Dental products

2.  Introduction and types of dental products with examples;
 Dentifrices: Calcium Carbonate and Dicalcium phosphate.
 Dental caries/dental plaque, Anti-caries agent: Role of fluoride as anticaries agent,
consequences of fluoride overdosing, Sodium Fluoride and Stannous fluoride.

4.  The inorganic compounds and their formulations which are used in maintaining the
oral and dental hygiene are known as dental products.
 Dental products include anticaries agents , polishing agents, and desensitizing
agents.

5. Dental products includes
 Anticaries agents: These are the agents which help in prevention of dental decay.
e.g. Sodium fluoride, stannous fluoride, sodium monofluorophosphate
 Cleaning agents (Dentifrices/ Polishing agents): Dentifrices are agents used along
with a toothbrush to clean and polish natural teeth. They must be abrasive to some
degree to remove the stains from the teeth. They are supplied in paste, powder, gel
or liquid form. e.g. Calcium carbonate, Dibasic calcium phosphate, calcium
phosphate, sodium metaphosphate
 Desensitizing Agents: These reduce sensitivity of teeth to heat and cold. Examples
include strontium chloride and zinc chloride.

6.  Dental caries, or tooth decay, involves a gradual demineralization (softening) of the enamel and
dentin. If it is not treated then microorganisms may invade the pulp, causing inflammation and
infection.
 Dental caries (tooth decay) is infectious disease, also called as dental plaque, in which acid
formed by the action of oral microbial flora on carbohydrates. Dental plaque is a biofilm or mass
of bacteria that grows on surfaces within the mouth. It is a sticky colorless deposit at first, but
when it forms tartar, it is often brown or pale yellow. It is characterised by decalcification of
tooth accompanied by foul smell.

7.  The microbial flora (primarily streptococcus mutans and lactobacillaceae) present in the
mouth act on carbohydrates (taken in tea and food) and produce acids, especially lactic acid.
Calcium salts are dissolved in acidic media, remaining organic matrix is easily digested by the
proteolytic enzymes and cavities are formed.
 Dental caries can be prevented and oral and dental hygiene can be maintained with the help of
dentifrices. Dentifrices are the products that enhance the removal of stain and dental plaque by
the toothbrush. The most accepted approach to prevent caries includes flossing and brushing
accompanied by administration of fluoride either internally or topically to the teeth.

8. Mechanism of action of Fluoride:
 The deposited fluorides on the surface of teeth prevent the action of acids or enzymes in
producing cavities.
 Fluoride is anticariogenic as it replaces the hydroxyl ion in hydroxyapatite with the fluoride ion
to form fluorapatite in the outer surface of the enamel.
 Fluorapatite hardens the enamel and makes it more acid resistant. It is also possible that
fluorides may possess some antibacterial activity and help in remineralization of enamel.
 A trace of amount of fluoride in drinking water is enough to prevent dental caries. Fluorapatite
has also shown antibacterial activity.

10. Administration and Effects of over dose of Fluoride:
 Fluoride can be administered by two routes, orally and topically.
 Fluoride can be administered orally as sodium fluoride tablets or drops added in water or fruit
juice. Fluoride when administered internally is readily absorbed from the gastrointestinal tract,
partially deposited in the bone or developing teeth and the remainder gets excreted by the
kidneys.

11.  A small quantity (0.5 -1 PPM) of fluoride thus becomes necessary to prevent caries. However,
if more quantity of fluoride (more than 2-3 PPM) is ingested it is carried to bones and teeth and
gives rise to mottled enamel known as dental fluorosis. Persons receiving slow continued
ingestion of fluoride may suffer from mottling of teeth, increased density of bones, gastric
disturbances, muscular weakness, convulsions and even heart failure.
 Addition of fluoride to the municipal water supply, known as fluoridation is able to help in
reducing and preventing dental caries.
 Topical fluoride solution, mouthwashes and gels are less effective than orally administered
fluoride. Sodium fluoride tablets or solution of sodium fluoride in a dose 2.2 mg/day is generally


12. Sodium fluoride
Molecular formula: NaF
Preparation: It may be prepared by neutralizing hydrofluoric acid with sodium carbonate.
2HF + Na2CO3 2NaF + H2O + CO2
Another method includes the double decomposition of calcium fluoride with sodium carbonate
wherein insoluble calcium carbonate can be removed by filtration.
CaF2 + Na2CO3 2NaF + CaCO3
Properties: A white powder or colourless crystals. Soluble in water practically, insoluble in
ethanol (95 %).

13. Identification
 Gives reaction A of sodium salts.
 Add about 4 mg to a mixture of 0.1 ml of alizarin red solution and 0.1 ml of zirconyl nitrate
solution and mix; the colour changes to yellow.
Test for purity: It is tested for appearance of solution, Acidity or alkalinity, chlorides,
fluorosilicate, sulphates and loss on drying.
Assay: Weigh accurately about 80 mg, add a mixture of 5 ml of acetic anhydride and 20 ml of
anhydrous glacial acetic acid and heat to dissolve. Cool, add 20 ml of dioxan. Titrate with 0.1 M
perchloric acid, using crystal violet solution as indicator, until a green colour is produced. Carry
out a blank titration.

14.  Action and uses
 Sodium fluoride due to its fluoride ion is an important agent in dental practice for retarding or
preventing dental caries. Fluoridised teeth have been resistant to microorganisms causing
dental caries. It also decreases microbial acid production.

 Sodium fluoride in 2 % aqueous solution is widely used topically; occasionally the solution is
applied to the surface of dry teeth periodically over several times in a year.

 Application: 1.5 to 3 ppm (equivalent to 0.7 to 1.3 ppm of fluoride ion) in drinking water;
topically as a 2% solution to the teeth.

15.  Caution: When consumed in larger doses, sodium fluoride is poisonous. High fluoride water
greater than 3 ppm) brings about mottling of teeth, gastric disturbances, etc. Stiller larger doses
may lead to systemic toxicities effecting central nervous, cardiovascular, musculo-skeletal and
respiratory systems. Sometimes, sodium fluoride is used as domestic insecticide. Greater
precaution is to be taken to prevent children getting access to such preparation.

16.  Note: Stannous fluoride is a valuable adjunct in the prevention of caries and is considered to
be superior to sodium fluoride for two reasons i) simplified application ii) greater effectiveness.

 The first advantage is supported by the fact that single application of 8 % aqueous solution to
the tooth surface is enough for every 6 months to 1 year, while, a 2 % sodium fluoride is
applied 4 times during a 10 days period.
 The second advantage derives from the fact that the stannous ion increases the anticariogenic
action of fluoride ion so that both ions contribute towards clinical effectiveness.

17. Stannous fluoride
Molecular formula: SnF2 Molecular weight: 156.7
Tin fluoride solution is obtained from using tin fluoride capsules by dissolving in water. A fresh
solution (about 8.0 %) finds use in dentistry.
Properties: It is a white crystalline powder having unpleasant astringent-salty taste. It is soluble
in water but insoluble in alcohol and organic solvents. Aqueous solution of stannous fluoride
deteriorates rapidly on standing because of oxidation of stannous cation to stannic form causing
turbidity. Thus stannous fluoride solution must be freshly made.

18.  Identification:
o To 5 ml of solution (1 in 100) in a test tube add 2 ml of calcium chloride test solution: a fine, white precipitate of
calcium fluoride is formed.

o Mix on a spot plate 2 drops of solution (1 in 100) with 2 drops of silver nitrate test solution: a brown-black precipitate
is formed.

 Uses:
 It is used to prevent dental caries, similar to sodium fluoride and sodium monofluorophosphate in the form of
solution, gel, mouth wash or dentifrice (toothpaste). It has unpleasant taste and may cause discolouration of
teeth on overusage.

 A freshly prepared 8 % solution of stannous fluoride is applied to the cleaned teeth. A single application has
been reported to be sufficient for six to 12 months.


21.  Dentifrices contain agents for cleaning tooth surfaces and providing polishing effect on the cleaned teeth. These
agents are abrasive in nature. They are responsible for physically removing plaque and debris. The overall effect
provides whiteness to the teeth. Dentifrices are applied as powders or pastes.
 Examples include dicalcium phosphate, sodium metaphosphate, calcium pyrophosphate, calcium carbonate and
calcium monohydrogen phosphate.
 The main drawback is that it will not be able to clean surfaces inside cavities and crevices between teeth, even if
the material reaches them during application. The cleaning action is dependent upon abrasive property and the
rubbing force used. Pumice is too abrasive for daily use in a dentifrice.

25. Properties: It occurs as fine, white, micro-crystalline powder. It is odourless and tasteless. It is
stable in air. It is almost soluble in water and alcohol. Calcium carbonate neutralises acids with
effervescence.
CaCO3 + 2 HCl CaCl2 + CO2 + H2O
Identification: It gives reactions which are characteristic of calcium and carbonates.
Uses:
 Precipitated chalk, which is having a fine powdery texture, is used in dentifrice, both powders
and pastes.
 It furnishes both abrasive and antacid effect in the mouth. If forms a common ingredients of
tooth powder and toothpaste.
 It is having a tendency to cause constipation and hence it is usually administered alternatively
or along with magnesium salts.
 It is rapidly acting non-systemic antacid. It neutralizes gastric acid and forms calcium chloride.

26.  Desensitizing agents reduce the pain in sensitive teeth caused by cold, heat or touch. These
products should be non-abrasive and should not be used on a regular basis unless directed by a
dentist. Examples include strontium chloride (Sensodyne®) and zinc chloride (Listerine®).
 The exact mechanism of action of desensiting agents is not known with certainty. However
they act probably like local anaesthetic.

27. Preparation: It is prepared byadding strontium carbonate to hydrochloric acid until effervescence
gets ceased. The solution is filtered, concentrated and allowed to crystallise.
SrCO3 + 2HCl SrCl2 + H2O + CO2
Uses: It acts desensitising agent in dental remedies.

28. Phr. Bholakant Raut
Quality Control Officer
Bachelor in Pharmacy, NPC Regd. No: G 1997
Preparation: It is prepared by heating granulated zinc with hydrochloric acid. When evolution of
hydrogen ceases, the solution is filtered and evaporated to dryness.
Zn + 2HCl → ZnCl2 + H2
Uses:
 It is used as an antiseptic astringent to the skin and mucous membrane as a 0.5–2.0% solution.
 It is used as an active ingredient to prepare magnesia cements for dental fillings and certain
mouthwashes.
 It is also used as dentin desensitizer, topically as a 10% solution to the teeth. It is for topical
use only and is administered as solution and mouthwash.