Topical CPP-ACP crèmes: beyond caries prevention

In many parts of the world, the use of Tooth Mousse and Tooth Mousse Plus (also known as MI Paste and MI Paste Plus in North America) has been a well established part of clinical practice for more than a decade. Underpinning these products is a large body of refereed papers and conference presentations as well as systematic reviews, the highest form of evidence in the pyramid of evidence-base practice. For example, a 2006 systematic review focused on chewing gums and lozenges enriched with CPP-ACP (Yengopal & Mickenautsch, 2006), identified over 120 journal articles, which included laboratory trials and animal studies as well as clinical trials and numerous in situ clinical studies. A 2009 meta-analysis identified more than 120 journal articles on CPP-ACP technology, which included animal model studies, in situ clinical studies, and randomized clinical trials, many of which were on the use of Tooth Mousse/MI Paste. A 2012 textbook chapter authored from our group identified that by the end of 2010, nine clinical trials of Tooth Mousse had been conducted across a range of locations around the globe which had shown regression of white spot lesions. Other studies have shown benefits in terms of caries reversal, caries prevention and altered plaque ecology in patients undergoing fixed orthodontic treatment, (He et al. 2010; Roberston et al. 2011; Akin et al. 2012; Wang et al. 2012; Uysal et al. 2012) results which are consistent with our current understanding of the various mechanisms by which Tooth Mousse affects the ionic and microbial aspects of the oral environment The purpose of this article is to summarize the recent research effort over the past decade which underpins the current clinical applications of Tooth Mousse (TM) and its related fluoride-containing counterpart, Tooth Mousse Plus (TMP).