Storage of samples in isotonic saline solution between tooth brushing periods is not able to imitate intraoral mineralization processes [ 17]. Furthermore, it should also be considered that preparations that support remineralization under laboratory conditions when the tooth surface is clean do not necessarily have a caries-preventive effect [ 12]. It is just that this has been adequately and evidence-based demonstrated for fluoride-containing oral care products [ 2, 3, 4, 5]. Corsodyl: Corsodyl, also known as Parodontax, is a fluoride-based toothpaste that is meant to cure and prevent gum bleeding and gingivitis. It was first produced by GlaxoSmithKline in 1937 (although it is now produced by Haleon). It is available in over 30 countries including the Republic of Ireland, the United Kingdom, and Germany. The active ingredient that makes this toothpaste unique is chlorhexidine. It also contains sodium bicarbonate, which is what gives it a slight salty taste. Chen L, Al-Bayatee S, Khurshid Z, Shavandi A, Brunton P, Ratnayake J. Hydroxyapatite in oral care products - a review. Materials (Basel). 2021;14:4865. https://doi.org/10.3390/ma14174865. Close-Up: marketed by Unilever, [10] it was launched in 1967 and was the first gel toothpaste in the world. [11] Three different toothpastes were investigated with regard to their remineralization properties of artificially demineralized human enamel:

Colgate and Unilever battle in India with the same smile". The Financial Express. April 21, 1999 . Retrieved March 13, 2012.Colgate expands reach of quirky toothpaste". USATODAY.com. Gannett Co. Inc. The Associated Press. March 22, 2006 . Retrieved July 28, 2011. Oral-B: a brand of the Procter & Gamble company. Oral-B is an American brand of oral hygiene products, including toothpastes, toothbrushes, electric toothbrushes, and mouthwashes. It has been owned by American multinational Procter & Gamble (P&G) since 2006. [ citation needed] White DJ. The application of in vitro models to research on demineralization and remineralization of the teeth. Adv Dent Res. 1995;9(3):175–93; discussion 194–7. https://doi.org/10.1177/08959374950090030101 Huysmans M-C, Young A, Ganss C. The role of fluoride in erosion therapy. In: Lussi A, Ganss C, editors. Erosive Tooth Wear. Monogr Oral Sci. Vol 25. Basel: Karger; 2014. p. 230–43. https://doi.org/10.1159/000360555

The remineralization of enamel surfaces after acid etching in vitro is likely more pronounced than in vivo. Some proteins found in saliva, such as statherine, PRP (=proline-rich phosphorus), cystatins, or albumins, have a high affinity for HAP and can thus inhibit (re)mineralization [ 18, 19]. However, since these proteins hardly penetrate into an initial lesion due to their size, remineralization can take place in initial carious lesions with the help of fluoride [ 20]. In contrast, in non-carious enamel lesions created directly with an acid, the defects are larger in diameter, allowing these salivary proteins to penetrate the enamel surface and thus inhibit remineralization. For example, it has been shown that enamel etched with acid retains its etching pattern in the oral cavity for months because no remineralization occurred due to the incorporation of the proteins [ 21].

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Marinho VC, Chong LY, Worthington HV, Walsh T. Fluoride mouthrinses for preventing dental caries in children and adolescents. Cochrane Database Syst Rev. 2016:CD002284. https://doi.org/10.1002/14651858.CD002284.pub2

The success in caries prevention is based in particular on the wide availability of fluoride in toothpastes [ 9, 10]. Patients at risk of caries, such as the elderly or children of primary dentition age, can be particularly effectively protected from caries by increased fluoride administration—for example, in the form of fluoride gels or varnishes [ 2, 3]. If the recommended dosage is observed, there are no concerns about the use of fluorides even for young children [ 11]. Taking into account the usual recommendations for use in dentistry, there is no toxicological risk for fluorides in toothpastes [ 12]. The HAP crystals in toothpastes may not seal the small defects of incipient enamel caries, but erode them more than the other abrasive agents. It has therefore been speculated that the significantly lower incidence of enamel caries after daily brushing with toothpaste containing HAP in vivo may be due to the abrasive loss of early caries lesions [ 29]. Due to this increased abrasiveness, a misinterpretation is possible in the selected in vitro test protocol of the present study, i.e. the more abrasive toothpaste would simulate a higher “remineralization”, since demineralized enamel would be most effectively eroded by the abrasive toothpaste. According to the manufacturer, Karex has the highest RDA value of the toothpastes tested here, at 60. The RDA value of Elmex is between 50 and 60; the RDA value of Ajona is 30. If the RDA value had had an influence on “remineralization” in the test protocol selected here, Karex would therefore have to enable the best remineralization. However, this is not the case. Karex exhibits the significantly lowest remineralization rate. An influence of the RDA value by abrasion of the demineralized enamel on the results presented here can therefore not be determined. Another possible influencing factor on the remineralization potential of toothpastes could be their pH value. For example, Karex has a saliva-neutral pH, whereas the pH of Elmex is in the acidic range. It is assumed that a product with an acidic pH remineralizes better than a product with a neutral pH. Several studies have shown a reinforcing effect for fluoride-containing agents by lowering their pH, which is associated with an improved ability to absorb minerals into enamel defects [ 30, 31, 32].From household names to forgotten history: Story of India's grand old brands such as Binaca, Dalda & Moti Soaps". The Economic Times. November 28, 2011 . Retrieved March 13, 2012. A pairwise comparison (Scheffé test) showed that the mean values of the toothpaste-treated analysis surfaces (S2—S4) also differed significantly from each other ( p< 0.001). Thus, the analysis surfaces treated with Elmex (S3) had a mean value of 5.01% (corresponding to the mean percentage of demineralization). The analysis surfaces treated with Ajona (S4) displayed a mean value of 8.89%; Karex showed a value of 9.85% (S2). The mean value of the percentage of demineralization of the surfaces treated purely with lactic acid (S1) was 11.78%. The control surfaces (S0) showed an average value of 0.35%. Hence, Elmex (S3) exhibited the lowest demineralization and thus remineralized most effectively, followed by Ajona (S4) and Karex (S2). Thus, Karex remineralized highly significantly less compared to the other toothpastes tested ( p< 0.001). Second test series (new demineralization) Ajona has demonstrated its anti-bacterial and anti-inflammatory properties and is five times more effective than normal toothpaste. Please use sparingly – a lentil-size amount is totally enough. Each 25 ml tube of Ajona concentrate is sufficient for approx. 150 applications.