Fluoride dentifrices: current status and prospects

Toothpastes have developed from the poorly effective formulations using incompatible abrasive systems to the highly effective products now being given credit for the decline in dental caries in most developed countries. The earliest toothpastes used sodium fluoride but this was soon replaced by stannous fluoride, sodium monofluorophosphate and amine fluoride. Monofluorophosphate has the advantage that it is compatible with a wide variety of abrasive systems. Although most toothpastes world-wide currently contain monofluorophosphate, sodium fluoride formulations are growing in availability because of the development of compatible abrasives. Clinical caries trials have indicated that, with proper formulation, there is little or no difference in effectiveness among toothpastes prepared with different fluoride agents, but that increasing the fluoride concentration will enhance the anti-caries effect. The addition of other active agents to fluoride toothpaste has been a relatively recent occurrence, and it is important to be assured that they do not interfere with the anti-caries activity of fluoride. Pyrophosphate, a calculus control agent, is one additive that was considered to be a potential problem; however, human and animal tests have shown that both caries and calculus inhibiting effects can be obtained from a single formulation. With the use of modern methodology to evaluate toothpaste formulations before clinical trials, many new products containing anti-calculus and other agents will probably become available in the coming years.