Plaque. Tartar. Gingivitis. We?re all familiar with these harmful dental conditions, either through stern warnings from the dentist or the steady barrage of toothpaste commercials on television. But are we familiar enough with the ingredients that can best combat such conditions? Fluoride is probably the best-known—and most controversial—ingredient, but there are several lesser-known but effective oral care ingredients that you and your customers should know about. Here?s a closer look at a few of them.

Neem
Inhabitants of rural areas in southern Asia and India have used the neem tree (Azadirachta indica) as a source of good oral hygiene for ages. A half-century ago, missionaries began introducing modern dental care procedures to these people, only to find that there was no need for them. ?They discovered that the people in rural India—who had never used a toothbrush, never used Colgate or Crest—had also never had cavities,? says Autumn Blum, a cosmetic chemist who owns the Clearwater, Fla.-based oral care company Organix South. ?They had fantastic teeth, all because of the neem tree. They?d pluck a branch down and use it as a toothbrush—the neem tree now has the nickname of ?the toothbrush tree.??

According to Blum, the neem tree is beneficial not only for its cleaning ability but also for protecting the mouth. Scientific research shows that neem bark extract can reduce the ability of some streptococci (the bacteria that cause strep throat and other oral conditions) to colonize tooth surfaces. In addition, the consistent use of neem toothpaste and mouthwash was shown to prevent or even reverse gingivitis. There have even been some reports of gum-tissue-loss reversal as a result of neem use. It?s believed that the antibacterial compounds and neem?s ability to bolster the immune response in the gums and tissues of the mouth account for these benefits. In fact, a study published in the Journal of Ethnopharmocology in 2004 by the College of Pharmaceutical Sciences in Manipal, India, suggests that dental gel containing neem extract significantly reduces plaque and bacteria in subjects? mouths.

?All the studies have always named the neem tree bark as the most effective part of the tree,? Blum says. ?But none of [the neem-based oral care products] used neem tree bark. I discovered why that is: When you use the bark, it turns the toothpaste completely brown. A lot of manufacturers have shied away from that because they think the mainstream consumer might not be used to their toothpaste being brown
they think it might stain their teeth. But of course it won?t.

?If you have beautiful teeth and perfect gums, I?d recommend sticking with the toothpaste you?re using. But if you have bleeding or inflamed gums, this toothpaste can really make a difference. We think of this line as treatment products. It?s not sold as a drug, obviously, but we believe it is a therapeutic product.?

Therapeutic oils
Kaneohe, Hawaii-based Dr. Tung?s Dental Products takes an Ayurvedic approach to oral care—meaning that its products are entirely herbally formulated and no ingredients are extracted. Best known for its line of tongue scrapers, the company also offers Rejuv for Gums, a therapeutic oil that helps to moisturize the mouth and eliminate dry mouth conditions. Additionally, some of its plants and botanicals—like cassia (also known as cinnamon bark) and ficus bengalensis (i.e., the banyan tree)—have an astringent quality said to be useful for healing gum tissue.

?Unlike other preparations, Rejuv for Gums is oil-based,? says Colin Davis, Dr. Tung?s president. ?Sesame oil has been used for centuries for skin massage and has been known to have antibacterial properties. It works well because it conditions the gums like it would condition the skin—the gums are really a form of skin anyway. The oil acts as a carrier for the herbs to better go into the skin. So it?s got a use as a preventive in that you can condition your gums in the same way you?d condition your skin.? According to a paper presented in 1988 at the Third Annual Scientific Meeting of the College of Health Professions at Wichita State University, sesame oil appears to have antimicrobial affects on subgingival plaque.

Rejuv for Gums contains more than 20 complete herbs. ?Each herb we use has its own effect,? says Davis. ?But there?s also a synergistic effect that occurs when they?re used in combination with one another.?

Xylitol
The natural sweetener xylitol was found to have beneficial effects on the mouth, teeth and gums by scientists in Europe during sugar shortages following World War II. The children who were born during these sugar shortages—and thus used xylitol-sweetened products—had far less tooth decay than other generations who had used sugar-sweetened products.

?So then the real clinical research began, and it was discovered that using xylitol in a daily regimen would consistently result in a 70 to 80 percent reduction in tooth decay,? says Blaine Yates, vice president of sales for Xlear Inc., the Orem, Utah-based maker of a line of xylitol-rich oral care products.

Xylitol, which is most commonly derived for commercial use from birch trees, cane bagasse, and corn cobs and stalks, is a white, crystalline substance that looks and tastes like sugar but has only 40 percent of the calories and several oral care benefits. A study carried out by the Institute of Dentistry at the University of Turku, Finland, found that when tested as a sugar substitute, or even as a small dietary addition, systematic xylitol use led to impressive reductions in dental caries.

Studies have also shown that xylitol causes certain strains of bacteria to lose their ability to stick to the tooth?s surface. ?In dental circles there?s something called biofilm. That?s what allows a bacteria to stick to your teeth,? Yates says. ?Xylitol inhibits that process; it makes the bacteria slippery, in a sense. So it?s that much easier to flush out the bacteria with saliva.? ?The monograph on xylitol isn?t complete, but the dental community has accepted this ingredient as beneficial. It?s generally recognized as safe,? says Chris Chappell, consumer care director for Kennebunk, Maine-based Tom?s of Maine Natural Care, which makes several products containing xylitol. ?It?s a cosmetic ingredient, not a drug, but it can be promoted as an antiplaque preventive. Studies have shown it to have properties of anti-adherence—that?s its primary function. It?s just an extra bonus that it?s sweet.?

Further studies have suggested that xylitol can also inhibit a bacteria?s ability to produce lactic acid, which is what eats at the tooth?s surface over time. Furthermore, Yates says, it?s been posited that xylitol can increase the body?s absorption of calcium, resulting in the hardening of teeth and bones.

Xlear?s Spry Dental Defense line offers several methods for consumers to make their mouth a xylitol-rich environment. ?What we?re trying to do is offer a variety [of ways] for people to get xylitol on their teeth,? Yates says. ?We?re making products that people are already using, only with xylitol instead of sugar or other sweeteners. So we?ve got chewing gum, toothpaste, rinses and gels, all with xylitol as a primary ingredient.?

Zinc citrate
Zinc citrate is derived from zinc and citric acid. When used in oral care products, the substance can effectively battle plaque buildup. Tartar forms in the mouth when plaque mineralizes on the teeth. If allowed to accumulate, tartar can provide even more surface area for plaque to accumulate. A study carried out by Port Sunshine Laboratories in Merseyside, England, showed that brushing with products that contained zinc citrate inhibited plaque regrowth.

?Tartar is the result of plaque buildup, and tartar, if not properly controlled, is a precursor to gingivitis, which is a serious condition for many people,? says Chappell. ?The zinc citrate prevents the buildup of tartar. We have products with two levels of zinc citrate, one with a cosmetic claim of being a tartar-control product and the other with a drug claim of being an anti-gingivitis product. The anti-gingivitis product simply has a higher level of zinc citrate.?

Natural Foods Merchandiser volume XXVI/number 7/p. 40, 42