Oral Hygiene Products
Oral hygiene products are usually not classified as dental materials. Their use is at least in part regulated by other laws, such as regulations regarding cosmetics. There is, however, no clear borderline. Oral hygiene products may lead to oral and extra-
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ral Hygiene Products A. Richards
10.2 Toothpastes and Mouthwashes
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Introduction
Oral hygiene products are usually not classified as dental materials. Their use is at least in part regulated by other laws, such as regulations regarding cosmetics. But there is no clear borderline. Bleaching agents, for instance, may contribute to a change in the aesthetic appearance. But on the other hand, bleaching agents are considered medical devices in many countries equivalent to dental materials – for many good reasons. Furthermore, side effects due to oral hygiene products have been observed that are similar to those caused by dental materials. Thus, such adverse effects were often erroneously attributed to dental materials. In order to diagnose side effects and identify their possible causes, information about adverse effects of oral hygiene products can be very helpful.
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Toothpastes and mouthwashes are the two most important oral hygiene products available to patients. These products differ from dental materials used in the dental office in a number of specific ways. The biggest difference is that, generally, these products are purchased by the patient without reference to a dental health professional. Also, oral hygiene products are classified as cosmetic preparations, which means they may not be subjected to the same rigorous controls as would be applied to drugs or medical devices (see also Chap. 3). Historical reviews describe how mouthrinses and toothpastes have been used for more than 3,000 years [50, 58, 74]. Throughout this time and up to the present day, they have been formulated to clean stains from the teeth, disguise malodor, and prevent or treat diseases in the teeth and supporting tissues. Because it has been shown that bacteria play a prime role in the etiology of the major oral diseases, many of the so-called active ingredients are directed toward the oral microflora or sequelae of their metabolism. Cleaning stains from teeth requires an abrasive, and the overall sales success of a product may depend on flavoring agents, which give a sensation of wellbeing, cleanliness, and reduced fears of oral malodor. These substances influence the compatibility of a product. A product’s biocompatibility may be altered by a change in any of these substances – their addition or removal or merely an alteration in their concentration. Other classes of substances contained in oral hygiene products include humectants, homogenizers, preservatives, foaming agents, and so on. Nearly all ingredients are potentially harmful, and the risk of harmful effects depends on concentration. Many antimicrobial agents added to toothpastes and mouthwashes possess powerful antimicrobial properties in concentrations that are used in other cosmetic products, such as soap. But these concentrations may
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