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Observations on the Clinical Use of a Chlorophyll Dentifrice
Observations on the clinical use of a chlorophyll dentifrice Austin H. K u tscher* D.D.S., and Neal W. Chilton,* D.D.S., M .P.H ., New York
Within the past few years, a number of preparations containing chlorophyll1 have been offered to the medical and dental professions and to the public. Although the importance o f this substance in plant physiology has long been recognized and although some reports o f its role in gen eral medicine,2' 5 surgery6’ 7 and dentistry 8*18 are available, final appraisal of its use in clinical dentistry has not yet been made. There are reports in the literature of the effect of chlorophyll on salivary lactobacillus counts.8,18’ 20 In the studies which have utilized dentifrices contain ing chlorophyll, the subjects brushed their teeth in a definite manner at specific times (controlled brushing). Since chlorophyll-containing dentifrices can be pur chased without prescription “ over the counter,” it is most likely that persons using such a dentifrice use it as they use other dentifrices rather than according to a controlled brushing technic. For this reason the effects o f “ uncontrolled” brushing o f the teeth with a chlorophyllcontaining dentifrice were studied.21 M ETH O D S AND M ATERIALS
Study 1. Effect of Uncontrolled Brushing with a Chlorophyll Dentifrice on Salivary Lactobacillus Counts • Twenty patients, aged 5 to 64 (5 males and 15 females), were selected for this study with no re gard for their previous dental history.
After a clinical and roentgenographic examination but prior to prophylaxis or treatment, a specimen o f stimulated saliva was obtained from each patient; the determination o f the lactobacillus count according to the Hadley technic22 was made by the caries-control labora tory of the School o f Dentistry, Univer sity o f Pennsylvania, by the routine method used there. The collection of all specimens was supervised by the same person. A supply o f a chlorophyll-con taining toothpaste sufficient to last for
T h is s t u d y w a s s u p p o r t e d ( in p a r t ) b y a g r a n t - in - a i d f r o m th e R y sta n C o m p a n y , M o u n t V e rn o n , N , Y . ♦ D iv is io n o f re se a rc h , Hannah and H a r r y P o sn e r R e se a r c h L a b o ra to ry , School o f t D e n ta l and O ra l S u r g e r y o f th e F a c u lty o f M e d ic in e , C o l u m b i a U n i v e rsity . 1.
W a t e r - s o lu b le
c h lo r o p h y ll
d e r iv a t iv e s .
2. G a h a n , E,; K lin e , P. R., a n d F în k le , T. H . C h l o r o p h y ll in t r e a t m e n t o f u lc e rs . A r c h . D e r m a t . & S y p h . 47:849 ( J u n e ) 1943. 3. B o w e rs, W . F. C h l o r o p h y ll in w o u n d h e a li n g a n d s u p p u r a t iv e d is e a s e . A m . J . S u r g . 73:37 ( J a n . ) 1947. 4. M o s s , N . H ., a n d o th e rs. E ffe c tiv e n e s s o f C h l o re s iu m in w o u n d h e a lin g a n d d e o d o r a n t e ffe c ts ; r e p o r t o f C o u n c i l o n P h a r m a c y a n d C h e m is t r y . J . A . M A 140: 1336 { A u g . 27) 1949. 5. L a n g le y , W . D., a n d M o r g a n , W . S . C h l o r o p h y ll in t r e a t m e n t o f d e r m a t o s e s ; r e p o r t o f 4 0 c a s e s . P e n n sy lv a n ia M . J . 51:44 ( O c t . ) 1947. 6. S m ith , L. W . , a n d L iv in g s t o n , A . E. W o u n d h e a l i n g ; e x p e r im e n t a l s t u d y o f w a t e r s o l u b le c h lo r o p h y ll d e r iv a t iv e s in c o n ju n c t io n w ith v a r i o u s a n t ib a c t e r ia l a g e n t s . A m . J . S u r g . 67:30 ( J a n . ) 1945. 7. S m ith , L. W . , a n d < L iv in g s t o n , A . E. C h j o r o p h y ll ; e x p e r im e n t a l s t u d y o f its w a t e r s o l u b le d e r i v a t iv e * in w o u n d h e a lin g . A m . J. S u r g . ¿ 2 :3 5 8 ( D e c . ) 1943. 8. A . D . A . C o u n c i l o p p o s e s n e w d e n t ifr ic e J . A . D . A . 39:224 ( A u g . ) 1949.
p r o m o t io n .
9. H e in , J . W . , a n d Sh a fe r, W . G . C h l o r o p h y M a s a p o t e n t ia l c a r ie s - p r e v e n t iv e a g e n t . P e n n s y lv a n ia D . J . 16:221 ( J u n e ) 1949. 10. B a ile y , H . H o w t o k e e p fr o m g e t t i n g f a ls e teeth. B e tte r H o m e s a n d G a r d e n s 29:32 ( N o v . ) 1951.
KUTSCHER— CHILTO N . . . VO LUM E 46, APRIL 1953 • 421
T a b l e 1 • S a l i v a r y la c f o b a c il lu s c o u n t s
(in
th o u sa n d s)
o f 2 0 p a t ie n t s b e f o r e a n d a f t e r 6 - 9 m o n t h s o f u n c o n t r o l l e d t o o t h b r u s h in g w it h a c h l o r o p h y l l d e n t if r ic e
P a t ie n t
B e fo re
A fte r
b r u s h in g
3 -6 m o.
D iffe re n c e
P e r i o d (11
b r u s h in g
12-1]
P e r io d
12)
1
2 .2 0
0 .6 0
2
5 .0 0
1 1 5 .0 0
3
52 .50
4.0 0
-4 8 .5 0
4
5 7 .8 0
1 0 .1 0
-4 7 .7 0
5
7 .2 0
1 5 .0 0
6
2 1 .9 0
3 2 .5 0
+
-1 .6 0 +
11 0 .0 0
+ 7 .8 0 1 0 .6 0
7
7 6 .7 0
6 5 .0 0
-1 1 .7 0
8
1 5 .8 0
1 2 .6 0
-3 .2 0
9
1 5 .7 0
1 0 8 .5 0
10
8 .0 0
12 8 .0 0
11
4 5 .0 0
1 2 .5 0
-3 2 .5 0
12
2 4 .0 0
3 4 .5 0
+
13
4.5 0
7 3 .0 0
+ 6 8 .5 0
+ 9 2 .8 0 +
1 2 0 .0 0 1 0 .5 0
14
2 0 .6 0
2 .7 0
-1 7 .9 0
15
0 .0 0
2 .6 0
+ 2 .6 0
16
0.0 5
0 .0 0
-0 .0 5
17
0 .5 0
1.20
+ 0 .7 0
18
10 .30
0 .0 0
19
, 2 3 .0 0
5 7 9 .0 0
20
4 2 8.00
4 3 .5 0
A v e ra g e
4 0 .9 4
6 2 .0 1 5
-1 0 .3 0 +
5 5 6 .0 0
-3 8 4 .5 0 + 2 1 .0 7 5
eight months was distributed to each patient. All patients were asked to brush their teeth in their usual manner twice daily and to continue all other oral hab its, including diet, as before. During the next several months, routine dental treat ment was performed as needed. A second saliva specimen was obtained from all patients three to six months after the original sample had been taken. The time of day at which the first and second samples were taken was similar for each patient. The lactobacillus counts were performed according to the same technic in the same laboratory by workers who knew nothing of the experiment being performed. Study II. Effect of Uncontrolled Brush ing with a Chlorophyll Dentifrice on Chronic Gingivitis • One hundred and nine patients, aged 11 to 65 (53 males and 56 females), constituted the experi mental group. The patients had chronic gingivitis in varying degrees, with or
without periodontal involvement. These patients received routine dental treatment, which did not include thorough perio dontal treatment, and were given a large supply of a chlorophyll-containing den tifrice. One hundred and thirty-seven comparable patients, aged 9 to 63 (62 males and 75 females), who had gingi vitis with or without periodontal involve ment, constituted a control group; they received similar routine dental care but continued to use the dentifrice of their own personal choice. No particular toothbrushing instructions were given to either group beyond a request that the patients brush their teeth twice daily. All patients were examined clinically before and after a period of six to nine months. Color photographs of the anterior segments were taken at the time of the examina tion. The gingival condition of the pa tients was evaluated before and after the six to nine month period according to: (1) clinical appearance o f the gingivae; (2) gingival sensitivity incident to sub gingival curettement; (3) gingival
11. R a p p , G . W . , a n d O le n , A l b e r t A . T h e e ffe c t o f w a t e r s o lu b le c h lo r o p h y ll " A " m o u t h o d o r s . ( A b s t . ) J . D . Res. 26:633 ( D e c . ) 1949. 12. C o u n c il o n D e n ta l T h e r a p e u tic s . C o u n c i l r e p o r ts o n st a tu s o f c h lo r o p h y ll in d e n t is tr y . J . A . D . A . 38:369 {M a rc h ) 1949. 13. C h l o r e s iu m to o th p a ste : J . A . D . A . 43:645 ( N o v . ) (951.
p r e l im in a r y
re p o rt.
14. Ta m , J . C ., a n d C la r k , H . B., J r . U se o f c h lo r o p h y ll o in tm e n t in im p a c t e d t h ir d m o la r w o a n d * . J . O r a l S u r g . 9:239 ( J u ly ) 1951. 15. Sh a w , J . H . In e ffe c t iv e n e ss o f s o d iu m c h lo r o p h y llin in p r e v e n t io n o f e x p e r im e n t a l c a r ie s. N e w Y o r k D . J . 16:503 ( N o v , ) 1950.
copper d en tal
16. K u tsc h e r, A . H ., a n d Y i g d a ll , Ir e n e R. C o m p a t a b ilit y o f c h lo r o p h y l w ith a n t ib io t ic s . A p r e lim in a r y r e p o rt. N e w Y o r k D. J . 18:87 ( F e b . ) 1952. 17. G o l d b e r g , S. L. U s e o f w a t e r s o l u b le c h lo r o p h y ll in o r a l se p sis, e x p e r im e n t a l s t u d y o f 300 e a s e l. A m . J. S u r g . 62:117 ( O c t . ) 1943. 18. G riffith s, B a r b a r a , a n d R a p p , G . W . E ffe ct o f w a t e r s o l u b le c h lo r o p h y ll o n m o u t n o r g a n is m s . ( A b s t , ) J . D . R e s. 29:690 ( O c t . ) 1950. 19. S h a fe r , W i l l i a m G ., a n d H e in , J o h n W . F u rth e r s t u d ie s o n th e e ffe c t o f c h lo r o p h y ll o n e x p e r im e n t a l d e n t a l c a r ie s. ( A b s t . ) J . D . Res. 29:666 ( O c t . ) 1950. 20. R a p p , G . W . C h l o r o p h y ll : th e g r e e n w o n d e r d r u g . I ll in o is D . J . 18:405 ( O c t . ) 1949. 21. T h e d e n t if r ic e u s e d in th is s t u d y w a s s u p p li e d b y th e R y sta n C o m p a n y a n d is a v a i la b l e c o m m e r c ia l ly a s C h lo r e s iu m . 22. H a d le y , F a ith P. A q u a n t it a t iv e m e th o d f o r e st i m a t in g B a c illu s a c i d o p h i lu s in sa liv a . J . D . Res. 13:415 ( O c t . ) 1933.
422 • THE JO U R N A L OF TH EA M ER1CA N DENTAL A SSO C IA T IO N
hemorrhage incident to subgingival curettement (estimation based on ease of provocation, duration and quantity o f bleeding); and (4) the patient’s own sub jective evaluation of his gingival appear ance, gingival hemorrhage and gingival sensitivity.
Tab le 2 • E ffe c t o n g i n g iv i t i s o f u n c o n t r o l l e d t o o t h b r u s h in g w it h a c h l o r o p h y l l d e n t if r ic e C lin i
G in g i
Sub
val
cal
val
j e c t iv e
s e n si t iv ity
a p p e a r h e m o r ance
rh a g e
sy m p tom s
C h lo r o p h y ll d e n t if r ic e Im p r o v e m e n t 1
0
2
2
S l ig h t
11
9
22
27
N o change
92
98
74
69
5
2
11
11
109
109
109
109
D e f in it e
RESU LTS
G in g i
C o n d it io n
Study I * The lactobacillus counts o f the 20 patients studied appear in Table 1. There were 10 patients who had higher counts and 10 patients who had lower counts after three to six months’ brushing with a chlorophyll dentifrice. There was an average increase of 21.075 thousands in the count after the experimental pe riod. A comparison of these counts was made first by converting to the loga rithms of the counts and then by perform ing a t-test on the differences in individ ual counts. The average difference in the logarithms of the counts was not found to be significant.
w o rse T o ta l c a s e s D e n t if r ic e o f o w n c h o ic e Im p r o v e m e n t D e f in it e
2
1
2
0
S l ig h t
5
5
14
13
125
127
98
108
5
4
137
137
N o change C o n d it io n w o rse T o ta l c a se s
2313 7
16 137
have influenced their estimate of their gingival condition. SU M M A R Y
Study I I ' The findings in this study are listed in Table 2. It is apparent that no important differences in gingival appear ance or gingival sensitivity were observed between the two groups at the end of the experimental period. It was found that 10 per cent of those using the chlorophyll dentifrice showed an increase in gingival bleeding compared with 17 per cent in the group using a dentifrice of their own choice. A greater percentage of those using the chlorophyll dentifrice (22 per cent) evidenced a decrease in gingival bleeding than of those in the control group (12 per cent). While the differ ences are suggestive, they are not clearly significant. A significantly greater per centage of those patients who used the chlorophyll dentifrice felt that there was an improvement in their gingival condi tion. This latter effect, of course, might be due to the fact that these patients knew that they were using a “ medicated” dentifrice so that this knowledge might
1. The effect of uncontrolled toothbrushing with a chlorophyll-containing denti frice on the lactobacillus counts of 20 patients was studied before and after six to nine months’ usage of this dentifrice. N o effect on the lactobacillus counts was noted. 2. The effect of uncontrolled brushing with a chlorophyll-containing dentifrice on chronic gingivitis was studied. One hundred and nine patients used the ex perimental dentifrice, while 137 patients used a dentifrice of their own choice. At the end of six to nine months, no impor tant differences were observed between the two groups with regard to changes in gingival appearance or gingival sensi tivity incident to subgingival curettement. While there was some tendency towards decreased gingival bleeding in the chlor ophyll dentifrice group compared with the control group, the difference was not statistically significant.
Within the past few years, a number of preparations containing chlorophyll1 have been offered to the medical and dental professions and to the public. Although the importance o f this substance in plant physiology has long been recognized and although some reports o f its role in gen eral medicine,2' 5 surgery6’ 7 and dentistry 8*18 are available, final appraisal of its use in clinical dentistry has not yet been made. There are reports in the literature of the effect of chlorophyll on salivary lactobacillus counts.8,18’ 20 In the studies which have utilized dentifrices contain ing chlorophyll, the subjects brushed their teeth in a definite manner at specific times (controlled brushing). Since chlorophyll-containing dentifrices can be pur chased without prescription “ over the counter,” it is most likely that persons using such a dentifrice use it as they use other dentifrices rather than according to a controlled brushing technic. For this reason the effects o f “ uncontrolled” brushing o f the teeth with a chlorophyllcontaining dentifrice were studied.21 M ETH O D S AND M ATERIALS
Study 1. Effect of Uncontrolled Brushing with a Chlorophyll Dentifrice on Salivary Lactobacillus Counts • Twenty patients, aged 5 to 64 (5 males and 15 females), were selected for this study with no re gard for their previous dental history.
After a clinical and roentgenographic examination but prior to prophylaxis or treatment, a specimen o f stimulated saliva was obtained from each patient; the determination o f the lactobacillus count according to the Hadley technic22 was made by the caries-control labora tory of the School o f Dentistry, Univer sity o f Pennsylvania, by the routine method used there. The collection of all specimens was supervised by the same person. A supply o f a chlorophyll-con taining toothpaste sufficient to last for
T h is s t u d y w a s s u p p o r t e d ( in p a r t ) b y a g r a n t - in - a i d f r o m th e R y sta n C o m p a n y , M o u n t V e rn o n , N , Y . ♦ D iv is io n o f re se a rc h , Hannah and H a r r y P o sn e r R e se a r c h L a b o ra to ry , School o f t D e n ta l and O ra l S u r g e r y o f th e F a c u lty o f M e d ic in e , C o l u m b i a U n i v e rsity . 1.
W a t e r - s o lu b le
c h lo r o p h y ll
d e r iv a t iv e s .
2. G a h a n , E,; K lin e , P. R., a n d F în k le , T. H . C h l o r o p h y ll in t r e a t m e n t o f u lc e rs . A r c h . D e r m a t . & S y p h . 47:849 ( J u n e ) 1943. 3. B o w e rs, W . F. C h l o r o p h y ll in w o u n d h e a li n g a n d s u p p u r a t iv e d is e a s e . A m . J . S u r g . 73:37 ( J a n . ) 1947. 4. M o s s , N . H ., a n d o th e rs. E ffe c tiv e n e s s o f C h l o re s iu m in w o u n d h e a lin g a n d d e o d o r a n t e ffe c ts ; r e p o r t o f C o u n c i l o n P h a r m a c y a n d C h e m is t r y . J . A . M A 140: 1336 { A u g . 27) 1949. 5. L a n g le y , W . D., a n d M o r g a n , W . S . C h l o r o p h y ll in t r e a t m e n t o f d e r m a t o s e s ; r e p o r t o f 4 0 c a s e s . P e n n sy lv a n ia M . J . 51:44 ( O c t . ) 1947. 6. S m ith , L. W . , a n d L iv in g s t o n , A . E. W o u n d h e a l i n g ; e x p e r im e n t a l s t u d y o f w a t e r s o l u b le c h lo r o p h y ll d e r iv a t iv e s in c o n ju n c t io n w ith v a r i o u s a n t ib a c t e r ia l a g e n t s . A m . J . S u r g . 67:30 ( J a n . ) 1945. 7. S m ith , L. W . , a n d < L iv in g s t o n , A . E. C h j o r o p h y ll ; e x p e r im e n t a l s t u d y o f its w a t e r s o l u b le d e r i v a t iv e * in w o u n d h e a lin g . A m . J. S u r g . ¿ 2 :3 5 8 ( D e c . ) 1943. 8. A . D . A . C o u n c i l o p p o s e s n e w d e n t ifr ic e J . A . D . A . 39:224 ( A u g . ) 1949.
p r o m o t io n .
9. H e in , J . W . , a n d Sh a fe r, W . G . C h l o r o p h y M a s a p o t e n t ia l c a r ie s - p r e v e n t iv e a g e n t . P e n n s y lv a n ia D . J . 16:221 ( J u n e ) 1949. 10. B a ile y , H . H o w t o k e e p fr o m g e t t i n g f a ls e teeth. B e tte r H o m e s a n d G a r d e n s 29:32 ( N o v . ) 1951.
KUTSCHER— CHILTO N . . . VO LUM E 46, APRIL 1953 • 421
T a b l e 1 • S a l i v a r y la c f o b a c il lu s c o u n t s
(in
th o u sa n d s)
o f 2 0 p a t ie n t s b e f o r e a n d a f t e r 6 - 9 m o n t h s o f u n c o n t r o l l e d t o o t h b r u s h in g w it h a c h l o r o p h y l l d e n t if r ic e
P a t ie n t
B e fo re
A fte r
b r u s h in g
3 -6 m o.
D iffe re n c e
P e r i o d (11
b r u s h in g
12-1]
P e r io d
12)
1
2 .2 0
0 .6 0
2
5 .0 0
1 1 5 .0 0
3
52 .50
4.0 0
-4 8 .5 0
4
5 7 .8 0
1 0 .1 0
-4 7 .7 0
5
7 .2 0
1 5 .0 0
6
2 1 .9 0
3 2 .5 0
+
-1 .6 0 +
11 0 .0 0
+ 7 .8 0 1 0 .6 0
7
7 6 .7 0
6 5 .0 0
-1 1 .7 0
8
1 5 .8 0
1 2 .6 0
-3 .2 0
9
1 5 .7 0
1 0 8 .5 0
10
8 .0 0
12 8 .0 0
11
4 5 .0 0
1 2 .5 0
-3 2 .5 0
12
2 4 .0 0
3 4 .5 0
+
13
4.5 0
7 3 .0 0
+ 6 8 .5 0
+ 9 2 .8 0 +
1 2 0 .0 0 1 0 .5 0
14
2 0 .6 0
2 .7 0
-1 7 .9 0
15
0 .0 0
2 .6 0
+ 2 .6 0
16
0.0 5
0 .0 0
-0 .0 5
17
0 .5 0
1.20
+ 0 .7 0
18
10 .30
0 .0 0
19
, 2 3 .0 0
5 7 9 .0 0
20
4 2 8.00
4 3 .5 0
A v e ra g e
4 0 .9 4
6 2 .0 1 5
-1 0 .3 0 +
5 5 6 .0 0
-3 8 4 .5 0 + 2 1 .0 7 5
eight months was distributed to each patient. All patients were asked to brush their teeth in their usual manner twice daily and to continue all other oral hab its, including diet, as before. During the next several months, routine dental treat ment was performed as needed. A second saliva specimen was obtained from all patients three to six months after the original sample had been taken. The time of day at which the first and second samples were taken was similar for each patient. The lactobacillus counts were performed according to the same technic in the same laboratory by workers who knew nothing of the experiment being performed. Study II. Effect of Uncontrolled Brush ing with a Chlorophyll Dentifrice on Chronic Gingivitis • One hundred and nine patients, aged 11 to 65 (53 males and 56 females), constituted the experi mental group. The patients had chronic gingivitis in varying degrees, with or
without periodontal involvement. These patients received routine dental treatment, which did not include thorough perio dontal treatment, and were given a large supply of a chlorophyll-containing den tifrice. One hundred and thirty-seven comparable patients, aged 9 to 63 (62 males and 75 females), who had gingi vitis with or without periodontal involve ment, constituted a control group; they received similar routine dental care but continued to use the dentifrice of their own personal choice. No particular toothbrushing instructions were given to either group beyond a request that the patients brush their teeth twice daily. All patients were examined clinically before and after a period of six to nine months. Color photographs of the anterior segments were taken at the time of the examina tion. The gingival condition of the pa tients was evaluated before and after the six to nine month period according to: (1) clinical appearance o f the gingivae; (2) gingival sensitivity incident to sub gingival curettement; (3) gingival
11. R a p p , G . W . , a n d O le n , A l b e r t A . T h e e ffe c t o f w a t e r s o lu b le c h lo r o p h y ll " A " m o u t h o d o r s . ( A b s t . ) J . D . Res. 26:633 ( D e c . ) 1949. 12. C o u n c il o n D e n ta l T h e r a p e u tic s . C o u n c i l r e p o r ts o n st a tu s o f c h lo r o p h y ll in d e n t is tr y . J . A . D . A . 38:369 {M a rc h ) 1949. 13. C h l o r e s iu m to o th p a ste : J . A . D . A . 43:645 ( N o v . ) (951.
p r e l im in a r y
re p o rt.
14. Ta m , J . C ., a n d C la r k , H . B., J r . U se o f c h lo r o p h y ll o in tm e n t in im p a c t e d t h ir d m o la r w o a n d * . J . O r a l S u r g . 9:239 ( J u ly ) 1951. 15. Sh a w , J . H . In e ffe c t iv e n e ss o f s o d iu m c h lo r o p h y llin in p r e v e n t io n o f e x p e r im e n t a l c a r ie s. N e w Y o r k D . J . 16:503 ( N o v , ) 1950.
copper d en tal
16. K u tsc h e r, A . H ., a n d Y i g d a ll , Ir e n e R. C o m p a t a b ilit y o f c h lo r o p h y l w ith a n t ib io t ic s . A p r e lim in a r y r e p o rt. N e w Y o r k D. J . 18:87 ( F e b . ) 1952. 17. G o l d b e r g , S. L. U s e o f w a t e r s o l u b le c h lo r o p h y ll in o r a l se p sis, e x p e r im e n t a l s t u d y o f 300 e a s e l. A m . J. S u r g . 62:117 ( O c t . ) 1943. 18. G riffith s, B a r b a r a , a n d R a p p , G . W . E ffe ct o f w a t e r s o l u b le c h lo r o p h y ll o n m o u t n o r g a n is m s . ( A b s t , ) J . D . R e s. 29:690 ( O c t . ) 1950. 19. S h a fe r , W i l l i a m G ., a n d H e in , J o h n W . F u rth e r s t u d ie s o n th e e ffe c t o f c h lo r o p h y ll o n e x p e r im e n t a l d e n t a l c a r ie s. ( A b s t . ) J . D . Res. 29:666 ( O c t . ) 1950. 20. R a p p , G . W . C h l o r o p h y ll : th e g r e e n w o n d e r d r u g . I ll in o is D . J . 18:405 ( O c t . ) 1949. 21. T h e d e n t if r ic e u s e d in th is s t u d y w a s s u p p li e d b y th e R y sta n C o m p a n y a n d is a v a i la b l e c o m m e r c ia l ly a s C h lo r e s iu m . 22. H a d le y , F a ith P. A q u a n t it a t iv e m e th o d f o r e st i m a t in g B a c illu s a c i d o p h i lu s in sa liv a . J . D . Res. 13:415 ( O c t . ) 1933.
422 • THE JO U R N A L OF TH EA M ER1CA N DENTAL A SSO C IA T IO N
hemorrhage incident to subgingival curettement (estimation based on ease of provocation, duration and quantity o f bleeding); and (4) the patient’s own sub jective evaluation of his gingival appear ance, gingival hemorrhage and gingival sensitivity.
Tab le 2 • E ffe c t o n g i n g iv i t i s o f u n c o n t r o l l e d t o o t h b r u s h in g w it h a c h l o r o p h y l l d e n t if r ic e C lin i
G in g i
Sub
val
cal
val
j e c t iv e
s e n si t iv ity
a p p e a r h e m o r ance
rh a g e
sy m p tom s
C h lo r o p h y ll d e n t if r ic e Im p r o v e m e n t 1
0
2
2
S l ig h t
11
9
22
27
N o change
92
98
74
69
5
2
11
11
109
109
109
109
D e f in it e
RESU LTS
G in g i
C o n d it io n
Study I * The lactobacillus counts o f the 20 patients studied appear in Table 1. There were 10 patients who had higher counts and 10 patients who had lower counts after three to six months’ brushing with a chlorophyll dentifrice. There was an average increase of 21.075 thousands in the count after the experimental pe riod. A comparison of these counts was made first by converting to the loga rithms of the counts and then by perform ing a t-test on the differences in individ ual counts. The average difference in the logarithms of the counts was not found to be significant.
w o rse T o ta l c a s e s D e n t if r ic e o f o w n c h o ic e Im p r o v e m e n t D e f in it e
2
1
2
0
S l ig h t
5
5
14
13
125
127
98
108
5
4
137
137
N o change C o n d it io n w o rse T o ta l c a se s
2313 7
16 137
have influenced their estimate of their gingival condition. SU M M A R Y
Study I I ' The findings in this study are listed in Table 2. It is apparent that no important differences in gingival appear ance or gingival sensitivity were observed between the two groups at the end of the experimental period. It was found that 10 per cent of those using the chlorophyll dentifrice showed an increase in gingival bleeding compared with 17 per cent in the group using a dentifrice of their own choice. A greater percentage of those using the chlorophyll dentifrice (22 per cent) evidenced a decrease in gingival bleeding than of those in the control group (12 per cent). While the differ ences are suggestive, they are not clearly significant. A significantly greater per centage of those patients who used the chlorophyll dentifrice felt that there was an improvement in their gingival condi tion. This latter effect, of course, might be due to the fact that these patients knew that they were using a “ medicated” dentifrice so that this knowledge might
1. The effect of uncontrolled toothbrushing with a chlorophyll-containing denti frice on the lactobacillus counts of 20 patients was studied before and after six to nine months’ usage of this dentifrice. N o effect on the lactobacillus counts was noted. 2. The effect of uncontrolled brushing with a chlorophyll-containing dentifrice on chronic gingivitis was studied. One hundred and nine patients used the ex perimental dentifrice, while 137 patients used a dentifrice of their own choice. At the end of six to nine months, no impor tant differences were observed between the two groups with regard to changes in gingival appearance or gingival sensi tivity incident to subgingival curettement. While there was some tendency towards decreased gingival bleeding in the chlor ophyll dentifrice group compared with the control group, the difference was not statistically significant.