Toothpastes have developed from the poorly effective formulations using incompatible abrasive systems to the highly effective products now being given credit for the decline in
dental caries in most developed countries. The earliest
toothpastes used
sodium fluoride but this was soon replaced by
stannous fluoride,
sodium monofluorophosphate and
amine fluoride.
Monofluorophosphate has the advantage that it is compatible with a wide variety of abrasive systems. Although most
toothpastes world-wide currently contain
monofluorophosphate,
sodium fluoride formulations are growing in availability because of the development of compatible abrasives. Clinical caries trials have indicated that, with proper formulation, there is little or no difference in effectiveness among
toothpastes prepared with different
fluoride agents, but that increasing the
fluoride concentration will enhance the anti-caries effect. The addition of other active agents to
fluoride toothpaste has been a relatively recent occurrence, and it is important to be assured that they do not interfere with the anti-caries activity of
fluoride.
Pyrophosphate, a
calculus control agent, is one additive that was considered to be a potential problem; however, human and animal tests have shown that both caries and
calculus inhibiting effects can be obtained from a single formulation. With the use of modern methodology to evaluate
toothpaste formulations before clinical trials, many new products containing anti-
calculus and other agents will probably become available in the coming years.