Stannous FLuoride
Place in Therapy
Stannous Fluoride toothpastes, currently marketed in Canada as Crest Pro-Health, have some evidence for reducing halitosis when used regularly with twice daily brushings. Although the evidence is from a few small trials, which do have methodological flaws and potential bias from manufacturer involvement in these trails, stannous containing toothpastes should be a second line option.
Stannous containing toothpastes shouldn’t be used as an initial treatment but are recommended as an option if triclosan is ineffective because of the stronger evidence for triclosan. Stannous Fluoride is a reasonable second line option because of its safety profile and easy compliance/low cost. Although the evidence for benefit may be weak, very few adverse events have been reported, with teeth staining being the main concern. Crest Pro-Health is formulated with a specific whitener, sodium hexametaphosphate, that has been shown to reduce teeth staining and further whiten teeth. Secondly, the cost of stannous toothpastes is very low, at only 4.99 for a 130 mL tube. Thirdly, compliance with a toothpaste may be better when compared to other products such as a mouthwash. Crest Pro-Health is easily accessible and toothpaste should be included in the oral health regimen with mechanical removal of bacteria through brushing, which is the mainstay of halitosis therapy.
References
1. Feng XP, Chen X, Cheng R, Sun L, Zhang Y, Toa H. Breath malodor reduction with use of a stannous-containing sodium fluoride dentifrice: A meta-analysis of four randomized and controlled clinical trials. American Journal of Denistry 2010;23:27-31
2. Natural Standard. Tin (Sn): Natural Standard Professional Monograph. Accessed from http://www.naturalstandard.com.proxy.lib.uwaterloo.ca/databases/ herbssupplements/tin.asp? Date Accessed July 7 2013.
3. Ford S, Bowman L, Fielder S, Le Crone J, Ramsey L, Winston JL. Comparison of short-term breath efficacy of stannous fluoride and ticlosan/copolymer dentifrice. Journal of Dental Research 2007;86(Sp Is):Abstract 2042.
4. Baig A, He T, Buisson J, Sagel L, Suszcynsky-Meister E, White D. Extrinsic whitening effects of sodium hexametaphosphate—a review including a dentifrice with stabilized stannous fluoride. Compend Cont Educ Dent. 2005;26(suppl 1):47-53
Stannous containing toothpastes shouldn’t be used as an initial treatment but are recommended as an option if triclosan is ineffective because of the stronger evidence for triclosan. Stannous Fluoride is a reasonable second line option because of its safety profile and easy compliance/low cost. Although the evidence for benefit may be weak, very few adverse events have been reported, with teeth staining being the main concern. Crest Pro-Health is formulated with a specific whitener, sodium hexametaphosphate, that has been shown to reduce teeth staining and further whiten teeth. Secondly, the cost of stannous toothpastes is very low, at only 4.99 for a 130 mL tube. Thirdly, compliance with a toothpaste may be better when compared to other products such as a mouthwash. Crest Pro-Health is easily accessible and toothpaste should be included in the oral health regimen with mechanical removal of bacteria through brushing, which is the mainstay of halitosis therapy.
References
1. Feng XP, Chen X, Cheng R, Sun L, Zhang Y, Toa H. Breath malodor reduction with use of a stannous-containing sodium fluoride dentifrice: A meta-analysis of four randomized and controlled clinical trials. American Journal of Denistry 2010;23:27-31
2. Natural Standard. Tin (Sn): Natural Standard Professional Monograph. Accessed from http://www.naturalstandard.com.proxy.lib.uwaterloo.ca/databases/ herbssupplements/tin.asp? Date Accessed July 7 2013.
3. Ford S, Bowman L, Fielder S, Le Crone J, Ramsey L, Winston JL. Comparison of short-term breath efficacy of stannous fluoride and ticlosan/copolymer dentifrice. Journal of Dental Research 2007;86(Sp Is):Abstract 2042.
4. Baig A, He T, Buisson J, Sagel L, Suszcynsky-Meister E, White D. Extrinsic whitening effects of sodium hexametaphosphate—a review including a dentifrice with stabilized stannous fluoride. Compend Cont Educ Dent. 2005;26(suppl 1):47-53