Friday, October 26, 2012

Oral Care Products as Recommended by a Dental Hygienist

Image found here.

As promised, here's a list of oral care products as recommended by JoAnn JoAnn Snider,  RDH, BSDH.

Thank you for this extensive list, Ms. Snider!

Product suggestions with key ingredients, manufacturer and contact info, and in some cases, where to buy for the best pricing.  

Some of the products have money-saving coupons available at their website so be sure and check first.  Online sources also may have special deals so check around:; are two such suppliers.  I have no financial interest in any site or product in this guide, although Oasis rinse (at the item a GSK product) and Diiachi have provided support for speaking at a prior dental hygiene conference and my trip to Philadelphia last year to be interviewed on camera for Evoxac.

Note:  Some mint flavors are quite strong and may be unsuitable for patients with a super dry mouth.  These are indicated by the M++ for strong mint, M+ for medium, and M for mild.

Bad breath:
Transient relief:
Sugar-free gum or candies (avoid Mannitol if at all possible) –Mint varies by product
Listerine breath strips or spray (M++ Mint or cinnamon)
Specialty products made for bad breath management:
Breath-Rx {M+} – Gum, toothpaste, or rinse; []
Clo-SYS {M} –Toothpaste;  Rinse  (add flavor or not; it’s your choice); Spray; Gum {M+}
Buffering Agents--OTC’s:
MI Paste (available through dental suppliers or online) – Use every 3-4 hours as directed.
                Assorted mild fruit, vanilla or very mild mint.  []
MI Paste Plus:  minerals and fluoride; use twice a day;   Assorted mild fruit, vanilla or very mild mint.
Nuvora Salese:  Xylitol, pH buffering; Peppermint M+++, Spearmint M+, and Lemon
[ or 1-877-530-9811]
*Special pricing for orders through a dental office
Sodium bicarbonate rinses: 

Buffering Agents by Prescription:
CariFree Rinse {M+}:  Xylitol, Sodium Fluoride, pH buffered with baking soda []
Numoisyn (see Dry Mouth Lozenges by Prescription only)
NeutraSal :  Buffers acids for normal pH with calcium phosphate; promotes remineralization;
Note: Each prescription comes with a Sjögren’s  support kit with Omega-3 supplement for dry mouth and dry eyes, and Xylitol gum.
                 [ or 1-866-963-8881]

Dry Mouth Gels:  OTC’s
MedActive Oral relief gel:  Spilanthes Extract, Xylitol;
Oral Balance:  minerals, enzyme complex;  []; coupons:  []
Oragel:  glycerine, sucralose, sorbitol, proprietary antioxidants; unflavored []

Dry Mouth lozenges: OTC’s
MedActive Oral Relief Lozenge: Xylitol, fruit flavors [ or 1-866-887-4867]
OraMoist:  Xylitol, enzymes and mild citrus flavor [ or 1-800-448-1448]
Salese from Nuvora; Mild lemon or Wintergreen [ or 1-877-530-9811]
*Special pricing for orders through a dental office
Thayer’s Dry Mouth lozenges:  Slippery Elm, Apple pectin, lemon flavor, Sorbitol []
Thayer’s Slippery Elm lozenges:  Cherry, Tangerine, and unflavored []
Theramints:  compressed Xylitol, Mint or Fruit[3M ESPE;] available through dental suppliers at a discount or online]

Dry Mouth lozenges: Prescription only
Numoisyn:  Tablets contain sorbitol and malic acid to stimulate normal salivation; sugar free and buffered with calcium to protect teeth; []

Dry Mouth Liquid:  Prescription only
Numoisyn Liquid:  Linseed extract; similar viscosity to that of natural saliva; can be used in conjunction with chlorhexidine without impairing the antibacterial effects ; extended relief;  []

Dry Mouth Rinse:  OTC’s
Biotene:  Minerals and natural enzymes for reduced inflammation; mild mint flavor []
Biotene PBF:  Extended action with special enzyme complex to reduce plaque and mineral deposits by up to 91%; green label; available at most drug and grocery stores []
Oasis:  Glycerine
MedActive Oral Relief Rinse:  Orange Crème and Ruby Raspberry flavors; Spilanthes Extract; Xylitol;

**Other alcohol-free oral rinses in mild flavors:
Tom’s of Maine “Cleansing” rinse:  Spearmint (M) []

Dry Mouth Sprays:  OTC’s
MedActive:  Xylitol, Orange Crème, Ruby Raspberry, Butterscoth, Vanillamint, Lemonade;
available online from multiple sources []
Oral Balance Spray:  minerals, enzymes; carried by most drug stores and large retailers
Rain:  Xylitol, Aloe Vera, glycerin; available online and many health food stores []
Thayer’s Dry Mouth Spray:  Xylitol, glycerine; lemon or peppermint []

Dry Mouth Toothpaste:  See “Toothpaste”

Floss that is soft and gentle to gum tissues:
Reach Gentle Gum Care
Reach CleanPaste dental floss

Fluoride, brush-on:  By prescription
Clinpro 5000 Plus toothpaste; 1.1% NaF, Vanilla-Mint is very mild and well tolerated. [3M ESPE]
PreviDent® 5000 Booster (1.1% Sodium Fluoride) M+
PreviDent® 5000 Plus toothpaste or gel;  1.1% NaF, Fruitastic; preferred to mint by many patients
PreviDent® 5000 Dry Mouth – Mint (M++) (Try Enamel Protect instead!)
PreviDent® 5000 Enamel Protect:  Milder flavor  (M)   
  More information on Colgate®  fluorides:  []
ProDentRx 5000; cool mint, berry fresh, and citrus splash. [Zila]

Fluoride for custom trays:  OTC
Gel-Kam .4% stannous fluoride, Fruit & Berry flavor

Fluoride for custom trays:    By Prescription
Denti-Care 1.1% neutral sodium fluoride gel
Denti-Pro Gel (1.1% Neutral Sodium Fluoride)
Omni .4% Stannous Fluoride, 12106N Natural Flavor
Prevident gel:  Mint (M+), Fruitastic;

Fluoride Rinses: OTC
ACT Restoring rinse or ACT Total Care:  alcohol-free;  []
ACT Dry mouth rinse:  Fluoride, Botanicals to soothe dry mouth;  alcohol-free; dye-free []
   Use alcohol-free ACT  twice a day if decay-free.
Phos-Flur from Colgate:  Mint; Kid flavors, Grape and Bubble Gum are alcohol-free; []
Tom’s of Maine (Kid’s) “Juicy-Mint” (alcohol-free and dye-free);  glycerin, sodium fluoride; []

Fluoride Rinses:  By Prescription
CariFree .05% NaF with Xylitol—complete care system []
CaviRinse .02% NaF, weekly rinse [3M ESPE]
ProDentRx .63% SnF in Cool Mint, Berry and Citrus [Zila]

Fluoride Varnish:  By Prescription
  All go on white and are reapplied 3-4 times a year for best results except as noted.
Cavity Shield [3M ESPE] Bubblegum; Sodium fluoride; Ideal for Primary teeth or sensitive folks
Duraflor Halo [Medicom}, Mint, Berry, Bubblegum;
EnamelPro w/ACP [Premier]; Bubblegum, Strawberry;
MI Paste Varnish [GC America]; Strawberry; goes on white; bioactive Recaldent and minerals included; ideal for dry    mouth where adequate minerals may not be present;  []**New, January, 2012
Prevident; Raspberry; Clear; Colgate; 2-3/year
Vanish; [Omni 3M ESPE ] Cherry, Melon, Mint; goes on Clear; 2-3/year.
UltraThin; Melon or mint (M+); goes on Clear; WaterPik;
Reduce bioburden:   OTC’s
Xylitol (where it is the primary ingredient in gum or candies)—See Xylitol listing

Reduce bioburden:   By Prescription
Alcohol-free Chlorhexidine Gluconate Oral Rinse USP, 0.12% from GUM®
--New SSF recommendation:  Twice a day for 1 week every three months in at risk patients. (4/20/2012)

Toothbrushes, battery powered with replaceable heads and batteries:
Oral B: Oral B/Braun; 8000 strokes/minute; oscillating head reduces gum trauma. Requires approximately 180 grams/cm2 to remove plaque
Sonic Spin-Brush [Arm & Hammer, 16,000 strokes/minute; replace head every 3 months]
Spin-Brush [Arm & Hammer, 6000 strokes/minutes; replace head every 3 months] Both require 180 grams/cm2 to remove plaque
Sonicare (basic unit with 31,321 strokes/minute); replacement heads are pricey compared to the Flexcare heads
Requires 80 grams/cm2 to remove plaque

Toothbrush, electronic/rechargeable:
Flexcare Electronic toothbrush: with or without the ultraviolet light sanitizer unit; least expensive heads of any Sonicare
31,321 strokes/minutes; requires 80 grams/cm2 to remove plaque
Oral B Triumph—Round head; oscillates; must dissolve out old toothpaste residue for best results
31,000 strokes/minute; requires 180 grams/cm2 to remove plaque
Sensonic from WaterPik (no indication on pressure required)

Toothpaste for Dry Mouth:
Biotene Regular—blue label; improves inflammation; enzymes and minerals []           
Biotene PBF – green label; 12 hour anti-plaque enzyme complex []
Tom’s of Maine:   Mild flavors well tolerated:  Silly Strawberry or Orange-Mango for kids []

Toothpaste for sensitive teeth:
Biotene Sensitive: Mild mint, Xylitol, enzymes and minerals []
Pronamel  Isoactive:  Mint; better than Sensodyne for mildness []
Tom’s of Maine Toothpaste for Sensitive Teeth:  Mint (M+)

Toothpaste for patients with frequent canker sores: 
Biotene or Biotene PBF
Rembrandt Canker Sore formula SLS-free formula
Tom’s of Maine “Clean and Gentle” SLS-free formula

Toothpaste for patients sensitive to Fluoride:
Tom’s of Maine Fluoride-free in Silly Strawberry []
Tom’s of Maine Fluoride-free Anti-Plaque and Whitening:  Mint []

“Water Flosser”
WP-100 (smaller footprint on your counter top; more tips to choose from); WP-60 (basic model)
WP-300 Small travel size in carrying case; WP-260  Children’s version (which I use for traveling)
WP-360, WP-450 Cordless or rechargeable hand held units
NEW**Shower Floss (coming soon)—cradle attaches to shower head; rechargeable.

Xylitol Products:
Compressed Tablets:
  Spry:  Assorted flavors,
  Theramints, 3M ESPE:  Fruit, Mint (M) []
  Xylimints:  Lemon; Licorice; Chocolate; Peppermint M+. etc.; Made in Finland;  Distributed by Tundra Trading Company, Glendale, CA  800-505-3895 and available online or at a number of retailers.)
   XylitolUSA:   Assorted flavors; Made in USA;  []
   Xyloburst:  Strawberry, Lemon and Mint []
Gum –  Chewing longer than 10 minutes does not provide additional benefits.
   Biotene:  Xylitol, minerals, bacteriocidal enzyme, mild mint. []
   MighTeaFlow:  Green tea, Xylitol, Glycerine []**new product; highly rated at the SSF conference!
   Spry:  Xylitol, mint or fruit flavors []
   Theragum:  – no longer available for sale even though it’s listed in the SSF product guide
   XyliChew:  Assorted flavors including Licorice; .8 grams Xylitol per piece; Made in Finland; Distributed by Tundra     Trading Company, Glendale, CA  800-505-3895 and available online or at a number of retailers.)
   Xyloburst:  Spearmint, Peppermint, Green Tea, Cinnamon and Fruit []
   XylitolUSA: Assorted flavors; Made in USA;  []
  Salese [] – Lemon, Spearmint; Xylitol delivery; Peppermint (M+++)

Prescription information for Medical and Dental Professionals:

Oral Candida:

Dr. Fred Vivino’s treatment for oral Candida:
Treatments- *Fluconazole (Diflucan®) 100mg daily for 14 - 21 days
Clotrimazole (Mycelex®) vaginal troches 5x/day x 21 days
*Other oral troches and Nystatin rinse has excessive amount of sugar contraindicated in dry mouth patients.

Angular chelitis from Candida alone:
OTC: Miconazole cream; Clotrimazole cream
Prescription: Nystantin, or Ketioconazole cream

Angular chelitis from mixed infection: Candida and Staph. Aureas
Topical Miconazole Nitrate 2%;
 Hydrocortisone 1%-Iodoquinol 1% topical cream

CariFree:  866-928-4445 | – Call or email for details please!
This protocol fits into the CAMBRA program with pH testing and preventive products. (more information and recent studies)

Rx:  Evoxac 30mg
Disp:  90 (for 1 month)
Sig:  1 capsule three times a day, preferably with meals
Refills:  12

Rx:  Numoisyn Liquid
Disp:  300 mL per bottle.
Sig:  Shake bottle well. Take 2 mL (about 1/2 teaspoon) of Numoisyn Liquid and rinse
around in the mouth before swallowing. Use as needed.
Refill:  12

Rx:  Numoisyn Tablets
Disp:  300
Sig: Dissolve 1 by mouth as needed for dry mouth several times a day
Refill:  12

Rx:  NeutraSal®
Sig:   2-10 times per day or as needed for dryness from Sjogren’s Syndrome
Dissolve in 1 oz tap, distilled or bottled water; Use immediately after the solution appears clear or nearly clear. Swish half for 30 seconds and spit out; repeat with the second half and spit out.
Disp:  10 boxes of 30
Refill:  4 times
**Ask about their “No Patient Left Behind” program to cover patient co-pay or one month free for patients without insurance coverage.  1-866-963-8881

Laura Strom clarified this list:
"I believe Evoxac became a generic about 3 weeks ago. Also Biotene was bought by a larger company and discontinued about 2 months ago."


Gill said...

For any UK Sjoggies. Colgate Duraphat 2800 ppm toothpaste is prescription only, can be obtained from the dentist, if your dentist is private rather than nhs, go to GP for presciption. Long term health conditions are covered by a medical excemption card, you have to apply for it, get the card and never pay for another prescription. £7.50 for a tube of toothpaste (lasts one month) is a lot of money in the long term! A pack with 2 tubes of toothpaste can be obtained by the pharmacist all under one prescription if you have to pay. If your GP hasn't got a clue about ordering, the pharmacist will tell the GP what the generic ordering name is.

Unknown said...

I don't understand the Biotene note - I see it alive and well all over the place...I sure hope the product does not go away...

Julia Oleinik said...

Thanks for the UK update, Gill.

Heidi - I agree. I've seen these products around too and use several of them. Hopefully they'll be around for awhile.

Anonymous said...

Like our body our teeth also have protective layer which provide shield against the germ attack. This can be done with the help of minerals like fluoride, which helps in remineralization process in teeth. You can go for toothpastes like colgate duraphat for all way protection and better oral health.

Amelia Davis said...
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Unknown said...

To clarify the Biotene questions: All the Biotene products were reformulated in 2013 and Oral Balance gel in January, 2014. Products that are being sold now (November, 2014) are not the same products made previously by Laclede, the original owner of Biotene and Oral Balance. GSK has changed the formulas to be "pH balanced" and in so doing eliminated most of the minerals and enzymes that made the original formulas worthwhile. I can't recommend any of the the Biotene line at this except for the green-label PBF oral rinse which has most of the original ingredients, although I find it less soothing than before. GSK in working to come up with something that we like and is studying new formulas at several dental schools. They have suspended production of their products, so anything you find at the stores now is old stock. If you purchased a Biotene products since the formulary changes and find it lacking, you can call their Biotene hotline number, 1-800-922-5856 and request a refund. JoAnn RDH

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