Crest Pro-Health Rinse causing tooth staining

[edgeworth]

I've been reading and hearing more and more about this problem. I can't believe that there isn't even a warning on the bottle that it can cause serious staining. The least you can do is let pts know the dangers, so they know what to look for, and can stop use at the first signs of trouble. Shame on P&G for not putting a warning on the bottle.

IMO, this product was not adequately tested regarding long-term side affects and it should be off the market.

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[crazy_sherm]

Do you have a link to an article?

 

[edgeworth]

Check out the reviews for this product on Amazon.com. In order to give a review on Amazon, you need to have purchased a product on the website, so this isn't the work of a single spammer. Moreover, most of the reviews are given under an Amazon "real name" handle. The bottom line here is that there are around 50 reviews and the vast majority of these reviews complain of serious brown tooth staining caused by the product:

amazon reviews

You can find similar complaints for the product under drugstore.com and other retail websites.

Also, if you have access to the Dental Town and Hygiene Town message boards (on the Docere.com website) you can read a lot of reviews of the product. In general, you are required to be a licensed denist, RDH or other dental professional to get access to these boards. But here is a sample of the negative reviews from the Dental Town board, and there are plenty of other similar comments on both DT and HT:

(from a member since '01 w/ over 3000 posts): "Saw a pt yesterday with pretty extensive staining. Only change in recent weeks was trying this new crest moutwash. Turns out it contains Cetylpyridinium Chloride, which is know to cause staining. Not as bad as Chlorhexidine, but still somehting to watch out for. The stain was very difficult to remove. 20 mintues of pumice and scaling. A lot like peridex stain."

(from a member since '04 w/ over 11000 posts): "It has come to my attention that we have had a few patients presenting for routine recall lately that have a lot of stain present when they have not had the same problem before. All have started using the Crest Pro Health Rinse recently on a daily basis. This product has not been around too long, but there is no warning regarding stain on the labeling and this has not been documented to my knowledge. Many of these previously used Listerine daily and did not have the same issues. I am wondering if any of you..particularly hygienists, have made the same observation. I don''t think the stain is damaging, but it is nice to know about these issues and warn your patients if that is the case. Thoughts? "

(from a member since '02 with 25 posts): "I have a healthy 14 year old patient who over the past two weeks noticed a stain develop at the gingiva and interproximal areas of all his teeth. He has generally good oral hygiene and has never had this before. We cleaned his teeth about two months ago.
The only change he reports in his hygiene protocol is that he added crest prohealth rinse and tooth paste about one month ago.

We prophyjetted the satin off the teeth without any problem and told him to stop the rinse.

Has anyone else seen these stains with this product?"

P&G has addressed the issue on their website, although I believe they are downplaying the significance of the staining. Also they blame the problem on the blue dye in the rinse, whereas I suspect that the culprit is the active ingredient (CPC):

P&G's response

There are several peer-reviewed articles on the web that show that staining is a side effect of CPC. I can provide links to those if you are interested.

In closing, here is a humorous take on the staining problem from Crest Rinse from an editorial in a Carolina paper (just to close w/ a little levity):

hobo teeth

 

[ems5184]

are any of you guys seeing that it is only related to the "blue" mint flavor and that patients using the "green" crest pro health rinse do not seem to have the same side effect of staining?

 

[aphistis]

Check out the reviews for this product on Amazon.com. In order to give a review on Amazon, you need to have purchased a product on the website, so this isn't the work of a single spammer. Moreover, most of the reviews are given under an Amazon "real name" handle. The bottom line here is that there are around 50 reviews and the vast majority of these reviews complain of serious brown tooth staining caused by the product:

amazon reviews

You can find similar complaints for the product under drugstore.com and other retail websites.

Also, if you have access to the Dental Town and Hygiene Town message boards (on the Docere.com website) you can read a lot of reviews of the product. In general, you are required to be a licensed denist, RDH or other dental professional to get access to these boards. But here is a sample of the negative reviews from the Dental Town board, and there are plenty of other similar comments on both DT and HT:

(from a member since '01 w/ over 3000 posts): "Saw a pt yesterday with pretty extensive staining. Only change in recent weeks was trying this new crest moutwash. Turns out it contains Cetylpyridinium Chloride, which is know to cause staining. Not as bad as Chlorhexidine, but still somehting to watch out for. The stain was very difficult to remove. 20 mintues of pumice and scaling. A lot like peridex stain."

(from a member since '04 w/ over 11000 posts): "It has come to my attention that we have had a few patients presenting for routine recall lately that have a lot of stain present when they have not had the same problem before. All have started using the Crest Pro Health Rinse recently on a daily basis. This product has not been around too long, but there is no warning regarding stain on the labeling and this has not been documented to my knowledge. Many of these previously used Listerine daily and did not have the same issues. I am wondering if any of you..particularly hygienists, have made the same observation. I don''t think the stain is damaging, but it is nice to know about these issues and warn your patients if that is the case. Thoughts? "

(from a member since '02 with 25 posts): "I have a healthy 14 year old patient who over the past two weeks noticed a stain develop at the gingiva and interproximal areas of all his teeth. He has generally good oral hygiene and has never had this before. We cleaned his teeth about two months ago.
The only change he reports in his hygiene protocol is that he added crest prohealth rinse and tooth paste about one month ago.

We prophyjetted the satin off the teeth without any problem and told him to stop the rinse.

Has anyone else seen these stains with this product?"

P&G has addressed the issue on their website, although I believe they are downplaying the significance of the staining. Also they blame the problem on the blue dye in the rinse, whereas I suspect that the culprit is the active ingredient (CPC):

P&G's response

There are several peer-reviewed articles on the web that show that staining is a side effect of CPC. I can provide links to those if you are interested.

In closing, here is a humorous take on the staining problem from Crest Rinse from an editorial in a Carolina paper (just to close w/ a little levity):

hobo teeth

It looks like you made your account specifically to bag on P&G.

I've got a share of Listerine stock that says we're missing some full disclosure here.

 

[edgeworth]

It looks like you made your account specifically to bag on P&G.

I've got a share of Listerine stock that says we're missing some full disclosure here.

No, I do not own any individual shares of either Pfizer or P&G stock. I have no financial interest in either company.

I just want to get the word out to prevent others from experience this staining because it's a real bear to get off.

 

[edgeworth]

are any of you guys seeing that it is only related to the "blue" mint flavor and that patients using the "green" crest pro health rinse do not seem to have the same side effect of staining?

Crest blames the problem entirely on the "blue dye". however, imo, the real culprit is the CPC which has long been known to cause staining of the teeth. I have heard of the staining happening with the "green" pro-health rinse as well, although I haven't seen it first hand.

 

[DDSABeach]

I've been reading and hearing more and more about this problem. I can't believe that there isn't even a warning on the bottle that it can cause serious staining. The least you can do is let pts know the dangers, so they know what to look for, and can stop use at the first signs of trouble. Shame on P&G for not putting a warning on the bottle.

IMO, this product was not adequately tested regarding long-term side affects and it should be off the market.

Crest Pro-Health toothpaste has stannous fluoride in it's product which FDA mandates any product using stannous Fluoride must be labeled warning the patient possible of staining. WITH ADAQUATE brushing! what patient adaquately brushes? so your going to see stains around the cervical and interproximal area's.

The added ingredients used to fight this staining is hexametaphosphate and extra silica which accounts for the grittiness that is felt in the toothpaste. And the bitter taste is the hexametaphosphate and stannous. Also CPH had only 9 clinical studies and that was on the ingredients only.

 

[edgeworth]

Crest Pro-Health toothpaste has stannous fluoride in it's product which FDA mandates any product using stannous Fluoride must be labeled warning the patient possible of staining. WITH ADAQUATE brushing! what patient adaquately brushes? so your going to see stains around the cervical and interproximal area's.

The added ingredients used to fight this staining is hexametaphosphate and extra silica which accounts for the grittiness that is felt in the toothpaste. And the bitter taste is the hexametaphosphate and stannous. Also CPH had only 9 clinical studies and that was on the ingredients only.

There is a warning on the CPH toothpaste that it may cause staining (as required by the FDA, as you mention). However there is no warning on the CPH Rinse that states that it may cause staining. And that is ironic, because I've never heard of anyone experience staining from the CPH toothpaste, but I've seen plenty of evidence of staining from the rinse.

I have told P&G many times that there needs to be a warning on the Crest Pro-Health Rinse, because of the possibility of severe staining from the CPC. However, as of yet, they have refused to do so. In fact, IMO, this product should NOT be sold OTC, but should require a scrip and only be used under the direct care and supervision of a dental professional.