Journal of Dental Research and Review

ORIGINAL ARTICLE
Year
: 2021  |  Volume : 8  |  Issue : 4  |  Page : 312--316

Abrasive action of different herbal toothpastes: A profilometric analysis


Meenu G Singla, Ishpreet Virdi 
 Department of Conservative Dentistry and Endodontics, Sudha Rustagi College of Dental Sciences and Research, Faridabad, Haryana, India

Correspondence Address:
Meenu G Singla
Sudha Rustagi College of Dental Sciences and Research, Sector 89, Kheri More, Faridabad - 121 002, Haryana
India

Abstract

Background: The abrasive action of herbal-based toothpastes is important to evaluate in order to prevent the risk of damaging the tooth surface and to prevent the injudicious use of such toothpastes by educating the patients. Objectives: The present study was performed to evaluate the abrasive action of four herbal-based toothpastes by measuring change in surface roughness of tooth enamel using profilometer and to compare it with conventional toothpaste. Materials and Methods: Thirty freshly extracted human anterior teeth were taken, and enamel samples of approximately 5 mm × 5 mm × 3 mm were obtained using diamond discs. These were mounted on acrylic blocks. The specimens were then distributed into five groups (n = 6) according to the toothpaste used: Patanjali Dantkanti, Vicco Vajradanti, Dabur Red, Meswak, and Colgate Total (control). The mounted specimens were brushed using respective toothpastes in each group. Profilometric readings were recorded before and after the toothbrushing, and the differences in readings were used to assess the change in surface roughness. Results: The least change in surface roughness was showed by Vicco toothpaste (0.15 ± 0.08), followed by Dantkanti (0.17 ± 0.13), Colgate Total (0.22 ± 0.08), Meswak (0.54 ± 0.22), and Dabur Red (0.81 ± 0.40). The mean change in surface roughness in Dantkanti, Vicco, and Colgate Total was found to be significantly lower (P ≤ 0.05) as compared to Dabur Red and Meswak. Conclusions: It can be concluded that based on abrasivity, Vicco and Dantkanti toothpastes are better choices as compared to Dabur Red and Meswak.



How to cite this article:
Singla MG, Virdi I. Abrasive action of different herbal toothpastes: A profilometric analysis.J Dent Res Rev 2021;8:312-316


How to cite this URL:
Singla MG, Virdi I. Abrasive action of different herbal toothpastes: A profilometric analysis. J Dent Res Rev [serial online] 2021 [cited 2022 May 21 ];8:312-316
Available from: https://www.jdrr.org/text.asp?2021/8/4/312/332925


Full Text



 Introduction



Dentifrices have been used for decades and have been verified to be an essential device for enhancing both oral health and esthetics.[1] The majority of the cleaning is accomplished by the mechanical usage of the toothbrush with the assistance of toothpaste. Toothpaste is a dentifrice used to clean, preserve, and enhance the health of teeth.[2] The use of toothpastes dates back to the historic past[3] and is one of the main irreplaceable elements of oral health care.[4] The toothpaste formulations started out in China and India. During that period, squashed bone, pulverized egg, and clamshells were used as abrasives as a part of tooth cleaning.[5]

A toothpaste is typically composed of abrasive 10%–40%, humectants 20%–70%, water 5%–30%, binder 1%–%, detergent 1%–3%, flavor 1%–2%, preservative 0.05%–0.5%, and therapeutic agent 0.1%–0.5%. The abrasive agents that are present in the toothpastes play a vital role in cleaning teeth.[1] The abrasiveness of toothpaste relies upon the quantity of abrasive, particle size, surface structure of the particle, and chemical impact of other types of ingredients in the product.[6] All of the toothpastes have certain levels of abrasivity measured by its relative dentin abrasivity (RDA) score.[7] A score of 0–70 is given for low abrasive toothpaste, 71–100 for medium abrasive toothpaste, and 101–150 for highly abrasive toothpaste, and a score of 151–250 is regarded as harmful limit.[8] Toothpaste with a higher RDA value causes greater abrasion compared to the one with lower RDA value. High abrasivity of toothpastes may damage hard and soft tissues, leading to gingival recession, cervical abrasion, and dentinal hypersensitivity.[9] Thus, opting for a paste with a low RDA can avoid both sensitivity and structural damages.[8]

Nowadays, the market is flooded with various types of toothpastes having different formulations. Current trend is moving toward alternate medicinal systems, especially herbal medicines. Herbal toothpastes have received attention from the public and dental professionals following a number of studies, which have reported beneficial effects on teeth.[6] In order to ensure the effectiveness of any toothpaste, the amount of abrasives in it must be assessed to allow for its therapeutic action without compromising oral tissues.[10] In the literature, there is little evidence regarding evaluation of abrasivity of the herbal toothpastes on the enamel surface.

Various methods have been described for measuring abrasivity of toothpaste. The quantitative techniques include RDA method and weight and volume loss techniques, which measure the amount of abraded material removed. Profilometer and light reflection techniques are the qualitative techniques that measure the roughness of the abraded surface.[11] Profilometer is a tool that can measure changes in surface roughness and provides roughness average (Ra) values for every profile. The profilometer produces a tracing using digital and analog hardware and software and calculates the average surface roughness (Ra) value for the consequent tracing.[12],[13]

The present study was conducted to evaluate the effect of four herbal-based toothpastes (Patanjali Dantkanti, Meswak, Dabur Red, and Vicco Vajradanti) on the surface roughness of tooth enamel and compare it with conventional toothpaste (Colgate Total) using profilometer.

 Materials and Methods



The study was conducted in the Department of Conservative Dentistry and Endodontics, Sudha Rustagi College of Dental Sciences and Research, Faridabad.

Study design

A total of 30 freshly extracted anterior teeth were obtained which were extracted due to periodontal reasons. The teeth were examined to exclude those with caries, cracks, or enamel defects. Post cleaning, the specimens were stored at 37°C in distilled water until use. The collected teeth were cut into 5 mm × 5 mm × 3 mm slices with double-sided thin-flex diamond discs mounted on a straight handpiece, under water and air spray. The cut slices were then mounted in acrylic blocks (DPI-RR cold cure, Mumbai, India) in such a way that the sound tooth enamel was present on their outer surface. Then, the specimens were randomly distributed into five groups (n = 6 samples per group) according to toothpaste being used. Four herbal toothpastes tested are as follows: Group A, Patanjali Dantkanti; Group B, Vicco Vajradanti; Group C, Dabur Red; and Group D, Meswak. Group E was of Colgate Total, which was kept as control. The ingredients of the toothpastes used are given in [Table 1].{Table 1}

Surface roughness analysis

Profilometer (Surftest SJ-210 Portable Profilometer, Mitutoyo, USA) was used to measure the surface roughness of the enamel samples [Figure 1]. To measure the initial surface roughness, diamond stylus was moved vertically in contact with the sample and then moved laterally across the sample for 4 mm on a hypothetical line and the value for initial surface profile displayed in microns was noted. Three readings were collected for each sample and the mean surface profile value was considered as the initial surface profile in micros. After this, the samples were brushed with a powered toothbrush (Colgate 360 Charcoal Battery Power Toothbrush) for 2 min twice daily for 30 days.[14] Uniform brushing force was delivered with the help of a brushing model (N-162 machine vice) in a direction perpendicular to the enamel surface [Figure 2]. All the specimens were then cleaned thoroughly with water to remove any abrasive particle or stains adhering to the surface. Then, the final surface roughness was evaluated again using a profilometer. The difference in pre- and post brushing Ra values was used to assess the change in surface roughness.{Figure 1}{Figure 2}

Statistical analysis

The readings were tabulated and subjected to statistical analysis using software SPSS version 21 (IBM SPSS Statistics for Windows, Version 21.0. Armonk, NY: IBM Corp. IBM Corp. Released 2013). The level of statistical significance was set at P ≤ 0.05. Intergroup comparison of change in roughness was done using Kruskal–Wallis test. Post hoc pairwise comparison was done using Mann–Whitney U test.

 Results



All the four groups of herbal toothpastes showed changes in the surface roughness of the samples. The mean change in surface roughness of Group A (Dantkanti) was 0.17 ± 0.13, Group B (Vicco) was 0.15 ± 0.08, Group C (Dabur Red) was 0.81 ± 0.40, Group D (Meswak) was 0.54 ± 0.22, and Group E (Colgate Total) was 0.22 ± 0.08. Intergroup comparison of change in roughness using Kruskal–Wallis test demonstrated a statistically significant difference (P < 0.05) between the groups [Table 2]. The change in surface roughness was shown to be least in Vicco, followed by Dantkanti, Colgate Total, Meswak, and Dabur Red in increasing order. The mean change in roughness scores of Group A (Dantkanti), Group B (Vicco), and Group E (Colgate total) was found to be significantly lower as compared to Group C (Dabur red) and Group D (Meswak). On pair-wise comparison using Mann–Whitney U test, significant differences were seen among all pairs of groups except between Group A and Group B, Group A and Group E, and Group B and Group E and also between Group C and Group D [Table 3].{Table 2}{Table 3}

 Discussion



Most of the available literature has focused mainly on antimicrobial properties of herbal toothpastes and few studies have been conducted on their abrasivity. Therefore, this in vitro study was undertaken to evaluate the effect of different types of herbal toothpastes (Patanjali Dantkanti, Meswak, Dabur Red, and Vicco Vajradanti Toothpaste) in causing abrasion.

This study was planned in in vitro conditions as in vivo clinical studies on tooth abrasion are almost impossible to conduct because of multifactorial nature of abrasion, not having fixed reference points in the oral environment, and the need for patient follow-up.[15]

In the present study, we have used enamel samples, while some other studies have used composite or acrylic resin samples. Similar composition of samples is an advantage for reducing the confounding factors and reproducibility of the study. However, our goal, when selecting enamel samples, was to simulate clinical setting conditions as much as possible.[15]

Colgate Total was used as control as it has RDA value of 70 (low abrasive), which is considered as borderline between low abrasive and medium abrasive toothpaste.[16]

In this study, by construction of a customized brushing apparatus with powered toothbrush, the brushing technique, brushing force, and duration and frequency of brushing were kept constant, which helped deliver uniform force.[17],[18]

Profilometer was used to assess the abrasivity of the toothpaste. Profilometry is among the most popular methods used worldwide for abrasion studies.[19] Its accuracy compared to other methods and its property of not damaging the tooth surface during the measurement are among the most important advantages of this method.[15] The profilometric readings were recorded by keeping the profilometric stylus at the center of each mounted enamel specimens before and after toothbrushing.[14]

In the present study, the maximum surface roughness was observed with Dabur Red toothpaste, followed by Meswak, Colgate Total (control), Dantkanti, and Vicco toothpaste in decreasing order.

Dabur Red toothpaste showed significantly higher surface roughness than Vicco Vajradanti, Dantkanti, and Colgate Total, which may be due to use of red-colored dentifrices containing red ochre and iron oxide. Such dentifrices are documented to be harshly abrasive to tooth enamel, which is similar to our results.[20]

Meswak showed significantly higher abrasivity as compared to Dantkanti and Colgate Total toothpaste. Meswak has silica abrasive particles incorporated, whereas Dantkanti has calcium carbonate abrasive particles. Silica particles are found to be more abrasive than calcium carbonate. Similar results were found in a study done by Camargo et al. and Ferreira et al.[21],[22]

Although both Colgate Total and Meswak have silica abrasive particles, Colgate Total showed significantly lower abrasiveness than Meswak. Moore and Addy found that different silicas with different particle sizes, used as abrasives, differ in their abrasion properties.[23]

Vicco showed the minimum abrasiveness among the tested groups and the values were significantly lower than Dabur Red and Meswak toothpaste. This toothpaste has all herbal-based contents and no separate abrasive particles have been added.

Apart from abrasives, other ingredients in the composition of toothpastes with different pH may affect the abrasivity of toothpaste.[15] Ranjikar et al. demonstrated that use of some agents and lubricants in the composition of toothpastes and their percentage could affect abrasivity of toothpastes due to their lubricating property, thus reducing friction.[24] Moore and Addy in 2005 showed that detergents also could influence the abrasivity. They compared brushing with water, detergent slurries, and toothpaste detergent slurries and reported that brushing with detergents alone also caused loss of dentine.[23]

One of the limitations of the present study is the lack of simulation of continuous washing action and remineralizing effects of saliva over worn out surfaces of teeth. Few in vitro studies have concluded that the abrasion was significantly lowered if saliva was used as a medium.[25]

It is recommended that further studies with a larger sample size using other methods such as scanning electron microscopy as adjuvant to profilometry should be conducted to evaluate the abrasive action of commercially available herbal toothpastes.

 Conclusions



Within the limitations of the present study, it can be concluded that all the tested herbal toothpastes caused enamel abrasion. On the basis of abrasivity, Vicco and Dantkanti toothpastes were found to be better choices than Dabur Red and Meswak as their abrasivity was similar to the conventional tooth paste, i.e., Colgate Total.

It is prudent to confirm the abrasivity of any commercially available toothpaste to check whether it falls within the acceptable limit, which can guide the consumer to choose the appropriate toothpaste.

Ethical clearance

SRCDSR/ABAD/2017/7632.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.

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