Oral care-bleeding gums,sensitivity,plaque,halitosis

1. DELHI PHARMACEUTICAL SCIENTIFIC
RESEARCH UNIVERSITY
ORAL CARE
PRESENTED BY :- PRESENTED TO :-
KUMARI SUPRIYA Dr . MADHU GUPTA

2. CONTENT
 Bleeding gums
1. Causes
2. Ways to stop bleeding gums
 Sensitive teeth
1. Causes
2. What to do for relief
 Plaque
1. Causes
 Halitosis
1. Causes

3. CONTENT contd.
 Role of antimicrobial agents
 Role of antioxidants
 Role of astringents
 Denture cleansers
 Building blocks and formulation of anticavity toothpaste
 Building blocks and formulation of sensitivity relief toothpaste
 Building blocks and formulation of whitening toothpaste
 Case study of marketed products

4. BLEEDING GUMS
• Gum bleeding is a common problem. However, whenever you
see blood on the bristles of your toothbrush or in the sink while
cleaning the teeth, you must take immediate action.
• According to the President of the Canadian Dental Association
from Manitoba, Dr. Peter Doig, eating coarse food can cause
scratches on your gums leading to bleeding gums.

5. BLEEDING GUMS
• The Orange County Dental Clinic can help in the prevention,
diagnosis and treatment of oral problems.
• When the plaque builds up on the gum line it can lead to
bleeding gums. When left untreated it can lead to inflamed
gums known as gingivitis.
• Plaque not removed hardens into tartar and leads to profuse
bleeding. It can cause advanced jawbone and gum disease
known as periodontitis.

6. CAUSES OF BLEEDING GUMS
• Bleeding Disorder
• Brushing hard
• Ill-fitting dentures/dental appliances
• Improper flossing
• Leukemia
• Gum or tooth-related infection
• Scurvy
• Deficiency of vitamin K

7. Effective Ways to Stop Bleeding
Gums
• Brush your teeth :- Brush your teeth 2-3times a day. But still
we would like to reiterate the fact since most of us
underestimate the power of incorporating this simple habit into
our health regimen.

8. Effective Ways to Stop Bleeding
Gums contd.
• Use mouthwash :- Mouthwash can be quite a challenge to
most of us since it leaves a stinging feeling after. However
using mouthwash will not only kill off bacteria, it would also
freshen your breath. A tip when buying mouthwash, choose
the one with less alcohol.

9. Effective Ways to Stop Bleeding
Gums contd.
• Floss everyday :- The plaque between the teeth and gum line
builds up overtime. Flossing after you brush will get rid of the
plaque that you missed after you brush.

10. Effective Ways to Stop Bleeding
Gums contd.
• Follow a healthy diet :- Your diet doesn’t have direct impact on
the bleeding of your gums. But eating raw and with high-fiber
fruits has a say on your overall oral health.

11. Effective Ways to Stop Bleeding
Gums contd.
• Ask your dentist :- If you’ve been following the steps above but
still dealing with bleeding gums, the best ways is to visit your
dentist. Apart from dental cleaning 2 times a year, there may be
other cause for your gum problems that he/she would only
know.

12. SENSITIVE TEETH
• Tooth sensitivity is a frequent annoyance in dental patients.
• This pathology occurs when the external layer of the tooth
enamel wears out or when the gums contract, leaving the tooth
root exposed.
• Sensitivity can affect one or more teeth. The main symptom of
this discomfort is similar to a chill in the tooth with acute and
severe pain.
• Dental sensitivity occurs when eating or drinking hot, cold or
acid drinks. In cases of extreme sensitivity, it can present only
by breathing cold air.

13. CAUSES OF SENSITIVE TEETH
• Cavities cause tooth enamel wear.
• Dental brushes with hard bristles produce tooth enamel. So does
aggressive brushing.
• Bruxism: an involuntary habit of clenching or grinding the teeth.
This syndrome also wears out tooth enamel and causes headaches.
• Old and damaged amalgams leave dentin exposed.

14. CAUSES OF SENSITIVE TEETH contd.
• Excessive acidic drinks cause tooth sensitivity as they erode
tooth enamel.
• The contraction of gums causes tooth root exposure.

15. WHAT TO DO IF YOU HAVE TOOTH
SENSITIVITY
• Eliminate acidic products in the diet.
• Use toothbrushes with soft bristles.
• Avoid the use of abrasive toothpaste.
• Use toothpaste for sensitivity.

16. PLAQUE
• Our teeth are covered with a sticky, colourless film of bacteria
known as plaque.
• A plaque which is not removed daily with the help of brushing
and flossing between the teeth can harden into tartar.
• Tartar is also known as dental calculus, which is a brown or
yellow coloured deposit that gets developed when plaque
hardens on the teeth.

17. CAUSES OF PLAQUE
• Plaque takes place when foods containing carbohydrates like soft
drinks, cakes, milk, raisins or candy are frequently left on the
teeth.
• Plaque hides under the gum line and between the teeth. That is
why it is advised to take care of your teeth and mouth by
maintaining good oral health.
• When food, saliva, and fluids combine together in the mouth, they
create an environment which allows the bacteria to develop and
deposit that collect on gums and teeth, especially where both of
them meet.

18. HALITOSIS
• The medical term for bad breath is halitosis, fetor oris,ozostomia,
or stomatodysodia.
• Halitosis is common among humans around the world and is
usually caused by an accumulation of bacteria in the mouth as a
result of gum disease, food, or plaque.

19. CAUSES OF HALITOSIS
• Poor dental hygiene
• Rotten eggs usually give out hydrogen sulfide.
• Poor denture hygiene.
• Dry mouth - The mouth is dry dead cells can build up on the
tongue, gums and the insides of our cheeks. These cells then
start to rot and give off an unpleasant smell.
• Morning bad breath.
• Tonsil stones.
• Infection in the mouth.

20. ANTIMICROBIAL AGENTS
• An antimicrobial is defined as a natural or synthetic substances
that kills microorganisms or stop their growth example
bacteria, fungi and algae.

21. ROLE OF ANTIMICROBIAL AGENTS IN ORAL
CARE
• Mostly antibacterial agents are used in control of plaque-related
diseases , particularly chronic gingivitis.
• Effective compounds show persistence action for many hours ,
notably chlorhexidine.
• Chemical plaque control agents are of limited therapeutic value
and are more valuable in preventive mode.
• Many antimicrobial agents are used as root canal disinfectant ,
root canal cleansers (MTAD-Mixture od Tetracycline ,Acid,
Detergent).

22. ROLE OF ANTIMICROBIAL AGENTS IN ORAL
CARE contd.
• Antimicrobial agents used :- 1. Chlorhexidine
2. Cetylpyridinium chloride
3. Hydrogen peroxide
4. Triclosan (dentifrices )
5. Sodium hypochlorite
(bleaching agents)
6.Iodine potassium iodide

23. ANTIOXIDANTS
• Antioxidants inhibit the “rusting” of cells in our body.
• Just as metals rust due to exposure to oxygen, cells in the body
also become damaged by exposure to certain “Reactive
Oxygen Species” (ROS).
• These damaging agents are caused by toxins present in the
environment, smoking, bad eating habits, poor metabolism,
lack of exercise and other factors.
• Free radicals are also responsible for damaging tooth.

24. ROLE OF ANTIOXIDANTS IN ORAL CARE
• Dental Caries :- Antioxidants prevent from dental caries.
• Studies proposes that antioxidant ‘catechin’ in tea can destroy
microscopic organisms that cause throat infection.
• Saliva is rich with antioxidants like uric acid , albumin , ascorbic
acid , glutathione ability to neutralize free radicals.
• In cancer antioxidants prevent by inhibiting oral carcinogenesis
by reversing premalignant lesions like leukoplakia.
• Other antioxidants :- Vit. C , Vit. E , Beta Carotene , Carotenoids ,
Lycopene.

25. ASTRINGENTS
• Astringent are also used to improve blood circulation and
tighten the skin besides improving the pH level of the skin.
• Astringents due to its remarkable shrinking and water
absorption qualities are majorly used in skin care as toners to
remove excess oil and makeup from the skin.
• One of the popular tannin, Oak Bark, is used to prepare
commercial astringents for cosmetic and medical use.

26. ROLE OF ASTRINGENTS IN ORAL CARE
• Astringents are widely used in medicines especially in dental
care to cleanse, tighten the gums and detoxify them and remove
plaque from teeth.
• Dentist can also apply astringents to gingival tissues before
taking impressions, placing Class V or root surface restorations.
• Astringents used in oral care :- Aluminum chloride , Ferric sub
sulfate , Ferric sulfate , Zinc chloride , Tannic acid.

27. DENTURE CLEANSERS
• Denture cleansers are used to clean dentures when they are out of
mouth.
• The main use is to control the growth of microorganisms on the
dentures , especially Candida albicans , thereby preventing
denture-related stomatitis.
• When dentures are worn in the mouth, a biofilm develops which
may be similar to dental plaque.

28. BUILDING BLOCKS OF ANTICAVITY
TOOTHPASTE
• Abrasives :- Used to remove food debris and residual stains of the
teeth and to polish tooth surface. Ex. – calcium carbonate , dibasic
calcium phosphate , insoluble sodium metaphosphate.
• Detergents & other foaming materials :- For cleaning action ,
promote penetration of paste and helps in removal of deposits &
debris. Ex. - sodium lauryl sulphate , magnesium lauryl sulphate ,
monoglycerides.
• Humectants :- Used to prevent drying out , impart some plasticity
to toothpaste. Ex. – glycerine , propylene glycol , sorbitol solution.

29. BUILDING BLOCKS OF ANTICAVITY
TOOTHPASTE
• Binding agents :- Solid and liquid phases of toothpaste tends to
separate in absence of binding agents during storage. Ex. – gum
arabic , gum tragacanth , carboxy methylcellulose , starch esters.
• Sweetening and flavouring agents :- Used for acceptance of
product. Ex. – saccharin sodium , chloroform , spearmint.
• Minor ingredients :- Titanium dioxide
pH regulators
Carragheen
Cellulose ethers

30. FORMULATION OF ANTICAVITY TOOTHPASTE
• Sorbitol 54.1%w/w
• Silica 18%w/w
• Xylitol 10%w/w
• Silica(Thickener) 5.5%w/w
• Polyethylene glycol 600 3%w/w
• SLS 1.2%w/w
• Flavour 0.9%w/w
• Tetrasodium pyrophosphate 0.5%w/w
• Titanium dioxide 0.5%w/w
• Sodium benzoate 0.5%w/w

31. FORMULATION OF ANTICAVITY TOOTHPASTE
• Carboxymethyl cellulose 0.35%w/w
• Sodium fluoride 0.243%w/w
• Sodium saccharin 0.2%w/w
• Colour water 100%w/w

32. BUILDING BLOCKS OF SENSITIVITY RELIEF
TOOTHPASTE
• Potassium nitrate :- The potassium ion hyperpolarizes the nerve
and stops it from firing. The nerve impulses are thus desensitized
and there is no pain.
• Strontium acetate & Chloride :- Strontium based toothpastes
(acetate/chloride) are able to replace some of the lost calcium and
block the exposed tubules in the dentinal tissue.

33. FORMULATION OF SENSITIVITY RELIEF
TOOTHPASTE
• Potassium nitrate 10%w/w
• Glycerine 25%w/w
• Polyoxyethylene
monolaurate 2%w/w
• Silica 24%w/w
• Flavour 1%w/w
• Sodium saccharin 0.25w/w
• Water 100%w/w

34. BUILDING BLOCKS OF WHITENING
TOOTHPASTE
• Hydrogen peroxide :- Used as whitening agent. Ex. – carbamide
peroxide .
• Abrasive :- Used to remove food debris and residual stains of the
teeth and to polish tooth surface. Ex. - calcium carbonate .

35. FORMULATION OF WHITENING TOOTHPASTE
• Glycerine 25%w/w
• Silica abrasive 20%w/w
• Propylene glycol 17.6%w/w
• Sodium bicarbonate 12%w/w
• Water 6%w/w
• Propylene glycol 3%w/w
• Sodium carbonate 2%w/w
• Sodium thickener 2%w/w
• SLS 1.7%w/w

36. CASE STUDY OF MARKETED PRODUCTS
1. COLGATE ANTICAVITY TOOTHPASTE - INGREDIENTS
Sodium fluoride - Anticavity
Triclosan - Antigingivitis
Silica
Propylene glycol
SLS
Chamomile extract
Tea tree oil

37. CASE STUDY OF MARKETED PRODUCTS
contd.
• CLAIM –
It only have cosmetic licence but claims for curing cavity
as medical toothpaste
It claims for anticavity property because of sodium fluoride
but does not show any action according to its property.
And also claims for antigingivitis property because of
triclosan but not cure gingivitis.

38. CASE STUDY OF MARKETED PRODUCTS contd.
• SENSODYNE – INGREDIENTS
Strontium chloride - Sensitivity
Potassium nitrate - Antihypersensitivity
Stannous fluoride - For repairing

39. CASE STUDY OF MARKETED PRODUCTS contd.
• CLAIM –
Sensodyne toothpaste claims their products "helps relieve the
pain of sensitive teeth", using the active ingredients of (either)
Strontium Chloride or Potassium Nitrate.
But does not give relief in sensitivity.
It only have cosmetic licence but claims for curing hypersensitivity
as medical toothpaste.

40. CASE STUDY OF MARKETED PRODUCTS contd.
• PEPSODENT WHITENING TOOTHPASTE –
INGREDIENTS
Hydrogen peroxide - Whitening action
Calcium carbonate
SLS
Potassium nitrate
Silica
Sodium saccharin

41. CASE STUDY OF MARKETED PRODUCTS contd.
• CLAIM –
It claims for whitening action on tooth but does not show
any effect.