Solving the problem with stannous fluoride: Extrinsic stain

J Am Dent Assoc. 2019 Apr;150(4S):S38-S46. doi: 10.1016/j.adaj.2019.01.002.


Background: This article highlights a stabilized stannous fluoride (SnF2) dentifrice that, in addition to being efficacious against caries, gingivitis, and dentin hypersensitivity, demonstrates high-performing stain prevention and removal efficacy.

Methods: An in vitro stain prevention model evaluated the efficacy of Colgate TotalSF containing 0.454% SnF2 and 1% zinc phosphate compared with Crest Pro-Health Whitening Power (The Procter & Gamble Company) and a nonabrasive SnF2 gel. L*, a*, and b* values were measured to assess whiteness comparing untreated and stained teeth, and with statistical analysis. A stain removal clinical study was conducted as a randomized, double-blind, 2-cell, parallel-group design using Colgate TotalSF and nonwhitening regular fluoride toothpaste. Participants were instructed to brush twice daily for 6 weeks and were examined for Lobene Composite Stain Index scores, with statistical analysis used at a significance of P < .001.

Results: In an in vitro stain prevention study, Colgate TotalSF performed 26% and 35% better than a competitor paste and nonabrasive SnF2 gel, respectively. In a clinical study, Colgate TotalSF use showed statistically significant extrinsic tooth stain reductions by 17.5% (3 weeks) and 27.8% (6 weeks) relative to regular fluoride toothpaste. No adverse effects were reported.

Conclusions: The results indicate that the stabilized Colgate TotalSF performed statistically better than other SnF2 pastes in an in vitro study, and statistically better than a regular fluoride toothpaste in a clinical study.

Practical implications: Colgate TotalSF offers an SnF2-based therapeutic dentifrice with notable performance in stain prevention and removal.

Keywords: Stannous fluoride; prevention; removal; stabilized; stain.

Publication types

  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Coloring Agents
  • Complex Mixtures
  • Dentifrices*
  • Double-Blind Method
  • Humans
  • Tin Fluorides
  • Tooth Discoloration*
  • Toothpastes
  • Treatment Outcome


  • Coloring Agents
  • Complex Mixtures
  • Dentifrices
  • Tin Fluorides
  • Toothpastes