Introduction

While removal usually necessitates mechanical debridement, calculus deposition may be readily prevented by topical application of various chemical inhibitors such as those found in the so-called "tartar control" toothpastes.  The first clinically proven tartar control dentifrice (Crest_® Tartar Control, The Procter & Gamble Co., Cincinnati, OH US), which was introduced in 1985, contained sodium pyrophosphate as the anticalculus ingredient.^4,5  In this dentifrice, pyrophosphate was combined with sodium fluoride for anticaries effects in a silica abrasive base.  Today, tartar control ingredients are found in more than 50% of all dentifrice sold in the United States.  Extensive clinical research has confirmed the efficacy of these formulations for both calculus and caries prevention.²  In addition, tartar control ingredients are combined in virtually all of the so-called "multibenefit" toothpastes.  Tartar control ingredients are thus found in commercial formulations offering whitening (stain removal), plaque prevention, the control of gingivitis, and more recently the treatment and prevention of dentinal hypersensitivity.

Figure 2 illustrates the chemical structure of pyrophosphate, the first widely-marketed anticalculus ingredient.  In its role as a mineral chelator/mineralization inhibitor, pyrophosphate helps naturally regulate mineralization with effects in both bone/tooth formation, calcium homeostasis, and in ectopic mineralization disorders.⁶  The primary feature of pyrophosphate and related molecules that contributes to the clinical response is the strong binding interaction with calcium, both in solution and on surfaces (Figure 3).

Pyrophosphate interacts with calcium by virtue of ion-pairing in solution and at the surface with cationic positive charge of the calcium attracted to the negative charges of oxygen on the phosphate anions.

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