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Health See other Health Articles Title: Arginine, Calcium Toothpaste Combats Dental Caries Medscape Editors' Recommendations Erythritol More Potent Than Xylitol Against Dental Caries Bottled Water a Risk Factor for Early Childhood Caries Diet and Oral Health Adding arginine and calcium salt to fluoride toothpaste makes it more effective in preventing dental caries, a large new clinical trial shows. Children using the experimental toothpaste for 2 years had 17.7% fewer decayed, missing, and filled teeth than children using a standard fluoride toothpaste, researchers from Colgate-Palmolive reported in an article published in the November issue of Caries Research. "It is clear that arginine, [sodium monofluorophosphate], calcium-salt formulations do reduce caries over time," Clifton Carey, PhD, a professor of cariology at the University of Colorado in Aurora, told Medscape Medical News. Dr. Carey was not involved in the study. Public health researchers have credited fluoride with dramatically reducing the prevalence of dental caries, but the disease remains very common worldwide, spurring researchers to look for new compounds to use against it. Although researchers do not completely understand how arginine combined with insoluble calcium affects caries, evidence suggests it changes the acid balance in saliva. In dental caries, bacteria metabolize sugar to produce acids that dissolve calcium phosphate in tooth enamel. When the bacteria metabolize arginine and insoluble calcium, they produce ammonia, an alkali, making saliva less acidic. Formulations of arginine and calcium may also replace calcium that has dissolved from tooth enamel. Previous clinical trials in people at high risk for caries have shown that toothpastes with fluoride, calcium, and arginine could reverse small early carious lesions more effectively than toothpastes with only fluoride as an active ingredient after 6 months of use. However, these studies did not show whether the arginine toothpastes could prevent actual cavities from forming during a longer period in a population at low to moderate risk for dental caries. Researchers have also wondered whether arginine was more effective when combined with dicalcium phosphate or calcium carbonate. To answer these questions, P. Kraivaphan, from the Faculty of Dentistry, Mahidol University, Bangkok, Thailand, and colleagues recruited 6000 children 6 to 9 years of age in Bangkok, where the fluoride level in tap water is less than 0.3 parts per million. The researchers randomly divided the children into 3 groups of equal sizes. One group received toothpaste with 1.5% arginine and dicalcium phosphate. One group received toothpaste with 1.5% arginine and calcium carbonate. Both of these toothpastes contained 1,450 parts per million of sodium monofluorophosphate. The control group received a toothpaste with silica and 1450 parts per million of sodium fluoride. At 24 months, 1679 children remained in each group. At the end of 1 year, all 3 groups had a lower prevalence of caries than when they started. After 2 years, the prevalence of caries had risen to levels similar to baseline in the 2 arginine and calcium groups but had risen above baseline in the control group. The arginine and dicalcium phosphate group, which started at 0.51 decayed, missing, and filled teeth, dropped to 0.25 at 1 year and then rebounded to 0.49 at 2 years. In contrast, the arginine and calcium carbonate group started at 0.49, dropped to 0.26 at 1 year, and then finished at 0.51. The control group started at 0.49, dropped to 0.24, and then finished at 0.62. Changes in caries were similar whether the researchers counted the number of damaged teeth or the number of damaged tooth surfaces. At the end of the study, the difference between the 2 arginine groups in decayed missing and filled teeth was not statistically different (P = .82), but the difference between the arginine and dicalcium phosphate group and the control group was statistically significant (P = .001), as was the difference between the arginine and calcium carbonate group and the control group (P = .007). The researchers recorded no adverse reactions to the toothpastes. Few studies have shown superiority of anticaries compounds relative to controls in populations at only moderate risk for caries, the researchers point out. "The ability of this study to demonstrate superior efficacy for the arginine-containing dentifrice relative to the fluoride only control could, thus, be viewed as a strength of the study," they write. They also cite previous studies showing that arginine-containing toothpastes were more effective than control toothpastes, regardless of which type of fluoride the controls contained (sodium fluoride or sodium monofluorophosphate). In addition, they point out that previous studies have shown the arginine and calcium combination effective not only in enamel caries but also root caries. Still, these studies do not add up to enough evidence for dental professionals to recommend arginine and calcium toothpastes to their patients, said Dr. Carey. "We still need more studies to demonstrate the mechanism of action of the arginine and any interactions that may be apparent with the toothpaste composition." The study was funded by Colgate-Palmolive, and some of the authors are employees of that company. Dr. Carey has disclosed no relevant financial relationships. Caries Res. 2013;47:582-590. Abstract Poster Comment: Brushing with bar soap works even better (followed by saline rinse). 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#1. To: Tatarewicz (#0)
When I lived in Illinois, people would throw marshmallows to Mike the Polar Bear in Brookfield Zoo. The sugar was rotting his teeth, so they brought in a vet dentist, shot him with a tranquilizer, and fixed his teeth. It is plain to see that marshmallows were not in the regular diet of a Polar Bear. ;)
"When bad men combine, the good must associate; else they will fall, one by one." Edmund Burke
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