Abstract
Aim: The primary objective of this work was to assess total soluble fluoride (TSF), pH values, and titratable acidity (TA) of various mouthwashes “in vitro,” and the second was to compare fluoride content on labels with measured TSF. Methods: Commercial mouthwashes were collected and analysed. Company, type, manufacturer data, and active ingredients (essential oils [EO], cetylpyridinium chloride [CPC], chlorhexidine [CHX], and fluoride) were described. TSF, pH, and TA capacity were measured. Descriptive quantitative analysis were performed per mouthwash. Results: In total, 54 mouthwashes from 20 brands were included. These included mouthwashes with the active ingredients EO (n = 11), CPC (n = 17), CHX (n = 18), and fluoride (n = 32); 27 mouthwashes with more than 1 of these active ingredients; and 4 with none of the above-mentioned ingredients. Fluoride was present in different formulations; most contained sodium fluoride (NaF), and a few had sodium monofluorophosphate and amine fluoride + NaF. The pH values of all evaluated mouthwashes ranged from 4.1 to 7.9. Twenty mouthwashes presented pHs below 5.5, of which 10 contained fluoride. TA ranged from 0 to 48. According to the manufacturer data, mouthwashes with fluoride had concentrations from 217 to 450 ppm, with 90% in the range from 217 to 254 ppm. Laboratory data revealed that TSF ranged from 229 to 500 ppm, with 90% in the range from 229 to 337 ppm. A statistically significant difference was observed between measured TSF and the labelled fluoride content on the packaging of the fluoride mouthwashes (mean difference, 43.92 ± 34.34; P < .001). Most of these mouthwashes contained at least the amount of fluoride as mentioned on the packaging (93%). Conclusion: The pH values and TA of commercially available mouthwashes showed a large variation. TSF levels of the fluoride mouthwashes were found to be at least the amount of fluoride as labelled. Dental care professionals should be aware of the pH, TA, fluoride content, and other active ingredients of different mouthwashes to better understand their potential impact on oral health.
| Original language | English |
|---|---|
| Pages (from-to) | 260-267 |
| Number of pages | 8 |
| Journal | International Dental Journal |
| Volume | 74 |
| Issue number | 2 |
| Early online date | 13 Oct 2023 |
| DOIs | |
| Publication status | Published - Apr 2024 |
Bibliographical note
Publisher Copyright:© 2023 The Authors
Funding
The authors acknowledge Blue®m, Colgate-Palmolive (in particular Christien Timmer), Curaden, Dentaid (specifically Pauline Heins), Farmadent, GSK, Mylan Healthcare B.V. (a Viatris company), and Sunstar Benelux B.V. (in particular Martijn Verhulst) for providing study products and or their expertise on the measurements performed. The authors would like to thank Lotte Heltzel and Tabasam Habibi for their initial contribution to the study, as they prepared a thesis on the same topic in accordance with the obligation to fulfil the requirements of the HAN bachelor's program in dental hygiene. In addition, David Alexander is appreciated for his contribution to the English revision. Finally, the authors gratefully acknowledge the International Federation of Dental Hygienists (IFDH) for awarding a 2021 IFDH Research Grant to the first author for covering in part the material costs, in particular for the fluoride electrode used in the present study. BVS contributed to conception and design, execution of the experiment, and analysis and interpretation and drafted and critically revised the manuscript. DES contributed to conception and design, and analysis and interpretation and critically revised the manuscript. GAW contributed to analysis and interpretation and critically revised the manuscript. MFT contributed to analysis and interpretation and critically revised the manuscript. JR contributed to conception and design, execution of the experiment, and analysis and interpretation and critically revised the manuscript. All authors gave final approval and agreed to be accountable for all aspects of work ensuring integrity and accuracy. This research received no specific grant from any funding agency in the public, commercial, or not-for-profit sectors. For this study, no funding was accepted, except for support from the regular appointment listed institutions. This research was supported by the Dutch Research Council (NWO) under project number: 023.017.105. Material costs were covered by the International Federation of Dental Hygienists (IFDH) by awarding the 2021 IFDH Research Grant to the first author. The authors acknowledge Blue®m, Colgate-Palmolive (in particular Christien Timmer), Curaden, Dentaid (specifically Pauline Heins), Farmadent, GSK, Mylan Healthcare B.V. (a Viatris company), and Sunstar Benelux B.V. (in particular Martijn Verhulst) for providing study products and or their expertise on the measurements performed. The authors would like to thank Lotte Heltzel and Tabasam Habibi for their initial contribution to the study, as they prepared a thesis on the same topic in accordance with the obligation to fulfil the requirements of the HAN bachelor's program in dental hygiene. In addition, David Alexander is appreciated for his contribution to the English revision. Finally, the authors gratefully acknowledge the International Federation of Dental Hygienists (IFDH) for awarding a 2021 IFDH Research Grant to the first author for covering in part the material costs, in particular for the fluoride electrode used in the present study.
| Funders | Funder number |
|---|---|
| Lotte Heltzel and Tabasam Habibi | |
| Mylan Healthcare B.V. | |
| Sunstar Benelux B.V. | |
| GlaxoSmithKline | |
| Nederlandse Organisatie voor Wetenschappelijk Onderzoek | 023.017.105 |
Keywords
- Fluoride
- Laboratory
- Mouthwash
- Oral rinse
- pH
- Titratable acidity