Home-Care Products [605571]

Home-Care Products
Braz Oral Res 2009;23(Spec Iss 1):17-22 17The history and global market of oral
home-care products
Abstract: This literature review reports the history and the current mar –
ket of oral home-care products. It provides information extending from
the products used by our ancestors to those currently available, as well as on the changes in the supply and consumption of these products. Al –
though the scientific knowledge about oral diseases has improved greatly in recent years, our ancestors had already been concerned with clean –
ing their teeth. A variety of rudimentary products and devices were used since before recorded history, like chewing sticks, tree twigs, bird feath –
ers, animal bones, tooth powder and home-made mouth rinses. Today, due to technological improvements of the cosmetic industry and market competition, home-use oral care products available in the marketplace offer a great variety of options. An increase in the consumption of oral care products has been observed in the last decades. Estimates show that Latin America observed a 12% increase in hygiene and beauty products sales between 2002 and 2003, whereas the observed global rate was ap –
proximately 2%. A significant increase in the per capita consumption of
toothpaste, toothbrush, mouthrinse and dental floss has been estimated from 1992 to 2002, respectively at rates of 38.3%, 138.3%, 618.8% and 177.2%. Pertaining to this increased supply and consumption of oral care products, some related questions remain unanswered, like the occurrence of changes in disease behavior due to the use of new compounds, their actual efficacy and correct indications, and the extent of the benefits to oral health derived from consuming more products.
Descriptors: Oral hygiene; Dental devices, home care; Dentifrices;
Mouthwashes. Juliana Jobim Jardim(a)
Luana Severo Alves(b)
Marisa Maltz(c)
(a) MSc, Graduate fellow; (b)Graduate fellow;
(c)PhD, Professor – Department of Social and
Preventive Dentistry, School of Dentistry,
Federal University of Rio Grande do Sul, Porto Alegre, RS, Brazil.
Corresponding author:
Marisa Maltz
Faculdade de Odontologia – UFRGS
Departamento de Odontologia Preventiva e Social
Rua Ramiro Barcelos, 2492
Porto Alegre – RS – Brazil
CEP: 90035-003
E-mail: [anonimizat]
Received for publication on May 04, 2009
Accepted for publication on May 12, 2009

The history and global market of oral home-care products
Braz Oral Res 2009;23(Spec Iss 1):17-22 18The history of oral home-care
products
Bacterial biofilm is a natural component of the
oral environment and is compatible with health in
balance situations. When biofilm accumulation on dental or gingival tissues occurs for a certain period of time and combined with others factors, it can lead to dental caries or periodontal disease – the major causes of tooth loss everywhere in the world
1 and
the two most common chronic human diseases.2
Although the scientific knowledge about the
etiology and dynamics of the development of oral diseases has presented a great improvement in the last decades, man has tried to find ways to clean his teeth since a remote past.
A variety of oral hygiene measures has been used
since before recorded history. This has been verified by excavations done all over the world, in which chewing sticks, tree twigs, bird feathers and animal bones were found.
The early history and evolution of the tooth –
brush has its origin in the chewing sticks used by the Babylonians as early as 3500 BC. Also known as “miswak” or “siwak”, it was also an ancient pre-Islamic habit. Mohammed was an enthusiastic supporter of its use as a “purgative for the mouth”. He used to report that “it makes the teeth white, clarifies the understanding, makes the breath fra –
grant, dries up the phlegm, strengthens the gums around the teeth, makes the glance clear, sharpens the power of the vision, opens the bowels and whets the appetite”, evidencing that, for some, “miswak” was not only a personal hygiene habit but also a spiritual custom. The chewing stick was a rudimen –
tary toothbrush used as a single agent or with tooth powder or extract of roses.
2
The first true bristled toothbrush was originat –
ed in China at around 1600 AD. The first modern toothbrush was reinvented in the late 18
th and early
19th centuries.2 The first patent for a toothbrush was
credited to H. N. Wadsworth in 1857, in the United States, but due to the high price of the hog bristle, the mass production of the product in America only started in the end of the 19
th century. As technol –
ogy progressed, natural swine bristles were replaced by synthetic fibers, usually nylon. The first electric toothbrush, an attempt to offer the public a brush that could simulate the action of a manual brush, was developed in 1939 in Scotland, but did not ap –
pear on the market until the 1960s.
Ancient Greek and Roman literature had first re –
ported the use of twigs as primitive toothpicks to remove food and debris from between the teeth. The intent of early humans was probably not to clean the teeth but simply to remove an unpleasant subjective sensation. The Greeks tended to keep these little in –
struments in their mouths continuously and were often referred to as “toothpick chewers”.
2 Around
1600 BC, the Chinese also used twigs made of trees carefully chosen from aromatic species that had the ability to clean and freshen the mouth. Wealthy citi –
zens often carried their gold or silver toothpicks in fancy cases and used them ostentatiously at meals. Many religions, both before and after the Christian era, enjoined their adherents to practice cleanliness of the teeth using twig cuts as a tooth-pick.
3
The development of toothpaste began as long ago
as 300-500 BC in China and India. First attempts at tooth cleaning included using abrasives such as crushed bone, crushed egg and oyster shells.
4 Tooth
powder was the first noticeable advance, and was made up of elements like powdered charcoal, pow –
dered bark, salt and some flavoring agents.
5
Modern toothpastes were developed in the
1800s. As the years passed, new components were added to their formulations, as soap and chalk. In 1873, toothpaste was firstly mass-produced. Due to advancements in synthetic detergents after World War II, the soap was replaced for emulsifying agents such as sodium lauryl sulphate and sodium ricinole –
ate. Fluoride was added initially in 1914, but the American Dental Association at first criticized its introduction. The ADA finally consented to the use of fluoride in toothpastes in 1960.
Besides the traditional tooth paste and brush, a
great variety of home-use oral products have been developed.
A concern about the cleaning of approximal
surfaces was first reported by Levi Parmly (1790-1859), the inventor of dental floss.
6 He stated that
the device should “be passed through the interstices of the teeth, between their necks and the arches of

Jardim JJ, Alves LS, Maltz M
Braz Oral Res 2009;23(Spec Iss 1):17-22 19the gum, to dislodge that irritating matter which no
brush can remove and which is the real source of dis –
tress”. Dental floss made of silk was used since the 19
th century, while nylon floss was made available in
the marketplace right after World War II. The diffi –
culty of flossing explains its reduced use and makes this technique less than universal.
2 Other interden –
tal cleaning devices have been developed, such as rubber tip stimulators and interdental brushes.
The first known reference to mouth rinsing is
found in Chinese medicine, around 2700 BC. Later on, in the Greek and Roman periods, mouth rinsing following mechanical cleansing became common among the upper classes, and Hippocrates recom –
mended a mixture of salt, alum and vinegar
2 while
Pythagoras recognized the freshening effect of an –
ise.5 Different products were used for mouth rins –
ing over the centuries. In the 1500s, wine or beer were used; in the late 19
th century, around 1890,
the use of essential oils was introduced among the dental care habits.
2 Freshening bad breath has been
the traditional use of mouth rinsing. Besides this cosmetic purpose, therapeutic mouth rinsing is now available, including fluoride, quaternary ammonium compounds and chlorhexidine.
Today, due to technological improvements of the
cosmetic industry and market competition, home-use oral care products available in the marketplace offer the consumer a wide variety of options. The toothbrush head is presented in different forms and sizes; bristles are presented in different hardness options (hard, medium, soft or extra-soft). Tooth –
pastes are presented in different concentrations of fluoride (from formulations without this component to versions with a very high concentration of it, such as 5000 ppm); and special versions present natural components, such as propolis and jua, for specific purposes, as tooth bleaching, dental erosion control or to reduce sensitivity. Mouth rinses have a cosmet –
ic or therapeutic use, just for mouth freshening or for controlling plaque, gingivitis and dental caries.
Owing to the wide variety of products available
in the marketplace and the strong appeal to consum –
ers exerted by the cosmetic industry, the consump –
tion of oral care products has increased in the last decades. In the following section, the changes in the consumption of oral health products and their main reasons are discussed.
The market of oral home-care
products
Nielsen Company7 (2004) studied the sales of
hygiene and beauty products in 56 countries com –
prising 95% of the world Gross Domestic Product
(GDP) and 75% of the world population. They di –
vided the Hygiene and Beauty products in 9 catego –
ries: baby products, cosmetics, hair products, paper products, oral hygiene, body hygiene and moistur –
izing, facial hygiene and moisturizing, sunscreen and hair removal. Although hygiene and beauty products are among the categories with the lowest sales increase in the world, around 2%, they rank fourth in sales (Graph 1). And Latin America has shown larger growth rates than those of the rest of the world. The oral hygiene products market pre –
sented an increase of 12% between 2002 and 2003, as shown in Graph 2.
The consulting firm Kline & Company
8 (2004)
studied the sales of oral care products in 16 coun –
tries. According to this study, Brazil occupied in 2004 the 10
th position in sales of oral care products.
The sales in Brazil were ahead of countries with higher economic power, like Canada and Spain, and countries in Latin America like Argentina (Table 1).
The consumption of toothpaste and toothbrush
per inhabitant per year is respectively 90% and 110% higher in Brazil compared with Argentina,
9
as shown in Table 2. In 2004, the sales of oral health products in Brazil was five times the sales of these products in Argentina, even though Argenti –
na showed a sales increase 8 times higher than that of Brazil from 2003 to 2004. The consumption of toothpaste, toothbrush, mouthrinse and dental floss had increased significantly, as can be seen in Table 3 (absolute values) and Table 4 (average per capita ).
Comparing the consumption per capita of these
products, an increase of 38.3% in toothpaste, 138.3% in toothbrush and 177.2% in dental floss can be noticed from 1992 to 2002.
9 Of all the oral
care products, mouthrinse is the one that presented during this period the most outstanding increase in sales: 618.5%. This could be due to the fact that the

The history and global market of oral home-care products
Braz Oral Res 2009;23(Spec Iss 1):17-22 20supply of these products was significantly enhanced
in the past 10 to 15 years. New mouthrinses for biofilm control and caries prevention, using differ –
ent active compounds, such as essentials oils, nat –
ural products (propolis and jua), cetylpyridinium chloride and fluoride are available at lower prices, and are produced by a larger variety of companies. The newest product release on the marketplace is a mouthrinse for dental bleaching. There is no data concerning the increase in over-the-counter dental bleaching products in Brazil; however, global data from Nielsen
7 (2004) showed a 48% sales increase
from 2002 to 2003.
According to internal estimates from Colgate-
Palmolive (unpublished data), toothpaste is in 99.9% of Brazilian homes. Each Brazilian consumes, per year, 1.67 toothbrush, 126 milliliters of mouthrinse and 18.8 meters of dental floss (which means 5.1 centimeters per day). Comparing these recent data with those showed previously, we can observe that the consumption of toothbrush increased from 1.12 in 2002 to 1.67 in 2009.
Current data from ABIHPEC
10 (2008) shows
that the market of oral care products has increased from 2002 to 2006 in Brazil, when it was handling around US$ 746.1 × 10
3, as shown in Graph 3. As
to the sales share in 2006, toothpaste represented 66%, dental floss, 21%, mouthrinse, 9% and tooth –
brush, 4% (Graph 4).
10
In general, four reasons for this sales increase
of oral care products in Brazil were pointed out by ABIHPEC
10 (2004) and confirmed by Nielsen7. The
reasons are:
Women’s increasing participation in the labor 1.
market: this fact created a need for practical products, in addition to an increase in the pur -Hair removal
Sunscreen
Facial hygiene/moisturizing
Body hygiene/moisturizing
Oral hygiene
Paper products
Hair products
Baby productsCosmetics
(US$ Millions) 0 500 1,000 1,500 2,500 3,000 2,0002002
2003
+7%
-14%
+7%+12%+7%+22%+9%
+12%+13%Graph 2 – Sales of Hygiene and
Beauty products in Latin America.
Growth by basket of products
(number of countries covering
the categories in each basket of products).
7Hair removal
Sunscreen
Facial hygiene/moisturizing
Body hygiene/moisturizing
Oral hygiene
Paper products
Hair products
Baby productsCosmetics
(US$ Millions) 0 500 1,000 1,500 2,500 3,000 2,0002002
2003
+1%
+4%
0%
0%+2%+5%
+7%
+5%+4%Graph 1 – World sales of Hygiene
and Beauty products. Growth by
basket of products (number of
countries covering the categories in
each basket of products).7

Jardim JJ, Alves LS, Maltz M
Braz Oral Res 2009;23(Spec Iss 1):17-22 21chasing power of the household. Hence, prod –
ucts that presented a faster and easier way of use,
like disposable dippers, had their sales increased. Dental home bleaching products, for example, are also time- and moneysaving alternatives to a dental visit.The use of cutting-edge technology by the indus – 2.
try, leading to increased productivity and, conse –
quently, lower prices to consumers.Constant release of different products, in an at – 3.
tempt to meet the consumers’ needs for new and interesting formats. An example is the addition of the strip format to the mouth-refreshing cat –
egory. Innovations in oral care products are con –
stantly being released onto the marketplace, like combinations of dentifrice, mouthrinse, dental bleaching and desensitizer in a single product.An increase in life expectancy, which leads to an 4.
increase in the proportion of elder consumers. This share of the population is growing faster in Latin America than in the rest of the world. The increasing desire to preserve a youthful ap –
Table 1 – Oral care products sales in 2004.8
Ranking Country Sales (US$ millions)
1 USA 2,738
2 China 1,335
3 Germany 1,021
4 Japan 959
5 Russia 863
6 United Kingdom 639
7 India 617
8 Italy 600
9 France 592
10 Brazil 506
11 Mexico 393
12 South Korea 360
13 Canada 234
14 Spain 207
15 Poland 185
16 Argentina 75Table 2 – Average consumption of toothpaste (kg/inhabit-
ant) and toothbrush (unit/inhabitant), per year, in selected countries in 2002.
9
CountryConsumption of toothpaste
(kg/inhabitant) Consumption of
toothbrush (unit/
inhabitant)
Argentina 0.21 0.41
Canada 0.26 0.88
Mexico 0.30 0.69
Brazil 0.40 0.86
Table 3 – Consumption of toothpaste (ton), toothbrush
(unit), mouthrinse (ton) and dental floss (unit) in Brazil be –
tween 1992 and 2002.9
YearProduct
Toothpaste Toothbrush Mouthrinse Dental Floss
1992 63,200 71,688 825 15,350
1993 62,980 82,693 843 16,032
1994 69,820 101,065 1,309 17,783
1995 67,394 111,758 2,131 22,635
1996 77,455 113,481 2,890 22,995
1997 84,629 122,601 3,569 22,921
1998 90,163 137,064 4,258 25,881
1999 96,151 139,546 3,577 30,319
2000 95,466 151,921 3,448 31,250
2001 104,075 184,768 5,438 45,000
2002 100,308 196,264 6,773 48,954Table 4 – Average consumption of toothpaste (gram), tooth –
brush (unit), mouthrinse (gram) and dental floss (unit) per
capita in Brazil between 1992 and 2002.9
YearProduct
Toothpaste Toothbrush Mouthrinse Dental Floss
1992 415.2 0.47 5.4 0.101
1993 407.6 0.54 5.5 0.104
1994 445.4 0.64 8.4 0.113
1995 423.8 0.70 13.4 0.142
1996 480.3 0.70 17.9 0.143
1997 517.7 0.75 21.8 0.140
1998 544.2 0.83 25.7 0.156
1999 572.6 0.83 21.3 0.180
2000 560.9 0.89 20.3 0.184
2001 603.7 1.07 31.5 0.261
2002 574.4 1.12 38.8 0.280

The history and global market of oral home-care products
Braz Oral Res 2009;23(Spec Iss 1):17-22 22pearance is reflected by an enhancement in the
development of anti-aging products. The sales increase of dental bleaching agents is also a re –
flection of this situation.Since remote times, our ancestors were con –
cerned with cleaning their teeth and keeping their mouths fresh and healthy. They developed a variety of rudimentary devices and products, which ulti –
mately led to today’s availability of a wide range of oral home-care products. A large increase has been observed in the consumption of these products in a short time interval: 12% over one year in Latin America,
7 for example. Some questions arise from
observing the current data. Has the behavior of dental diseases changed over the time due to expo –
sure to compounds like fluoride, antimicrobials or chlorhexidine? Do dental professionals know the actual efficacy and the correct indications of the available products? To what extent the increased supply and consumption of home-care products has actually promoted an improvement in oral health? Future investigations may answer these questions in order to guide consumers and professionals in using oral home-care products.
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7. Nielsen Company. Os produtos mais quentes do mundo – infor –
mações sobre o crescimento de categorias de higiene & beleza [online]. São Paulo: Nielsen Global Services; 2004. Available from: http://www.acnielsen.com.br.
8. Kline & Company. Global Cosmetics & Toiletries 2004: World Overview [online]. Kline & Company: Business proc ess
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Available from: http://www.klinegroup.com/ .
9. Manfredini MA. Características da indústria de equipamentos odontológicos e de produtos para higiene bucal no Brasil entre 1990 e 2002 [Dissertação de Mestrado]. São Paulo: Coordena-doria de Controle de Doenças da Secretaria de Estado da Saúde de São Paulo; 2006.
10. Abihpec. São Paulo: Associação Brasileira da Indústria de Hi-giene Pessoal, Perfumaria e Cosméticos; 2008. Available from: www.abihpec.org.br.US$ · 103
Year0400800
600
200
2001406.9
2002351.2
2003349.0
2004453.1
2005617.6
2006746.1
Graph 3 – Sales of oral care products from 2001 to 2006
in Brazil. Values are expressed in dollars.10 ToothbrushMouthrinseDental flossToothpaste9%
21%4%
66%
Graph 4 – Oral care products sales share in 2006 in Brazil
(Source: ABIHPEC).10