Madrid-Troconis CC, Perez-Puello S.d.C. . Casein phosphopeptide-amorphous calcium phosphate nanocomplex (CPP-ACP) in dentistry: State of the art. Revista Facultad de Odontología Universidad de Antioquia. 2019;30:248–62. GC Tooth Mousse® supplies calcium and phosphate needed for patients with poor saliva flow; this situation can be further augmented by elevating the level of fluoride (by using GC Tooth Mousse Plus®, which has fluoride). GC MI Paste Plus is the only product for professional use containing RECALDENT™ enhanced with 900 ppm of a unique, patented form of fluoride.Does not irritate dry mouths caused by certain medications.The paste is indicated for use as a topical treatment for high-caries risk, xerostomia, orthodontics, post-bleaching, oncology, paediatric, and high plaque/special needs. In vivo results showed no statistical difference between the two topical agents. Both topical agents showed statistically significant difference from the control group after 60days.

Chen X, Daliri EB, Kim N, Kim JR, Yoo D, Oh DH. Microbial etiology and prevention of dental caries: exploiting natural products to inhibit cariogenic biofilms. Pathogens. 2020;9:569. The evaluation of fluorescence changes after application of casein phophopeptides (CPP) and amorphous calcium phosphate on early carious lesions. Of the twelve studies included in this systematic review, three studies were direct comparisons of Tooth Mousse® versus a control group [ 34, 36, 40] and two studies versus a placebo crème [ 31, 33]. The remaining six studies compared the efficacy of Tooth Mousse® (MI Paste®) and/or Tooth Mousse Plus® (MI Paste Plus®) to other products and techniques with or without a control group - including fluoride toothpaste [ 37], fluoride mouthrinse [ 38, 39], fluoride gel [ 30], fluoride varnish [ 41], chlorhexidine gel [ 32] and microabrasion [ 38]. The studies by Beerens et al. [ 35], Krithidkadatta et al. [ 39], and Huang et al. [ 41] involved comparisons with Tooth Mousse Plus® (MI Paste Plus®) - containing 900ppm Fluoride, all other studies utilised only the non-fluoride containing Tooth Mousse® (MI Paste®).Tao S, Zhu Y, Yuan H, Tao S, Cheng Y, Li J, et al. Efficacy of fluorides and CPP-ACP vs fluorides monotherapy on early caries lesions: a systematic review and meta-analysis. PLoS ONE. 2018;13(4):e0196660. With regard to safety, no serious side effects or adverse events were reported in any of the studies included in the final review. However, five studies [ 35, 37, 39– 41] did not report side effects or adverse events in their papers. One study [ 33] recorded one participant with non-serious gastro-intestinal symptoms that were possibly related to the use of Tooth Mousse® and another [ 38] made the statement “although CPP-ACP had side effects” but did not make any reference to what the side effects were. Asokan S, Geethapriya PR, Vijayasankari V. Effect of nonfluoridated remineralizing agents on initial enamel carious lesions: a systematic review. Indian J Dent Res. 2019;30(2):282–90. RECALDENT ® or Casein Phosphopeptide-Amorphous Calcium Phosphate (CPP-ACP) is a unique ingredient derived from naturally occurring protein found in cow’s milk. RECALDENT ® is exported worldwide and used as ingredient in various functional foods and dental products. The CPP-ACP technology is the result of many years of research at the University of Melbourne into the anticariogenic properties of milk. There is a high-level of evidence supporting the ability of CPP-ACP to remineralise early caries lesions and prevent their progression [ 10, 11, 12, 13, 14]. There are now twelve published systematic meta-analyses of these clinical studies to support the use of CPP-ACP to lower caries risk [ 11, 12, 13, 14, 15, 16, 17, 18, 19, 20, 21, 22]. In addition, CPP-ACP effectiveness has also been demonstrated in relation to the reduction of cariogenic bacteria and increased colonization of commensal microorganisms, and the reduction of dentine hypersensitivity [ 23, 24, 25, 26]. A randomized clinical study to evaluate the remineralizing effect of Tooth Mousse® on white spot lesions compared with a control group. Blinding of the examiner was not reported. Patients in the Tooth Mousse® group applied the crème twice daily after toothbrushing. Patients in the control group brushed twice daily.

While the focus of this study was not on the relationship between dental professionals and patients, it was evident that the quality of such relationship was essential for participants being encouraged to modify their daily routines. Participants talked about the value of TMP being prescribed by a dentist, and at the same time, being educated by dentists and members of a dental team on how to apply the product. It is well established in the literature that dentists’ and dental team members’ attitude towards patients can impact on treatment acceptance and home care compliance [ 9, 39, 40, 41, 42]. Our findings confirm that having a positive relationship between dental professionals and patients can be a facilitator of change. Interventions: Only Tooth Mousse® (MI Paste®) or Tooth Mousse Plus® (MI Paste Plus®) formulations were considered. No other formulations of CPP-ACP such as gum, lozenges, solutions, mouthrinses, toothpastes or varnishes were considered. Product used - a CPP-ACP dental crème which is difficult to obtain or no longer available commercially.The effect of casein and calcium containing paste on plaque pH following a subsequent carbohydrate challenge. Llena C, Leyda AM, Forner L. CPP-ACP and CPP-ACPF versus fluoride varnish in remineralisation of early caries lesions. A prospective study. Eur J Paediatr Dent. 2015;16:181–6. Comparisons: Tooth Mousse® (MI Paste®) or Tooth Mousse Plus® (MI Paste Plus®) (Test) versus a routine oral care regimen for the prevention of dental caries (Control) with or without comparisons to additional preventive products. Reema SD, Lahiri PK, Roy SS. Review of casein phosphopeptides-amorphous calcium phosphate. Chin J Dent Res. 2014;17:7–14. Sturges JE, Hanrahan KJ. Comparing telephone and face-to-face qualitative interviewing: a research note. Qual Res. 2004;4(1):107–18.

Reynolds EC, Cai F, Shen P, Walker GD. Retention in plaque and remineralization of enamel lesions by various forms of calcium in a mouthrinse or sugar-free chewing gum. J Dent Res. 2003;82:206–11. Significant improvement in lesion depth was observed in both groups. No significant difference was found between the test and control groups after 12weeks.Effects of casein phophopeptide amorphous calcium fluoride phosphate paste of white spot lesions and dental plaque after orthodontic treatment: a 3-month follow-up. b Krzyściak W, Jurczak A, Kościelniak D, Bystrowska B, Skalniak A. The virulence of Streptococcus mutans and the ability to form biofilms. Eur J Clin Microbiol Infect Dis. 2014;33:499–515. No significant differences were found in the test groups compared to the control group at the end of the 8week study by any of the examining panels.