Forty years ago dental caries was a major health problem for most children and adults living in developed countries and the dental profession was unable to cope with the demand for clinical care [ 1]. Since then the prevalence and severity of dental caries has declined. For example the mean DMFT for 12 year olds in Australia dropped from 4.8 in 1977 to 1.1 in 1993 [ 2] and in the United Kingdom from 3.1 in 1973 to 0.8 in 2003 [ 3]. The change in caries prevalence has been accompanied by an alteration in the distribution of lesions, with pit and fissure caries levels increasing [ 4]. Despite the general improvements in oral health, caries continues to be a challenge for the dental team, particularly for those clinicians working in low income and socially disadvantaged areas where the prevalence of caries is still a public health issue. Another change that has had an impact on clinical practice is the increased prevalence of new carious lesions in adults, reaching a level as high as that seen in children [ 5]. Therefore, the profession has to plan treatment and preventive care pathways based on the understanding that dental caries is no longer a rapidly developing problem in childhood, but a slowly progressing disease of adulthood. All except two [ 34, 39] of the nine studies reported on the regression of white spot lesions in orthodontic patients. This body of evidence, containing seven clinical studies [ 33, 35– 38, 40, 41] of variable strength of evidence utilised either visual scoring or fluorescence techniques for the assessment of dental caries. Some were compared with placebo pastes and others with different preventive products and/or control groups. Of these seven studies, four showed a significant advantage from the use of Tooth Mousse® in the regression of white spot lesions in orthodontic patients over 12 weeks to 6 months [ 33, 37, 38, 40]. Andersson A, Skold-Larsson K, Hallgren A, Petersson LG, Twetman S. Effect of a dental cream containing amorphous cream phosphate complexes on white spot lesion regression assessed by laser fluorescence. Oral Health Prevent Dent. 2007;5(3):229–33. Reynolds EC, Cai F, Cochrane NJ, Shen P, Walker GD, Morgan MV, et al. Fluoride and casein phosphopeptide-amorphous calcium phosphate. J Dent Res. 2008;87(4):344–8.

Kargul B, Altinok B, Welbury R. The effect of casein phosphopeptide-amorphous calcium phosphate on enamel surface rehardening. An in vitro study. Eur J Paediatric Dent. 2012;13(2):123–7. During this process of change, participants identified key facilitators for changing daily routines to include TMP application. These included: (a) seeing the long-term positive effects of TMP, (b) seeing research evidence, (c) TMP being endorsed by their dentist, (d) being educated by the dentist/dental team on how to apply the product and (e) having the support of a family member. During a qualitative interview, it is crucial to give participants the opportunity to tell their story in their own words. The questions asked should delve into the study aim and be tailored to the participants’ experience [ 27]. As previously reported, interview’s questions were adapted from a previous study [ 9] to include this study’s aims and participants’ experiences. Although researchers took care to maintain quality and rigor during such process, one may presume that certain questions could be considered leading to responses. For example, the following question may be considered a leading question… So, once you knew about GC Tooth Mousse Plus, what difference did it make for you? Nevertheless, this question was included in our interview script because of the well-established effectiveness of the product in the dental literature. In addition, this question resulted in important data generation which the researchers had not anticipated (e.g. data shown on Tables 6, 7, 8 and 9).

CONCESSION PBS PRICE

Davies RM, Blinkhorn AS. Preventing dental caries: Part 1 the scientific rationale for preventive advice. Dental Update. 2013;40(9):719. -720, 722, 724-716. AIHW. Oral health behaviours in the Australian population 2004–06. Canberra: Australian Institute of Health Welfare; 2009. Colgate Sensitive Pro-Relief Toothpaste (Original, Repair & Prevent, Enamel Repair, Extra Strength, Smart White

Sweet L. Telephone interviewing: is it compatible with interpretive phenomenological research? Contemp Nurse. 2002;12(1):58–63.Wang JX, Yan Y, Wang XJ. Clinical evaluation of remineralization potential of casein phosphopeptide amorphous calcium phosphate nanocomplexes for enamel decalcification in orthodontics. Chin Med J. 2012;125(22):4018–21. When it comes to using the Biomin F with fluoride and GC Tooth Mousse with fluoride I would recommend using the Biomin F for your regular brushing. That means brushing twice daily for two minutes. The manufacturers also recommend that after you finish brushing swirl the foamy toothpaste around your mouth for 30 seconds, and spit out the excess. Do not rinse, with anything, do not eat, and do not drink anything for at least 30 minutes after brushing. Use the Tooth Mousse directly before bed time. Massage a small amount onto the affected tooth. Zheng H, Thomas PA. Marital status, self-rated health, and mortality: overestimation of health or diminishing protection of marriage? J Health Soc Behav. 2013;54(1):128–43. Flink H, Tegelberg A, Arnetz JE, Birkhed D. Patient-reported negative experiences related to caries and its treatment among Swedish adult patients. BMC Oral Health. 2017;17(1):95. Of the twelve studies included in this systematic review, three studies were direct comparisons of Tooth Mousse® versus a control group [ 34, 36, 40] and two studies versus a placebo crème [ 31, 33]. The remaining six studies compared the efficacy of Tooth Mousse® (MI Paste®) and/or Tooth Mousse Plus® (MI Paste Plus®) to other products and techniques with or without a control group - including fluoride toothpaste [ 37], fluoride mouthrinse [ 38, 39], fluoride gel [ 30], fluoride varnish [ 41], chlorhexidine gel [ 32] and microabrasion [ 38]. The studies by Beerens et al. [ 35], Krithidkadatta et al. [ 39], and Huang et al. [ 41] involved comparisons with Tooth Mousse Plus® (MI Paste Plus®) - containing 900 ppm Fluoride, all other studies utilised only the non-fluoride containing Tooth Mousse® (MI Paste®).