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How do enzim® Toothpaste Work

The basic principle of enzim® toothpaste is to restore the function of the natural peroxidase system found in saliva. enzim® employs a natural enzyme system to produce small amount of Hydrogen Peroxide that is used for extra generation of OSCN (boost the natural salivay peroxide system) and so controls the resident bacterial flora and keeps out the unwanted pathogens.

One of the main defence mechanisms of saliva is the lactoperoxidase system (LPO system). This system is activated in part by hydrogen peroxide which oxidises thiocyanate to hypothiocyanite. Hydrogen peroxide itself possesses antimicrobial activity and has been shown to play an important role in oral health. Hydrogen peroxide in the oral cavity is produced by both the human host and members of the oral microbiome.

In addition to the LPO system, other salivary components including lysozyme and lactoferrin are critical to the mouth’s natural defences against bacteria. Lysozyme is an antibacterial protein found in a variety of mucosal fluids. Quantitatively, it is the most important salivary component with antibacterial properties, due to its ability to break glycosidic linkages in peptidoglycans. The effect is most pronounced against Gram-positive bacteria due to the thick peptidoglycan layer in the cell wall, whereas the peptidoglycan is protected by an outer membrane in Gram-negative bacteria. Lactoferrin has been shown to permeabilise the outer membrane of Gram-negative bacteria making them susceptible to penetration by lysozyme. This action of lactoferrin is in addition to its main mode of action as an iron-binding protein which reduces the concentration of iron available as a co-factor for bacterial enzymes and in turn retards bacterial growth. As well as bacteriostatic properties, lactoferrin is known to have bactericidal properties in its own right resulting from direct interaction between the protein and bacteria. Lactoferrin and lysozyme have been shown to work synergistically in combination and additionally both lactoferrin and lysozyme have been reported to have elevated antimicrobial activity when combined with the LPO system.

Regarding to Midda and Cooksey (1986) reported that the LD50 dose of using enzyme toothpaste in rats, more than 15g/kg was resulted in no death, no signs of toxicity or changes in abnormal histological signs.

The study research were reported by Dr. Juni Handajani, Mkes, Prof. Dr. drg Al Supartinah S., SU, Sp KGA and Alexander Agung showed that enzyme toothpaste has anti-bacterial power against Streptococcus Alpha starting at a concentration of 5%. This result can be interpreted that if you use enzyme toothpaste that has been mixed with saliva, resulting in dilution of the paste, then the enzyme toothpaste can still function as an anti-bacterial against Streptococcus alpha.

Streptococcus Alpha is the dominant bacteria at the beginning of plaque formation and is always present in plaque. Streptococcus Alpha is also called Streptococcus viridans because it forms a greenish color around its colonies. These bacteria function to facilitate the colonization of other bacteria including anaerobic bacteria which play a very important role in periodontal disease. Streptococcus also produces histolytic enzymes and toxic substances that can destroy tissues (Michalek and Mc Ghee, 1982). Streptococcus Alpha members include: Streptococcus pneumoniae, Streptococcus viridans, Streptococcus salivarius, Streptococcus sanguis, Streptococcus mitis, Streptococcus mutans and others. Streptococcus mitis, Streptococcus salivarius, Streptococcus sanguis have a role in gingival inflammation and periodontal tissue damage (Jawetz et al, 1986).

The antibacterial activity of enzyme toothpaste against S. Alpha is probably due to the presence of the enzyme lactoperoxidase and the presence of thiocyanate co-factor. Lactoperoxidase and thiocyanate enzymes are components in saliva, while hydrogen peroxidase comes from bacterial metabolism in the oral cavity. Peroxidase production levels from bacteria are too low to activate the antibacterial power system in saliva. The optimum concentration of hydrogen peroxidase which is capable of functioning as an anti-bacterial agent in saliva is a concentration of 0.0001% so that to achieve this concentration it is necessary to add amyloglucosidase and glucose oxidase enzymes to toothpaste (Midda and Cooksey, 1986).

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