The two step neutralizing mouth wash to minimize the effects of acid erosion on tooth enamel.


The Problem


Dental erosion is a significant oral health problem.  It is exacerbated by highly acidic diets, certain medications causing low salivary flow, and systemic conditions such as gastroesophogeal reflux (GERD), and bulimia.  Erosive tooth wear from hydrochloric acid occurs when stomach juice is regurgitated in conditions such as GERD and bulimia. Prevalence of dental erosion in GERD patients is approximately 24% (Pace et al., 2008).  According to the National Eating Disorders Association, approximately 11 million Americans suffer from eating disorders. The majority of these patients require extensive restorative work to return the teeth to optimal function and esthetics. A formulation is needed to 1) prevent and treat tooth erosion in patients exhibiting tooth damage and 2) re-harden and re-mineralize the teeth after an acidic challenge. 


The Technology Solution

Researchers at the University of Tennessee have developed a two-step mouthwash for the treatment of acid erosion, especially in patients with chronic health conditions leading to such erosion.  The two step system is composed of a neutralizing mouthwash and a re-mineralizing mouthwash. The neutralizing mouthwash contains sodium bicarbonate, and is applied to the oral cavity first for approximately 30 seconds.  The re-mineralizing mouthwash contains fluoride and is applied to the oral cavity second for approximately 30 seconds.  In addition, the neutralizing mouthwash contains components which increase the microhardness of the teeth and enhance the re-mineralization.  Some initial results show that the process of neutralizing the acidic environment of the oral cavity prior to re-mineralization increases the microhardness of the teeth (representative data shown below).  Hardness significantly decreased after HCl immersion and significantly increased after re-mineralization in all groups. Sodium bicarbonate solution plus fluoride rinse significantly increased percent hardness recovery in comparison to water plus fluoride rinse in both artificial saliva and human saliva. This process works best as a two-step formulation as opposed to a formulation in which all components are included in one mouthwash.  In addition, the inventors propose that the formulation works best as a rinse compared to a gel or paste.  Brushing immediately after an acidic regurgitation can lead to further deterioration of enamel as a result of erosion-abrasion caused by the toothbrush bristles incorporating acid into the enamel.





Related Publications:


1.    Tantbirojn D, Huang A, Ericson MD, Poolthong S. Change in surface hardness of enamel by a cola drink and a CPP-ACP paste. J Dent 2008; 36:74-79.


2.    Tantbirojn D, Pintado MR, Versluis A, Dunn C, DeLong R. Quantitative analysis of tooth surface loss associated with gastroesophageal reflux disease: A longitudinal clinical study. J Am Dent Assoc 2012; 143:278-285.


Features and Benefits


•    Effective treatment for acid erosion in patients with chronic health conditions causing tooth erosion.

•    Formulation which enhances microhardness of teeth.




Provisional patent application number 61/770863 filed March 2013.

International Patent Application No. PCT/US2014/019447 filed February 2014.


The Inventors


Dr. Mojdeh Dehghan is an Assistant Professor in the College of Dentistry.  Dr. Daranee Versluis-Tantbirojn is an Associate Professor in the College of Dentistry.  Their research interest is in the prevention and treatment of tooth erosion caused by acidic challenges, especially in patients with chronic health conditions leading to tooth decay.


Patent Information: