A Systematic Review of the Effectiveness of Anticalculus Dentifrices

To assess the evidence on the effectiveness of commercially available anticalculus dentifrices. Systematic search for published and unpublished epidemiological data in 7 electronic databases, 5 journals, and the bibliographies of retrieved papers and by making contact with subject experts in this field. Thirty-two reports were identified containing comparisons of one or more active agents with a placebo dentifrice and calculus measured using the Volpe-Manhold Index (VMI). Random effect model for 3-month studies showed an effect size of -0.6 for all comparisons. The effect sizes varied from -0.3 for dentifrices with zinc chloride 0.5% to -1.1 for pyrophosphate 1.3% and copolymer 1.5% dentifrices. Meta-analysis of all the studies with 6-month follow-up gave an effect size of -1.1 (-1.5 to -0.8) and for 12-month follow-up the effect size was -13.6 (-21.4 to -5.8). Anticalculus dentifrices containing pyrophosphates, zinc compounds and/or co-polymers were effective in significantly reducing calculus scores (VMI). Keywords: calculus, anti-calculus, dentifrices, pyrophosphate, zinc citrate, co-polymer, toothpaste, systematic review