Products FAQ

• Piezon Led Handpiece -> FS-455: compatible with the Airflow Prophylaxis Master, Airflow Master Piezon (previous generation), P250/P150 (simple stand alone scalers).
• Airflow Max Handpiece -> FS-477 /US: compatible with the Airflow Prophylaxis Master, Airflow Master Piezon, Airflow Master, Airflow S2, Airflow S1 (old devices).
• Perioflow handpiece -> FS-474: compatible with Airflow Prophylaxis Master, Airflow Master Piezon, Airflow Master.

The above-mentioned handpieces are not compatible with handies.

We will need a credit card for all purchases of Airflow stations (Prophylaxis Station & Station +) and Table Tops (Airflow Master & Airflow One). For large purchases, customers will have the option of paying in installments with their credit card and / or using a financing plan from an outside company, however this will be on a case by case basis and should be discussed with Sacha and / or Daniel. Invoices can be sent “due on receipt” (if required) for all other EMS related products.

No deposit required, yes we will place the order in Netsuite and ship it out when received in stock.

Only sold in packs of 4 bottles, no possibility of dismantling and selling individually.

Brian will place an order for Aqua FX (cleaning solution) from Maxill (located in Ontario) and Renaud will add it to the order form.

There is a one year warranty on the machine and parts. When customers register their device on the EMS app, they get an additional one year warranty. (This only applies to the machines themselves, not the handpieces purchased on their own as are considered as consumables).

No, the customer should contact the distributor from whom he purchased the machine for all maintenance and repair.

Orders are shipped from Switzerland by sea and take approximately 7-8 weeks to arrive (1-2 weeks to prepare by EMS and approximately 5 weeks to ship by sea), once order is placed. In the rare event that we are out of stock and an airflow machine is urgently needed, there is a possibility to ship by air, but since this is about 3 times the cost of shipping by sea, it will be on a case-by-case basis and to be discussed with Brian.

Yes, all reps will have their own demo unit and receive it (shipped directly to their homes) in mid-February.

As a clinician you don’t want to do GBT with a handy: - these are heavy devices - they consume way too much powder - they are less efficient. In theory you can do it but you will waste your health and money.

No not at all : the powder does not stay in the mouth: it is either ingested by the patient or aspired by the suction.

(again: the powder removes biofilm mechanically, not chemically)

Go to the Options Menu and choose the Sound Tab. Then select the Sound playback language option you would like to hear. There are 35 choices total with 16 different languages. For French you could choose Male or Female or 2 additional French Canadian accents.

There are other translation options for the printouts, or even the Patient educational movies. Note there are also translation options for the on screen user, but these are rarely made quickly for a patient's needs. Most of these changes are done on setup and will be reviewed in training or advanced training. Offices that have a known foreign speaking patient base can be taught to switch from their main language to a foreign option in under 10 seconds with just a few minutes of simple practice.

Yes our installation team requests every office to sign and provide a HIPAA BAA. Before we install software to a new office, we request they provide a HIPAA or BAA agreement that they have created. If their office does not have a HIPAA agreement made, we can offer one to help protect their patient data for any work our Florida Probe installation, training or technical support team does in the future for their office. Note also that most offices are using a link from another software, so we can force any password requirements to only let Florida Probe open from a link and thus their same password used for their Practice Management software will work to open Florida Probe software. Offices should be using a screen saver or way to block patients from using or seeing computers in the office when not in use by the dental staff.

This answer depends on many variables. If you are talking to a small office with only 1 hygienist who always has a dental assist available, then the main selling point is that this person could be doing much more useful tasks in the office beyond a perio chart. Even when they are accurate and easy to locate they never annonce "Warning" or "Danger" indicators as the software can do to help increase treatment acceptance. For larger offices there is rarely an assistant for multiple hygienists at the same time, so when charting is needed in multiple rooms they either have to stagger them or wait and delay their perio charting. The busier offices get the more likely it is that hygienists never have the assistant when they were promised. Dental assistant work in the office is very valuable and we don't think of VoiceWorks as putting them out of a job, rather we value their time so much we think they can be using their time more wisely. They can only be in 1 place at a time and we know the #1 place they will be is working at the side of the dentist vs. the hygenist. If an office has 5 hygienists probing at the same time, will the office want to hire additional staff, or will perio charting not get done, or put off to a future appointment? Just pick up the headset and start charting, never needing to call and wait for the assistant again.

Yes, this could be a future option, but is not yet available from the headset now. Notes can be left in the personal page for each patient. They can be left in the form of a Post-It note per tooth, but require the user to enter larger notes by keyboard.

Ever is a big timescale. No for 2021. We are looking into this option, but I can't promise a full odontogram soon. We will be expanding the Post-It Note option to allow many more custom features that offices may consider is very close to allowing their full needs for an odontogram.

The Post-It note was designed to quickly mark a Note on the Chart and link it to any tooth or location on the Chart. It appears in a bright yellow mark and is commonly marked as "NOTE" by saying "Add Note" when charting. You can come back at a later time and Open the Note to view details, or even Edit the note. You may change the Name or Title of the Note, or the description of the note. To leave a long paragraph of notes you must currently use the keyboard to type this data in. A future version would allow you to add the long notes by voice. We currently have added 2 custom notes called "OVH" that stands for overhang of a crown margin. And "ABS'' that stands for an Abscess. In the future users can create their own custom notes to quickly update the chart for Perio or odontogram charing needs.

The Voice Profiles are actually stored in the database and not the headset, so the good news is there is no limit. In theory you could have over 1,000 different users with just 1 headset. The most I have seen is 36 different users (different voice profiles) at 1 office location. We typically see 1-3 users per workstation or per headset if hygienists share rooms. In theory there is also no real limit for the number of charts a patient can have, or no limit to how many total patients a dental office can have. I think with the SQL type database we calculated you should be able to easily store 6 million charts and that would average 6 charts per patient, or 1 million different patients for a very large database. The most charts I have ever seen for 1 patient was 62 charts for an office in Japan where the patient had 62 charts. They were charting every month for over 5 years.

I think it may be confusing to say there is a free 3 month trial. We offer a 3 month 100% money back guarantee from the date of training, so that a user can fall in love with the system. If the user is not happy for Any reason at the end of the 3 months from the starting date of the training they can return the headset and get a full refund on their purchase, including the 3 months of paid in monthly use/training/support/warranty package.

It depends on the software they have. Dentrix, OpenDental and Eaglesoft = YES. Other software No. Remember that we only store the Missing teeth, crowns, implants, pontics, bridges and impacted teeth, so only these are transferred over. We are adding more software that links these over, so in time there will be more.

Here is a list with more software companies we link with as found on our website http://floridaprobe.com/pmi.htm

No, but we have an outline of training items covered in each of the different training courses.Remember there are 3 different training options. The Main 1 hour training. This is a 1 hour, and 1 on 1 training for each new VoiceWorks user. They receive a training packet and are asked to complete 2 practice charts before jumping in with real patients. Their goal is to complete 10 real charts and then update us by clicking on the LiveChat button to receive their $20 Gift Card. Once every new user in that office has completed their 10 chart goal, then they are qualified for the optional 1 hour Advanced training as a group. Both of these trainings can qualify for 1 hour each of CE credit. There is also a 15 min. front office training given on request for the front office staff on how to enter charts back to your PM software (for insurance use) and printing charts for patients to take home and improve treatment acceptance. New users are also given a series of emails with training videos as follow up from their live training.

75% of our new offices are signed up to receive updates automatically through the internet. These upgrades occur about 3 to 4 times per year. The server computer is automatically updated and then will alert each workstation the next time they run that a newer software version is now available. Users can click on a button to learn more about what is new about this update if they are curious. Users can decline up to 3 times and then will be forced to update when they close their software down for the day. The average update should take less than 4 minutes, depending on the speed of their network.

25% of our offices request updates not to be done automatically. These offices typically have very tight security or may prefer to delay smaller updates and do them manually only once per year. In these cases we can have them request them at set intervals or set calendar reminders to check in with them to encourage updates. Software updates can be sent through email as a downloadable link and then a computer technician from our team can remote in and install updates for the office or turn over that work to their support person. Updates then take about 20 minutes on the servier and about 10 minutes per workstation. Offices are typically added to an email update service to keep them aware of new updates and features. Offices that have requested new improvements may be called or emailed directly as soon as new software addresses these special requests.

We are currently discussing a Post-It Note option for Canal Treatments. That is typically called "ENDO" where the roots have been treated already. You could do the same for Fillings or Sealants, but no ideal abbreviations have yet been chosen for the various fillings or sealant options. In summary, not yet, but we are considering how to best chart these and many other options.

#1. Their ability to enter data by headset or by keyboard continues to work after the 48 months, so they can never be locked out of entering new patients.  It is important to understand that when a customer switches from paying monthly to the Smart membership, their keys switch from checking in monthly to never needing to check in again and thus can Never be turned off in the future.

If the customer had gone 48 months one month at a time (never purchased the Smart Membership) and then stopped their monthly payments, then their software keys turn off and they can not enter new charts. They can always view and print their past charts, but not enter new charts or edit/delete older charts.

#2. After 48 months end, their Warranty and software updates will end. Their free training would also end.  We would still give them some simple technical support like answer any questions they had by LiveChat or phone, but long complicated support like installing software to new computers would not be available after 48 months ended.

#3. The office could turn the Warranty/Support/Training/Software updates (about 3 per year) by buying a simple 1 year warranty/software/support plan. The cost is $644CAD for a 1 year plan and thus includes Warranty, training, support by phone/chat/email/text and software updates (3/year).  They would just buy 1 year as needed... Note for offices with multiple headsets pay an increase of 15% per extra headset.

In summary the offices can choose to come back on the warranty/software/training/support plan after 48 months at a specially reduced rate. this plan is totally optional of course and is a 1 year all inclusive plan.  Offices that don't pick the Smart Membership, never get these specially discounted rates for the warranty/software/training/support.  Remember the warranty covers 100% of the equipment, so the headset, cables and usb keys.  

The Dental Rat is quite different from the VoiceWorks system and does not offer speed or flexibility with perio charting data entry, so many users are left disappointed with the Rat. The Dental Rat product costs about $1,000 to $1,300 US dollars depending on discounts and has no monthly fee. It simply acts like a mouse on the floor that also allows numbers 1-4 to be easily entered or number 5-8 also to be entered to any chart by double tapping a footswitch button. It connects easily to your current chart, so they don't need to use separate software for perio charting and thus installs easily. The main problem is that it is very slow to complete any perio chart that has data beyond 1-4. Entering Bleeding or Recession or any other data types forces the user to either enter a 2nd, or 3rd pass around the mouth, or requires complicated use of your heel and toe to control a mouse on the screen. A chart in Dentrix for example that includes pocket depth, bleeding, missing teeth, recession and plaque could take 5x or even 6x as long as VoiceWorks. If you want to back up or skip to another tooth it may not be possible or requires complicated heel/toe mouse movements. In summary users find it so challenging to enter complicated charts, they error on only putting in pocket depth numbers and rarely add bleeding or other important chart data. Some argue that having 4 buttons on the footswitch requires you to constantly look at your foot and thus further slow down your data entry as you can't keep your focus in the mouth of the patient to use the Rat.  There are some complaints about your foot/calf getting tired during perio charting and thus a product that may have good intentions, but is abandoned or not used long term.  Maybe we should offer a special discount or Trade in discount for any old Rat users to help them give VoiceWorks a try.  I would need to approve this with Daniel first, but we could offer 3 free months of No monthly payments from Florida Probe during your 3 month trial, so there is a special deal to push Rat users to do a speed test.  Rat vs VoiceWorks, how much time (and money) can you save in 3 months?

Here is the Comparison the Rat offers on their website  https://dentalrat.com/competitive-comparison/

Their product name has always made me cringe knowing it is for a dental office and I guess the idea was a mouse is small and their product is much larger and on the floor, so they think of it as Rat sized.

Of course they say the Rat is 100% accurate, but of course people tap the wrong pedal easily and thus make many mistakes. Then it is VERY hard to undo an error with the Rat.

They say Voice is not wireless... so that is not true.

They say they offer a 3 year warranty and Voice does not (we include a lifetime warranty, training, support and updates when you are on the monthly, so of course their claim is not true. Our other option is a 4 year warranty, so that is 1 year longer than their 3

They say voice won't work in busy/noisy practice (of course that depends on the voice system).

They claim their system is easy to use (depends on your training and skill levels of course, and assumes you know your current software well and have good foot/eye coordination) 

I don't feel these comparison charts are ever truly believed by the clients and in the case of the Rat's chart are a failed attempt to put down other products.  For a customer that already has purchased the Rat and you are trying to get them to switch, I dont think a comparison chart will help them decide between the two as they already purchased the other product.  I think the Rat users are our best customer in that they have demonstrated they will spend 1,500CAD to help improve their perio charting and clearly have a need of solo perio charting and are likely frustrated.  I think we need a special deal or "trade in" offer to get them just to try out our VoiceWorks system risk free.  If they are buying VoiceWorks only for speed or only to solo probe, you should pick up some customers. Ideally we want to find the higher level customers that want to improve their periodontal program with a more complete system and educate and motivate patients to wellness.  Rat customers may be on the bottom end of the potential customer range and know we can't convert 100%.  3 free months = $309CAD trade in value

http://floridaprobe.com/pmi.htm Yes, we have a list of known Practice Management dental software and MaxiDent ($595CAD) is the only one that I know of in Canada that charges for the free bridge/link.  Softdent seems to charge sometimes ($1,100), but offices may have purchased a bridge/link for X-ray or other uses and then linking to VoiceWorks is free.  It is rare they start free and then switch without telling us as happened in the MaxiDent case. 

Yes, there are translation options for different things in the software, so it helps to know what your needs are and why we may switch some language options and not others. In summary you can switch the voice playback so patients in the chair can heir their periodontal exam results as you go and thus be more a part of the exam to be part of the "Co-Diagnosis effect" and be more likely to say yes to needed treatments once they know they have problems or there is a sense of urgency to get help for their periodontal condition. You can also switch translation/language options for printouts or even patient education options.  There is one additional area of the software you can switch and that typically is done only when you install the software and that is the full On-Screen text for offices that may not speak the default choice of English.

For Voice Playback: There are 35 different choices including No sound or Sound or Sound Effects, but only 15 different languages total with many having a choice for Male or Female options.

VoiceWorks Playback List VoiceWorks

For the Printouts there are 11 different language/translation options

VoiceWorks Printout Languages

For Patient Education Options there are 11 different languages, but note a few extra for Spanish based on different countries that have some special requests.

VoiceWorks Education Languages 

For the full software on screen translations there are only 6; English, French, Spanish, Portugues, German, and Chinese.

Yes, you can add 2 custom buttons to the top row or tootbar to be used at any time in your FP/VoiceWorks software. These buttons can play any Movie or image or take you to a website. In summary they can easily be customized or turned on to do almost anything. Most offices use them to play a Video they downloaded from the internet or that helps them explain a treatment.

Let FP support do this for you  Call or Live Chat our FP tech support team to set these up for you. 

Do it yourself:  If you want to do this on your own it is simple

Step#1  Find the Video or image or website you want to use and download it to your computer.

Step#2  From The View drop down on any workstation, just click to add the "Custom Toolbar Button 1"

Step#3  A Dialog will appear that lets you add the name of the button, I typed in "Video1", but if you downloaded a video about EMS treatment, I would call it "EMS Video".  Then type in the file location, or click the Browse button to get the name and location of the file, Then Uncheck the box "Hide Button", so this new button you just created will now appear at the top of the toolbar (see right side).

Step#4 See the new button you just created appear and click it to test it. It will open your movie in a dialog and let you play it. Note you can change the size of the movie window and also the location it pops up on the screen, so it remembers that for next time.  Now it is ready when you want to play this video from the screen anytime.  You can do this for Images, websites or any file you can browse to. Some offices use this to show an informed consent form on screen that they have patients read and or print/sign.

VoiceWorks Setup Video

Remember that You can then set up Button #2 for another item to link to if you wish. I would just click the LiveChat button and ask our IT team to do this for you.

Desensitizing agents have been shown to be protective of the pulp when placed on crown preparations to reduce dentin permeability. Advantage Arrest, a desensitizer, has been shown safe to the pulp when placed on exposed dentin. In addition, studies have shown desensitization and efficacy in treating softened dentin before placing direct restorations. Usually the tooth is first treated with Advantage Arrest 38%. This provides the benefit of sealing tubules plus the antimicrobial benefits of both silver and fluoride. 

Treating carious areas with Advantage Arrest 38% acts as a whole mouth fluoride treatment. It can also be used in place of sealants in grooves. A protective effect has been shown to non-treated teeth and surfaces. These findings come from high quality randomized clinical trials. 

Yes.

Although there are no head to head clinical trials comparing Advantage Arrest as a cavity liner, it has been used successfully in this way.

Advantage Arrest will not discolor intact enamel or dentin. Advantage Arrest can discolor demineralized tooth structure brown/black. Some of this discoloration may shadow a restoration and can create less than optimal esthetic restorations.

Yes, it will improve aesthetics.

No excavation, decay removal or anesthesia is required. The area to be treated should be “dry tooth brush” clean, free of plaque and debris. The area should be free of saliva, so as not to dilute the material. Transfer the material from a disposable plastic dappen dish to the surface to be treated and allow time to dry, which generally occurs in 30-60 seconds. If accelerated drying is required due to patient compliance use a low/weak air stream to dry the material. 

The chemical action of the Advantage Arrest occurs almost immediately in the outer layers of the softened dentin and can be confirmed by changes in the hardness and density of the dentin surface, similar to caries that arrests naturally because of positive changes in oral hygiene, diet, or daily application of fluoride in custom trays. The darkening of the lesion occurs over 24 hours and may increase over a week. Reexamination of the lesion at the next regular recall is appropriate and reapplication of Advantage Arrest may be warranted. Repeat until the lesion has arrested. 

Caries arrest studies were conducted with Advantage Arrest applications of once and twice annually. Arrested lesions were retreated every six-months. 

Clinicians have reported that they will recall their first cohort of Advantage Arrest patients within 3-6 weeks to evaluate the application and action of the treatment. Once they have a feel for the predictability of the material with their application technique they will set recall appointments based on the risk level and caries activity of the patient with higher risk patients at 3-month intervals. Moderate to high-risk patients, where it appears that home care and diet counselling has had positive impact, are recalled at 6-months. 

This depends on the lesion.  Larger will take longer; and it could be 2-6 months. If it’s deep enough, it could also reach the pulp in that time and fail. The deeper the lesion the higher the risk of failure.

No shaking, and separation only occurs from light or evaporation (or contamination from an unknown ingredient).

Advantage Arrest will arrest secondary decay around restorations including crowns.  It wil not increase the strength of the crown cement or adhesion, but will stop the disease process and harden decayed enamel and dentin.  If the decay has compromised the strength of the restoration prior to Advantage Arrest application, replacement of the restoration should be considered. 

Yes. The arrested dentin is harder than healthy dentin.

We will be looking for changes in shape and size of the translucency.  Additionally, secondary dentin formation can and does occur through time.  Also, the 97% efficacy rate that is being quoted here is regarding Advantage Arrest as a stand alone treatment (without the use of a restoration).  When you seal Advantage Arrest in with a restoration those numbers will change.  Although, we don’t have data if it will increase or decrease.  We must also consider this question in reverse.  What is the long term success rate of a restoration?  GI vs Composite? Sandwich vs single layer?  97% is pretty damn good when you start comparing Advantage Arrest arrest rates to restoration retention rates.

On healthy tooth surfaces you will get an effect for about 6+ months depending on the patient. 

It will create silver phosphate, and silver chlorides and various other particulates on the surface as well as some in the dentinal tubules.  Here’s an image of what it looks like.

Every 6 months.

Advantage Arrest treated sites will arrest and partially remineralize (although not enough to show up radiographically).  This site will now be impregnated with silver minerals and fluoride.  The silver, although chemically bound to the tooth, is not part of the natural tooth structure and will gradually release into the mouth.  This takes years to happen (2 or 3), but if enough leaches out of the tooth, it could soften back up.  This leaching effect is why one Advantage Arrest treated site in a mouth will help protect all the other teeth.

If the patient improves their care and lowers their caries risk, it’s possible that as silver leaches out, the lesion will remineralize naturally and stay arrested.  This is dependent upon the patient and their home care.  Reapplying Advantage Arrest in either case will ensure it stays arrested.

If you cover over an Advantage Arrest treated surface, it will hold the Advantage Arrest in place and not need re applied.

When you are a new user, when first arresting very deep lesions, and/or are not applying a restoration on top.

We recommend high caries risk patients have up to 5 sites treated per visit, with reapplications at intervals greater than 1 week apart. 

Yes, Advantage Arrest is antimicrobial and even one site treated in the mouth will help reduce the caries risk for the remainder of the teeth.

Advantage Arrest is prone to evaporation and light sensitivity.  As the ammonia evaporates, silver will crash out of the system leaving black flecks at the bottom.  Typically this happens slow over the course of many hours so it's possible to dispense early and use later in the day.  Light however, will be the major issue.  Strong lights can cause it to crash in just a few minutes to hours.  So, as long as they keep it dark, it may work.  Have them experiment and see how it goes.  If they start to see black build-up, it's going bad, if not, it's still good.  Also, a significant amount of black needs to build up before it's out of specification.

These applicators will not absorb the product as it applies, and there is no risk of leaving flock portions of the applicator on the site.

Also, ideal when you are first arresting very deep lesions and/or are not applying a restoration on top.

It may not penetrate as deeply in a non dried lesion.  Many times it may require a 2nd treatment in 1 week

Arrested lesions look like a scar on radiographs. You will observe radio-opacity as the mineralization of the previously softened dentin increases. Ultimately the best test of arrest is still the color change and tactile hardness of the dentin surface. 

It is advised that you educate your referring dentist about your use of Advantage Arrest since the appearance of a treated lesion might be new and confusing for many practitioners. 

Yes it can. It may not penetrate as deeply in a non dried lesion.  Many times it may require a secondary treatment in 1-2 week.

Yes, I would be lost without my Diagnodent, especially since we started our extensive Advantage Arrest program.  I feel it gives us a very good depiction of the relative The actual effect on reducing the bacteria in a lesion with resulting much lower readings from our Diagnodent gives me, the clinician, a reference point on what is happening in the lesion. ...2. if we find a tooth or area of teeth that is NOT getting decreased numbers on follow-up evaluations, it leads us to raising our level of Oral Health Education (OHE) with that particular patient and possibly shortening the interval between applications to 3 or 4 months instead of 6. I have attached an info sheet we give to many of our patients to help with the OHE, it really seems to have a profound effect on how they perceive their problem with chronic tooth decay and better helps them understand what they need to do to help solve the problem. Jo Frencken new book on Minimal intervention dentistry feels the D2 is better than other forms of electrical evaluation devices, but did not give it a high rating.  I, on the other hand, would not practice with our mine, we have 2 in our office.

Advantage Arrest does affect Diagnodent readings.  It will lower them but I’m not sure how long it takes for that reading to change.  Diagnodent doesn’t actually look at the tooth.  It looks for porphyrins produced by bacteria during their metabolic process.  Since Advantage Arrest kills the bugs, the porphyrins get reduced

Advantage Arrest can be applied near the gingival with little concern.  If accidental contact occurs it is not harmful or caustic.  The contact will result in a temporary staining of the soft tissue that will fade to nothing in a few days.  If liquid Advantage Arrest is in contact with the soft tissue for extended periods, some blanching may occur, but it is not harmful.  Do not apply near the gingival if there are open wounds, stomatitis, or ulcerative gingivitis as Advantage Arrest will be an irritant.

Advantage Arrest can be applied at the margins of restorations to arrest or prevent secondary decay.  Some surface staining may occur on the restoration, but it can pumiced off.

Advantage Arrest can be used on non vital teeth with the same effect it will have on vital teeth.  In the mouth, the color change will happen gradually over the course of about 3-5 hours with full darkening within about 24 hours.  Some teeth darken slower or faster based on moisture, lesion and light exposure.  With extracted teeth you may find faster darkening based on the lighting conditions of where they are stored.

This is hard to pinpoint, but it could be any of those reasons.  We know that some lesions simply do not arrest with Advantage Arrest (perhaps 10% of the time??).  It could be due to the lesion arresting somewhat on its own already and there is no collagen exposed.  It could be due to not drying the lesion first, or not allowing it time to penetrate the lesion (60 second soak).  We simply don’t know.  Try two or three applications and if it doesn’t work then the site may need other treatment.

It’s ok to do either of these options.  Leave it, remove partial, remove all.  All will work fine.

It’s best to re-apply every 6 months to 1 year.  Even if it still appears hardened and arrested.  The long term success rates are almost perfect if you reapply.

It is an irritant, and will likely cause some damage.  The specific results are relatively unknown as it hasn’t been studied in depth.  For this reason I recommend only using Advantage Arrest as an indirect pulp cap and not on any exposures.  I’ve attached one study on this topic.  For indirect pulp caps, there will be secondary dentin formation due to the high pH of Advantage Arrest.

Yes.  Even if there’s only 0.1mm of dentin.  Ag and F will always reach the pulp in deep applications that that is ok.  It’s the ammonia you don’t want on the pulp (and ammonia evaporates upon contact with the tooth [boiling point of 91 degrees F]).  I’ve attached an article that clears this up.

We expect about 6 months, but again, this isn’t well studied. 

I don’t expect any negative side effects of using Advantage Arrest on these sites as long as the pulp is not exposed. It will reduce the oral bacterial load. It will likely not be a long term fix, but it should buy some time until the teeth can be extracted or treated. There aren’t many other options.

You can let them paint everywhere if they want.  That’s fine too but it uses more product, and takes more chair time.

There are IADR studies that show remineralization takes place under and near varnish applications.  You can find them by searching their abstracts for Pfarrer.

After Advantage Arrest application dry the surface as well as possible, then proceed with whatever the recommended process for restoration is that the restorative material requests.  

CAUTION: if there is a light cure step, be prepared for the material to blacken in the light cure step. 

Yes.  Very much compatible to the point it's recommended as part of the Silver Modified Atraumatic Restorative Technique (SMART).

Yes, it will improve esthetics, help to arrest remaining decay and lessen the blackening oxidation.

It can be applied very near the pulp, as long as there are no exposures.  If the Advantage Arrest leaches through infected or affected dentin to the pulp it is not a problem; only when there is exposure.  Placing Advantage Arrest over a GI will only help the margins from secondary decay, and will give you surface staining.  Under GI will provide a strong liner and protection from secondary decay.

Advantage Arrest is only corrosive in its liquid form.  Once applied and dried it is no longer corrosive.

No especially if exposure.

No.  The goal as clinicians is not to remove 100% of the decay, but to stop/prevent the disease.  Decayed surface that can be returned to function (even without restoration) is stopping the disease and restoring function.  You’re just using a chemistry instead of amputation.  Yes, leaving decay under a restoration, treated with Advantage Arrest prior to placement will leave some radiotranslucency under/around the restoration.  This must be noted in the chart and then watched for changes over time, rather than the presence or absence of translucency at any given point.  This is a change from previous thinking about restorations.

Advantage Arrest is ionic silver and ionic fluoride held in suspension by the ammonia.  It reacts with the teeth immediately upon application and tries to bind with anything that will allow it.  That’s why it works so fast.

Approximately 25 microns into enamel and 300 microns into dentin. This will seal off the surface of any lesions and cause the remainder of the lesion to arrest. In a 2002 study by Dr. Chu, 100% of lesions stained black to the outer edge of the lesion were arrested.

10.4

Fluoride varnish is sodium fluoride.  Advantage Arrest is free, ionic fluoride.  Once you factor out the weight of the sodium in fluoride varnish, the 5% works out to 22,600 ppm F rather than 50,000 ppm F that 5% denotes (fluoride makes up 45.45% of the weight of NaF).  In Advantage Arrest, 5% is free ionic fluoride, but it’s not adjusted for specific gravity.  When you do that mg/ml it works out to 44,800 ppm F.

On a healthy tooth, Advantage Arrest deposits free silver and free fluoride ions as it does anywhere.  The silver will form silver phosphate on any receptor sites on the surface of the tooth as well as some silver chlorides and silver oxides.  The oxides do not get trapped in the body of a lesion, or bind to proteins in the tooth (since they are all covered by hydroxyapatite) so they simply wash away.  Most Silver chlorides and other random mineral formations do as well and you’re left with silver phosphate bound on exposed phosphate in the hydroxyapatite outer layers (which gives you the protection).  The exposed calcium binds with fluoride to form calcium fluoride and florapatite. We know these minerals form, and there are others we are still discovering.  The short answer is that excess silver and silver oxides wash away.

Yes and no.  Advantage Arrest will denature all proteins in bacteria and fungus so it will kill both.  However, when you wipe out a biofilm, it leaves the chance to “regrow” after the kill whatever opportunistic organism gets there first.

9.5 mg would be correct, but you must also account for the specific gravity of about 1.25 or 1.26 of the product.  This brings the actual number to 7.6 mg Advantage Arrest per drop (if a drop is 0.025 ml).

Advantage Arrest does not cause secondary dentin to form.  It works by very different means when compared to other fluoride products.  Most fluoride will create fluorapatite and regrow portions of lost enamel rods and hydroxyapetite crystals.  The fluoride portion of Advantage Arrest does do this as well, but that is not the main function of how Advantage Arrest works.

The main hardening effect of Advantage Arrest comes from the silver.  Silver in its ionic form is wicked into the body of the lesion and binds to collagen and phosphate sites.  It forms silver chlorides, silver phosphates, silver oxides (the black one) and various other minerals that we don’t fully understand yet.  These minerals fill the voids where enamel rods, hydroxyapetite crystals and other tooth structure once was but was lost to the caries disease.  These “cavitations” within the lesions get filled with silver precipitates and harden.  This is why Advantage Arrest will even harden up the soft mushy dentin in lesions.  Think of it this way… if you think of the lesion having a similar structure to a sponge; fluoride will harden the sponge to make it a hard sponge but it will still have holes.  Advantage Arrest will fill in the holes in the sponge as well and harden the sponge too.

Another analogy is the galvanization process of steel.  Steel is coated with zinc to fill in the voids and reduce the likelihood of rust.

Silver, and most metals, are broad spectrum antimicrobials in that they kill a wide variety of bugs.  I think it would be effective against anything it touches.  Having said that, it’s likely limited to activity in the mouth.  It will be diluted so far if it passes into the gut that I would expect any notable activity. 

All of the research published never mentioned GI side effects which would be what is noticed first in any type of bacterial changes in the gut.

There is always oxygen present.  Perhaps not in quantities to sustain aerobic life, but to some capacity.  The tooth passes fluid through diffusion channels and tubules constantly, and oxygen can be preferentially bound to by numerous materials.

Also the restoration process itself can introduce oxygen, and sometimes energy in the form of light or other, that can cause or quicken the blackening. 

GI restorations are designed to be porous and allow some transfer.

There is always oxygen present.  Perhaps not in quantities to sustain aerobic life, but to some capacity.  The tooth passes fluid through diffusion channels and tubules constantly, and oxygen can be preferentially bound to by numerous materials.

Also the restoration process itself can introduce oxygen, and sometimes energy in the form of light or other, that can cause or quicken the blackening. 

GI restorations are designed to be porous and allow some transfer.

That's what its main use is for here; to prevent sedation or general anesthesia use in the very young patient group. It's the best reasonable option, with almost no toxicity risk; much less risk than you have with general anesthesia or sedation.

Scientific literature suggests 1-2 drops (same than for adults) per 10 kg body weight for children under 3 years old.

Reference: University of California in San Francisco Advantage Arrest Protocol

Silver diamine fluoride should not be placed on exposed pulps. Other topical fluorides (e.g. fluoride varnish) should not be used in the same appointment. Studies have shown that 38% Advantage Arrest conveys more effective protection against decay in other teeth than fluoride varnish with reduced overall fluoride exposure. 

It will have an effect on the whole mouth but not as much as if you would have applied it on all of the non-decayed occlusals.  If you’re using it with the intent to replace a sealant, I would apply it to all occlusal surfaces that you need that benefit.  The other teeth (incisal for example) will also receive a benefit.

There are no postoperative limitations. Patients may eat or drink immediately. Patients may brush their teeth with fluoridated toothpaste on their regular schedule. 

The Margin of Safety for the volume of product needed to treat six sites is within 130 times the NOAEL (no-observed-adverse-effect-level). Treating more sites in one visit will likely have little practical impact on patient safety. Like protocols for fluoride varnish application, the suspension for several days of fluoride supplements is advised.

There are no demonstrated or proven side effect on pregnant and/or breastfeeding women as per the latest studies on the matter. However, as clinicians, we still have to follow the risks vs benefits rule.

Some blackening (or a significant amount) due to exposed collagen and open dentinaltubules which will fill with silver.

Colloidal silver will provide much much higher amounts of silver than an application of Advantage Arrest.  If the patient is going to continue using colloidal silver, it would be a good idea to have them stop taking it for a few days after Advantage Arrest application just to be sure, but we don’t forsee any issues.

Advantage Arrest and fluoride varnishes that are applied once every six months or so are not notable factors when calculating fluorosis risk.  Fluoride varnishes caused fluoride blood plasma levels about the same as brushing your teeth with regular toothpaste, and Advantage Arrest has 1/10th the amount of Fluoride of a fluoride varnish application.  In short, it will be almost immeasurable. 

Daily use of F products and ingestion of fluoridated water will be the notable factors that determine fluorosis.  

The capillary action of the applicator brush supplied with Advantage Arrest reduces dripping from the brush when transferring the material from a disposable plastic dappen dish. Patients should be protected with bibs and safety glasses as in any clinical procedure. Contact to skin and oral tissue is not harmful but is likely to cause temporary tattooing. On skin and oral soft tissue the effect is not immediate, rather it will be noticed within hours. The staining will be limited to direct areas of contact and will fade over a period of 24-72 hours. If you believe you have touched the applicator to the skin of a patient it is good to advise them of possible tattooing. 

When dispensing Advantage Arrest it is a good idea to use an absorbent material that has a coated bottom, like a patient bib, under the dappen dish and applicator to avoid contact with metal trays and office countertops. If Advantage Arrest comes in contact with instruments or countertops wash immediately with water, soap, ammonia or iodine tincture and then rinse thoroughly with water. Sodium hypochlorite (household bleach) can also be used for difficult stains. 

Yes, darkening of decayed, demineralized sites occurs as the lesion arrests. This is similar to what is seen when caries arrests from changes in diet or increased use of other fluorides. A recent study showed that patients see the discoloration as a clear indication that the treatment is working. Similar to the treatment of eroded and hypersensitive dentin, the treated area can be restored using glass ionomer or with a sandwich restoration of both glass ionomer and composite. In lab studies, bond strength of composite by itself to treated surfaces is reduced but the clinical importance is unknown. 

38% Advantage Arrest should not be diluted in an attempt to reduce discoloration. Studies have shown that diluted solutions may not be effective for caries arrest. 

Ionic silver adsorbs onto almost any protein surface and is especially tenaciously bound to denatured proteins. This accounts for the specificity to carious collagen over normal collagen, but both will stain. The differentiator between these stains is that with Advantage Arrest use, intrinsic pigmentation of a carious lesion occurs and surface protein staining occurs primarily on healthy tissue. These oxides are bound to the tissue and don’t wash or polish away. This is why the blackened lesion retains its dark color for so long, and is most likely the reason the antimicrobial effect is long lasting. 

The functional indicator of effectiveness is when the silver oxide is bound to the diseased collagen. If the surface doesn’t turn black, the silver didn’t bind and the antimicrobial effect will only be short lived. 

Not if there is no active decalcification and collagen proteins exposed.

Ozone is a completely different animal.

The ozone machines try to control the environment around the tooth for a few seconds/minutes and generate ozone that gets pumped into the body of lesions.  This gas will kill bacteria in the lesion and on surrounding surfaces.  Ozone does nothing for the mineral of the tooth, or to add structural integrity to the site.  It is an effective killing tool against the bacteria.  This reduction in turn leads to natural mineralization over the next weeks/months, but it’s a slower process and then subject the patients oral habits.

Advantage Arrest uses silver as it’s antimicrobial agent that is also driven (capillary action) into the lesion.  It kills bacteria and then also binds to the proteins in the tooth.  It creates minerals that harden in the voids of the lesion and add structural integrity to the site very quickly (48-72 hrs).  It also contains Fluoride so you get fluorapatite formation too.

In short, they both “arrest” or stop the disease, but Advantage Arrest is the only one that adds structural integrity too.  


Allow to air dry, do not rinse” and don’t blast with air. Cotton pellet blotting is fine too. I doubt it will demineralize. 

They are designed to clean, but not abrade the surface.

Yes, it’s been thought about, but likely not possible.  Advantage Arrest is ionic in the liquid so it will bind with any new additives.  Blue dye is about all we could get into the liquid.

These are very different products.  Advantage Arrest can be used on resorption (to slow or stop the progress), but there is no data on this use, and I’ve heard conflicting results.  Some improved, some continued to worsen.

It puts silver in the tooth, which isn’t natural.

If nothing else can be done, it’s worth a try.

I would avoid any varnish prior to Advantage Arrest application.  Always Advantage Arrest first, then Varnish, otherwise the resin of the varnish may prevent Advantage Arrest from entering the tooth.

• Antibacterial agent 

• Fluoride

• Desensitizing

• Caries control

• It is shifting what you bill to a recurring treatment of arresting disease

• More conservative

• Patient satisfaction

• Minimize, and even avoid local and general anesthesia

• Cut down on chair time with a restoration to do other procedures

• Buy time until the treatment of choice can be done

We don’t expect any negative side effects of using Advantage Arrest on these sites as long as the pulp is not exposed. It will reduce the oral bacterial load. It will likely not be a long term fix, but it should buy some time until the teeth can be extracted or treated. There aren’t many other options.

SDF should not cause long lasting pain unless there is an exposure of the pulp or other wound.  It’s possible to get very short term zingers as the ammonia evaporates, not anything longer than a few seconds.

When applying Advantage Arrest and wiping away the excess, do we etch on top of wet SDF (after a minute of penetration) or we give it a few secondes of light cure before the etch and rinse step?

Answer:

Complete the SDF application by drying the surface before Acid etch.  Dry away excess SDF, then move to the restorative part.  Avoid light cure if possible.

Use eye protection that will work for the patient. Even swimming goggles that seal could be an option. SDF has a pH of ten so damage can occur. I don’t know he severity, and I prefer not to find out. 

Regarding the abscess, SDF will not speed that process, but can slow the process.  In most documented deep lesion cases, the outer layers arrest, the inner layers still proceed for several months until they either arrest due to being cut off from the oral environment, or they reach the pulp and abscess.  Unfortunately, it sounds like the latter took place here.

I use the Fuji line of glass ionomer cement restoratives.  Because I receive an overwhelming number of inquiries related to this topic, I have created online resources.

Please direct her to my website, YouTube channel, and comprehensive CE course via the following links

The topic of leaving decay under a restoration has been researched over several decades; even without using SDF as a liner.  Edwina Kidd did much of this research and it can be seen in PubMed just by searching her name.  She showed that bacteria may exist, but the decay doesn’t progress when cut off from the oral environment.  The hall crown technique also proved this.  SDF as a liner has proved this again.  More recently Rella Christensen has shown that bacteria exist under SDF treated sites and under restorations, but the decay doesn’t progress.

In short, you will never get a sterile environment, even if you remove all of the decay.  But, the lesion will stop in most cases.  Adding SDF is the belt and suspenders method to ensure this takes place.

Back in the Amalgam days, Silver nitrate was used in this manner which is why those amalgam restorations lasted decades.

The variation they saw in drop size and ppm F and Ag is well within the specification range of the product.  It’s effective at all of the measured points.

In short, she proved that the product should be opened, dispensed and then closed with the cap on tight when in storage.  That’s exactly what our instructions say.

In essence, the publication means nothing for SDF, but we’re glad JADA included another article on SDF.  Also, the levels tested are still 10 fold lower than fluoride varnish on toxicity, and hundreds of times lower on silver than the EPA’s limits.  The conclusion in the article makes you question that, but there is no question.

Source: https://drive.google.com/open?id=1WeS2kIpAJpW_IOR8MQhtcYhAlyH1tb2U

As you know, the X-pur Crystal is a low pH agent & so after the clinician removes the temporary restoration after the 2-week interim provisional -- I strongly suggest to use the X-pur Crystal to cleanse & re-apply to the entire crown restoration surface again & then gently air disperse the entire surface from 4 to 5 inches with brief jets of air for only a moment in order to disperse the agent & then follow with the adhesive luting system whether a 1-step agent like the Kuraray system.

Nothing documented.

It’s odd that SDF would burn one location but not another in the same patients mouth.  My guess is that there was some form of open wound at the site near 17 and not at the other site.  The issue was the wound and not the application or the product.  Ulcerative gingivitis or any wound would cause pain and irritation, potentially blanching and other local issues.  If it were an allergic reaction it would be more generalized and happen at both locations.

Sensitivity after use could be due to deep caries under the restoration, it could be due to changing the osmotic pressure in the dentinal tubules or could be wounds or pulpal involvement.

Nitric Acid is by far the best thing to remove SDF stain, however, it is very corrosive to some surfaces and skin so use extreme caution.  You can get it at hardware stores such as Home Depot in the form of Concrete Cleaner solution.

It will eat metals, marble, and remove the surface luster from some artificial surfaces, but we’ve seen it safely used on plastics, formica, corian, granite and other surfaces.

You may also try D-Lead soap (order it on line).  It’s  a soap for firearms users to remove lead residue from skin and will also lift silver.  I have not tested it so I cannot vouch for its effectiveness.

SDF has been used with retraction cord and there aren’t any known interactions with the hemostatic agent.  However, the clinicians that I know that have done this decided not to do them again after seeing the stain caused by the retraction cord.  The cord will absorb and spread the SDF all the way around the tooth, and onto the gingival, leaving black stains on the entire surrounding gingival (which is temporary).

I recommend using the retraction cord first, then removing and using SDF after while the soft tissue is still slightly retracted from the tooth, but no cord is present.

Ozone is a good way to kill bacteria, but it doesn’t harden residual decay left behind.  The statement that lesions must be decontaminated prior to restorations is not accurate.  This was proven repeatedly by the Hall Technique crown studies, and Dr. Edwina Kidd’s work in the 1990’s, again by Dr. Tencate’s work, and then again by Dr. Chu’s and Dr. Geoff Knights work with SDF.  You simply need to have sound margins when the restoration is placed and the residual decay or carious material will die and arrest.

Ozone does kill bacteria, it is effective, but SDF does that and hardens residual decay. Regarding depth of penetration, many things affect that with both techniques.  Lesion size, severity, dryness, etc. It’s hard to say one is deeper than the other, but we do have data showing SDF penetrates 2.42mm into lesions.  Likely farther in some cases.

No issue using it in children as young as their first erupting tooth.  2 drops per 10 kg.  I haven’t seen any study that demonstrated any deleterious effect on permanent dentition formation.

I forget what’s on the Canadian labeling, but our limitation of 5 sites per visit was due to the sensitivity study and claim we have in the USA.  The study only looked at five sites, so that’s what the FDA allowed.  From a toxicity perspective, you’re safe doing extensive applications, which can likely be completed with 2 drops in small children.

Yes, but a similar benefit could be achieved by placing the SDF around the margin after the crown is seated.  If you have a PFM crown, SDF darkness won’t be seen through the crown.  If you have a zirconia or milled block crown, it’s possible that the SDF black could be seen through the crown so be cautious for aesthetics.  The margin will have a black ring around it if SDF is used.

Yes there is a benefit here.  SDF on a healthy surface will provide similar benefits as a sealant, but will need reapplied every 6 months.  It won’t stop food trapping of course, but it will stop or slow demin in those areas.

I would reapply varnish as a generalized application, although SDF does provide a benefit which may be as strong or stronger than varnish.  The data supporting SDF for whole mouth prevention exists, but it’s not a lot of data yet.  To be sure, I’d apply the varnish since there is much more data supporting it’s preventive actions.

When the AA bottle is closed tightly, and the temperature fluctuates through time ammonia wants to evaporate.  The liquid ammonia becomes gas, and the bottle gets slightly pressurized, just like a soda bottle with CO2.  It can make a pop when opened. If the bottle was inverted or shaken before opening, or if dried silver is in the threads of the cap, it can cause that material to puff/spray out when opened, and cause a popping noise.  

 

The good news is that it was stored properly, in a closed container.  There’s little that can be done to stop the popping, but make sure the cap and threads are dry and clean before closing, and store the bottle upright to minimize any of this action.

I believe that the reason why Cetacaine cannot be used on large areas of denuded or inflamed tissue is to prevent excessive systemic absorption of the anesthetic.

The good news is that Cetacaine isn’t used on large areas of denuded or inflamed tissue because it is applied drop by drop in periodontal pockets. The concern is, most likely, with the spray, as it is more difficult to control the quantity of Cetacaine being applied to the tissue which subsequently, could lead to large areas of denuded or inflamed tissue being affected which, could potentially, increase the likelihood of excessive systemic absorption.

At the dose we recommend and using the delivery method we demonstrate

(i.e. 0.4 ml syringe), Cetacaine is a safe topical anesthetic.

This is a compounded anesthetic that looks to be very powerful. Oraqix is only 2.5% each of lidocaine and prilocaine. In the USA, we also find practices using pharmacy-compounded topicals. Currently in the USA, the FDA allows pharmacies to compound unique formulas for a doctor’s prescription, that aren’t available otherwise. It is to be prescribed for, and used on, one specific patient. However, we meet dentists and hygienists all the time that tell us they use a compounded topical. There are liability concerns should there be any issues with the compound or the facility that made it. Search “FDA warning letter compounding pharmacy”. I am not sure of the FDA approval process for these compounds, if there even is one.

As to the formula and how it compares to Cetacaine? It appears to contain very high concentrations of Lidocaine and Prilocaine, I can’t see how much tetracaine HCl. Lidocaine and Prilocaine are absorbed systemically, so if an injection should also be required, the added dosing must be seriously considered.

I hope this helps. Please let me know if you have other questions or need more information.

- This product does not have manufacturer's directions and the exact dosing in unknown. Basically, they would by applying it blindly.

- The TAC 20 does have double the tetracaine at 4%. The 2% tetracaine with Cetacaine in combination of the 14% Benzocaine, and 2% butamben provides exceptional comfort for the clients that lasts for close to 1 hr. This is immediate and profound.

Cetacaine can cause allergic reactions since para-aminobenzoic acid (PABA) is the main degradation product of benzocaine, which is one of the 3 active pharmaceutical ingredients (APIs) in Cetacaine.  Information on adverse reactions is contained in the prescribing information (i.e., the package insert).

Today’s environment is characterized by heightened sensitivity to virus infection and inflection control. This new reality is the new norm.

We are introducing Cold & Flu Guard™ because Health Care Workers, and especially Dental Professionals and Pharmacy Teams are at heightened risk of viral infection due to their profession, their patients and their interactions with consumers.

There is a need for a novel, effective, convenient, safe and well tolerated options to protect themselves, their staff, their patients and their family against viruses that enters through their mouth and nose.

The Cold and Flu Guard barrier consists of two ingredients that together provide the main effective result – High molecular weight Hyaluronic Acid and Flavobac.

Traps: HA creates an organic barrier that traps pathogens.

Deactivates: Flavobac inhibits the viruses’ ability to bond, deactivating their ability to infect cells.

Protects: The Cold and Flu GuardTM barrier protects the oral and nasal cavity and throat.

Naturally rich in antioxidants (bioflavonoids) Non-GMO, Natural, Alcohol-Free,
Paleo friendly, gluten free Non-prescription

Cold & Flu Guard™ is a class 1 medical device in Canada. According to the Canadian Medical Devices Regulations, this class of devices does not require an approval process. Moreover, a prescription is not needed to obtain the Cold & Flu Guard. OS holds an establishment license for medical devices, which gives it authorization to sell and distribute the product in Canada.

C&FG is a Novel product, designed to protect and relieve.

• C&FG Forms a barrier against sore throat and nasal congestion.

The primary components.

• Traps: HA Traps and isolates pathogens by coating the mucosa whilst Priming Neutrophils.
• Primes: HA Primes Neutrophils.
• Deactivates and destroys: Flavobac: destroys viruses’ envelope, deactivating and destroying the virus, neutralizing their ability to infect cells

No, it does not require a prescription.

The active ingredients come from Spain and England, are organic, non GMO, and purified – with an exclusive process and patented.

Anyone at risk of getting a cold or the flu can benefit from COLD & FLU GUARD. However, not everybody can use Cold & Flu GuardTM. Do not use Cold & Flu Guard if you are hypersensitive/allergic to any of its ingredients. Do not use Cold & Flu Guard without the approval of your physician if you are pregnant or under 5 years of age. We suggest that you contact your doctor if you have a high fever or if your symptoms are worse than those of a common cold. These symptoms may be due to something else. Keep out of reach of children to prevent accidents with small parts.

A. FOR SELF AND STAFF - We recommend that clinicians use Cold & Flu GuardTM in addition to their PPE protocol, 5 minutes before they get to the clinic, every 3 hours at the office, and when they leave to go home.

B. FOR CONSUMER: Recommend, as the oral expert, the Cold & Flu GuardTM to their patients.

• Starting with the most at risk.
• And risky work, social, travel TM situations.

C. FOR YOUR PATIENTS: Offer Cold & Flu Guard nasal and oral spray as an add-on to their PPE protection when they arrive at the clinic to create an additional protective barrier against sore throat and nasal congestion.

Integrate in their clinic protocol

1) As a part of HCW office protocol.

2) As a new part of daily PPE – to reduce the risk of self infection.

3) or at the first sign of an infection (sore throat or nasal congestion).

We recommend that patient use Cold & Flu GuardTM as soon as they feel that they are at risk of becoming infected with a cold virus. For example if someone can’t social distance such as a store, a train, a long term care, a restaurant, a family gathering or in an office.

They should open your mouth and point the nozzle towards their throat. Press the pump and spray 2 puffs every three hours up to 3 times a day. Repeat the same action in each of nostril.

Cold and Flu Guard is easy to use and begins working immediately by forming a protective barrier.

Flavobac has been demonstrated to kill 99% of all tested viruses within 5 minutes.

The Cold and Flu Guard barrier protects the mouth and throat, Cold and Flu Guard is used in the oral cavity, nose and throat, where the cold and flu viruses take hold and multiplies.

Cold & Flu Guard is an organic non GMO product. It is safe and well tolerated. When using the spray in the nasal cavity, some people may notice a slight stinging sensation at first, this subsides after a few seconds, please do not be alarmed by this. The application of the product may also cause a short term runny nose, this is perfectly normal and is a sign the products is working.

The Cold and Flu GuardTM barrier protects the nose, mouth and throat. In-vitro tests show that FlavobacTM is effective in colds and flu viruses.

Flavobac is a unique organic, non GMO, Plant-based bioflavonoids complex adapted for medical use by a UK Research Team.

Flavobac has better anti-viral activity than antiseptics and has already been proven to be an extremely effective virucide in vitro against severe acute respiratory syndrome coronaviruse (SARS-CoV Urbani). FlavobacTM also inactivate enveloped respiratory viruses influenza A (H1N1, H5N1, H3N2), respiratory synctial virus (RSV), icosahedral symmetry, such as rhinoviruses, coxsackievirus, gumboro virus, herpes virus 1 and 2, and hepatitis A and B viruses (Data on file).

Flavobac has been shown to be safe when administered to the oral and nasal cavity and as a mouthwash

Since the late 1990s, a British team of scientists has been working to achieve a biotechnological breakthrough in pathogen control building on research initiated in the 1930s by Hungarian Nobel Prize winner Szent-Gyorgi.

Years of intensive research lead to the development of a complex which had demonstrated efficacy against 40 viruses and bacteria and validated in laboratory tests which comply with European Standards.

Flavobac was one of the complex born from this research from a former ICI chemist, Ian Ripley.

Safe; Flavobac is an organic non GMO product with extensive safety.

Tolerable: While some patients may experience tingling in throat this is normal, and possibly a sign that it is binding properly. Do not be alarmed, it will pass soon.

Flavobac is very well tolerated especially when compared with antiseptic agents and medications in common use[15].

Bioflavonoids have been consumed by humans since the advent of human life on earth, that is, for about 4 million years. They have extensive biological properties that promote human health and help reduce the risk of diseases.

The United States Department of Agriculture has estimated that in the United States, adults generally consume 200–250 mg of bioflavonoids each day.

Flavobac is a natural bioflavonoid powder extract from bitter oranges. The main component are the citrus flavanones naringin and neohesperidin. A wide spectrum of beneficial effects has been attributed to naringin including cardiovascular, hypolipidemic, anti-atherosclerotic, antidiabetic, neuroprotective, hepatoprotective, and anticancer activities [14, 15]. The FDA consider naringin and neoheperidin as GRAS. As indicated in the Food, Drug and Cosmetic act 21 USC 321(s), GRAS substances are exempt from the premarketing clearance. They stated that “Flavonoids comprise a group of naturally occurring compounds which are among the most ubiquitous in the plant kingdom. They are found in every family and in nearly every species of the higher plants.” Kuhnau (1976) stated that flavonoids are the most common and active antioxidants.” ”Naringin has been accorded GRAS status as a flavoring agent in food (21 CFR 182.20. Office of the Federal Register, 1981) and hesperidin has been given similar status ( Buckely, 1968.)”.

Flavobac is used worldwide under the CITROX formulation, both as oral rinse, tooth paste, handwashing agent (usually a lower concentration solution containing foaming agents) and for pre- procedural oral antisepsis (usually simply as a low concentration solution). CITROX is commercially available since ......in Europe as a mouthwash and as a sore throat spray’.

Cold and Flu Guard is an innovative unique product that forms a protective barrier against the sore throat and nasal congestion caused by cold and flu viruses. It is highly innovative as it is the first and only to bring together HMWHA & FLAVOBAC and demonstrating efficacy against difficult strain of cold & flu viruses.

C&FG is a unique plant-based patent protected complex of potent bioflavonoids and hyaluronic acid augmented by xylitol and natural acid.

FLAVOBAC is a complex of plant based bioflavonoids natural biomolecules that are known to be effective antivirals. These biomolecules act at different stages of viral infection, particularly at the molecular level to inhibit viral growth. Its exact antiviral Mechanism of Action against RNA and DNA viruses is still being researched.

The combination of the bioflavonoids and organic acids make the FLAVOBAC a potent antimicrobial, antiviral and antifungal to due its ability to:

• Bind with cell walls to effect extracellular and soluble proteins through hydrogen bonding which the bacteria and viruses need to survive.
• To disrupt the microbial membranes including cell wall polypeptides and membrane-bound enzymes.
• The bioflavonoids (hydroxylated phenols) have been shown to be toxic to microorganisms as they effect enzyme inhibition.
• The bioflavonoids have been found to stimulate macrophages which have an indirect negative effect on infections.

There is no limitation on days of therapy. This will go in the same section illustrating Bioflavonoids have been consumed by humans since the advent of human life on earth etc.

Flavobac™ is an organic non GMO bioflavonoid product with extensive safety. Cold & Flu Guard can be used every day continuously as a barrier against sore throat and nasal congestion. Follow the recommended doses indicated on the label and continue to use at least 2 days after symptoms subside.

Bioflavonoids have been consumed by humans since the advent of human life on earth, that is, for about 4 million years. They have extensive biological properties that promote human health and help reduce the risk of diseases. The United States Department of Agriculture has estimated that in the United States, adults generally consume 200–250 mg of bioflavonoids each day. Each dose of Cold & Flu Guard contain 1.2mg of bioflavonoids.

Ideally wait 30 minutes to allow the product to coat.

This is not required.

Flavobac has demonstrated efficacy against many of the leading causes of viral infection (see chart). It is labeled both to relive and protect against current symptoms of sore throat and nasal congestion. Furthermore, the components of flavobac and HA play a critial role nad have been demonstrated as follows: Traps: HA Traps and isolates pathogens by coating the mucosa whilst Priming Neutrophil Deactivates and destroys: Flavobac: destroys viruses’ envelope, deactivating and destroying the virus, neutralizing their ability to infect cells

Recommendation is to apply 3-4 times daily. At the start of the day, mid morning, mid afternoon, end of day.

C&FG is a unique plant-based patent protected complex of potent bioflavonoids and hyaluronic acid augmented by xylitol and natural acid.

Ingredients also include Water, glycerine, xylitol, polysorbate 20, ethanol, bioflavonoids, mint flavor, disodium phosphate, anhydrous, stevia, cetylpyridinium chloride, sodium hyaluronate, Paleo friendly, gluten free.

C&FG is Naturally rich in antioxidants, tested for quality and potency. Flavobac™, and hyaluronic acid are 100% natural ingredients. C&FG is Paleo friendly, gluten free, and sustainably sourced.

• Do not use Cold & Flu Guard™ without the approval of your physician if you are pregnant or under 5 years of age.
• Do not use Cold & Flu Guard™ if you are hypersensitive/allergic to any of its ingredients.
• Nasal: One may notice a slight stinging sensation at first; this subsides after a few seconds. This product may also cause a short-term runny nose.
• Contact your doctor if you have a high fever or if your symptoms are worse than those of a common cold. These symptoms may be due to something else.
• Keep out of reach of children to prevent accidents with small parts.

When using the spray in the nasal cavity, you can notice a slight stinging sensation, which subsides after a few seconds. It can also cause a short-term runny nose and watery eyes. Because Cold & Flu Guard contains natural acids, it may persist, discontinuation should be considered.

We are following recommended guidelines, which states that herbal/health supplement should not be given to a child without the advice of a doctor.

We recommend 3 times a day as per Cold & Flu Guard labelled indication.

Nasal bleeding has not been reported in Europe were it has been sold for the last 3 years.

People who are allergic to bioflavonoids can be allergic to Flavobac.

It is recommended to keep out of reach of pets and not to use on pets as C&FG contains Xylitol and the concentration within C&FG has not been assessed in pets.

No nasal bleeding has been reported in Europe were it has been sold for the last 3 years. When using the spray in the nasal cavity, you can notice a slight stinging sensation, which subsides after a few seconds. It can also cause a short-term runny nose and watery eyes.

The combination of HA and Flavobac coats the nasal and oral cavities and keeps your mouth and nose humid.

Bioflavonoids have been consumed by humans since the advent of human life on earth, that is, for about 4 million years. They have extensive biological properties that promote human health and help reduce the risk of diseases.

The United States Department of Agriculture has estimated that in the United States, adults generally consume 200–250 mg of bioflavonoids each day.

Flavobac™ is a natural bioflavonoid complex extracted from bitter oranges. The main components are the citrus flavanones naringin and neohesperidin. A wide spectrum of beneficial effects has been attributed to naringin including cardiovascular, hypolipidemic, anti-atherosclerotic, antidiabetic, neuroprotective, hepatoprotective, and anticancer activities [14, 15]. The FDA consider naringin and neoheperidin as GRAS. As indicated in the Food, Drug and Cosmetic act 21 USC 321(s), GRAS substances are exempt from the premarketing clearance. They stated “Flavonoids comprise a group of naturally occurring compounds which are among the most ubiquitous in the plant kingdom. They are found in every family and in nearly every species of the higher plants.” Kuhnau (1976) stated that flavonoids are the most common and active antioxidants.” ”Naringin has been accorded GRAS status as a flavoring agent in food (21 CFR 182.20. Office of the Federal Register, 1981) and hesperidin has been given similar status ( Buckely, 1968.)”.

Refer the question to our medical expert who will answer the following:

Virucidal activity of Flavobac™.

Flavobac™ has a higher virucidal activity than commonly used antiseptic agents including chlorhexidine and alcohol 70%. It has been shown to be active in vitro against the coronaviruses that have caused epidemics in the last two decades, namely SARS-CoV causing the severe acute respiratory syndrome (SARS) epidemic of 2002–3. SARS-CoV-2 is highly homologous with SARS-CoV, and as such it is considered a close relative of SARS-CoV[12]. Initial in vitro work looking at the virucidal activity of Flavobac against SARS-CoV by Hvivo’ group[Data on file] showed that the lowest concentration of Flavobac to be effective (>1 Log reduction) was 2% when used for 5 minutes or more under “dirty” conditions and 5% when used for 1 minute or more; [Data on file]. In subsequent in-vitro work by Hvivo’s group Flavobac™ showed a clear reduction (> 1 Log reduction) in viral titre for Influenza A: H3N2, H5N1 (Bird Flu) and H1N1 (Swine Flu), the lowest concentration tested and yet still effective against all Influenza viruses, was 1% when used for 1 minute or more. Virology laboratories in the United Kingdom have independently demonstrated that Flavobac is efficacious in the inactivation of three different subtypes of Influenza A: H5N1 (Bird Flu), H3N2 and H1N1 (Swine Flu). This was observed as a significant reduction of viral titre observed in the two separate trials performed. Other studies evaluated the virucidal activity of Flavobac against Human Rhinovirus and HIV. The results demonstrated significant virucidal activity against all the viruses at all concentrations and time-points.

We are working on a nasal and oral applicator similar to the one used in Europe.

Yes, we can suggest that the patient distribute the Cold & Flu Guard in their mouth and throat for a few seconds before swallowing it.

We recommend a normal inhalation while spraying

Clinical studies are in development to determine how long does the effect last. We recommend that Cold & Flu Guard be used 3 times a day to maximize its effect.

This information is proprietary and covered under patent.

Deactivate means that the virus cannot infect healthy cells once it has been in contact with Flavobac. [A virus is a tiny infectious agent that reproduces inside the cell of living hosts. Unlike most living things, viruses do not have cells that divide. So technically, they are not killed, they are deactivated].

Each dental clinic should decide how to integrate the Cold & Flu Guard in their clinic protocol. Given that the bottle does not touch the patient’s mouth or nose and can be administered by the clinic staff, they may decide to use one bottle for more than one patient.

Flavobac has demonstrated efficacy against many of the leading causes of viral infection (see chart). It is labeled both to relive and protect against current symptoms of sore throat and nasal congestion. Furthermore, the components of flavobac and HA play a critical role and have been demonstrated as follows: ü Traps: HA Traps and isolates pathogens by coating the mucosa whilst Priming Neutrophilü Deactivates and destroys: Flavobac: destroys viruses’ envelope, deactivating and destroying the virus, neutralizing their ability to infect cells.

Yes, there is a robust scientific program ongoing. The 6 main studies span in vitro to clinical data across targets (viruses, microbiome, resource utilization, RWE). More information can be obtained by contacting OS and will be published as they are completed.

The handpiece does buzz after 30 secs, but does not stop after 2 mins, but instead 4 mins. After 2 mins it takes a small “break”. Sorry for the mistake!

As for the Brushheads: unfortunately we do not have the numbers of bristles used in the CHS200 & CHS300. In the communication about the Hydrosonic Bristles we should generally focus on the arrangement and the Hydrosonic Effect caused by the bristles. On the new Bristles which you will sell as well, the focus should be on the CURACURVE and the DROP SHAPE. For all of them, it is important to point out, that we do not use nylon filaments, but CUREN instead, which has the huge advantage of absorbing less water, which keeps the bristles flexible and light.

• Hydrosonic Pro brush head power: approx. 1404 filaments / diameter 0.152mm

• Hydrosonic Pro brush head sensitive:  approx. 2184 filaments / diameter 0.127mm

• Hydrosonic Pro brush head single: approx. 810 filaments / diameter 0.0889mm

• Hydrosonic Black is White brush head carbon: approx. 1824 filaments (charcoal) / diameter 0.152mm inside / 0.127mm outside

• All Curaprox brush heads come with gentle Curen filaments which allows for efficient cleaning at minimal pressure.

The are cleaning mechanically as well as create a hydrodynamic effect. To create a good hydrodynamic effect, we achieved best results with this kind of brush which has some more space between the filaments bundles.   

So the cleaning method as well as the much smaller brush head design whit less dense bristle tuft is s different to a manual brush head like the 5460. Therefore the number of filaments is and was never a communication focus for this product.

The focus is the droplet shape, Curacurve ergonomic and gentle filaments.

•  As colors is an important part of our “brand identity”, we are planning to enlarge our bristle colors for the Hydrosonic range. A project is already running.

Good oral health is achievable at the touch of a button. The Hydrosonic pro toothbrush

enables you to achieve that professional clean feeling in the gentlest way possible – even in

the case of orthodontic appliances, dental implants, sensitive gums or any other obstacle to

effective oral hygiene. Forty years of experience in manufacturing manual toothbrushes and

the expertise of Dr U. P. Saxer have gone into the making our electric toothbrush range.

• Ultra-fine Curen® filaments absorb less water than nylon bristles to remain gentle and

flexible

• Patented tear-shaped brush head for perfect tooth-to-tooth cleaning

• Swiss made angular brush heads for barrier-free accessibility

• Unique single brush head ideal for cleaning around orthodontic appliances and dental

implants, as well as along the gumline

• Sleek and minimalist design, making it a pleasure to use»

Everyone who cares about their oral health and is looking for an electric toothbrush that has

been developed by professionals to ensure the most gentle and effective brushing experience.

With our unique brush heads, it is the perfect device for those who wear braces or dental

implants. This sleek and lightweight product is also perfect for people with limited mobility.

It enables highly effective plaque removal in the gentlest way possible. The proven,

ultra-fine Curen® filaments on the patented tear-shaped brush head enable precise toothto-

tooth cleaning. Thanks to the Curacurve® ergonomics of the brush heads, all areas of

the mouth are within easy reach. In addition, the hydrodynamic effect produced by the

toothbrush cleans interdentally. Do you have braces or dental implants? Rest assured that

the unique single brush head is an amazing tool for cleaning around your braces or dental

implants, and along the gumline.

The complete Hydrosonic range of toothbrushes was designed and developed in Switzerland.

The handpiece of the toothbrush is produced in China but manually inspected and boxed in

Switzerland. The brush heads are completely Swiss made. Both the handpiece and brush

heads adhere to our high quality standards.

Our brush heads are the result of forty years of experience in manufacturing manual toothbrushes.

Proven Curen® filaments combined with a patented tear-shaped brush head and

Curacurve® ergonomics make the difference. With a sleek, lightweight and high-powered

handpiece, the Hydrosonic product range is comprised of unique devices designed to optimise

your daily toothbrushing routine.

Tooth brushing is essential for good oral care and the prevention of oral disease.

Both manual and electric toothbrushes are safe and effective at removing plaque and

preserving oral health. Electric toothbrushes deliver a hydrodynamic effect, which is caused

by the device producing 30,000 motions per minute, creating a turbulent liquid flow that

cleans interdental spaces, niches and sulcus. Having the brush head move without

any effort is ideal for people with limited mobility.

The device produces more than 30,000 motions per minute that cause the brush head

filament to vibrate, creating a turbulent flow of liquid in your mouth. This turbulence enables

the toothpaste and saliva in your mouth to find their way into interdental spaces, niches and

sulcus (or pockets), where the liquid disturbs plaque and the bacteria that creates it.

The force of the brush head motions enable oral fluids to reach areas of the mouth that the

bristles alone cannot reach. However, we still recommend that you use either interdental

brushes or floss to ensure a thorough clean.

Based on 40 years of expertise in manufacturing manual toothbrushes, we use the same

Curen® filaments on our electric toothbrushes as on our proven manual toothbrushes.

Compared to nylon filaments, Curen® filaments absorb less water and, therefore,

remain smooth and flexible. This leads to a unbelievably gentle brushing experience and

enables the hydrodynamic effect to work to its fullest potential. Even bacteria find it difficult

to accumulate on brush heads with Curen® filaments.

Our Hydrosonic models are recommended for children 6 years and older.

If used correctly, our Hydrosonic product range should not cause any side effects. If you do

experience any unpleasant effects related to the use of our electronic toothbrushes, please

inform your dentist and/or get in touch with us directly.

The brush heads on our electric toothbrushes feature the same Curen® filaments we have

been using on our manual toothbrushes for the last 40 years. They are proven to be gentle,

effective and harmless – perfectly suited for people who have very sensitive teeth.

No – none of our products or raw materials are tested on animals. Our entrepreneurial attitude

is strictly against animal testing. Furthermore, the regulation of the EU has prohibited

animal testing since 2009.

The Hydrosonic pro, like many other electric devices, is made of transparent silicone.

It contains a battery and electronic pieces. Throwing the device into the sea, woods or your

regular waste would harm the environment badly. At the end of its service life,

please dispose of the device in the most approriate way.

Yes, you can and definitely should. Using sonic toothbrushes will make it easier for you to

achieve and maintain optimal oral health. Our Hydrosonic pro toothbrush features comes

with a single brush head that is perfect for those who have orthodontic appliances (e.g.

brackets, braces), dental implants or restorations such as crowns or bridges.

We are not aware of any negative effects caused by using this product with dental implants.

Our recommendation is to replace your brush head every 3 months because the ultra-fine

filaments are likely to be worn out by this time, even if they don't appear to be at first glance.

If you wear orthodontic brackets or braces, it is best to change the brush head after eight

weeks as the amount of wear will be higher. We also recommend to change brush heads

after a cold, as bacteria may have accumulated on the bristles.

Curaden AG provides a guarantee for material, function and manufacturing defects for two

years from the date of purchase. Register your device to receive an additional 1-year

guarantee for free on www.curaprox.com/myCuraprox.

The batteries in our toothbrushes last approximately 60 minutes without needing to be

recharged, which enables you to clean your teeth approximately 15 times (4 minutes per

cleaning session). Check the LED stripe on the toothbrush from time to time – you'll see the

charging level every time you remove the handpiece from the charging station or when

switching the device off. The stripe features 7 levels that show how much battery the device

has left. Once you have reached the lowest battery level and the stripe lights up red,

your device should be charged. NOTE: If your battery is completely empty, you will not see

any lights on the toothbrush while it is charging. It will take a few minutes for the device

to reach a low level of energy to light up. Last but not least, it is important to note that the

brushing power of the device will be the same, regardless of how much battery it has left.

As often as you want. We recommend brushing your teeth at least twice a day.

«It is absolutely safe to use – our brush heads are made of the softest Curen® filaments,

which are very gentle on your teeth and gums. Furthermore, our brush heads have a rubber

back to prevent any discomfort or damage to your mouth.»

Once it is charged, just switch the toothbrush on by pressing the only button on the device.

The toothbrush will start to work with the last mode used. By holding the button for

2 seconds, you’ll be able to change modes.

«Possible cause: The device is not charged or not turned on.

Solution: Place the device securely on the charger. Press the on/off button. Ensure the toothbrush

is properly inserted into the charging port and that the USB plug is inserted correctly

into a mains power plug socket.

If it is still not working, switch on the handpiece. If it is running, plug it into the connected

charger. If the handpiece stops automatically, the charger is working. If it continues to run,

the charger is broken. The defective charger can be returned and replaced. Of course, you can

always get in touch with us.»

The bristles do the hard work for you – simply hold the brush head against each tooth for

two to three seconds without applying too much pressure. After brushing your teeth, rinse

and remove the brush head, or simply leave it on the device. Caution: do not bend the device.

Check out our Curaprox Youtube channel for useful instruction videos. Learn how to brush

your teeth and take care of your oral health. https://www.youtube.com/watch?v=XrkjOu-8Ot4

This gap is an important feature of the device. If the brush head were to rest on the handpiece

without this little gap, the vibrations would be blocked and, thus, not transmitted correctly.

This gap provides the required clearance to enable vibrations.

Clean the device using only water and a soft cloth. If you need to clean the charger, unplug it

first and clean it with a damp, soft cloth without any detergent.

Although it is IPX 7 waterproof, we do not recommend that you use your toothbrush while

showering, especially as this can distract you from performing effective oral hygiene.

Anybody that wants to replace it's regular or trial units Curaprox Hydrosonic Pro toothbrush needs to email service@oralscience.com with a proof of purchase and serial number of the non-workin gunit.

Oral Science will send a free unit to the client (no shipping fee). The client does not need to send back the broken Hydrosonic Pro.

Standard warranty is 2 years, and 1 additonal year if the product is registered at https://curaprox.ca/info/warranty.

The CPS «Prime» are not plastic coated. The only brushes of Curaprox that are plastic coated are the CPS «Soft Implant». There is no reason for the CPS «Prime» to be plastic coated as the wire will never come in touch with the tooth surface due to the way the bristles are bound into the wire unlike the competitor brands which are spiral bound. 

The main difference between Curaprox and them is the quality of the product. Curaprox brushes last 5 times longer than the TEPE ones.

Unfortunately, we do not have any other guidelines.

However, the steel holder can be sterilized like any other metal surgical instrument in a dental office.

And the cleaning and sterilization procedure of the IAP are similar to a sterilization procedure for non-metal components.

We recommend the sterilization with 134°C for 18 minutes in the sterilizer.

I'm sorry that I can’t give you more information.

What I believe this person is referring to is the "powders" that people are using or making on their own and NOT our BIW toothpaste.  Since we use a "nonoparticle" of the carbon it is ultra-fine and I have not had any reports from any of the hundreds of offices who sell and recommend BIW that they are noticing it in the gingival margin.  BIW is a toothpaste that has all of the properties of a toothpaste and is created to certain specifications and has been tested for the RDA which was at 76 as the average of the separate tests that were done.  Powders are mixed with water by the consumer which greatly varies the RDA depending up how much water the individual uses, etc.  There are more and more articles now being written and many KOL's are agreeing that our BIW is the only activated carbon toothpaste they feel is safe for patients to use.  

Activated charcoal only reacts with particles that can be polarised such as the ones which are responsible for bad breath. Fluoride and other components, however, cannot be polarised which is why they are not being adsorbed by the activated charcoal. Hydroxyapatite cannot be adsorbed due to its size and shape of the particles. Most importantly, however, we compared our White Is Black toothpaste to a reference White Is Black formulation without activated charcoal. The results were significant: the PCR increased from 65 to 100 and the cleaning efficiency index (CEI) went up from 1.41 to 1.66, simply by adding activated charcoal. These results prove that activated charcoal is the main reason for the gentle whitening in the Black Is White and White Is Black toothpastes.

• Aminoglucoxidase delays the formation of biofilm which is the main cause of gingivitis/periodontal diseases.

• It also activates Glucose Oxidase that, by releasing hydrogen peroxide, eliminates harmful bacteria which cause gingivitis/periodontitis.

• The Glucose Oxidase enzyme than activates the Lactoperoxidase enzyme which inhibits bacterial growth resulting again in the prevention of biofilm formation which cause gingivitis/periodontitis.

Between 3.5 and 4.5%

Between 3 and 4%

Due to the Blue Filter, which reflects blue light, and the adsorption capability of activated charcoal most people can already see first results immediately.

The BIW Toothbrushes have approx. 5100 Bristles, and that is because there is a white spot in the middle of the brush to indicate the user where is the black toothpaste.

Reason:

-the black bristles have Diameter 0.10 mm (same as the CS 5460)

-the white bristles have Diameter 0.12mm (same as the CS 3960)

-the white bristles are a little bit stronger, because it is easier to clean the CS 3960 bristles from the black carbon toothpaste.

So, if the white bristles would have a Diameter 0.10mm – the bristles would stay gray = ugly.

You should not speak about it if not asked tho because it is less than 5460.

We confirmed with the manufacturer, and on thousands of offices that used the Black is White toothpaste all over the world, none have reported charcoal particles below the gum line. The reason is that it uses a "nonoparticle" of the carbon which is ultra-fine, contrary to charcoal powder.

All toothpastes containing charcoal have as the raw ingredient what we call "charcoal powder".

For the toothpaste with no active charcoal, the charcoal is just a powder and whitens the teeth with the abrasion of the particles on the teeth. These particles can be really small and not perceptible to the naked eye.

The fluoride in the BIW (sodium monofluorophosphate) does not react with the hydroxyapatite in the toothpaste. It only reacts in the mouth with the enamel through the interaction with natural acids.

Black is White toothpastes contain the same enzymatic system as our enzycal toothpastes.

The blue filtering is caused by the ingredient “Prestige Sparkling Blue” which contains titanium dioxide tin oxide and mica”

Nothing, no restorative material and Black is White ingredient can be mixed together to stain.

May 2000 JADA, there is a tox section in this article that shows blood plasma levels after fluoride varnish application are equal to or less than after tooth brushing with OTC pastes.  There are many others but this one came to mind first.