[Chemical additives in toothpastes to inhibit calculus formation]

Dental calculus has a secondary effect on the pathogenesis of periodontal diseases by harboring bacterial biofilm on its rough surfaces. Consequently, professional removal of both calculus and biofilm is a crucial part of the therapy and prevention of gingivitis and periodontitis. Today, crystal growth inhibitors such as zinc ions in the form of zinc chloride or zinc citrate, and pyrophosphates alone or in combination with copolymer are added to toothpastes to prevent the mineralization of the dental biofilm. In addition, triclosan is used as an antimicrobial agent in combination with copolymer as an additive in toothpastes to reduce the amount of plaque and thus the substrate for calculus formation. In clinical trials, chemical additives have demonstrated an inhibiting impact on calculus formation. However, it must be clarified that in addition to home-based oral hygiene, the formation of dental calculus depends on other factors such as access to professional dental care, diet, age, ethnicity, time since last professional tooth cleaning, systemic diseases or medications. However, since chemical additives in toothpastes do not reach the deeper sites of periodontal pockets, they are recommended for the inhibition of supragingival calculus formation, thus assisting the primary prevention of gingivitis as well as the secondary prevention of periodontal disease.