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acidulated phosphoric acid?
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acidulated phosphoric acid?

hello.  i am under the impression phosphoric acid is the most evil stuff around.  burns enamel away, etc.  i am a bit nutty about avoiding cavities and i was in a store and saw this mouthwash (phos flur perhaps) with much more sodium fluoride in it than the mouthwash i generally use (act).  so of course i bought it.  just out of curiosity i looked at the ingredients yesterday and saw it has something called "acidulated phosphoric acid" in it.  this freaked me out although i'm sure this is much different than the phosphoric acid i avoid in things like diet coke.  but just looking for confirmation that this is so.  also, am i foolish for using this, super powerful (i believe) mouthwash, without being told to use it by a dental professional?  thanks for any input!
Tags: acid, Teeth
9 Comments Post a Comment
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2084768_tn?1332386042
Hello kathy_feng,

Alright, a quick breakdown of all the fluorides used in the dentistry. There are: stannous fluoride, acidulated phosphatic fluoride (APF) and neutral sodium fluoride.

The first two: stannous and APF do have contraindications in what patients they should not be used. Why? Stannous may well...stain restorations. APF contraindications too include restorations and patients with hypersensitivity.
In such cases Neutral Sodium is used as it works well and does not have any contraindications with restorations or hypesensitivity.

You were asking whenever it is okay to use such a strong mouthwash. Now, how much fluoride can be put into products is strictly regulated, with some research in the past that a) Fluoride poisonous in LARGE quantities and b) that in large quantities it causes fluorosis. As such without prescription most of stuff you can buy at your local pharmacy or some shop have fairly similar concentration of fluoride.

As to what kind of brand. There are two brands I would suggest to my patients and it actually may be a good idea to use them together. One is Listerine (NOT Total Care Zero), with this brandname being a bit expensive it can also be suggested to use CVS brand. These two mouthwashes are the only ones which have Seal of Approval by the American Dental Association. Meaning that a) they were approved by the dentists, b) that these two are only ones which kill off bacteria effectively.

Next for the anti-cavity mouthwash. I would say as of right now ACT would be the best on the market. The concentration of fluorides in both ACT and Phos Flur is fairly similar (it is in 0.01s I believe). Phos Flur uses APF, ACT uses neutral sodium.

Hope this helps. :)
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Avatar_n_tn
i would like to thank you for the rapid and in depth response.  i guess in retrospect my question is silly because the ingredient in phos flur is not phosphoric acid!  however, i would like to follow up with you because you seem to have some good thoughts on various rinses.  first of all, the phos flur is ADA approved and says it had prescription strength levels of fluoride in it.  but you would recommend regular (alcohol free, version i assume) act over the phos flur?  any thoughts on the restore type of act versus the regular?  i notice, oddly, different kinds of act have different levels of fluoride so i make sure to get the kind with the highest fluoride level.  ALSO...so listerine...which listerine do you recommend?  i assume one with no alcohol, right?  just regular zero (not total care), i assume?  i also use that crest total care mouthwash.  any thoughts on that stuff?  
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2084768_tn?1332386042
kathy_feng,
Firstly, Phos-Flur does contain phosphoric acid.

On to next things... :) It may depend on which country you are from.  If you are from US, than "Prescription strength levels" may be a bit of a misleading tag. Manufacturers by law restricted being able to put only that much fluoride into toothpaste, mouth rinse etc.

As to which mouthrinse to choose. Without knowing your overall oral health and background, I would recommend sticking to Act. If you DO want to continue using Phos-Flur, I would highly recommend talking to your Dental Hygienist. They are usually far more knowledgeable about such things. As it is pretty much...well their job. :)

Alcohol vs Non-Alcohol. We are getting into territory of what is ADA Seal of Acceptance is all about.
There are two types of products: cosmetic and therapeutic. In order to get ADA approval - the product HAS to have therapeutic qualities.

For example, a mouthrinse with no alcohol may say that it takes care of bacteria. The issue with that is, just rinsing with regular water will take care of SOME of the bacteria, but not majority of it. Alcohol in mouthrinses is what exactly kills off pathogenic bacteria. So please...please...please do not get Total Zero. If you do decide to pick up two - anti-plaque/cavity and anti-bacterial than please choose Regular Listerine or CVS Brand name. Those are two top notch brands. :)

Now...if you would like to get even more information you can always visit ADA website. They have wonderful little tool where you can look at what sort of products there are out and the even compare these products against each other.
http://www.ada.org/adasealproducts.aspx

Note: Different dental professionals may be biased towards one or another type of brand. I am more of a Listerine type of fella, as this is what I give to my patients in the clinic. A lot of people complain of the taste, but it works as intended - meaning it protects them and myself. :)
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Avatar_n_tn
thank you for the response.  i guess what i am asking is...i have been told that alcohol containing mouthwashes are perhaps more detrimental than helpful to the human mouth as the alcohol is very drying and a dry mouth is a breeding ground for bad stuff.  you disagree with this notion?  you think the alcohol does more good than harm?  thanks!
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2084768_tn?1332386042
Yes, I would suggest sticking to alcohol mouthrinses. However, I would suggest patients who are chronic alcoholics, those who are recovering alcoholics, those who have xerostomia (dryness in the mouth), and also those who are taking a lot of medications (which may cause xerostomia) + children. In these type of cases I would suggest patients to use something other than mouthrinses containing alcohol.

The way I was taught about mouthrinses is that: alcohol = therapeutic (kills bacteria, makes your mouth feel fresher, etc), non-alcohol = cosmetic (washes away SOME of the bacteria, masks the smell).
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Avatar_n_tn
ok thank you for your opinion but i guess i am actually still curious about the phosphoric acid in phos flur.  i am under the impression that this acid is horrific for your teeth (i avoid beverages with it) so i am curious what the deal is to make it safe in mouthwash.  i am assuming it is safe when used in a mouthwash.  it must be, right?
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2084768_tn?1332386042
kathy_feng,
Everything in large quantities is harmful. Phosphoric acid helps etch/prepare the enamel of the tooth for acceptance of fluoride: i.e. it dissolves microscopic portions of enamel on teeth, create micropores to which fluoride attaches to. This been hypothesized does cause some harm to the enamel, but make the tooth and "regenerates" enamel in the long run.
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Avatar_n_tn
thanks for the information.  any thoughts on novamin?  would novamin in combination with phos flur be very effective in strengthening teeth, then?  i've read novamin works better in conjunction with fluoride and i'd guess if phos flur gets into teeth better it might also help novamin bond to teeth to strengthen them?  thanks again!
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2084768_tn?1332386042
kathy_feng,
I do not have a lot of experience with NovaMin, so I cannot comment or recommend it.

From what I have read most of the research is concentrated more on proving that it works in reducing hypersensitivity, 1 or 2 articles were trying to prove that it has anti-gingivitis properties. Research which they have on their website states that it helps to form new hydroxyapatite crystals, which can be found in our teeth. So, I can see how NovaMin with fluoride can help with remineralization. I always take research on companies' websites with a grain of salt, but the one done outside the company too looks promising.

I would suggest though to talk to your dentist/hygienist to see wherever by consuming water in your area, using mouthwash and toothpaste combined may have adverse effects in the future. As we've discussed before - too much fluoride = bad. :)
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