Clinpro 5000 - Tried and True Product October 2010
Clinpro 5000
This unique prescription fl uoride paste can slow or eliminate the progression of caries.
The concept of caries as a disease, and one that can be healed through remineralization, has been around for decades although it has gained greater attention within the past 5 years.1,2 With the introduction of casein-based pastes, treating caries medically has become increasingly accepted, although it is still a topic of intense scrutiny and a focus of current research.3,4
It has been well documented that fl uoride can interrupt the demineralization process in the presence of low pH. As saliva production increases, its natural components raise oral pH to 5.5 or higher, which aids the remineralization process resulting from the deposit of calcium and phosphate.4-7
Given the positive historical impact of topical fl uoride on the incidence of caries, as well as the natural and complex process of remineralization, the researchers at 3M ESPE, working with leading scientists, developed Clinpro 5000, a 1.1% sodium fl uoride anticavity toothpaste coupled with a proprietary formulation of tri-calcium phosphate (TCP). This prescription-strength dentifrice works to optimize the remineralization process, which has been shown to slow and even reverse the progression of pre-carious white lesions.2,8
Progressing Science
To document the therapeutic effects of Clinpro 5000, 3M ESPE initially conducted a pH cycling experiment in which prepared bovine incisors were exposed to an acidic solution. The test specimens were then subjected to 20 days of pH cycling with daily, multiple soakings of demineralizing solution followed by artifi cial saliva and toothpaste/fl uoride preparation treatments. Results showed that Clinpro 5000 was more effective than comparable toothpastes/fl uoride-containing preparations with regard to fl uoride uptake and remineralization. Ongoing research continues to support these results.
Patient Compliance
Topical creams with fl uoride and casein-based derivatives seek to optimize the pH of the oral environment and enhance the natural remineralization process. Many of them achieve this through application after brushing and provide benefi ts through longer exposure time. As a result of the extra steps and added dwell time, patient compliance becomes an issue. Clinpro 5000 offers the solution to patient compliance by incorporating the therapeutic fluoride/TCP formulation into a once-daily dentifrice. The prescription- strength fluoride concentration’s of Clinpro 5000 also provides increased fluoride effi cacy when compared with lower fl uoride concentration and overthe- counter dentifrices.10,11 Patients simply replace one of their daily brushings with Clinpro 5000 to obtain the benefits of this formulation.
Clinpro 5000, in the form of a vanilla- mint–flavored toothpaste (and spearmint in October 2010), takes advantage of the brushing process by balancing abrasivity for cleaning and removal of plaque with improved bioavailability of fl uoride, calcium, and phosphate in a single-step process for the patient. The natural process of dental remineralization is facilitated by brushing as enamel is cleaned and made more readily accessible to the benefi ts of saliva exposure. Brushing with the proper dentifrice also can optimize oral pH to greater than 5.5, reducing acids and further facilitating the remineralization process.2
Solving a Problem
The formulation of this unique dentifrice was carefully constructed because dental remineralization is delicate and depends on the complex relationship between oral pH, saliva production, plaque/biofi lm removal, the presence of calcium and phosphate, and the availability of fl uoride. Generating a stable and therapeutic dentifrice capable of preserving the integrity of calcium for both effective and optimal delivery to compromised enamel was a problem that Clinpro 5000 solved.
The manufacturing of Clinpro 5000 results in a protective barrier around the calcium, preserving it in the presence of fl uoride ions. During brushing, the barrier is intended to break down, releasing the calcium and allowing it to interact with both fl uoride and phosphate at the right time, in the optimal pH with both cleansed enamel and naturally therapeutic saliva. The conditions for remineralization created by brushing with Clinpro 5000 paired with improved patient compliance through simple replacement in an established patient routine, leverage what has already been studied: Brushing cleans teeth by removing plaque and reducing plaque-causing bacteria, fl uoride protects teeth by reducing the effects of demineralization caused by acidic foods and sugars, and calcium and phosphate are the agents of tooth remineralization.2-9,12,13
Early Intervention = Tooth Preservation
The current trend toward minimally invasive dentistry, which seeks to preserve rather than remove tooth structure, is being supported through products that promote healing dental tissue through the remineralization process. By providing a mode of treatment that can be tolerated and effectively and routinely used by patients, Clinpro 5000 offers dentists the option for early intervention of caries and the potential to preserve natural tooth structure. —Monica Roy
References
1. Featherstone JD. Remineralization, the natural caries repair process—the need for new approaches. Adv Dent Res. 2009;21(1):4-7.
2. Cury JA, Tenuta LM. Enamel remineralization: controlling the caries disease or treating early caries lesions? Braz Oral Res. 2009;(Suppl 1):23-30.
3. Pitts NB, Wefel JS. Remineralization/desensitization: what is known? What is the future? Adv Dent Res. 2009;21(1):83-86.
4. Zero DT. Dentifrices, mouthwashes, and remineralization/ caries arrestment strategies. BMC Oral Health. 2006;15(Suppl 1):S9.
5. Featherstone JD. Dental caries: a dynamic disease process. Aust Dent J. 2008;53(3):286-291.
6. Tanimoto K, Le T, Zhu L, et al. Effects of fl uoride on the interactions between amelogenin and apatite crystals. J Dent Res. 2008;87(1):39-44.
7. Featherstone JD. Prevention and reversal of dental caries: role of low level fl uoride. Community Dent Oral Epidemiol. 1999;27(1):31-40.
8. Wilding RJ, Solomon CS. Arrested caries: a review of the repair potential of the pulp-dentine. J Dent Assoc S Afr. 1996;51(12):828-833.
9. Fontana M, Zero DT. Assessing patients’ caries risk. J Am Dent Assoc. 2006;137(9):1231-1239.
10. Biesbrock AR, Bartizek RD, Gerlach RW, et al. Effect of three concentrations of sodium fl uoride dentifrices on clinical caries. Am J Dent. 2003;16(2):99- 104.
11. Biesbrock AR, Gerlach RW, Bollmer BW, et al. Relative anti-caries effi cacy of 1100, 1700, 2200, and 2800 ppm fl uoride ion in a sodium fl uoride dentifrice over 1 year. Community Dent Oral Epidemiol. 2001;29(5):382-389.
12. Aspiras M, Stoodley P, Nistico L, et al. Clinical implications of power toothbrushing on fl uoride delivery: effects on biofi lm plaque metabolism and physiology. Int J Dent. 2010;2010:651869. Epub 2010 Apr 15.
13. Terézhalmy GT, Biesbrock AR, Walters PA, et al. Clinical evaluation of brushing time and plaque removal potential of two manual toothbrushes. Int J Dent Hyg. 2008;6(4):321-327.
