Re-examining the Plaque-Gingivitis Connection and the Role of Stannous Fluoride
Course Number: 579
Course Contents
Antimicrobial Products are Not Interchangeable
As shown in Table 2, there is more than one antimicrobial chemotherapeutic product that targets plaque and gingivitis. The bioavailable SnF2 dentifrice reviewed herein is distinct in its breadth of benefits, including effect on plaque virulence. SnF2 formulations have been shown to act in the gingival sulcus where disease begins by interfering with the inflammatory process itself via binding the toxins that would typically trigger a chain of events leading to the edema and bleeding typifying gingivitis.
The multiple therapeutic benefits uniquely offered concurrently in bioavailable SnF2 dentifrices were outlined earlier. What solidifies them as truly ‘all-in-one’ are the additional features inherent in these multicare toothpastes: tartar control, and the coveted esthetic benefits of stain prevention/whitening.
These advanced SnF2 dentifrices have evolved significantly beyond the early generation SnF2 toothpastes that were thought to be associated with stain and adverse taste in certain patients. With the discovery that SnF2 can be destabilized by other ingredients, a series of formulation innovations were undertaken to ensure optimal bioavailability and the provision of the full range of therapeutic and cosmetic benefits. Current research-supported bioavailable 0.454% SnF2 formulations have been optimized for maximum esthetics and cosmetic benefits with zinc citrate or sodium hexametaphosphate. Numerous clinical investigations including negative and positive (whitening) controls have concurred that the new generation SnF2 dentifrices not only do not promote stain, but in fact provide clinically proven stain-inhibiting and whitening actions for high patient acceptance. 44,45,77,79
Patients with special oral hygiene concerns and/or those undergoing restorative or certain cosmetic procedures (e.g., dental implants; work that abuts the gingival margin like veneers), are especially vulnerable to the adverse effects of plaque build-up, where healthy adjacent tissues are integral to the long-term integrity of these procedures.81-82 Suchpatients can significantly benefit from the biofilm-inhibiting, bacteriostatic/bactericidal, anti-inflammatory actions of bioavailable SnF2 in areas where mechanical plaque removal can be particularly challenging and an added defense strategy is desirable.