As a healthy mouth contributes to a healthy body, it is essential to understand the science behind products, read the research studies and consider how a particular technology or product fits with the process of care and then make recommendations for patients. Promoting good general and oral health and providing sound dental health education will encourage patients to participate in the self discovery process that is necessary for them to become an active participant in their own oral healthcare. With favourable behaviour towards helping aid prevention, oral hygiene products containing stabilised chlorine dioxide, fluoride and hydroxyapatite could be of value to a wide spectrum of clinical oral hygiene concerns, when used as part of an oral healthcare regime. They provide a valuable aid for dental health and function, as well as encourage patient compliance.
There is growing clinical evidence that small infections in the mouth can affect the whole body and may be a contributing factor to several diseases. Researchers have uncovered potential links between periodontal disease and other serious health conditions.
Dental plaque is often seen as the precursor to tooth decay and gum problems. It contains more than 600 different microorganisms, contributing to the oral cavity’s overall dynamic environment that frequently undergoes rapid changes in pH, nutrient availability and oxygen tension. Plaque biofilm formation is not limited to tooth surfaces, about 80 per cent of the remaining surfaces include the oral mucosa, tongue and saliva serve as reservoirs of pathogenic bacteria.
According to Jorgsen and Slot “under suitable conditions, periodontal pathogens colonise the subgingival environment, incorporating into a tenacious biofilm, impacting both caries and periodontal disease” as a result of protein degradation. The plaque bacteria (Streptococcus mutans) demineralise the tooth surface by producing acids through the metabolisation of carbohydrates and which attack the minerals in the enamel, the cementum and the dentin.
The late eminent American periodontist, Prof Perry Ratcliff claimed that the link between oral malodour and periodontitis has implications for treatment and that extremely low concentrations of volatile sulphur compounds (VSC), the family of gases which are primarily responsible for oral malodour, are also highly toxic to the tissues in the mouth. When VSC are absent, the toxins from bacteria do not cross the epithelial barrier. When VSC are present, they alter the epithelial barrier, allowing the bacterial toxins to penetrate through the epithelium into the deeper tissues. These act as antigens to start the immune response, which starts the inflammatory reaction that causes tissue destruction to form periodontal pockets. Professor Ratcliff explains: “Traditional procedures of scaling, root planing and the practice of oral hygiene, combined with tongue scraping are effective at reducing levels of VSC in mouth air and are satisfactory cosmetic treatment. However, oral care products which can demonstrate efficacy at lowering the concentrations of VSC in periodontal pockets may also be significant adjuncts to periodontal therapy as they help to prevent gingival disease.”
Research has shown that stabilised chlorine dioxide can demonstrate efficacy at lowering concentration of VSC in periodontal pockets by oxidising them on contact.
New technology
The challenge remains, to eliminate or control VSC and bacteria that cause tooth decay and gum disease in a way that does not introduce substances or cause bacteria to build an immune resistance. Stabilised chlorine dioxide has proven to be effective at this, as it works closely with the natural oral pH. It is very gentle on the delicate tissues of the mouth and when exposed to the acidic areas, where plaque has formed, the chlorine dioxide is released. Once released, it reduces the production of acid in the mouth, eliminates the VSC that cause bad breath and effectively helps to control plaque-causing bacteria. It acts as an oxidising agent and de-activates amino acids, decreasing the ability of negative micro-organisms/bacteria in the oral cavity to multiply.
The tooth enamel is formed from hydroxyapatite and its fluorinated derivative named fluoroapatite, which are both among the hardest materials existing in nature. Hydroxyapatite supports a naturally occurring function in the first line of defence against caries. It does this by neutralising acids caused by plaque bacteria and by providing calcium and phosphate ion building blocks, which diffuse back into the enamel to restore lost minerals. Hydroxyapatite can effectively improve the mechanism of regenerating tooth enamel and helps reduce the sensitivity of teeth by blocking dental tubules. It acts as a filler, repairing minute pits and fissures in the enamel surface, resulting in smoother, glossier enamel, with fewer sites likely to harbour plaque and stains. Hydroxyapatite also remineralises subsurface demineralised areas of the enamel and restores mineral density and translucency to enhance the whiteness of the teeth. Hydroxyapatite protects against decay by helping remove plaque, restoring smoothness and mineral density to both surface and subsurface enamel, and also restores translucency and gloss, contributing to both the health and natural beauty of the teeth.
As the mouth provides a window into an individual’s general health status, prevention (controlling dental plaque biofilm, bacterial infections and VSC) is the foundation of successful dentistry. Using and recommending oral hygiene products containing stabilised chlorine dioxide, fluoride and hydroxyapatite (like UltraDEX) can be a significant aid in obtaining a healthy oral environment, when used as part of an oral hygiene regime.