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CC BY 4.0 · Eur J Dent 2024; 18(01): 109-116
DOI: 10.1055/s-0043-1761193
Original Article

Effect of A Fluoride Toothpaste Containing Enzymes and Salivary Proteins on Periodontal Pathogens in Subjects with Black Stain: A Pilot Study

Maria Carelli
1   Department of Diagnostics and Public Health, Microbiology Section, University of Verona, Verona, Italy
,
Iuliia Zatochna
2   Dental Hygiene Unit, Azienda Provinciale per i Servizi Sanitari of Trento, Rovereto, Italy
,
Angela Sandri
1   Department of Diagnostics and Public Health, Microbiology Section, University of Verona, Verona, Italy
,
Gloria Burlacchini
1   Department of Diagnostics and Public Health, Microbiology Section, University of Verona, Verona, Italy
,
Angelica Rosa
1   Department of Diagnostics and Public Health, Microbiology Section, University of Verona, Verona, Italy
,
Francesca Baccini
2   Dental Hygiene Unit, Azienda Provinciale per i Servizi Sanitari of Trento, Rovereto, Italy
,
Caterina Signoretto
1   Department of Diagnostics and Public Health, Microbiology Section, University of Verona, Verona, Italy
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Abstract

Objective Black stain (BS) is an extrinsic dental discoloration particularly difficult to treat. Although its etiology is not fully clear yet, chromogenic bacteria inside the oral cavity seem to be involved. In this pilot study, we evaluated whether a toothpaste containing enzymes and salivary proteins could improve oral health and reduce the presence of periodontal pathogens in subjects predisposed to BS discoloration.

Materials and Methods Twenty-six subjects were enrolled in the study: 10 subjects without BS; 16 subjects with BS, randomly assigned in two groups: test (n = 8) and control (n = 8). The test group used a toothpaste containing sodium fluoride, enzymes, and salivary proteins. The control group used a toothpaste with amine fluoride. At enrollment and after 14 weeks, participants were subjected to professional oral hygiene, evaluation of BS (through Shourie index) and oral health status, collection of saliva and dental plaque samples. The presence of periodontal pathogens in plaque and saliva of all subjects was investigated by molecular analysis (PCR).

Statistical Analysis The prevalence of investigated microbial species in patients with/without BS was performed by Chi-squared test. The variation in the prevalence of the investigated species after treatment in test and control group was analyzed by t-test.

Results Clinical evaluation showed that 86% of participants with BS had a reduction in the Shourie index, independently from the toothpaste used. In particular, a greater reduction in the Shourie index was observed in subjects using an electric toothbrush. We did not observe an effect of the fluoride toothpaste containing enzymes and salivary proteins on the composition of the oral microbiota of the test subjects in comparison with controls. When comparing all subjects with BS (n = 16) and without BS (n = 10), P. gingivalis detection was significantly higher in saliva samples collected from subjects with BS (p = 0.0129).

Conclusion We verified that the use of an enzyme-containing toothpaste alone is not sufficient to prevent the formation of BS dental pigmentation in subjects predisposed to this discoloration. Mechanical cleaning, especially using electrical toothbrushes, seems to be useful to counteract BS formation. Moreover, our results suggest a possible association between BS and the presence of P. gingivalis at the salivary level.

Keywords

black stain - enzyme-based toothpaste - oral hygiene - periodontal pathogens.

Supplementary Material



Publication History

Article published online:
04 March 2023

© 2023. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution License, permitting unrestricted use, distribution, and reproduction so long as the original work is properly cited. (https://creativecommons.org/licenses/by/4.0/)

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  • References

  • 1 Watts A, Addy M. Tooth discolouration and staining: a review of the literature. Br Dent J 2001; 190 (06) 309-316
    CrossrefPubMedGoogle Scholar
  • 2 Wilkins EM. Clinical practice of the dental hygienist. 9th ed.. 2005
    Google Scholar
  • 3 Koch MJ, Bove M, Schroff J, Perlea P, García-Godoy F, Staehle HJ. Black stain and dental caries in schoolchildren in Potenza, Italy. ASDC J Dent Child 2001; 68 (5-6): 353-355, 302
    PubMedGoogle Scholar
  • 4 Ronay V, Attin T. Black stain-a review. Oral Health Prev Dent 2011; 9 (01) 37-45
    PubMedGoogle Scholar
  • 5 França-Pinto CC, Cenci MS, Correa MB. et al. Association between black stains and dental caries in primary teeth: findings from a Brazilian population-based birth cohort. Caries Res 2012; 46 (02) 170-176
    CrossrefPubMedGoogle Scholar
  • 6 Hattab FN, Qudeimat MA, al-Rimawi HS. Dental discoloration: an overview. J Esthet Dent 1999; 11 (06) 291-310
    CrossrefPubMedGoogle Scholar
  • 7 Li Y, Zhang Q, Zhang F, Liu R, Liu H, Chen F. Analysis of the microbiota of black stain in the primary dentition. PLoS One 2015; 10 (09) e0137030
    CrossrefPubMedGoogle Scholar
  • 8 Albelda-Bernardo MA, Jovani-Sancho MDM, Veses V, Sheth CC. Remediation of adult black dental stains by phototherapy. BDJ Open 2018; 4: 17035
    CrossrefPubMedGoogle Scholar
  • 9 Garcia Martin JM, Gonzalez Garcia M, Seoane Leston J, Llorente Pendas S, Diaz Martin JJ, Garcia-Pola MJ. Prevalence of black stain and associated risk factors in preschool Spanish children. Pediatr Int 2013; 55 (03) 355-359
    CrossrefPubMedGoogle Scholar
  • 10 Chen X, Zhan JY, Lu HX. et al. Factors associated with black tooth stain in Chinese preschool children. Clin Oral Investig 2014; 18 (09) 2059-2066
    CrossrefPubMedGoogle Scholar
  • 11 Gasparetto A, Conrado CA, Maciel SM, Miyamoto EY, Chicarelli M, Zanata RL. Prevalence of black tooth stains and dental caries in Brazilian schoolchildren. Braz Dent J 2003; 14 (03) 157-161
    CrossrefPubMedGoogle Scholar
  • 12 Heinrich-Weltzien R, Bartsch B, Eick S. Dental caries and microbiota in children with black stain and non-discoloured dental plaque. Caries Res 2014; 48 (02) 118-125
    CrossrefPubMedGoogle Scholar
  • 13 Żyła T, Kawala B, Antoszewska-Smith J, Kawala M. Black stain and dental caries: a review of the literature. BioMed Res Int 2015; 2015: 469392
    CrossrefPubMedGoogle Scholar
  • 14 Jain Y. A comparison of the efficacy of powered and manual toothbrushes in controlling plaque and gingivitis: a clinical study. Clin Cosmet Investig Dent 2013; 5: 3-9
    CrossrefPubMedGoogle Scholar
  • 15 Saba C, Solidani M, Berlutti F, Vestri A, Ottolenghi L, Polimeni A. Black stains in the mixed dentition: a PCR microbiological study of the etiopathogenic bacteria. J Clin Pediatr Dent 2006; 30 (03) 219-224
    CrossrefPubMedGoogle Scholar
  • 16 Adams SE, Arnold D, Murphy B. et al. A randomised clinical study to determine the effect of a toothpaste containing enzymes and proteins on plaque oral microbiome ecology. Sci Rep 2017; 7: 43344
    CrossrefPubMedGoogle Scholar
  • 17 Cawley A, Golding S, Goulsbra A, Hoptroff M, Kumaran S, Marriott R. Microbiology insights into boosting salivary defences through the use of enzymes and proteins. J Dent 2019; 80 (Suppl. 01) S19-S25
    CrossrefPubMedGoogle Scholar
  • 18 Daly S, Seong J, Newcombe R. et al. A randomised clinical trial to determine the effect of a toothpaste containing enzymes and proteins on gum health over 3 months. J Dent 2019; 80 (Suppl. 01) S26-S32
    CrossrefPubMedGoogle Scholar
  • 19 Pedersen AML, Darwish M, Nicholson J, Edwards MI, Gupta AK, Belstrøm D. Gingival health status in individuals using different types of toothpaste. J Dent 2019; 80 (Suppl. 01) S13-S18
    CrossrefPubMedGoogle Scholar
  • 20 García L, Tercero JC, Legido B, Ramos JA, Alemany J, Sanz M. Rapid detection of Actinobacillus actinomycetemcomitans, Prevotella intermedia and Porphyromona gingivalis by multiplex PCR. J Periodontal Res 1998; 33 (01) 59-64 DOI: 10.1111/j.1600-0765.1998.tb02292.x.
    CrossrefPubMedGoogle Scholar
  • 21 Pardo A, Signoriello A, Signoretto C. et al. Detection of periodontal pathogens in oral samples and cardiac specimens in patients undergoing aortic valve replacement: a pilot study. J Clin Med 2021; 10 (17) 3874
    CrossrefPubMedGoogle Scholar
  • 22 Xia T, Baumgartner JC. Occurrence of Actinomyces in infections of endodontic origin. J Endod 2003; 29 (09) 549-552
    CrossrefPubMedGoogle Scholar
  • 23 Mashima I, Theodorea CF, Thaweboon B, Thaweboon S, Nakazawa F. Identification of Veillonella species in the tongue biofilm by using a novel one-step polymerase chain reaction method. PLoS One 2016; 11 (06) e0157516
    CrossrefPubMedGoogle Scholar
  • 24 Nakano K, Inaba H, Nomura R. et al. Detection of cariogenic Streptococcus mutans in extirpated heart valve and atheromatous plaque specimens. J Clin Microbiol 2006; 44 (09) 3313-3317
    CrossrefPubMedGoogle Scholar
  • 25 Kouidhi B, Al Qurashi YMA, Chaieb K. Drug resistance of bacterial dental biofilm and the potential use of natural compounds as alternative for prevention and treatment. Microb Pathog 2015; 80: 39-49
    CrossrefPubMedGoogle Scholar
  • 26 Chen L, Zhang Q, Wang Y, Zhang K, Zou J. Comparing dental plaque microbiome diversity of extrinsic black stain in the primary dentition using Illumina MiSeq sequencing technique. BMC Oral Health 2019; 19 (01) 269
    CrossrefPubMedGoogle Scholar
  • 27 Costa MT, Dorta ML, Ribeiro-Dias F, Pimenta FC. Biofilms of black tooth stains: PCR analysis reveals presence of Streptococcus mutans . Braz Dent J 2012; 23 (05) 555-558
    CrossrefPubMedGoogle Scholar
  • 28 Takeshita T, Kageyama S, Furuta M. et al. Bacterial diversity in saliva and oral health-related conditions: the Hisayama study. Sci Rep 2016; 6: 22164
    CrossrefPubMedGoogle Scholar
  • 29 Shi W, Tian J, Xu H, Zhou Q, Qin M. Distinctions and associations between the microbiota of saliva and supragingival plaque of permanent and deciduous teeth. PLoS One 2018; 13 (07) e0200337
    CrossrefPubMedGoogle Scholar