Recaldent™ is derived from the milk protein, casein. For many years it has been known that milk and its derivatives have a tooth protective effect. Research has shown that this activity is due to a part of the casein protein called Casein Phosphopeptide (or CPP), which carries calcium and phosphate ions in the form of Amorphous Calcium Phosphate (or ACP). This study was designed to understand how everyday adult Australians became regular users of GC Tooth Mousse Plus ® (TMP). To the best of our knowledge, there is no detailed data on the characteristics of regular users of TMP; hence the context of this study is based on data from oral health population surveys, as described below. You may want to avoid stannous fluoride containing toothpastes if you are concerned about staining. Generally, stannous fluoride is linked to staining on teeth, also manufacturers claim they can reduce this effect with the correct formulation. Alexandrino LD, Alencar CM, Silveira A, Alves EB, Silva CM. Randomized clinical trial of the effect of NovaMin and CPP-ACPF in combination with dental bleaching. J Appl Oral Sci. 2017;25(3):335–40. Different toothpastes do have different active ingredients for sensitivity. You need to give them a couple of weeks to see if they do have an effect.

Tenani CF, De Checchi MHR, Bado FMR, Ju X, Jamieson L, Mialhe FL. Influence of oral health literacy on dissatisfaction with oral health among older people. Gerodontology. 2020;37(1):46–52. One might also consider it somewhat unusual that the bulk of the evidence on remineralisation studies comes from orthodontic patients who are a very select group of individuals undergoing specialist dental care and not typical of the general population. However it would be unwise to dismiss the results because of the narrow specificity of the target group as it would reduce the data set to two studies. If one considers the orthodontic publications there is a some degree of evidence for the benefits of regression of white spot lesions, with four studies [ 33, 37, 38, 40] showing positive results and three [ 35, 36, 41] showing no significant difference to the control groups. When the three studies [ 35, 39, 41] utilising Tooth Mouth Plus® (MI Paste Plus®) are considered – Krithikadatta et al. [ 39] was the only one with a direct comparison between Tooth Mousse® and Tooth Mousse Plus®. The results of this study did not show a significant difference between the non-fluoride and fluoride-containing forms of the CPP-ACP crème and the authors suggested that further studies would be required to confirm these results. Robertson MA, Kau CH, English JD, Lee RP, Powers J, Nguyen JT. MI Paste Plus to prevent demineralization in orthodontic patients: a prospective randomized controlled trial. Am J Orthod Dentofac Orthopedics. 2011;140(5):660–8. Lechuga VM. Exploring culture from a distance: the utility of telephone interviews in qualitative research. Int J Qual Stud Educ. 2012;25(3):251–68. A broad search of the literature was carried out in December 2013 that identified 7576 articles of which the majority were duplicates. Once these duplicates were removed and the remainder limited to those where CPP-ACP was the primary focus and published in English, 172 articles were identified for closer inspection. The PREMEDLINE search identified one additional paper. Of the 173 articles, the inclusion and exclusion criteria in Table 1 were applied which led to 28 articles being excluded immediately as they were review articles, case reports or letters to the editor.Griffin SO, Griffin PM, Swann JL, Zlobin N. New coronal caries in older adults: implications for prevention. J Dent Res. 2005;84(8):715–20. Although it prevents the message being passed on, it does not treat the cause of sensitivity, so you could develop sensitivity once again. Parnell C, Gugnani N, Sherriff A, James P, Beirne P. Non-fluoride topical remineralising agents containing calcium and/or phosphate for controlling dental caries (Protocol). Cochrane Database Syst Rev. 2012(3). Wilson TG Jr. Compliance and its role in periodontal therapy. Periodontology. 2000a;1996(12):16–23.

If the research data for the prevention of dental caries is assessed, two of the studies [ 31, 32] which were randomised controlled trials (over 12 and 24 months respectively), reported that Tooth Mousse® did not offer a benefit in terms of a reduction in dental caries for young children over brushing with a fluoride toothpaste. Whilst the third prevention study [ 30] reported enamel demineralisation (over a relatively short period of 60 days) in a group of orthodontic patients and once again a fluoride product performed just as well as Tooth Mousse®. Therefore, it would be unwise to recommend Tooth Mousse® (MI Paste®) for the prevention dental caries. When TMP was first recommended to participants, despite not being pleased with the possibility of keep losing teeth, incorporating an additional step into their oral hygiene routine was not straightforward (Table 7)—as it is expected with any change of habit. However, they knew something had to shift if they sincerely wanted to keep their teeth. Feelings such as anxiety, uncertainty, determination, confidence, and reassurance were part of such process. Participants spoke about three main barriers: (a) being difficult to apply TMP daily, (b) TMP not being available at chemist/pharmacy and (c) TMP being an expensive product.

Miscellaneous

Decide whether to go for SLS-Free. This is worth considering if you suffer from sore gums or ulcers. I go into more detail in my post on the best SLS-Free toothpastes.