What is the best choice of toothpaste?

Middle East dental consensus: Stabilized Stannous Fluoride based dentifrice is toothpaste of choice

A selected panel of ME elite dental academics gathered for a two-day scientific consensus to discuss recommendations for best choice of toothpaste. This unique assembly took place at The Address Hotel, Dubai Marina, UAE. The consensus was led by Professor Hien Chi Ngo, Dean of College of Dental Medicine of the University of Sharjah and Dr. Elias Berdouses, Board Member of Emirates Pediatric Dental Club. The consensus was achieved by the Delphi methodology (A structured survey approach conducted in multiple rounds of questionnaires and answers. It is regarded as a systematic, interactive forecasting method relying on a group panel of experts*), resulting in an unbiased evidence based conclusion on the best type of toothpaste available.

Introduction

An ideal toothpaste should protect gums, teeth and the oral environment with minimal side effects and environmental impacts. In addition to the body of evidence supporting fluoride effectiveness, evidence suggests that Stabilised Stannous Fluoride, with verified bio-availability, has additional benefits. In association with sustained patient compliance (daily use) and effective mechanical debridement; this group recommends the following:

Gum Health
  1. There is emerging scientific evidence supporting the anti-inflammatory action of Stabilised Stannous Fluoride.
  2. In Patients with gingivitis, which can predispose to periodontitis, there is evidence that a toothpaste with Stabilised Stannous Fluoride has distinctive advantages in restoring and maintaining gingival health by reducing plaque and calculus deposition.
Tooth Health
  1. There is strong evidence to support that Stabilised Stannous Fluoride is superior to other forms of Fluorides in anti-bacterial efficacy and the reduction in acidogenicity of plaque.
  2. Stabilised Stannous Fluoride based toothpaste has been found to be effective in managing dental caries.
  3. A Stabilised Stannous Fluoride based toothpaste, in addition to addressing all etiological factors helps reduce progression of erosive tooth wear.
  4. There is strong evidence to support that the use of Stabilised Stannous Fluoride toothpaste is effective in reducing dentine hypersensitivity.
General
  1. Based on the recommendation of the European Academy of Paediatric Dentistry (2009), the dosage for toothpaste for children is twice daily: Up to 2 years of age: a pea size of 500ppm, 2 to 6 years of age: a pea size 1000ppm and 6 years and above 1450ppm fluoride: 1-2cm.
  2. Where higher concentrations of Fluoride toothpastes are not available, larger amount and longer exposure to toothpaste may be recommended based on individual needs.
  3. It is recognised that patients with fixed orthodontic appliances may have an increased risk of gingival inflammation and dental caries.
  4. We recommend further scientific studies in the areas of peri-implantitis, root caries and dentine erosion.
  5. To increase compliance, oral health care providers should consider the effectiveness of products and patient specific needs regarding age, medical conditions, taste and texture.
In conclusion, based on current literature we recommend that a Stabilised Stannous Fluoride based toothpaste is the toothpaste of choice.**

Left to Right, Standing: Dr. Eleftherios Kaklamanos, Prof. Khaled Balto, Dr. Elias Berdouses, Prof. Crawford Bain, Prof. Hien Ngo, Dr. Ajay Juneja, Dr. Montaser Al-Qutub, Sitting: Dr. Samira Al-Osailan, Prof. Nada Naaman, Dr. Arwa Al-Sayed, Dr. Naif Al-Mosa
Over the two days, the consensus recommendations were agreed upon and signed off by the consensus expert panel:

Prof. Hien Chi Ngo, - Moderator, Dean of College of Dental Medicine, University of Sharjah, UAE
Dr. Elias Berdouses – Moderator, Board Member Emirates Pediatric Dental Club, UAE
Prof. Crawford Bain – Chairman Periodontics Department, Hamdan Bin Mohammed College of Dental Medicine, UAE
Dr. Arwa Al-Sayed - Chairman of the Saudi Fellowship Program in Implant Dentistry, Saudi Commission for Health Sciences, KSA
Dr. Eleftherios Kaklamanos - Assistant Professor of Orthodontics, Hamdan Bin Mohammed College of Dental Medicine, UAE
Dr. Naif Al-Mosa – Chairman Department of Pediatric Dentistry and Orthodontics, King Saud University, KSA
Dr. Montaser Al-Qutub – Head, Division of Periodontics and Postgraduate Program Director in Periodontics, King Saud University, KSA
Dr. Ajay Juneja – Specialist Prosthodontist, The Dental Studio, UAE
Prof. Khaled Balto – Director of Postgraduate Endodontic Programs, King Abdulaziz University, KSA
Dr. Samira Al-Sailan - Oral & Maxillofacial Surgery Consultant, King AbdulAziz University, KSA
Prof. Nada Naaman – Honorary Dean, Professor Department of Periodontology, Saint-Joseph University, Lebanon

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