Oral health at SGS proderm

Hi Caro! I think the initial question is pretty clear: What kind of oral health studies are we commonly doing here at proderm?

We mainly do cosmetics and consumer care studies. But we can absolutely also do pharmaceutical and medical device studies.

Ok, what would be typical products in consumer care studies?

Well, toothpastes, toothbrushes, mouthwashes, tooth whitening products. We had one that was a tooth paste in combination with some sort of LED device.  

Tooth whitening products?

Oh yes – Testing tooth whitening properties of products is one of the most common things we do in oral care!

So, the subjects need to have discolored teeth, I suppose?

That's not a problem. People drink a lot of tea and coffee.

So how do you measure that - Is there something like a tooth color scale?

Oh yeah! The Vita shade guide - It's like a card where there are lots of little plastic plates with different colors. You usually use these at the dentist when you need to ensure dentures fit in with the rest of the teeth in terms of color, for example.

But the way we usually assess coloring of teeth is by taking photos and evaluating the pictures photo-analytically. They are not like cool marketing photos, though, as people have to wear these cheek retractors.

Ah, photography and image analysis seem to be some sort of core competency at proderm

Yes, of course we always try and use that, as that's actually what makes us special - with the many photo devices and photo systems that we have.

So what else is there?

Well, plaque and gum health. It's a bit of a departure from the cosmetic impact; it's also about health, a healthy oral cavity and healthy gums.

For plaque scoring we virtually paint the teeth with a blue color like you do with children at the dentist to show them how bad they are at brushing their teeth.

I think I've seen that in TV commercials.

Exactly! At the end of the day, it's always a visual assessment. Gum health assessment goes a bit in the same direction. You always have a visual assessment, which is just a bit nastier, because you basically go along the gums with this probe thing until it bleeds and then you assess the strength of the bleeding visually. And that is also the crux of both plaque scoring and gum health assessments. It is really challenging to show product differences in such studies because these are usually minimal differences and you need super good evaluators.

Then how do we do it?

First of all, you need a tried-and-tested panel of evaluators, which we have now expanded a bit. All very experienced and trained dentists!

So how do we ensure the assessment is done uniformly? Wouldn't everybody do this a bit differently?

In all the studies where we have visual assessments, the evaluators are always very well trained. It's really difficult and it's super important to have trained and "well calibrated" evaluators. We go through a lot of effort to get that right before each study.

I mean, apart from the scoring, when testing tooth brushes, people also brush their teeth very differently. How do we deal with that?

Oh that's not so difficult to standardize. You just ensure subjects brush each side for a specific amount of time.

We are still on the subject of the most common oral health studies at proderm, is there anything else that comes to mind?

Sensitive teeth! We do a common study design where you look at how sensitive the teeth are to pain. There are toothpastes that have ingredients that try to fill up pores in the enamel, so that the nerve endings are not so exposed.  Sponsors like to claim that their products make the teeth less sensitive. One way to test this is to poke the tooth with a device called Yeaple probe that helps measure the force needed for people to begin feeling discomfort in their teeth.

Yeaple Probe sounds like something you would have found in a toy shop in the nineties or something.

Ha ha, no it's a device for measuring dentinal hypersensitivity that can apply force to a tooth in discreet increments of 10g, so this helps to harmonize measurements across investigators, which is very important if you want to show that a product really protects the teeth from pain.