by mechanical process. Use of liquid dentifrices is comparatively less than the

solid ones. They are basically aqueous or hydro alcoholic solutions of surfactants with

additional components of thickening agent, sweetener, flavor etc. They do not contain any

abrasive as they will sediment. So the action of these preparations on dental surface is less

but cleansing effect is a little more.[5]

6.1 Ingredients

Odium Myristate sulphate,

Methyl Cellulose,

Saccharine. Sodium,

Flavoring oil,

Glycerine,

Alcohol, Water.



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7. THE LATEST ADVANTAGE IN TOOTHPASTE AND ORAL HYGINE TOTAL

CARE DENTISTRY

The Lancet, officially classified fluoride as a neurotoxin. As a result, parents began to avoid

toothpaste brands containing this ingredient and started to use more natural toothpaste like

Earth paste and Desert Essence containing natural ingredients like coconut oil, peppermint

oil, and cinnamon oil.

Now a day’s toothbrush made from bamboo or recycled plastic, organic dental creams, and

mineralized tooth powders. Toothpaste offering multiple benefits such as cavity protection,

fresher breath, and whiter teeth are popular. Advancements in oral hygiene include better

dental implants. In the past, implants often failed, but today 95% to 98% of implants are

successful according to the Australian Dental Journal.

Fig No. 04.

Conventional toothpaste uses detergents and abrasives to separate plaque. A dental gel

developed by Livionex separates plaque from your teeth by breaking molecular bonds, so this

could be the next generation of toothpaste. Experts say that technological innovation will

improve and broaden access to dental care. In the near future, doctors will tailor treatment to

the genetics of patients. And a host of diagnostic tools will further develop preventative

medicine. Biomaterial will fill cavities, and chemicals in your breath will diagnose disease.[7]

8. ADVANCEMENT IN TOOTHPASTE

Different forms of toothpastes have been around for thousands of years. Around 5000BC, the

Egyptians started to use a paste to clean their teeth. This was before toothbrushes were even

invented. Ancient Greeks and Romans also used toothpastes. In China and India, toothpaste

was first introduced around 500BC. Same things are found in ancient toothpaste that modern

toothpastes do: Cleaning the teeth and gums, whitening teeth, and freshening breath.

Different countries and peoples used different ingredients for their toothpastes. Greek and

http://wakingscience.com/2016/02/fluoride-officially-classified-as-a-neurotoxin-in-worlds-most-prestigious-medical-journal/

http://onlinelibrary.wiley.com/doi/10.1111/adj.12304/full



255

Romans included crushed bones and oyster shells in their toothpastes. Some countries added

ingredients to help with bad breath.

In 1780, people scrubbed their teeth with a powder made from burnt bread. In 1824, a dentist

“Peabody” added soap to toothpaste for cleaning the teeth. Soap was later replaced by sodium

lauryl sulfate. Colgate developed the first commercially produced toothpaste in 1873. It was

nice smelling and sold in a jar. Dr. Washington Sheffield was the first person to put

toothpaste in a collapsible tube. It is believed that this version of toothpaste is most similar to

the modern version.

Toothpastes continued to develop in the 1900s. In 1914, fluoride was added to toothpastes

because it was discovered that fluoride significantly decreases cavities. In 1975, herbal

toothpastes were developed as an alternative to fluoride toothpastes. In 1987, edible

toothpaste was invented by NASA so that astronauts could brush their teeth in space without

spitting into zero gravity. This edible toothpaste is now used by children who are learning to

brush their teeth. The first whitening toothpaste was invented in 1989.

Modern toothpastes typically contain fluoride, coloring, flavoring, sweetener, and ingredients

that make the toothpaste a smooth paste that foams and stays moist. Toothpastes come in

tubes throughout the world.[14]

9. THE DEVELOPMENT OF A NEW DUESENSITISING MOUTHWASH

Dentine hypersensitivity is a complex and painful oral condition that affects 4–57% adults in

the world. Proper diagnosis is established after exclusion of its etiology which is based on

Brainstorm’s hydrodynamic theory which tells that dentine tubules to be capillary tubes

where the fluid behavior obeys the laws of fluid movement.

Clinical efficacies of mouthwash as a delivery system to address dentine hypersensitivity are

not leading to conclusion. They found that both products decreased the intensity of

hypersensitivity, with no difference between products after two weeks. Only after six weeks

was there a statistically significant difference in sensitivity as measured by cold air blast

between the groups favoring the potassium nitrate containing group. There was no difference

after six weeks using tactile measurements. On the other hand Gillam et al. did detect a

difference at both two and six weeks between a 3% potassium nitrate and sodium fluoride

mouthwash and a sodium fluoride mouthwash.



256

The main aim was to investigate the in vitro performance of a novel mouthwash technology

(Pro-ArginTM

Mouthwash Technology) that provide dentine occlusion with a consequent

reduction of hydraulic conductance. The new technology is based on the delivery of an

adhesive complex formed by arginine/copolymer/pyrophosphates at the microscopic scale.

The use of Pashley cell instead of dentine segments has proven to be successful for screening

mouthwash formulation with high reproducibility result.[8]

10. COSMETIC DENTISTRY

Cosmetic dentistry is a method of professional oral care that focuses on improving the

appearance of your mouth, teeth and smile. Although cosmetic dentistry procedures are

usually optional, rather than essential, some cases of treatment also provide restorative

benefits.

The most common procedures used in cosmetic dentistry are fairly simple, whereas others are

more complex and require specialized care.

Composite bonding

Composite bonding refers to the repair of decayed, damaged or discolored teeth using

material that resembles the color of tooth enamel. Your dentist drills out the tooth decay and

applies the composite onto the tooth's surface, then "sculpts" it into the right shape before

curing it with a high-intensity light. Also referred to as simply "bonding," per the Consumer

Guide to Dentistry, this effectively covers the damage to the tooth and gives the appearance

of a healthy tooth in its place. Bonding is one of the least expensive cosmetic dentistry

procedures available to patients with tooth decay, chipped or cracked teeth and worn-down

edges.

Fig No. 05.

http://www.yourdentistryguide.com/bonding/

http://www.yourdentistryguide.com/bonding/



257

Inlays and Onlays

These are also known as indirect fillings, which are made by a dental laboratory, and they are

used when a tooth has mild to moderate decay or there is not enough tooth structure to

support a filling. Provided there is no damage to the tooth cusps, according to Choice One

Dental Care, the inlay is placed directly onto the tooth surface. When the cusp or a greater

portion of the tooth is damaged, however, an onlay is used instead to cover the tooth's entire

surface.

Inlays and onlays are made in a dental laboratory from composite resin material and attached

to the teeth with adhesive dental cement. They provide support to strengthen teeth, restore

their shape and avoid any further decay or deterioration.[9]

Fig No. 06.

Fig No. 07.

http://www.choiceonedentalcare.com/inlays-and-onlays-atlanta/

http://www.choiceonedentalcare.com/inlays-and-onlays-atlanta/



258

Fig No. 08.

Teeth Whitening

One of the most basic cosmetic dentistry procedures, teeth whitening or teeth bleaching can

be performed at your dentist's office. Whitening should occur after plaque, tartar and other

debris are cleaned from the surface of each tooth, restoring their natural appearance. Teeth

can also be bleached to achieve an even lighter shade than this original color, according to the

American Dental Association (ADA) Mouth Healthy site.

Over the years, teeth become stained and worn from food, drinks, medication and personal

habits such as smoking. Whitening coats the teeth and this procedure can be done in the

dental office or at home. Additionally, patients can use toothpastes such as Colgate® Optic

White® Platinum to achieve the same effect in a one to two week period. This product is

available in four different formulas, and works to whiten teeth more than three shades over a

period of two weeks and for optimal results within four weeks.

Fig No. 09.

http://www.mouthhealthy.org/en/az-topics/w/whitening

http://www.mouthhealthy.org/en/az-topics/w/whitening

http://www.colgate.com/app/ColgateOralCare/Whitening/ColgateOpticWhite/US/EN/HomePage.cwsp

http://www.colgate.com/app/ColgateOralCare/Whitening/ColgateOpticWhite/US/EN/HomePage.cwsp



259

Product Used For Teeth Whitening

Fig No. 10.

Fig No. 11 Fig No. 12

Fig No. 13.

Bleaching

Tooth whitening (termed tooth bleaching when utilizing bleach), is either the restoration of a



260

natural tooth shade or whitening beyond the natural shade. Restoration of the underlying,

natural tooth shade is possible by simply removing surface stains caused by extrinsic factors

such as tea, coffee, red wine and tobacco. The buildup of calculus and tartar can also

influence the staining of teeth. This restoration of the natural tooth shade is achieved by

having the teeth cleaned by a dental professional (commonly termed "scaling and polishing"),

or at home by various oral hygiene methods. Calculus and Tartar are difficult to remove

without a professional clean.

To whiten the natural tooth shade, bleaching is suggested. It is a common procedure in

cosmetic dentistry, and a number of different techniques are used by dental professionals.

There is also a plethora of products marketed for home use to do this also. Techniques

include bleaching strips, bleaching pens, bleaching gels and laser tooth whitening. Bleaching

methods generally use either hydrogen peroxide or carbamide peroxide which breaks down

into hydrogen peroxide. Common side effects associated with bleaching include increased

sensitivity of the teeth and irritation of the gums.[11]

11. CONCLUSIONS

"A Clean Mouth Will Lead to Clean Body" One cannot be healthy without oral health and

general health should not be interpreted as separated entities.

As the end of twentieth century approaches and the challenges of the twenty-first century

approach, it is instructive to recall how the century opened for dental education with an

abundance of proprietary school, a trade not fully transformed into a profession, a minuscule

research and science base, a population be set by serious dental disease and resigned to tooth

loss, and a limited set of treatment. During the twentieth century, dental health, practice, and

education have been transformed. Oral health research has led to preservative, diagnostic, and

management strategies that have greatly diminished the incidence the incidence and severity

of dental disease.

These change flow in part in part broader scientific and social development including public

policies to promote individual and community health. Beyond these influences, however lies

the dedication of several generations of dental practitioners, education, researchers and public

official to improving oral health through education, professional and scientific achievement.

Because it is the nature of report such as this one to be critical, the committee wants to stress

that it recognized these contributions.

https://en.wikipedia.org/wiki/Debridement_(dental)

https://en.wikipedia.org/wiki/Tooth_polishing

https://en.wikipedia.org/wiki/Oral_hygiene

https://en.wikipedia.org/wiki/Cosmetic_dentistry

https://en.wikipedia.org/wiki/Cosmetic_dentistry

https://en.wikipedia.org/wiki/Hydrogen_peroxide

https://en.wikipedia.org/wiki/Carbamide_peroxide

https://en.wikipedia.org/wiki/Hydrogen_peroxide



261

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