Todays Challenges

1
Todays Challenges

• Latest campaigns opposing fluoridated water
  supply
• Bottled water consumption
• Dietary disorders among young adults anorexia,
  bulimia
• Salivary dysfunction in cancer patients or older
  population using multiple drug therapies

2
High Risk Patients

• Systemic diseases (GERD)
• Eating disorders (Bulimia)
• Diet with high fermentable carbohydrates/
  frequency
• Poor plaque control habits
• Insufficient fluoride therapy
• Drug-induced xerostomia
• Salivary dysfunction with cancer treatment/drugs

GERD Gastro-Esophagelial Reflux Disease
3
Most Common Dental Diseases

• Dentinal Hypersensitivity
• Dental Caries

Chambers, J., CE supplement, Dimensions DH Aug
2006
4
Caries ManagementTraditional Therapy

• Evaluation includes
• Radiographs
• Clinical exam (explorer)
• Subsurface illumination
• Dental history
• Dietary history
• Plaque assessment

5
Remineralization

• 4 mechanisms of action
• Recaldent
• NovaMin
• SensiStat
• ADA Foundation ACP

6
Remineralization

• New smart material to promote remineralization

ACP
Amorphous
Calcium
Phosphate
7
Amorphous Calcium Phosphate

• Composed of hydroxyapatite minerals
• Phosphorus, oxygen, calcium compounds
• Amorphous
• No particular crystal form or pattern

8
Amorphous Calcium Phosphate

• Fluoride and hydroxyapatite combined equals
  fluorapatite crystals
• Fluorapatite is stronger than original
  hydroxyapatite enamel
• The highest concentration of F2 in ACP layer

Final Report Enamel Fluoride Uptake Study
05-106, Modified FDA Method 40, Dental
Products Testing, Indiana University Emerging
Technologies Center, December 2005.
ACP
9
Enamel Pro Varnish5 NaF and ACP

• Rosin contains ACP salts
• Oral saliva activates the ACP delivery
• Opposite charges of calcium, phosphorous and
  fluoride increases Na fluoride uptake by 200
• In varnishes, fluoride sustains activity for
  additional 24 hours

NIST, Indiana University data on file
10
Enamel Pro

• Only prophy paste available with a patented
  formulation that creates ACP
• ACP is activated upon contact within the oral
  environment as salivary ions and protease enzymes
  catalyze the delivery of Ca and P minerals to the
  enamel surface

Tung, M.S., Malerman, R. Huang, S. McHale, W.A.
Reactivity of Prophylaxis Paste Containing
Calcium, Phosphate and Fluoride Salts Journal of
Dental Research, Vol. 84, Special Issue A, IADR
Abstracts, 2005.
11
Enamel Pro

• Benefits
• Contains 1.23 APF fluoride
• 31 fluoride uptake due to oppositely charged
  ions of Ca, P () and F (-)
• Produces a higher luster as a result of Ca
  deposits by filling in surface irregularities in
  enamel

Tung, M.S, Eichmiller, F. Compendium Cont. Educ.
Dent., Vol. 25, No 9, Suppl. 1, Sept, 2004, p.
9-13.