title: Comparison of effectiveness of abrasive and enzymatic action of whitening toothpastes in removal of extrinsic stains - a clinical trial.
abstract: OBJECTIVE
  To compare the effectiveness of abrasive component (perlite/calcium carbonate) and enzymatic component (papain and bromelain) of whitening toothpaste in removal of extrinsic stains.
  
  
  METHODS
  This study is a randomized, triple blind and parallel group study in which 90 subjects aged 18-40 years were included. At baseline, stains scores were assessed by Macpherson's modification of Lobene Stain Index and subjects were randomly assigned to two groups with 45 subjects in each. Group 1 used whitening toothpaste with enzymatic action and group 2 with abrasive action. After 1 month, stain scores were assessed for the effectiveness of the two toothpastes and 2 months later to check the stain prevention efficacy. Wilcoxson's test was used to compare between baseline 1 and 2 months stain scores, and Mann-Witney U-test was applied for intragroup comparison.
  
  
  RESULTS
  The mean baseline total stain score for the subjects allocated to the enzymatic toothpaste was 37.24 ± 2.11 which reduced to 30.77 ± 2.48 in 1 month, and for the abrasive paste, total stain reduced from 35.08 ± 2.96 to 32.89 ± 1.95. The reductions in total stain scores with both the pastes were significant compared with baseline stain scores (at 1 month Group 1, P = 0.0233 and Group 2, P = 0.0324; at 2 months, Group 1 P = 0.0356). Both the toothpastes proved to be equally good in removal of extrinsic stains; however, the enzymatic paste showed better results as compared to abrasive toothpaste.
  
  
  CONCLUSIONS
  Whitening toothpaste with abrasive action and enzymatic action are equally effective in removal of extrinsic stains; however, whitening toothpaste with abrasive action needs to be used with caution.
authors.affiliation: Department of Public Health Dentistry, KLE VK Institute of Dental Sciences, Belgaum, India.
authors.forename: P A
authors.initials: PA
authors.lastname: Patil
authors.forename: A V
authors.initials: AV
authors.lastname: Ankola
authors.forename: M I
authors.initials: MI
authors.lastname: Hebbal
authors.forename: A C
authors.initials: AC
authors.lastname: Patil
mesh_terms: D000293:Adolescent; D000328:Adult; D000537:Aluminum Oxide / Q000627:therapeutic use*; D001963:Bromelains / Q000627:therapeutic use*; D002119:Calcium Carbonate / Q000627:therapeutic use*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D010206:Papain / Q000627:therapeutic use*; D012824:Silicic Acid / Q000627:therapeutic use; D012822:Silicon Dioxide / Q000627:therapeutic use*; D058205:Tooth Bleaching Agents / Q000627:therapeutic use*; D014075:Tooth Discoloration / Q000188:drug therapy* / Q000517:prevention & control; D014099:Toothbrushing / Q000295:instrumentation / Q000379:methods; D014100:Toothpastes / Q000627:therapeutic use*; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D058205:Tooth Bleaching Agents; D014100:Toothpastes; C003076:Perlite; D012824:Silicic Acid; D012822:Silicon Dioxide; D001963:Bromelains; D010206:Papain; D002119:Calcium Carbonate; D000537:Aluminum Oxide
keywords: Macpherson's Lobene stain index; bromelain; papain; perlite; whitening toothpaste