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Mechanism of action

The stain prevention and whitening effects of many stabilized stannous fluoride formulations in Procter & Gamble’s portfolio are provided by an advanced, high cleaning silica system and sodium hexametaphosphate (polyphosphate). The high cleaning silica gently removes stain mechanically during brushing, while the sodium hexametaphosphate works chemically. The sodium hexametaphosphate provides for excellent stain removal and prevention (Baig et al. 2005; Terezhalmy et al. 2007):

  • Sodium hexametaphosphate has a strong affinity for and attraction to the tooth surface and the pellicle film at the tooth surface to which surface stain is attached.
  • - The sodium hexametaphosphate molecule is negatively charged while the calcium ions in the pellicle and enamel are positively charged. Since opposites attract, the polyphosphate is strongly attracted to these calcium sites.

  • The sodium hexametaphosphate adsorbs to the pellicle, disrupting it.
  • - As a result of disruption of the pellicle, the stain that was attached to and trapped in it becomes displaced, released and lifted away from the tooth surface.

  • Thirdly, the retention of sodium hexametaphosphate at the tooth surface and in the tooth pellicle prevents new stain from binding and accumulating at the tooth surface. (Figure 24)

The 2-step stabilized stannous fluoride formula contains hydrogen peroxide in the second step to provide whitening by disruption of carbon bonds. Stain is composed of materials containing carbon bonds that reflect back only the wavelengths of light that appear colored. Hydrogen peroxide breaks the carbon bonds, so the stain then reflects back more wavelengths of light, making the stain appear white (Goldstein & Garber, 1995). The smooth texture stabilized stannous fluoride formula uses a combination of silica and zinc citrate for stain prevention. The silica gently removes surface stains while the zinc citrate indirectly protects against stains by preventing calcification of plaque into tartar, thereby reducing the surface area that can attract stains.

Lobene Composite Stain Score, Evaluable Subjects
Lobene Composite Stain Score, Evaluable Subjects, Week 3 and 6


  • This study utilized a randomized, two-week, double-blind, parallel group design.
  • At Baseline, an IML examination was performed on the facial surfaces of the twelve anterior teeth. The two teeth with the highest IML composite scores were selected as the test teeth.
  • Subjects were stratified on stain scores of the test teeth, and gender, and randomized to one of two treatment groups:
  • - Experimental 0.454% stabilized stannous fluoride dentifrice (Crest® PRO-HEALTH Clean Mint [Smooth Formula], Procter & Gamble); or

    - 0.243% sodium fluoride/0.3% triclosan positive control whitening dentifrice (Colgate® Total® Whitening, Colgate-Palmolive).

  • Subjects were instructed to use their respective test product following the manufacturer’s instructions at home over the two week study duration.
  • Tooth color was reassessed at Week Two.
  • Baseline to post-treatment change in stain score was tested using paired t-tests. Analysis of covariance (ANCOVA) with treatment as a factor and Baseline Lobene score as the covariate was used to assess treatment differences post-treatment. All comparisons were two-sided using a 5% level of significance.

‡ Friesen L, et al. Am J Dent 2016; 29:20-24.
§ Baig A and He T. Compend Contin Educ Dent. 2005;26 (Suppl 1): 4-11.

Stannous Fluoride Clinical Significance


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Profil du patient : Le patient est un homme caucasien de 68 ans qui est semiretraité d’une exploitation agricole.

Motif de consultation : “Mes dents sont rugueuses et d’apparence brune, puis ma bouche est sèche. J’ai également des lésions derrière ma dernière dent à droite, en bas.”

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Profil du patient : Le patient est un homme caucasien de 50 ans en bonne santé.

Motif de consultation : “Je suis très préoccupé par les taches sur mes dents avant.”



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In-Office Research of Stain Removal Efficacy of Stannous Fluoride Dentifrice

Purpose: An in-office trial compared use of three dentifrices on cleaning/stain removal, while also obtaining subjects’ assessment of the perceived occurrence of tooth staining.

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Extrinsic Stain Removal Efficacy of a Stabilized Stannous Fluoride Dentifrice

Purpose: To assess the extrinsic stain removal benefit delivered by a SnF2 dentifrice and a positive control dentifrice over a two-week period.

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Effects of Paste/Gel Sequence on Post-Prophylaxis Stain, Calculus and Plaque

Purpose: A randomized controlled trial was conducted to assess the effectiveness of a daily 2-step dentifrice and gel system to prevent stain, calculus and plaque after a dental prophylaxis.



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Quand les professionnels des soins buccodentaires ont demandé à leurs patients ce qu’ils aimeraient le plus améliorer par rapport à leur sourire, des dents plus blanches étaient la réponse qui revenait le plus souvent.