Sensodyne NUPRO 5000 (Novamin) vs Clinpro 5000 - Which would you choose?

[kellogg9]

Not sure if you guys are familiar with different prescription toothpaste brands. The ones i am trying to figure out which to get are:

• Dentsply Sensodyne NUPRO 5000 (1.1% Sodium Fluoride + 5% NovaMin)
• 3M Espe Clinpro 5000 (1.1% Sodium Fluoride + Tri-Calcium Phosphate)

Since they both have the same level of NaF (@ 5000ppm) my focus is on the Calcium/Phosphate delivery they both provide. For those not familar, NovaMin is just a branded name for Calcium and Phosphate....two key elements to tooth re-mineralization. And yes, i know NovaMin contains silica and sodium as well but they are not important to my question.

Recently I was made aware that Fluoride and Calcium in the same toothpaste tube is not efficient primarily because the ions will interact with each other while sitting on the shelf of a store and render the fluoride and calcium inactive (becoming Calcium Fluoride which is less soluble in the mouth when used by the patient).

I notice that all of the NovaMin toothpastes that contain fluoride make no effort to separate the two (by way of separate compartments within the tube) which makes me wonder if the paste is less efficient than it could normally be in reducing white-spot lesions and sensitivity.

So i came across 3M's solution which is called Tri-Calcium Phosphate which claims to encapsulate the calcium and phosphate in some way so it doesn't interact with the fluoride in the tube and so when a patient uses the product while brushing it will release the calcium/phosphate (requires some kind of mechanical friction to release these elements) so that it can interact with the fluoride to form Fluorapatite on the enamel. Here is a video presentation of the process.

I am confused. Which is telling the truth and which is the most efficient at calcium/phosphate delivery?

I've read virtually every paper on fluoride and NovaMin interaction as well as papers by Dentsply and 3M and unfortunately both companies do not compare each other directly (at least not under teh same conditions). And the studies that talk about fluoride use with NovaMin is inconsistent.

I had to call Dentsply to get some answers and one researcher explained that because their NUPRO 5000 paste is in hydris which has no water their fluoride ions are not interacting in the tube.

Any thoughts on the matter? Which toothpaste would you go for....based on the data? I notice that a lot of dentists prescribe Clinpro 5000 but it seems to me it is mostly because of marketing by 3M more than the data.

For me i just want to know who is the most efficient at Calcium/Phosphate delivery to the enamel with Fluoride. Obviously the only difference between the products is 3M's trick to separate the calc/phos from the fluoride.

Here are their Product Details pages just in case u want to read more info:
Dentsply Sensodyne NUPRO 5000
3M Espe Clinpro 5000

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[SeattleRDH]

Great question. I want to know the answer too. We have Clinpro 5000 in our practice. I'm partial to OMNI's ControlRx, though.

 

[kellogg9]

Great question. I want to know the answer too. We have Clinpro 5000 in our practice. I'm partial to OMNI's ControlRx, though.

Unless i am mistaken ControlRx is a 1.1% sodium fluoride (NaF) paste. Clinpro and Nupro, which is also a 1.1% NaF paste, also includes some form of calcium/phosphate ions to enhance remineralization.

My fear of only having just a high concentration NaF paste such as ControlRx is that it would only create a hardened fluorapatite protective layer on the surface of the tooth and potentially prevent continuous remineralization of subsurface white spot lesions from occurring more efficiently due to the surface not allowing the calcium and phosphate (in the saliva) to precipitate to deeper portions where the lesion actually exists.

This is why i am thinking something like Clinpro or a product that includes NovaMin might be more efficient when applied with a higher concentration of fluoride (1.1%+) since its inclusion of calcium and phosphate ions (and some mix that increases the pH in the saliva e.g sodium) would speed up remineralization and allow the fluorapatite-making ions to go deep in the tooth before the surface layer becomes hardened (reducing surface pathways to the inner areas) allowing for the lesion to have more raw material to work with and repair that lesion. But then maybe 1.1% isnt all that much and it only becomes an issue at higher concentrations (5%+) like with varnish.

Anyway, i am not a dentist or a student..just a regular person with a keen interest in the world of science and dentistry so i might be wrong.

 

[mimiamira]

where did you get this information please? that fluoride and calcium may not be mixed in the same toothpaste because they will have a reaction between them?
I am interested to know, because i tried to check it but i didn´t find anything like this. thanks

 

[LillyLillyDVM]

Kellogg,

Excellent question, and I couldn't have put it better myself!

My answer? Neither. Because of the unresolved questions about fluoride/calcium, I decided the prudent choice would be to go WITHOUT FLUORIDE, and opt for solo Nova-Min. I think "Dr. Collins" toothpaste has this sort of formulation, but the one I opted for is Burt's Bees without fluoride. I just ran out of my first tube, and I have to go and buy another one tonight. I've never favored toothpaste, for the most part I never liked the taste, the texture, and especially not all that darn foam. I've always used bicarb for brushing, but for some reason, Burt's Bees really appeals to me, very possibly because I find the chemistry of the Nova-Min intriguing, and I'm looking forward to seeing how it works for me. Because of anti-cholinergic medication I take, my teeth have gone from outstandingly healthy and strong to badly compromised, so I'm looking forward to gaining some advantage with the Nova-Min.

On the other side of things, as someone with a mild hypothyroid condition that nonetheless requires medicating, I looked into the effect of the competition between the iodine I need to keep my thyroid in order and the other halogens, and decided that fluoride may be problematic for me in any event, I think it could be problematic for a lot of people, in fact, but I have other battles to fight, so I'll let that one go.

Long story short: Burt's Bees fluoride free with sodium-calcium-phosphosilicate for me. 🙂