Is there a role for triclosan/copolymer toothpaste in the management of periodontal disease?

Blinkhorn, Anthony; Bartold, P. Mark; Cullinan, M. P.; Madden, Theresa E.; Marshall, R. I.; Raphael, Sarah; Seymour, G. J.

doi:10.1038/sj.bdj.2009.669

Cited by 53 publications

(56 citation statements)

References 73 publications

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“…While the usefulness of triclosan in household and personal care products may be questionable, triclosan-containing toothpaste has been shown to be effective in the control of plaque and gingivitis (reviewed in Blinkhorn et al, 2009) and in slowing the progression of periodontitis in susceptible people (Rosling et al, 1997;Ellwood et al, 1998;Cullinan et al, 2003) and hence has a defined therapeutic benefit which contributes significantly to the maintenance of oral health. The association between periodontitis and cardiovascular disease (CVD) is now well established such that individuals with periodontitis are at higher risk of having CVD than periodontally healthy patients (Bahekar et al, 2007;Humphrey et al, 2008).…”

Section: Contents Lists Available At Sciencedirectmentioning

confidence: 99%

The influence of a triclosan toothpaste on adverse events in patients with cardiovascular disease over 5-years

Cullinan

Palmer

Carle

et al. 2015

Science of The Total Environment

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Adverse effects of long-term usage of triclosan-containing toothpaste in humans are currently unknown. We assessed the effect of long-term use of 0.3% triclosan-toothpaste on serious adverse events (SAEs) in patients with cardiovascular disease (CVD). 438 patients with a history of stable CVD were entered into the 5-year longitudinal Cardiovascular and Periodontal Study at Prince Charles Hospital, Brisbane, Australia and randomised into test (triclosan) or placebo groups. There were no significant differences in demographics or clinical features between the groups. Patients were examined at baseline, and annually for 5-years. SAEs were classified according to the System Organ Classes defined by MedDRA (Medical Dictionary for Regulatory Activities). Results were analysed using chi square and Kaplan Meier analysis. Overall, 232 patients (123 in the triclosan group; 109 in the placebo group) experienced 569 SAEs (288 in the triclosan group and 281 in the placebo group). There was no significant difference between the groups in numbers of patients experiencing SAEs (p=0.35) or specific cardiovascular SAEs (p=0.82), nor in time to the first SAE or first cardiovascular SAE, irrespective of gender, age or BMI after adjusting for multiple comparisons (p>0.05). The adjusted odds of experiencing an SAE were estimated to increase by 2.7% for each year of age (p=0.02) and the adjusted odds of experiencing a cardiovascular SAE were estimated to increase by 5.1% for each unit increase in BMI (p=0.02). Most cardiovascular events were related to unstable angina or myocardial infarcts, 21 were associated with arrhythmia and 41 were vascular events such as aortic aneurysm and cerebrovascular accident. Within the limitations of the present study the data suggest that the use of triclosan-toothpaste may not be associated with any increase in SAEs in this CVD population. The long-term impact of triclosan on hormone-related disease, such as cancer, in humans remains to be determined.

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Section: Contents Lists Available At Sciencedirectmentioning

confidence: 99%

The influence of a triclosan toothpaste on adverse events in patients with cardiovascular disease over 5-years

Cullinan

Palmer

Carle

et al. 2015

Science of The Total Environment

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“…Randomized controlled trials (RCTs) have shown that fluoride-chlorhexidine interventions significantly reduced bacterial load and pH drop from glucose metabolism [Giertsen and Scheie, 1995], and most importantly, lowered caries increment in high-risk groups . Sytematic reviews have also found high-quality evidence that fluoride-triclosan toothpastes give a small improvement in reducing coronal caries compared to conventional fluoride dentifrices [Blinkhorn et al, 2009;Riley and Lamont, 2013]. However, the use of such broad-spectrum antimicrobial agents may not be ideal, as the aim of antimicrobial treatment in caries prevention should preferably be to modify the plaque biofilm ecology by weakening cariogenic virulence factors rather than eliminating microflora.…”

Section: Fluoride Alone May Not Be Sufficientmentioning

confidence: 99%

Ecological Approaches to Dental Caries Prevention: Paradigm Shift or Shibboleth?

Philip

Suneja²,

Walsh³

2018

Caries Res

125

113

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Contemporary paradigms of dental caries aetiology focus on the ecology of the dental plaque biofilm and how local environmental factors can modulate this to cause disease. The crucial role that a healthy oral microbiome plays in preventing caries and promoting oral health is also being increasingly recognized. Based on these concepts, several ecological preventive approaches have been developed that could potentially broaden the arsenal of currently available caries-preventive measures. Many of these ecological approaches aim for long-term caries control by either disrupting cariogenic virulence factors without affecting bacterial viability, or include measures that can enhance the growth of health-associated, microbially diverse communities in the oral microbiome. This paper argues for the need to develop ecological preventive measures that go beyond conventional caries-preventive methods, and discusses whether these ecological approaches can be effective in reducing the severity of caries by promoting stable, health-associated oral biofilm communities.

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“…29,30 In addition, the combination of triclosan and copolymer seems to be effective in dentifrices. 25,26,31 Therefore, the present survey focused on chlorhexidine (CHX), a fixed combination of essential oils (EO) and cetylpyridinium chloride (CPC).…”

Section: Resultsmentioning

confidence: 99%

“…Actually, triclosan seems to be an effective agent in dentifrices when combined with a copolymer. 25,26 Many efforts have been made to improve the expected benefits and help patients to comply with oral rinsing.…”

Section: Introductionmentioning

confidence: 99%

Self-performed supragingival biofilm control: qualitative analysis, scientific basis and oral-health implications

Cortelli

Aquino

et al. 2010

Braz. oral res.

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Patients frequently fail to achieve an optimal mechanical plaque control. However, many patients are not confident about using mouthrinses, and many professionals refuse to prescribe them for regular daily use. Aiming at achieving a better understanding of the use and prescription of mouthrinses in periodontics, 24 dentists with different dental educational levels were purposively chosen and interviewed in a qualitative research. Partial data was presented at the 15th Congress of the Brazilian Association for Oral Health Promotion (ABOPREV), and full data was presented at the 88th General Session and Exhibition of the International Association for Dental Research (IADR). The professionals' answers were confirmed or rejected through scientific data analysis. Additionally, scientifically supported answers were provided for the interviewees' most frequent unanswered questions. Around half of the participants (46%) reported that they recommended the use of mouthrinses, although a high percentage (64%) of the dentists answered that they knew very little about the efficacy of mouthrinses and also about the oral benefits (54%) provided by them. All interviewees reported that they were aware of the fact that their patients, and themselves, failed to floss and, less frequently, to brush their teeth, and all of them believed that oral health impacts overall systemic health. Seventy five percent answered that using mouthrinses was safe. Most participants (55%) did not declare themselves as mouthrinse users. We concluded that dentists with different levels of dental education have only partial knowledge related to mouthrinse use in periodontics. The use of effective mouthrinses on a daily basis is justified and can help patients achieve or maintain a healthier mouth. A healthier mouth will positively impact patients' quality of life and could also benefit their overall systemic health

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Is there a role for triclosan/copolymer toothpaste in the management of periodontal disease?

Cited by 53 publications

References 73 publications

The influence of a triclosan toothpaste on adverse events in patients with cardiovascular disease over 5-years

The influence of a triclosan toothpaste on adverse events in patients with cardiovascular disease over 5-years

Ecological Approaches to Dental Caries Prevention: Paradigm Shift or Shibboleth?

Self-performed supragingival biofilm control: qualitative analysis, scientific basis and oral-health implications

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