Johannsen A, Emilson CG, Johannsen G, Konradsson K, Lingström P, Ramberg P. Effects of stabilized stannous fluoride dentifrice on dental calculus, dental plaque, gingivitis, halitosis and stain: A systematic review. Heliyon. 2019;5(12):e02850. doi:10.1016/j.heliyon.2019.e02850 Dental calculus or tartar is calcified deposit occurring on the teeth or other solid structures in the oral cavity such as restorations, prosthetic appliances, and dental implants. Calculus is calcified dental plaque which can be classified as supragingival or subgingival calculus. Dental plaque is the diverse community of microorganisms found on tooth surface as a biofilm. The microorganisms bind tightly to one another and the tooth surface by means of an extracellular matrix of polymers of host and microbial origin.[ 1 , 2] Dental plaque biofilms are responsible for many common oral diseases including dental caries, gingivitis, periodontitis, and peri-implantitis.[ 3] Fluoride: This is the single most important ingredient in conventional toothpaste. “Fluoride is going to be the primary active ingredient,” says Dr. Manz. Dr. Kennedy adds, "[Sodium fluoride] is a safe way to strengthen your teeth and to prevent tooth decay or cavities.” Those patients with sensitive teeth should look for brands like Sensodyne that incorporate potassium nitrate into their toothpaste formulas, as potassium nitrate helps to soothe inflamed nerves,” Dr. Kunen suggests. If you're unsure which toothpaste will best fit your individual needs, ask your dentist for guidance. The principal ingredients in Abhaibhubejhr Herbal Toothpaste were fruit pericarp of Garcinia mangostana Linn (mangosteen), leaf of Piper betle Linn (betel), and leaf of Psidium guajava Linn (guava). Phytochemical studies showed that mangosteen pericarp contained various bioactive substances including xanthones, tannins, triterpenes, anthocyanins, polysaccharides, phenolic compounds, Vitamin B 1, B 2, and C.[ 11] These xanthones exhibit a variety of biological and pharmacological properties including antibacterial, anti-inflammatory, antiviral, antifungal, antioxidant, antiallergy, analgesic, and anticancer.[ 12 , 13] Due to its antimicrobial activity, mangosteen pericarp could probably lead to the reduction of plaque and calculus formation. Some studies suggested that mouthwash containing mangosteen pericarp has benefits as an adjunct to periodontal treatment and for control of oral malodor.[ 14 , 15]

Tooth brushing is relatively effective in dental plaque removal, but it is still inadequate for the maintenance of gingival health. Chemotherapeutic agents have been used to supplement the mechanical removal of dental plaque and calculus from teeth. To the best of our knowledge, this study is the first to evaluate the effect of Abhaibhubejhr Herbal Toothpaste in the control of supragingival calculus formation. This study showed significant anticalculus benefits for the Colgate Total and Abhaibhubejhr toothpastes. Results from this study also showed superior calculus inhibition properties for the Colgate Total versus the Abhaibhubejhr toothpaste. These findings are consistent with other reports in literature showing positive anticalculus benefits for Colgate Total toothpaste.[ 8 , 9] The active ingredients in Colgate Total toothpaste were 0.3% triclosan and 2.0% PVM/MA copolymer, whose mechanism of action is antimicrobial. Triclosan is a broad-spectrum antimicrobial agent active on both Gram-positive and Gram-negative bacteria. At bacterioctatic concentrations, triclosan prevents essential amino acid uptake, while at bactericidal concentrations, triclosan destroys the integrity of the cytoplasmic membrane and causes leakage of cellular contents.[ 10] Medjedovic E, Medjedovic S, Deljo D, Sukalo A. Impact of fluoride on dental health quality. Mater Sociomed. 2015;27(6):395-398. doi:10.5455/msm.2015.27.395-398 So it’s more important now than ever that we strengthen our fight against cavities, to give our children a future to smile about.Calculus is invariably covered with plaque on its surface. Calculus promotes the retention of dental plaque and may increase the rate of plaque formation. Its porosity can serve as a reservoir for periodontal pathogens and can retain noxious bacterial components such as endotoxin.[ 4 , 5] All subjects received an evaluation of their oral soft/hard tissues by the dental examiner. This examination included an evaluation of the soft and hard palate, gingival mucosa, buccal mucosa, mucosa-gingival fold areas, tongue, sublingual and submandibular areas, salivary glands, and the tonsillar and pharyngeal areas. Candidates were examined by the examining dentist to identify those subjects who demonstrate the presence of supragingival calculus. The scoring procedure used to evaluate calculus formation was the Volpe-Manhold calculus index which uses a standardized and calibrated (in millimeters) periodontal probe to measure supragingival calculus formation in three planes (mesial, midline, distal) of the lingual surfaces of the six lower anterior teeth. Adding the 18 measurements of six teeth constitutes, a total Volpe-Manhold score for each subject.[ 6 , 7] There are different types of fluoride, but stannous fluoride and sodium fluoride are most commonly used in toothpaste. Stannous fluoride acts as an antibacterial agent, which can help eliminate bad breath and plaque buildup. It can also help reduce tooth hypersensitivity when brushing. Sodium fluoride strengthens teeth and helps protect them from decay and cavities. Xylitol: Another beneficial ingredient often found in toothpaste is xylitol. It's a sweetener that “not only makes toothpaste taste good, it helps eradicate bad bacteria that cause tooth decay,” Guava leaf contains essential oils, flavonoids, tannins, eugenol, saponins, triterpenes, malic acid, and phenolic acid.[ 18] The potential pharmacologic activities of the extract from guava leaf have been reviewed including antimicrobial, antioxidant, anti-allergy, anti-genotoxic, anti, antiplasmodial, antispasmodic, cardioactive, cough suppressant, antidiabetic, anti-inflammatory, antinociceptive, and antiplaque.[ 19] It has been reported that the extract of guava leaf reduced the adherence of early plaque bacteria to an experimental pellicle.[ 20] Razak and Rahim,[ 21] in 2006, also found that treatment of the early plaque settlers with aqueous guava extract reduced the cell-surface hydrophobicity of Streptococcus sanguinis, Streptococcus mitis, and Actinomyces sp. The extract was observed to have the ability to alter and disturb the surface characteristics of the early plaque settlers and make them less adherent leading to its potential as an antiplaque and anticalculus agent.

When you’re shopping for toothpastes, you want to make sure that you are looking for ingredients that make you healthier,” says Erinne Kennedy, DMD, a dentist and spokesperson of the American Dental Association (ADA). Dr. Kennedy also recommends looking for active ingredients like fluoride and hydrogen peroxide, which will keep your mouth clean and free from disease. Nayak PA, Nayak UA, Khandelwal V. The effect of xylitol on dental caries and oral flora. Clin Cosmet Investig Dent. 2014;6:89-94. doi:10.2147/CCIDE.S55761 We researched dozens of toothpastes and evaluated them for key ingredients, flavor, cavity prevention and other dental benefits, and price. A dentist from our Medical Expert Board also reviewed the contents of this article for medical accuracy surrounding dental hygiene and the efficacy of different active ingredients in toothpastes.Inclusion characteristics included good general health, male and female subjects, aged 18–70, inclusive, scoreable lower six anterior teeth free of large restorations or dental prosthetic crowns, a Volpe-Manhold calculus index score of at least 10, and available for the 20-week duration of the study. Fluoride has been a key component of toothpaste for over 50 years, targeting the tooth itself to help make it stronger and working by helping to prevent mineral loss and enhance mineral gain by being incorporated into the tooth as fluorapatite. However, it has proven to help protect against cavities to an extent, but not enough to eradicate them. With the incorporation of arginine, Colgate has established a toothpaste technology that targets the true cause of cavities, the plague germs, a technological advance that should be considered the new gold standard for cavity protection worldwide.

Test phase: Oral soft/hard tissue and calculus examination, randomization of subjects, oral prophylaxis and toothpaste use at home

This study was approved by the Faculty of Dentistry, Mahidol University Institutional Review Board (COA. No.MU-DT/PY-IRB 2012/016.1204). Adult subjects from the Faculty of Dentistry, Mahidol University, Thailand, signed an informed consent form and were screened by the examining dentist to identify those subjects who meet the inclusion characteristics and demonstrate a tendency to form calculus. The first 150 subjects who meet the inclusion/exclusion were entered into the pretest phase of this double-blind, randomized, parallel clinical study. Recently, there has been a growing interest in natural products. People's interest has been shifted from synthetic toothpaste to herbal toothpaste. Herbal toothpaste does not contain any artificial colors or flavors that many of the regular toothpaste have. Artificial colors and flavors of the toothpaste are also giving birth to many diseases and health-related issues. The demand for herbal toothpaste suppliers has risen due to the great advantages which are associated with this toothpaste type. There are a number of brands of herbal toothpaste on the market. Abhaibhubejhr is a widely known herbal-based toothpaste containing Guava leaves, Betel vine leaves, and Mangosteem peel for which medicinal properties are claimed. However, many of the health claims made for them have not been clinically proven. As the global leader in Oral Care we continue to be committed to making the best scientific and technology advances available to all Shopping for the right toothpaste can be overwhelming because of the number of types available on store shelves. Since toothpaste is necessary to improve your oral hygiene, it is essential to find one that works best to prevent cavities, and disease but also gives you fresh breath and a dazzling white smile. Pretest phase: Oral soft/hard tissue and calculus examination, oral prophylaxis and toothpaste use at home