[0001] This invention relates to dental hygiene, and more particularly it relates to a method
of cleaning teeth.
[0002] It is known that a wide variety of elemental cations, including those derived from
gallium, yttrium, lead, indium, beryllium, cerium, dysprosium, iron, arsenic, thorium,
iridium, rubidium, vanadium, zirconium, titanium, tin, thallium, aluminium, copper,
ruthenium, gold, samarium, rhodium, mercury, lithium, cobalt, lanthanum, uranium,
zinc, barium, caesium, strontium, calcium, cadmium and chromium, reduce the acid solubility
of tooth enamel in an in vitro test system (R. S. Manly and B. G. Bibby, J. Dent.
Res., 1949, 28, 160-171 ). It is also known thattooth enamel may be remineralised
by sequential application to the teeth of a cationic and an anionic component which
react below the tooth surface to form an insoluble salt. Examples of the cationic
component are ions derived from barium, lanthanum, manganese, lead, tin, zinc, indium,
zirconium, iron, titanium, vanadium and cadmium (UK Patent Specification No. 1,452,125,
equivalent to French Patent No. 2,202,697). French Patent No. 997,488 states that
caries can be prevented by using an oxidising solution containing a metallic catalyst
derived from iron, copper, manganese, zinc, silver or one of the 14 rare earth elements.
This patent contains no Examples.
[0003] It has been found that administration of yttrium nitrate to rats, either by intraperitoneal
injection or via the drinking water, reduces the incidence of caries and this effect
has been attributed to the incorporation of yttrium into the dental enamel, thus reducing
its acid solubility. (R. Castillo Mercado and T. G. Ludwig, Arch. oral. Biol., 1973,
18, 637-640). It has also been found that mouthrinsing with a stannous fluoride solution
reduces plaque formation on tooth enamel (N. Tinanoff, J. M. Brady, and A. Gross,
Caries Res., 1976, 90, 415-126; N. Tinanoff, J. Dent. Res., 1977, 56, Spec. Issue
A, A138).
[0004] It has now been discovered, and herein lies our invention, that deposits such as
dental plaque may be removed from the surface of teeth, or may be prevented from adhering
thereto, by application of the lanthanum cation.
[0005] The invention consists of the use of a salt of lanthanum for the manufacture of a
non-oxiding aqueous composition for cleaning plaque and for stains from human teeth
which consists essentially of the unbound cation of the element lanthanum in the form
of a water soluble salt and in free of any ingredients which precipitates the cation
as a water-insoluble salt.
[0006] The invention is particularly useful for cleaning teeth in human beings. The efficient
cleaning of teeth is, of course, of immense cosmetic value. One of the substances
routinely found on the surface of teeth is bacterial plaque and the method of this
invention is particularly useful in removing plaque from teeth or in preventing its
adhering thereto. The method of the invention is also useful in removing various types
of stain from teeth, for example the stain produced by smoking tobacco. In addition
bacterial plaque is generally regarded as a dominant etiological factor in caries
and periodontal disease and removal of plaque from teeth or prevention of its accumulation
is known to have a beneficial effect in those conditions.
[0007] Only a very small proportion of the population of an industrialised country is free
from caries or periodontal disease, and it is to be expected therefore that, for the
majority of that population, application of the method of the invention will result
in the additional benefit of a reduction in the incidence of caries and/or peridontal
disease.
[0008] When used in the invention, the cation is in the form of a water-soluble salt. Examples
of such water soluble salts are the chloride, bromide, iodide, nitrate, acetate or
sulphate. The cation may also be used in the form of a salt with an antibacterial
anion.
[0009] The preferred compound for use in the invention is lanthanum chloride, LaC1
3.
[0010] The amount of cation used in the method of the invention may vary from 0.01 m.moles
to 1 m.moles of cation and preferably form 0.1 m.moles to 0.5 m.moles of cation, and
it may be applied from once a week to 1 to 10 times per day. A preferred regime is
three times per day, after meals, or failing this, twice per day, night and morning.
[0011] The invention achieves a satisfactory result simply by application of the cation
to the teeth, for example in the form of a simple aqueous solution. However, an improved
degree of cleansing can be achieved if the invention is combined with one or more
of the normal mechanical methods of cleaning teeth, for example if combined with the
use of a toothbrush, toothpick, dental floss, dental probe or rotary dental brush.
A particularly preferred adjunct to the invention is the use of a toothbrush.
[0012] The cation for use in the invention may be presented in the form of a composition
such as a simple aqueous solution or suspension or in the form of a more sophisticated
composition such as a mouthwash, toothpaste, prophylaxis paste, toothpowder, pastille,
chewing gum or oral spray, or it may be incorporated into a beverage, nutritional
substance or confection. It may also be incorporated into the public water supply.
[0013] The compositions described above are those which are well known to those skilled
in this art. They may incorporate any of the ingredients normally used in such compositions,
with the addition of the cation in the form of a salt. In the case of a mouthwash
or oral spray the cation is incorporated at the desired user concentration. In the
case of a toothpaste, prophylactic paste, toothpowder, lozenge or chewing gum, it
may be necessary, depending on the nature of the ingredients in the composition, to
increase the concentration of the cation to above the level of the desired user concentration,
for example by up to five times the desired user concentration, in order to allow
for incomplete availability of the cation in use as a result of specific binding of
the cation to one or more of the ingredients. In these formulations it is preferable
to use ingredients which avoid precipitation of the cation in the form of an insoluble
salt.
[0014] A typical mouthwash has an aqueous base and generally incorporates a thickener and
a flavour.
[0015] A gel has an aqueous base and generally incorporates a gelling agent, a surfactant,
a flavour and a preservative.
[0016] A toothpaste has an aqueous base and generally contains an abrasive, a binder, a
thickener, a surfactant, a humectant, a flavouring agent and a sweetening agent.
[0017] Specific compositions are described, by way of example only, in Examples 6 to 9.
[0018] The invention is illustrated, but not limited, by the following Examples:-
Example 1
[0019] Sixty dental students, average age 19 years volunteered for the experiment After
having had a thorough prophylaxis, all the students were instructed to suspend oral
hygiene for 3 days. To provoke plaque formation the students rinsed with 10 ml. of
15% w/v aqueous sucrose solution for 1 minute every second hour between 8 a.m. and
10 p.m. At the end of this period the amount of plaque which had accumulated on the
teeth was estimated by use of a Plaque Index, as follows:―
0 - No firmly attached plaque
1 - No firmly attached plaque visible, but some collected with a dental probe
2 - Slight amount of firmly attached plaque visible
3 - Extensive amount of firmly attached plaque visible.
[0020] The 16 individuals showing the highest Plaque Index values were selected for further
study over a period of 4 days. At the start of this period, the participants were
brought to Plaque Index=0. During the test, no oral hygiene was allowed, and in addition
to the sucrose rinses, 2 daily rinses with 10 ml. of 20 m.molar aqueous lanthanum
chloride solution were instituted in a group of 8 individuals, the remaining 8 acting
as controls. At the end of the 4 day period, plaque estimations were made by one person,
the results being statistically averaged. The whole experiment was carried out under
double blind conditions.
[0021] The control group had a mean Plaque Index of 1.0 whereas the treated group had a
mean Plaque Index of zero. The very small amount of deposit which was present in the
treated group was very loosely attached to the tooth surface and could be blown off
with an air jet.
[0022] In a parallel experiment, individuals who rinsed with a 20 m.molar solution of aqueous
stannous fluoride had a mean Plaque Index of 0.3.
Example 2
[0023] A test panel of ten volunteers had a thorough prophylaxis to remove plaque from their
teeth so that the Plaque Index measured according to Löe, J. Periodontal., 1967, 38,
610-616, was zero at the start of the experiment. The panel was provided with new
toothbrushes and instructed to brush their teeth each morning and evening for 30 seconds
over a period of four days, according to each individual's own habits, with a 10 ml.
test solution, and then to rinse the teeth with the remainder of the test solution.
The test solutions were 20 mM aqueous NaCl, 10 mM aqueous LaCl
3, 20 mM aqueous LaCl
3 and 20 mM aqueous YCl
3. The whole experiment was carried out under double blind conditions, each person
using one of the test solutions in turn. Each person's Plaque Index was brought to
zero before using a new test solution. The results obtained were as follows:―

Example 3
[0024] In a parallel experiment solutions of 20 mM aqueous GdCl
3 and aqueous YbCl
3 were tested in groups of four people according to the protocol described in Example
2. The results obtained were comparable with those obtained for YC1
3 in Example 2.
[0025] A similar result was obtained using 20 mM La
2(SO
4)
3 though a complete solution at this concentration was not achieved.
Example 4
[0026] A test panel of 10 volunteers all of whom had intact buccal surfaces on their upper
and lower teeth, first molar to first molar inclusive, were separated into two groups
(A and B) having five persons in each.
[0027] On Day 0 each person's mouth and teeth was stained with a plaque disclosing agent,
erythrosine and then each person had a thorough prophylaxis in order to reduce to
zero Gingival margin Plaque Index measured according to Harrap, J. Clin. Periodontol.,
1974, 1, 166-174.
[0028] On Days 1 and 2 each person was instructed to brush their teeth as normal with their
own toothbrush and toothpaste. They were then re-examined to ensure the presence of
healthy gingiva, and their Gingival margin Plaque Index was again reduced to zero.
[0029] On Day 3, at 7 a.m., each group brushed their teeth with 20 mi. of either a 20 mM
aqueous lanthanum acetate solution or water respectively with a new soft toothbrush
dipped in the respective test solution. Rinsing for 1 minute was then carried out
with the remainder of the test solution. No after-rinses with water were permitted.
[0030] On Day 4, at 1 pm., each person's teeth was stained with disclosing agent and the
Gingival margin Plaque Index scored, the scoring being performed blindly.
[0031] Days 1 to 4 of the test period were repeated, groups A and B interchanging test solutions.
[0032] The results obtained were as follows, the figures in the second and third column
being a summation of the percentage score for each of the 24 teeth.

Example 5
[0033] A subject rinsed his mouth and teeth with 10 ml. of 20 mM aqueous LaCI
3 solution for 1 minute. The solution tasted salty but was not unpleasant-there was
no metallic taste. After rinsing the subject spat out pieces of organic debris. His
mouth and teeth felt much cleaner and in particular his teeth felt dry and dean.
[0034] On a separate occasion the same subject rinsed with 10 ml. of 20 mM aqueous stannous
fluoride. The solution tasted acid and metallic. The cleansing effect experienced
with stannous fluoride was not as great as that with LaCl
3.
[0035] A different subject found that rinsing with 20 mM aqueous LaCl
3 solution significantly reduced the amount of tooth stain caused by smoking tobacco.
