Stannous Fluoride

Stannous fluoride exerts antibacterial effects by two modes of action. First, stannous fluoride exerts a killing effect on bacteria (bactericidal action). This is probably due to non-specific interaction with the bacterial membrane that causes membrane disruption. The result is leakage of cellular components that leads to cell lysis and death.

The second, and more important, mode of antibacterial activity is through stannous fluoride’s inhibition of metabolic enzymes. The inhibition of metabolic activity affects bacteria in a number of ways, including:^58,59

• reduction of bacterial growth

• prevention of bacterial adhesion to oral surfaces (e.g., enamel, exposed dentin)

• reduction in bacterial toxins that are recognized to boost the inflammatory response leading to gingivitis

Stannous fluoride’s inhibitory effect on bacteria is related to its inhibition of bacterial glycolysis, an energy making process whereby metabolic enzymes break down carbohydrates. In addition, studies have demonstrated that stannous fluoride significantly reduces metabolic toxins produced by bacteria in plaque biofilm.^58,59 Stannous effects are further recognized to bind to bacterial toxins, preventing immune receptor signaling. Stannous is therefore important to rebalance the oral microbiome in favor of a healthier flora, not only reducing the amount of plaque but reducing plaque toxicity for both soft and hard tissue.^60,61

One of the major breakthroughs in stannous fluoride formulation efforts was due to technology innovations that enabled the combination of both whitening and stabilization chemistries to provide highly effective stannous fluoride formulations that are not compromised by common esthetic negatives, such as poor taste or staining of earlier stannous fluoride products.^42,61,62