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Background: This in vitro study analysed the effect of different fluoride concentrations in acidic or neutral liquid dentifrices in protecting enamel and dentine from erosive and abrasive wear. Methods: Bovine enamel and dentine specimens (n = 132) were randomly allocated to 11 groups (each n = 12): experimental liquid dentifrices with 550 ppm F, 1100 ppm F, 5000 ppm F or 0 ppm F/placebo (each at pH 4.5 and pH 7.0); and commercial dentifrices with 550 ppm F (Colgate Baby, pH 7.0), 1100 ppm F (Crest, pH 7.0) and 5000 ppm F (Duraphat, pH 7.0). The specimens were subjected to erosion for 90 seconds, 4 times/day, over 7 days. Immediately after the first and last erosion, the specimens were brushed for 15 seconds using one of the dentifrices. Tooth wear was measured profilometrically (lm) and analysed by ANOVA (p < 0.05). Results: All fluoridated liquid dentifrices significantly reduced enamel wear compared to the placebo and commercial dentifrices. Only liquid dentifrices with 1100 and 5000 ppm F significantly reduced dentine wear compared to placebo dentifrice. The pH had no effect, but the consistency had a significant impact on the effect of dentifrices. Conclusions: Liquid dentifrices with high F concentration appear to be a good option to prevent tooth wear.

To evaluate the influence of dentifrice pH and fluoride (F) concentration on F uptake by plaque and nails, two sets of 5- to 6-year-old children were randomly allocated into four groups, according to the type of dentifrice they had been using for 1 year: (1) experimental liquid dentifrice (ELD), 1,100 ppm F, pH 7.0; (2) ELD, 1,100 ppm F, pH 4.5; (3) ELD, 550 ppm F, pH 4.5, and (4) commercial toothpaste, 1,100 ppm F, pH 7.0. In one set of children, nails were clipped. In the second, plaque samples were collected 1 h after the last use of dentifrice. F concentration in plaque and nails was analyzed. Plaque F concentration was significantly lower in group 4 than in groups 1–3. Nail F concentration was significantly higher in group 4, and significantly lower in group 3, than in group 1 or 2. Plaque F uptake was influenced significantly by dentifrice consistency and nonsignificantly by pH and F concentration. Reduction of dentifrice pH did not affect nail F concentration.

The risk of contamination and dissemination by SARS-CoV-2 has a strong link with nasal, oral and pharyngeal cavities. Recently, our research group observed the promising performance of an anionic phthalocyanine derivative (APD) used in a mouthwash protocol without photoexcitation; this protocol improved the general clinical condition of patients infected with SARS-CoV-2. The present two-arm study evaluated in vitro the antiviral activity and cytotoxicity of APD. Additionally, a triple-blind randomized controlled trial was conducted with 41 hospitalized patients who tested positive for COVID-19. All the included patients received World Health Organization standard care hospital treatment (non-intensive care) plus active mouthwash (experimental group AM/n = 20) or nonactive mouthwash (control group NAM/n = 21). The adjunct mouthwash intervention protocol used in both groups consisted one-minute gargling/rinsing / 5 times/day until hospital discharge. Groups were compared considering age, number of comorbidities, duration of symptoms prior admission and length of hospital stay (LOS). The associations between group and sex, age range, presence of comorbidities, admission to Intensive care unit (ICU) and death were also evaluated. The in vitro evaluation demonstrated that APD compound was highly effective for reduction of SARS-CoV-2 viral load in the 1.0 mg/mL (99.96%) to 0.125 mg/mL (92.65%) range without causing cytotoxicity. Regarding the clinical trial, the median LOS of the AM group was significantly shortened (4 days) compared with that of the NAM group (7 days) (p = 0.0314). Additionally, gargling/rinsing with APD was very helpful in reducing the severity of symptoms (no ICU care was needed) compared to not gargling/rinsing with APD (28.6% of the patients in the NAM group needed ICU care, and 50% of this ICU subgroup passed way, p = 0.0207). This study indicated that the mechanical action of the protocol involving mouthwash containing a compound with antiviral effects against SARS-CoV-2 may reduce the symptoms of the patients and the spread of infection. The use of APD in a mouthwash as an adjuvant the hospital COVID-19 treatment presented no contraindication and reduced the hospital stay period.Trial registration: The clinical study was registered at REBEC—Brazilian Clinical Trial Register (RBR-58ftdj).

Aim This case series demonstrated that phthalocyanine derivate mouthwash is a promising alternative for reducing the viral load of SARS-CoV-2 and for clinical improvement of infected patients who presented mild and moderate symptoms. Purpose The aim of this study was to report a case series of patients diagnosed with COVID-19 that used the phthalocyanine derivate mouthwash to reduce clinical symptoms. Patients and Methods Eight patients used 5mL of phthalocyanine derivate mouthwash gargling/rinsing for one minute, five times daily, over a fourteen day period. Two measurement scales were applied for each patient in different periods to verify sore throat – VAS – Visual Analogue Scale for Pain and the clinical conditions – PS – Performance Status. Results All patients presented a significant reduction in clinical symptoms with the use of the mouthwash for gargling/rinsing after few days of use, without hospitalization. Conclusion The phthalocyanine derivate mouthwash protocol appears as a potential alternative for clinical improvement of COVID-19 infected patients. Daily use of this mouthwash rapidly reduced clinical symptoms such as sore throats, cough and mouth ulcers. Large, high-quality randomized controlled trials with larger sample size are necessary to confirm the effectiveness of this mouthwash protocol against COVID-19.

Background: Low-fluoride dentifrices have been suggested as alternatives to reduce dental fluorosis risk, but there is no consensus regarding their clinical effectiveness, which has been suggested to be increased when their pH is acidic. Aims: This single-blind randomized clinical trial evaluated the caries increment during the use of a low-fluoride acidic liquid dentifrice. Methods: Four-year-old schoolchildren (n = 1,402) living in a fluoridated area (0.6–0.8 ppm F) were randomly allocated to 4 groups differing according to the type of dentifrice used over a 20-month period. Group 1 (n = 345): liquid dentifrice, 1,100 ppm F, pH 4.5. Group 2 (n = 343): liquid dentifrice, 1,100 ppm F, pH 7.0. Group 3 (n = 354): liquid dentifrice, 550 ppm F, pH 4.5. Group 4 (n = 360): toothpaste, 1,100 ppm F, pH 7.0. At baseline and after 20 months, clinical examinations were conducted (dmfs index) and caries increment was calculated. Data were analysed by GLM procedure using classrooms (cluster) as unit of analysis (p < 0.05). Results: The mean ± SD (95% CI) net increments found were as follows. Group 1: 2.06 ± 2.38 (1.8–2.3); group 2: 2.08 ± 2.87 (1.7–2.4); group 3: 2.05 ± 2.79 (1.7–2.4), and group 4: 2.08 ± 2.34 (1.8–2.4). No significant differences were detected among the groups. Conclusion: In a population with high caries risk living in a fluoridated area, as the selected sample, and according to the present protocol, the low-fluoride acidic liquid dentifrice seems to lead to similar caries progression rates as conventional 1,100 ppm F toothpaste.

Objectives This in vitro study aimed to characterize the mineral content and surface and cross-sectional morphology of enamel and dentin tissues treated with a 1450 ppm fluoride-containing toothpaste with REFIX technology. Materials and Methods Bovine enamel blocks (n = 5) were obtained (4 × 4 × 6 mm), demineralized (artificial caries lesion), and treated (pH cycling and brushing with the toothpaste). During the pH cycling, which lasted for 7 days (demineralization and remineralization took 6 and 18 hours, respectively), the enamel was brushed for 5 minutes using an electric toothbrush before being immersed in a remineralizing solution. The dentin blocks were acid-etched for 2 minutes (0.05 M citric acid, pH 1.8) to expose the dentinal tubules (n = 5). Morphological analysis of the dentin was performed immediately and after 7 days of brushing with the dentifrice, and compared with the control group. The specimens were then cross-sectioned. The surface and cross-sectional micromorphology were assessed using scanning electron microscopy (SEM). The elemental analyses (weight%) were determined with an energy-dispersive X-ray spectroscopy (EDS). Results The toothpaste with REFIX technology remineralized and repaired the surface enamel effectively. The elemental analysis also demonstrated that treating the enamel with the toothpaste formed a silicon-enriched mineral layer on the enamel surface. Elemental analysis of the enamel cross-sections showed that the toothpaste induced a mineral change. The results were also consistent in the dentin, where the dentinal tubules were progressively occluded until there was complete occlusion after 7 days. Conclusions We prove the biomimetic mechanism of action of fluoridated toothpaste containing proprietary REFIX technology for obtaining silicon-enriched, remineralized and repaired dental tissues.

Periodontal patients often report dentin hypersensitivity (DH) caused by root surface exposure or periodontal treatment. Tubular blocking technologies in toothpastes are effective for pain relief, but no specific chemical/physical agent has been reported for periodontal patients. This double-blind randomized clinical trial compared the effects of three technologies in reducing DH in periodontal patients. Eighteen (18) participants were randomly assigned into three groups: SEN (NOVAMIN technology); REG (REFIX technology); REGK (REFIX technology + potassium citrate). Periodontal patients presenting with DH were evaluated at 6 moments: T1 and T2 - immediately before and after scaling and root planing procedures (SRP); T3 - after polishing sensitive areas with their assigned dentifrice and T4, T5, T6 - after 2, 4 and 8 weeks of SRP respectively. Sensitivity was assessed by air blast (Schiff scale) and patients’ perceptions using the visual analogue scale (VAS). Data were analyzed by two-way repeated measures ANOVA complemented by the Tukey test with significance set at 5% (p <0.05). Preliminary outcomes revealed SEN, REG and REGP reduced DH in periodontal patients (n=18). All patients initially presented moderate to severe pain (64.3) and after treatment they reported mild pain (21.3). Similarly, the dentist evaluation showed significant reduction in DH with the use of the three technologies (2.26 to 0.56). No statistically significant differences were found between the three study groups for patients (p=0.751) and dentist evaluations (p=0.632). According to these preliminary outcomes, all three technologies equally reduced DH in periodontal patients. Clinical trials #NCT04422184