Enamel protection: a comparison of marketed dentifrice performance against dental erosion.

Purpose: To determine the relative ability of various marketed toothpastes formulated with either stabilized stannous fluoride (SnF(2)), sodium fluoride (NaF), or sodium monofluorophosphate (SMFP) to protect human enamel against the initiation and progression of damage due to dietary acid attack, using a laboratory erosion cycling model. Methods: Cores of ground and polished enamel from extracted human teeth were soaked in pooled, human saliva (pellicle formation) and then subjected to erosion cycling conditions that included exposure of tooth specimens to: (1) treatments in a 1:3 slurry (w/w) of toothpastes and saliva; and (2) acid challenges using either citric acid (Study 1) or both citric and phosphoric acids (Study 2). These acids represent potentially damaging acids found in common food and drinks. Upon completion of treatments, specimens were analyzed with regard to the depth of tooth mineral removed from exposed areas of the treated specimens over the course of the study. Two studies were conducted: Study 1 included a marketed, stabilized SnF(2) toothpaste vs. marketed NaF toothpastes; Study 2 tested the same stabilized SnF(2) product compared to a marketed SMFP toothpaste and a NaF control. Results: The stabilized SnF(2) toothpaste included in these studies demonstrated a highly significant reduction in enamel surface loss, relative to the control, in each study: Study 1 = 65% reduction; Study 2 = 58% reduction when using citric acid and 84% reduction when using phosphoric acid. Products formulated with NaF resulted in a net loss of between +1% and -21%, with none of the NaF toothpastes performing significantly different from the control (P< 0.05, ANOVA). For the SMFP product included in Study 2, results were also not significantly different from the NaF control. In both studies, the stabilized SnF(2) paste demonstrated a highly significant level of protection compared to all other test groups included in the study, regardless of the type of dietary acid challenge considered. (Am J Dent 2011;24:205-210).