CaviStat- Containing Dentifrice as Inhibitor of Acidic Occlusal Fissure pH

Introduction and Objective: Occlusal fissures are highly prone to dental caries development largely because their morphologies favor retention of acid-producing bacteria and fermentable carbohydrate substrate. Earlier, we showed with a 2 µm diameter tip Sb electrode that occlusal fissure pH becomes and remains more acidic after CHO exposure than in other plaque-accumulating dentition sites. Here we examined an arginine bicarbonate/calcium carbonate (CaviStat) containing toothpaste for its effects on fissure pH acidity caused by fermenting oral bacteria. Method: Fissures of extracted third molars were filled with (i) mixed bacteria harvested from whole saliva or dental plaque (ii) pure cultures of L. casei, L. acidophilus, L. gasseri or (iii) other highly acidogenic bacteria. Molars with fissure-filled bacteria were incubated at 37°C in a water bath enclosed in a chamber designed to avoid moisture loss while permitting substrate manipulation and fissure pH measurements for times up to 18 hours. Glucose at 2.8, 28 and 280 mM. and the CaviStat-containing toothpaste were applied to the fissures in various ways, times and amounts. Results: Upon glucose addition, the pH dropped from neutrality to between 4.5 and 5.5 with the mixed salivary or plaque bacteria depending upon the glucose concentration provided, but fell to around 4.0 and sometimes below with the lactobacilli. When the pH after glucose addition reached its lowest level, adding the CaviStat-containing toothpaste caused the pH to immediately rise above 8.0 where it remained throughout the experiment, even overnight. Without toothpaste addition, the pH remained at low pH, even overnight if the original sugar substrate provided was high. Other manipulations showed similar substantial acid-neutralizing and pH-raising results. Conclusion: The CaviStat- containing toothpaste has a powerful effect on fissure pH. It easily neutralized fissure acidity for many hours, making it potentially an ideal occlusal fissure anti-caries agent.