Arginine, Calcium Toothpaste Combats Dental Caries

Laird Harrison

Adding arginine and calcium salt to fluoride toothpaste makes it more effective in preventing dental caries, a large new clinical trial shows.

Children using the experimental toothpaste for 2 years had 17.7% fewer decayed, missing, and filled teeth than children using a standard fluoride toothpaste, researchers from Colgate-Palmolive reported in an article published in the November issue of Caries Research.

"It is clear that arginine, [sodium monofluorophosphate], calcium-salt formulations do reduce caries over time," Clifton Carey, PhD, a professor of cariology at the University of Colorado in Aurora, told Medscape Medical News. Dr. Carey was not involved in the study.

Public health researchers have credited fluoride with dramatically reducing the prevalence of dental caries, but the disease remains very common worldwide, spurring researchers to look for new compounds to use against it.

Although researchers do not completely understand how arginine combined with insoluble calcium affects caries, evidence suggests it changes the acid balance in saliva.

In dental caries, bacteria metabolize sugar to produce acids that dissolve calcium phosphate in tooth enamel. When the bacteria metabolize arginine and insoluble calcium, they produce ammonia, an alkali, making saliva less acidic. Formulations of arginine and calcium may also replace calcium that has dissolved from tooth enamel.

Previous clinical trials in people at high risk for caries have shown that toothpastes with fluoride, calcium, and arginine could reverse small early carious lesions more effectively than toothpastes with only fluoride as an active ingredient after 6 months of use. However, these studies did not show whether the arginine toothpastes could prevent actual cavities from forming during a longer period in a population at low to moderate risk for dental caries. Researchers have also wondered whether arginine was more effective when combined with dicalcium phosphate or calcium carbonate........