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Clinical evaluation of a salivary calculus preventive agent
Periodontia CLINICAL
I.
LOUIS
EVALUATION OF PREVENTIVE
GROSSMAN,
D.D.S.,
A SALIVARY AGENT
DR.I\IED.DENT.,
CALCULUS
PHILADELPHIA,
PA.
A previous paper,l a report was presented dealing with the relative efI Nfectiveness of a number of chelating and other chemical agents in dissolving a salivary calculus substitute and salivary calculus itself. In addition, these agents were examined for their possible destructive effect on enamel, such as roughening or etching of the enamel surface. It was found that, while a number of the chemical solutions studied readily dissolved both tartar and the tartar substitute, many also caused etching of the enamel. In fact, ten of the twenty-one solutions tested etched enamel; eleven of the solutions apparently had no effect on enamel, and had variable degrees of efficacy insofar as dissolving tartar was concerned. Of the chemicals tried in vitro which were effective in dissolving the tartar substitute and at the same time did not etch enamel, Ex 347* appeared to show the greatest promise. It was quite effective in dissolving both the tartar substitute and tartar removed from teeth. On the other hand, it did not etch enamel even when extracted teeth were exposed to its action for several weeks. Under the circumstances, it was tried clinically in thirty-one patients. The clinical effectiveness of the solution was determined in the following manner : patients having heavy deposits of salivary calculus were selected for the study. A heavy deposit was considered one in which salivary calculus covered the lingual surfaces of the lower anterior teeth in a band about 3 mm. broad or greater, within a period of three or four months but not more than six months. Such patients were then asked whether they would be interested in preventing the calculus, of which they were aware, by brushing the teeth with a solution for one minute twice a day. In those cases in which the patient signified a willingness to cooperate, he was told to brush his teeth in the usual manner and then rinse his mouth. The chemical solution was then to be applied with a multitufted toothbrush to all the teeth for one minute a.nd the applied solution was not to be rinsed afterward. Observations of the degree of calculus formation were made upon return of the patient at the stated intervals to which he was accustomed, namely, three, four, or six months. The result was then recorded as marked reduction in calculus, slight reduction, no reduction, or uncooperative. ‘Supplied
by
-4. J. Parker
Co.,
Philadelphia, 607
Pa.
608
LOUIS
I.
GROSSMAN
Upon return of the patient, observation was made with regard to amount of salivary calculus present and this observation was recorded in the manner stated. In some cases the patient volunteered the information that no calculus or less calculus was felt by the tongue as it was rubbed across the lower anterior teeth. In a few cases patients acknowledged that they were uncooperative because they could not or did not want to take the time to apply the solution. In one case the patient stated that “the solution puckered the mouth and caused a raw feeling in the mouth.” This reaction disappeared upon discontinuing the use of the solution and reappeared after some days upon recommencing the use of the solution. Of the 31 patients who used the solution, 19 showed a marked reduction in the amount of calculus that developed. In a number of these, the teeth became calculus-free. In 8 cases, the reduction in calculus formation was slight, but definite. In 3 cases the patients were uncooperative and discontinued the use of the preparation after a short period of time while in 1 case the patient claimed to have used the preparation according to directions but there was no evidence of a reduction in the amount of calculus formation. In those cases where the development of salivary calculus was unduly rapid and heavy, developing in so short a time that a prophylaxis was necessary every three months, the preventive effect of Ex 347 was most obvious. Often, no calculus or only a little calculus was present in the usual areas of deposition, the lingual surfaces of the lower anterior teeth and the buccal surfaces of the upper molars. However, in one case the usual amount of calculus was present in the interproximal areas of the lower anterior teeth. When the patient’s attention was directed to this and an effort was made to force the solution between the teeth, such areas also became practically tartar-free. It is interesting to note that in some cases in which the patient’s teeth were subject to staining, as well as calculus formation, there was decidedly less staining following the use of Ex 347. A chemical solution intended to prevent the formation of salivary calculus was tested in thirty-one patients who ordinarily were subject to heavy tartar formation in a relatively short period of time-three to four months in most, cases. The solution tested apparently prevented the development of tartar or reduced its formation markedly in nineteen cases; slight reduction was apparent in eight cases; no reduction was observed in one case; three patients discontinued the use of the solution because of various reasons. Reference 1. Grossman,
Louis
I.:
Effect
of Chemical
ORAL MED. AND ORALPATH.~: 2203
MEDICAL
TOWER
BLDG.
484,1954.
Agents
on a Calculus
Substitute,
OWL
SURG.,
I.
LOUIS
EVALUATION OF PREVENTIVE
GROSSMAN,
D.D.S.,
A SALIVARY AGENT
DR.I\IED.DENT.,
CALCULUS
PHILADELPHIA,
PA.
A previous paper,l a report was presented dealing with the relative efI Nfectiveness of a number of chelating and other chemical agents in dissolving a salivary calculus substitute and salivary calculus itself. In addition, these agents were examined for their possible destructive effect on enamel, such as roughening or etching of the enamel surface. It was found that, while a number of the chemical solutions studied readily dissolved both tartar and the tartar substitute, many also caused etching of the enamel. In fact, ten of the twenty-one solutions tested etched enamel; eleven of the solutions apparently had no effect on enamel, and had variable degrees of efficacy insofar as dissolving tartar was concerned. Of the chemicals tried in vitro which were effective in dissolving the tartar substitute and at the same time did not etch enamel, Ex 347* appeared to show the greatest promise. It was quite effective in dissolving both the tartar substitute and tartar removed from teeth. On the other hand, it did not etch enamel even when extracted teeth were exposed to its action for several weeks. Under the circumstances, it was tried clinically in thirty-one patients. The clinical effectiveness of the solution was determined in the following manner : patients having heavy deposits of salivary calculus were selected for the study. A heavy deposit was considered one in which salivary calculus covered the lingual surfaces of the lower anterior teeth in a band about 3 mm. broad or greater, within a period of three or four months but not more than six months. Such patients were then asked whether they would be interested in preventing the calculus, of which they were aware, by brushing the teeth with a solution for one minute twice a day. In those cases in which the patient signified a willingness to cooperate, he was told to brush his teeth in the usual manner and then rinse his mouth. The chemical solution was then to be applied with a multitufted toothbrush to all the teeth for one minute a.nd the applied solution was not to be rinsed afterward. Observations of the degree of calculus formation were made upon return of the patient at the stated intervals to which he was accustomed, namely, three, four, or six months. The result was then recorded as marked reduction in calculus, slight reduction, no reduction, or uncooperative. ‘Supplied
by
-4. J. Parker
Co.,
Philadelphia, 607
Pa.
608
LOUIS
I.
GROSSMAN
Upon return of the patient, observation was made with regard to amount of salivary calculus present and this observation was recorded in the manner stated. In some cases the patient volunteered the information that no calculus or less calculus was felt by the tongue as it was rubbed across the lower anterior teeth. In a few cases patients acknowledged that they were uncooperative because they could not or did not want to take the time to apply the solution. In one case the patient stated that “the solution puckered the mouth and caused a raw feeling in the mouth.” This reaction disappeared upon discontinuing the use of the solution and reappeared after some days upon recommencing the use of the solution. Of the 31 patients who used the solution, 19 showed a marked reduction in the amount of calculus that developed. In a number of these, the teeth became calculus-free. In 8 cases, the reduction in calculus formation was slight, but definite. In 3 cases the patients were uncooperative and discontinued the use of the preparation after a short period of time while in 1 case the patient claimed to have used the preparation according to directions but there was no evidence of a reduction in the amount of calculus formation. In those cases where the development of salivary calculus was unduly rapid and heavy, developing in so short a time that a prophylaxis was necessary every three months, the preventive effect of Ex 347 was most obvious. Often, no calculus or only a little calculus was present in the usual areas of deposition, the lingual surfaces of the lower anterior teeth and the buccal surfaces of the upper molars. However, in one case the usual amount of calculus was present in the interproximal areas of the lower anterior teeth. When the patient’s attention was directed to this and an effort was made to force the solution between the teeth, such areas also became practically tartar-free. It is interesting to note that in some cases in which the patient’s teeth were subject to staining, as well as calculus formation, there was decidedly less staining following the use of Ex 347. A chemical solution intended to prevent the formation of salivary calculus was tested in thirty-one patients who ordinarily were subject to heavy tartar formation in a relatively short period of time-three to four months in most, cases. The solution tested apparently prevented the development of tartar or reduced its formation markedly in nineteen cases; slight reduction was apparent in eight cases; no reduction was observed in one case; three patients discontinued the use of the solution because of various reasons. Reference 1. Grossman,
Louis
I.:
Effect
of Chemical
ORAL MED. AND ORALPATH.~: 2203
MEDICAL
TOWER
BLDG.
484,1954.
Agents
on a Calculus
Substitute,
OWL
SURG.,