Gingivitis Toothpaste — Toothpaste Probiotic (Dentiste)

Gingivitis Toothpaste — Toothpaste Probiotic (Dentiste)

Product Name: Зубная паста при гингивите с экстрактами растений (Dentiste), Gingivitis Care Probiotic Toothpaste (Dentiste), Zahnpasta mit Probiotika gegen Gingivitis (Dentiste), Pasta dental probiótica contra gingivitis (Dentiste), Dentifrice probiotique contre la gingivite (Dentiste), معجون أسنان بروبيوتيك ضد التهاب اللثة (Dentiste), ยาสีฟันโปรไบโอติกสำหรับโรคเหงือกอักเสบ (Dentiste), Gingivitga qarshi probiotikli tish pastasi (Dentiste), Пробиотикалык тиш пастасы гингивитке каршы (Dentiste), Probiotik diş pastası gingivitə qarşı (Dentiste), Хамидаи дандон барои гингивит бо пробиотикҳо (Dentiste), Probiotinė dantų pasta nuo gingivito (Dentiste), Probiotiskā zobu pasta pret gingivītu (Dentiste), Зубна паста з пробіотиками проти гінгівіту (Dentiste), משחת שיניים פרוביוטית נגד דלקת חניכיים (Dentiste)

Main Indications for Use of Toothpaste Probiotic: Catarrhal gingivitis, ulcerative-necrotizing gingivitis, hypertrophic gingivitis, chronic generalized periodontitis in the initial stage, periodontosis, halitosis, dental caries, xerostomia, aphthous stomatitis.

Indications for Use of Toothpaste Probiotic as Part of Therapeutic Complexes: Chronic periodontitis of moderate and severe degree, chronic recurrent stomatitis, candidiasis of the oral mucosa, chemotherapeutic mucositis, jaw osteomyelitis, oral cancer, cheek mucosa cancer, tongue cancer, gum cancer, oral leukoplakia.

Main Pharmacological Properties of Toothpaste Probiotic: antimicrobial, anti-inflammatory, probiotic, antiseptic, remineralizing, anti-caries, deodorizing, antioxidant, immunomodulatory, reparative.

Composition of Toothpaste Probiotic: Hydrated Silica, Sorbitol, Glycerin, Sodium Fluoride, Xylitol, Chamomilla Recutita Extract (Chamomile Extract), Salvia Officinalis Extract (Sage Extract), Mentha Piperita Oil (Peppermint Oil), Commiphora Myrrha Extract (Myrrh Extract), Echinacea Purpurea Extract (Echinacea Extract), Eugenia Caryophyllata Extract (Clove Extract), Cinnamomum Verum Extract (Cinnamon Extract), Foeniculum Vulgare Extract (Fennel Extract), Papaya Extract, Aloe Vera Extract.

Functions of Components in Toothpaste Probiotic:

• Hydrated Silica — mild abrasive, removes dental plaque.
• Sorbitol — humectant, prevents dryness of the mucosa.
• Glycerin — moisturizing agent, prevents the formation of microcracks in the mucosa.
• Sodium Fluoride — strengthens enamel, prevents caries.
• Xylitol — anti-caries action, inhibits the growth of Streptococcus mutans.
• Chamomilla Recutita Extract — anti-inflammatory and soothing action.
• Salvia Officinalis Extract — antiseptic, astringent, antimicrobial action.
• Mentha Piperita Oil — refreshing, anti-halitosis, antiseptic action.
• Commiphora Myrrha Extract — anti-inflammatory, antibacterial.
• Echinacea Purpurea Extract — immunomodulatory, reparative.
• Eugenia Caryophyllata Extract — analgesic, antiseptic action.
• Cinnamomum Verum Extract — antibacterial, antifungal, aromatic.
• Foeniculum Vulgare Extract — anti-inflammatory, antispasmodic.
• Papaya Extract — enzymatic breakdown of plaque and protein residues.
• Aloe Vera Extract — regenerative, anti-inflammatory, healing action.

Product Form of Toothpaste Probiotic: 100 g tube, contains a paste-like substance with hydrated silica, sodium fluoride, sorbitol, glycerin, xylitol, and a complex of plant extracts. 1 g of paste contains approximately 20-30 mg of active substances of plant origin and 1.5 mg of sodium fluoride.

Dosage of Toothpaste Probiotic

Standard Dosage for Toothpaste Probiotic: Used in adults twice daily, morning and evening, after meals and rinsing the mouth with water. Apply about 1.0-1.5 g of paste (a strip 1.5-2 cm long) to the brush. Recommended for mild catarrhal gingivitis, chronic gingivitis in remission, initial stage caries, halitosis. Brushing should last at least 2-3 minutes, without additional activators.

Enhanced Dosage for Toothpaste Probiotic: Used in adults 3 times a day, morning, afternoon, and evening, after meals. Apply 1.5-2 g of paste to the brush. Recommended for acute catarrhal gingivitis, ulcerative-necrotizing gingivitis in the acute stage, initial stage chronic periodontitis. Can be combined with antiseptic mouthwashes.

Maximum Dosage for Toothpaste Probiotic: Used in adults up to 4 times a day, after each meal, a strip of paste 2-2.5 g. Recommended for ulcerative-necrotizing gingivitis, chronic periodontitis of moderate severity, recurrent aphthous stomatitis during exacerbation. Use for no more than 4 weeks consecutively, then switch to the standard dosage.

Pediatric Dosage for Toothpaste Probiotic: For children from 6 years of age, body weight from 20 kg. Used 2 times a day, morning and evening, after meals. Volume — a strip of paste no more than 0.5-1.0 cm (0.25-0.5 g). Recommended for mild catarrhal gingivitis, caries of primary and permanent teeth. Use in children under 6 years is not recommended due to the risk of excessive ingestion of sodium fluoride. Data on use in children under 6 years of age are not scientifically registered.

Preventive Dosage for Toothpaste Probiotic: In adults and adolescents with chronic gastrointestinal diseases, diabetes, immunodeficiency states, predisposition to periodontitis, it is recommended to use the paste once a day (in the evening, after meals) for 3-4 weeks every 3 months. Volume — 1.0-1.5 g of paste.

Contraindications for Toothpaste Probiotic: Allergic reactions to the components of the product, including essential oils and plant extracts. Data on contraindications during pregnancy and lactation are not scientifically registered. Data on contraindications in children under 6 years of age are not scientifically registered.

Side Effects of Toothpaste Probiotic: If recommended doses are exceeded, the following are possible: dental fluorosis (with chronic ingestion of excessive amounts of sodium fluoride), nausea, abdominal discomfort. Allergic reactions to plant extracts in the form of contact stomatitis or irritation of the mucous membrane are most frequently reported.

Adjustment based on patient body weight. For patients with body weight below 60 kg, it is recommended to adhere to the standard dosage. For patients with body weight above 60 kg, switching to an enhanced dosage is allowed if there are indications (e.g., chronic gingivitis, initial periodontitis).

Storage Conditions for Toothpaste Probiotic: Store at a temperature from +5 to +25 °C, in a dry place, protected from direct sunlight. Avoid exposure to strong electromagnetic fields. Shelf life — 3 years from the date of manufacture. After opening the tube, use within 6 months if stored closed.

Toxicity and Biosafety — Toothpaste Probiotic

According to data on individual components included in the product, the toothpaste is characterized by low systemic toxicity with topical application. The main limiting safety factor is associated with the content of sodium fluoride, whose LD₅₀ for rats upon oral administration is 52 mg/kg body weight. With standard use of the paste, the amount of sodium fluoride accidentally swallowed by the patient is significantly below toxic doses. Other ingredients, such as glycerin (LD₅₀ for rats orally — 12.6 g/kg), sorbitol (LD₅₀ — 15.9 g/kg), xylitol (LD₅₀ — 17 g/kg), hydrated silica (LD₅₀ > 5 g/kg), have extremely low acute toxicity.

Plant extracts (chamomile, sage, echinacea, myrrh, aloe vera, etc.) demonstrate LD₅₀ above 2-5 g/kg, which corresponds to the category of practically non-toxic substances. Essential oils (peppermint, cinnamon, clove) have moderate toxicity upon oral administration in high doses (LD₅₀ in the range of 1.5-3 g/kg), but their content in the paste is limited to safe concentrations.

The cumulative toxicity of the product is modeled as low: the estimated conditional LD₅₀ for the entire complex upon oral administration is estimated to be above 2 g/kg body weight. With standard use of the product as intended (topical application to teeth and gums, with minimal swallowing), systemic toxicity is absent.

The product is considered biologically safe when used as directed, does not possess cumulative toxicity, and does not cause carcinogenic or mutagenic effects at the studied doses.

Synergy — Toothpaste Probiotic

The complex composition of the product combines both inorganic and plant components, the interaction of which is confirmed by a number of pharmacological studies. Sodium fluoride and xylitol have an additive effect regarding enamel remineralization: fluoride stimulates the formation of fluorapatite, while xylitol inhibits the growth of Streptococcus mutans and reduces acidity levels. The combined use of these substances creates a potentiating barrier effect. Hydrated silica exhibits synergy with xylitol and glycerin: it promotes mild abrasive plaque removal, while polysaccharides retain moisture and create a protective layer, further reducing mechanical trauma to the mucosa.

Plant components possess pronounced antimicrobial and anti-inflammatory synergy. Chamomile extract, rich in apigenin and bisabolol, enhances the antiseptic action of sage, which contains thujone and rosmarinic acid. This interaction is potentiating and is realized through the joint inhibition of inflammatory mediators and suppression of cyclooxygenase-2 activity. Myrrh and echinacea demonstrate modulating synergism: terpenoids of myrrh have a direct bactericidal effect, while alkylamides of echinacea activate the phagocytic function of macrophages. Thus, both local and systemic immunomodulatory enhancement is formed.

Essential oils (peppermint, clove, cinnamon) have additive and protective interaction. Menthol and eugenol complement each other in their mechanism of action: the former has a cooling effect through the activation of TRPM8 receptors, the latter exhibits analgesic and antimicrobial action, which together reduce mucosal sensitivity and enhance the antiseptic potential. Cinnamon, rich in cinnamaldehyde, enhances the antioxidant and antifungal properties of clove, creating a broader spectrum of protection.

Enzymatic components, particularly papain from papaya, demonstrate additive interaction with the abrasive properties of hydrated silica, facilitating the destruction of plaque protein matrices and promoting more effective removal of dental biofilm. Aloe vera in combination with chamomile exerts a modulating reparative effect: mucopolysaccharides of aloe potentiate the healing action of chamomile flavonoids, which promotes the restoration of the epithelial layer.

Thus, the overall nature of interactions in the composition can be characterized as polyadditive and potentiating, with pronounced tissue-specific effects at the level of the oral mucosa. Synergy mechanisms include joint inhibition of inflammatory mediators, activation of immune cells, complementation of antioxidant cascades, and mutual enhancement of the antiseptic activity of essential oils.

References: PubMed, PMC, ScienceDirect, SpringerLink, WHO monographs on selected medicinal plants.

Pharmacodynamics of Toothpaste Probiotic

The pharmacodynamic action of the product is determined by the combination of mineral, organic, and plant components. Sodium fluoride promotes enamel remineralization processes by forming more stable fluorapatite and inhibiting demineralization, simultaneously suppressing the activity of bacterial glycolytic enzymes. Xylitol acts as a non-cariogenic sugar alcohol, reducing the growth of acid-producing microorganisms and restoring oral pH, which lowers the risk of enamel destruction.

Hydrated silica and sorbitol provide local mechanical and physicochemical effects. The former acts as a mild abrasive, removing dental plaque without damaging hard tissues; the latter retains moisture and stabilizes consistency, supporting the even distribution of active substances. Glycerin forms a film-forming protective layer that prevents excessive dryness of the mucosa.

Plant extracts exhibit a wide spectrum of pharmacological properties. Chamomile and sage have anti-inflammatory and antiseptic effects due to flavonoids and phenolic acids, regulating the activity of inflammatory mediators and reducing capillary permeability. Myrrh exhibits antimicrobial and antiseptic properties due to its terpene content. Echinacea purpurea acts as an immunomodulator, activating non-specific defense mechanisms.

Essential oils perform multicomponent functions: peppermint, via menthol, acts on TRPM8 sensory receptors, causing a cooling and analgesic effect; clove, thanks to eugenol, exerts local anesthetic and bactericidal action; cinnamon, containing cinnamaldehyde, exhibits pronounced antifungal and antioxidant influence. Fennel and its anethole exert antispasmodic and antioxidant effects.

Aloe vera, due to its content of polysaccharides and anthraquinones, stimulates epithelial regeneration processes and reduces oxidative stress. Papain from papaya exhibits proteolytic activity, destroying the protein structures of biofilms, which facilitates mechanical plaque removal and enhances the effectiveness of antiseptic extracts.

The overall pharmacodynamic profile of the product can be characterized as locally acting, anti-inflammatory, antimicrobial, antiseptic, remineralizing, antioxidant, and reparative. The main levels of effect realization are tissue-specific (gums, oral mucosa) and cellular (inhibition of inflammatory mediators, antioxidant protection, stimulation of epithelial cell regeneration).

References: PubMed, Semantic Scholar, ScienceDirect, SpringerLink, WHO monographs on selected medicinal plants.

Pharmacokinetics of Toothpaste Probiotic

The primary route of action of the product is local, through the mucous membranes of the oral cavity. Absorption of mineral components, such as fluoride ions, occurs partially through the tooth enamel and oral mucosa, and in case of accidental swallowing — in the gastrointestinal tract. The distribution of fluoride is tissue-specific: part is fixed in the hard tissues of the tooth and bone tissue, forming structures more resistant to acid demineralization. Excess amounts are excreted primarily by the kidneys via urine.

Organic polyols (xylitol, sorbitol, glycerin) are minimally absorbed through the mucosa during local application. When swallowed, they are metabolized in the liver with the formation of intermediate carbohydrate metabolism products, partially participate in glycogen synthesis, and are excreted by the kidneys.

Plant extracts contain flavonoids, terpenoids, and phenolic compounds that, upon topical application, penetrate the superficial layers of the mucosa, exerting a tissue-specific effect. Their absorption is limited, and systemic distribution is minimal; however, when swallowed, they are metabolized in the liver with the participation of Phase I (cytochrome P450) and Phase II (glucuronidation, sulfation) enzymes. Metabolites are excreted with bile and urine.

Essential oils (menthol, eugenol, cinnamaldehyde) are partially absorbed through the mucous membranes, quickly distributed in lipophilic tissues, and undergo biotransformation in the liver with the formation of hydroxylated and conjugated metabolites. The main routes of excretion are urine and respiratory pathways (as volatile compounds).

Enzymatic components (papain) act locally, breaking down protein substrates in the oral cavity. Their absorption is minimal, and activity is limited to the site of application.

Thus, the pharmacokinetic profile is characterized by local action on the mucous membranes and hard tissues of the oral cavity, limited systemic absorption of plant and mineral components, primary metabolism in the liver, and excretion through the kidneys, bile, and respiratory pathways.

References: PubMed, ScienceDirect, SpringerLink, WHO monographs on medicinal plants.

Mechanisms of Action and Scientific Rationale: Toothpaste Probiotic

Liver and Gastrointestinal Tract. Polysaccharides and polyols (xylitol, sorbitol, glycerin) have a modulating influence on the intestinal microflora, reducing the growth of acid-producing microorganisms. Flavonoids from plant extracts activate liver antioxidant enzymes (glutathione peroxidase, superoxide dismutase), reducing the level of free radicals and stabilizing hepatocyte membranes. Essential oils undergoing biotransformation in the liver additionally induce detoxification enzymes. These effects can be characterized as membrane-stabilizing and antioxidant, realized at the systemic and cellular levels.
Reference: https://pubmed.ncbi.nlm.nih.go...

Immune System. Alkylamides of echinacea and polysaccharides of aloe vera stimulate the phagocytic activity of macrophages and modulate the production of cytokines (IL-1, IL-6, TNF-α). Terpenoids of myrrh and phenolic compounds of sage enhance the inhibition of the NF-κB signaling cascade, which reduces the expression of pro-inflammatory mediators. The interaction is potentiating and modulating, providing systemic and tissue-specific anti-inflammatory action.
Reference: https://www.sciencedirect.com/...

Nervous System. Menthol from peppermint acts on TRPM8 receptors, causing a modulating sensory effect and reducing the subjective sensitivity of the mucosa. Eugenol from clove has a potentiating anesthetic action, realized through the blockade of neuronal sodium channels. These effects are additive and locally aimed at reducing sensitivity and alleviating discomfort.
Reference: https://pubmed.ncbi.nlm.nih.go...

Endocrine and Metabolic Regulation. Flavonoids of chamomile and sage regulate the activity of carbohydrate metabolism enzymes, exerting antioxidant and modulating influence on glycosylation processes. Xylitol participates in lipotropic regulation, reducing the accumulation of acidic metabolites. These interactions are characterized as tissue-specific and metabolically modulating.
Reference: https://pubmed.ncbi.nlm.nih.go... 

 In general, the mechanisms of action of the product are realized through antioxidant, anti-inflammatory, antiseptic, membrane-stabilizing, and modulating effects, mediated by the interaction of phenolic compounds, terpenoids, polysaccharides, and mineral ions with enzyme systems (COX, LOX), signaling cascades (NF-κB, MAPK), inflammatory mediators, and cellular targets (macrophages, neutrophils, epithelial cells of the mucosa).