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EL LABORATORIO PROFECO REPORTA

Enjuagues bucales

Ilustración Cynthia Márquez

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Consumidor • Febrero 2009

Cuando la propia boca es una emergencia sanitaria, a nadie se le puede culpar más que a uno mismo. Para evitar la caries o la gingivitis, el procedimiento es tan sabido que parece una cantaleta: el primer paso es cepillar los dientes a diario después de cada comida, recurrir al hilo dental para eliminar los restos de comida escondidos entre los dientes... y el uso de enjuagues bucales. Sí, el uso de estos últimos no es superfluo, como muchos pueden creer. Pero no todas las marcas son igual de capaces de auxiliar en la salud bucodental.

Febrero 2009 • Consumidor

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L

os enjuagues bucales ayudan a suprimir temporalmente el mal aliento, reducen las bacterias en la boca y la refrescan, dejando en ella un sabor agradable. Algunos contienen ingredientes activos para ayudar a proteger contra enfermedades orales como la caries o la gingivitis. La caries dental es una enfermedad común, aunque en los últimos años su frecuencia ha disminuido gracias a los programas de salud bucodental, a una mayor atención dental y a la utilización de algunos ingredientes activos en los dentífricos y en las aguas de consumo. La caries se caracteriza por la destrucción del esmalte dental y la

dentina (tejido duro situado debajo del esmalte) ocasionado por bacterias (entre ellas el streptococcus mutans), que se desarrollan en la placa dental y producen un medio ácido que erosiona el esmalte dental. Entre los ingredientes activos destaca, en varias de las marcas, el flúor, que es un mineral esencial para la salud dental, el cual, además de su poder antiséptico, endurece el esmalte, lo que lo hace más resistente a la caries. A mayor cantidad de flúor en los dientes, menos riesgo de disolución del esmalte por los ácidos producidos por las bacterias y, por tanto, menos posibilidad de caries u otras lesiones en dientes y encías.

Normatividad
NOM-002-SCFI-1993. Productos preenvasados. Contenido neto-Tolerancias y métodos de verificación. NOM-137-SSA1-1995. Información regulatoria. Especificaciones Generales de etiquetado que deberán ostentar los dispositivos médicos, tanto de manufactura nacional como de procedencia extranjera.

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Consumidor • Febrero 2009

Destaca también en la formulación de enjuagues bucales la adición de componentes como el alcohol y/o algunos antibacteriales tales como el triclosan, el cloruro de cetil piridinio y el gluconato de clorhexidina, entre otros, que ayudan a prevenir las enfermedades bucales y en particular el último para combatir la gingivitis, mismo que en su etiqueta o envase recomienda su uso sólo bajo la supervisión de un odontólogo, y que no sea de uso continuo. La gingivitis resulta una de las enfermedades bucales más comunes, y consiste en la inflamación de las encías, lo cual provoca dolor, hinchazón y sangrado fácil. Puede aparecer en cualquier momento y no hay ningún grupo de edad que se vea más afectado. La gingivitis suele ser causada, habitualmente, por el cepillado incorrecto de los dientes, que no acaba con la placa dentobacteriana, y que provoca

una acumulación de bacterias que, cuando se solidifica, se convierte en el molesto y peligroso sarro. Otra de las propiedades que se resaltan en estos productos es el combate a los gérmenes causantes del mal aliento, el cual es producido por la descomposición bacteriana de restos de alimentos entre los dientes, de saliva, o de células, generando sustancias volátiles. Estas sustancias, que son las que

Ficha técnica
Periodo del estudio: 26 de agosto al 15 de diciembre de 2008 Periodo de adquisición de productos: 26 de agosto al 20 de noviembre de 2008 Marcas analizadas: 23 Pruebas realizadas: 1,865 Periodo de análisis: 27 de agosto al 12 de diciembre de 2008

causan los problemas bucales, se evaporan y llegan a otras personas en forma de un aliento desagradable. Por razones que todavía se desconocen, algunas personas tienen más bacterias que otras. Existen varias teorías al respecto: cambios hormonales, toma de medicamentos, muchas veces antibióticos que producen un desequilibrio en las bacterias orales, o predisposición genética. Si el mal aliento no es de origen oral, el dentista debe diagnosticar la procedencia del problema y remitir al paciente al médico especialista más adecuado. Si tiene dudas, aclaraciones o requiere más información sobre este estudio, comuníquese al Laboratorio Nacional de Protección al Consumidor, al teléfono 5544 2122 si vive en el área metropolitana de la Ciudad de México, o consulte nuestro sitio en Internet en www.profeco.gob.mx.

El estudio
Se analizaron 23 enjuagues bucales, algunos de ellos usan la denominación de antiséptico bucal o solución antiséptica. El estudio incluye aquellos que tienen compuestos que ayudan a combatir la gingivitis o agentes activos como el flúor, agentes blanqueadores como peróxido de hidrógeno y otros que contienen agentes que tienen función antiséptica. Sólo dos de los productos analizados recomiendan su uso antes del cepillado, y los otros posterior a este. Todos fueron sometidos a las siguientes pruebas: Contenido neto e información al consumidor. Se revisó que la cantidad contenida en el producto corresponda a lo mencionado en etiqueta y que la información fuera veraz, comprobable y no induzca a error al consumidor con respecto a la naturaleza y características del producto, además de que reúna los requisitos de etiquetado establecidos para productos higiénicos. Contenido de flúor, edulcorantes y conservadores. Para los productos que ostentan contener flúor, su contenido fue verificado ya que es un ingrediente activo para la prevención de caries. Se verificaron también otros ingredientes declarados en algunos productos y que fueron determinados para comprobar la veracidad de su etiqueta. Prueba de reto microbiano. Los productos fueron sometidos a una prueba de reto microbiano, en donde se probó su eficacia para actuar ante una carga dada de microorganismos, específicamente sobre bacterias que se encuentran en la cavidad bucal, como son los pertenecientes al género streptococcus, básicamente las especies mutans, asociadas con la caries, tanto en animales de experimentación como en humanos. La bacteria obtiene su energía del alimento que ingerimos, entre las sustancias que aprovecha figuran los azúcares e incluso el almidón. La bacteria genera subproductos que acidifican la boca y los dientes, lo que inhibe a las otras bacterias, permitiendo al streptococcus mantener una posición de claro dominio para que se produzca la caries. Precio. Aunque no fue un criterio para evaluar la calidad del producto, las tablas de resultados incluyen el precio promedio por cantidad recomendada para un enjuague. Para calcularlo, se utilizó el precio promedio pagado al adquirir los productos.

Febrero 2009 • Consumidor

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Enjuagues bucales con alcohol
Astringosol Ice Complete País de procedencia México Contenido neto 300 ml Contenido de flúor 228 mg/kg Ingredientes activos cloruro de cetilpiridino y fluoruro de sodio Precio por cantidad recomendada $1.70 Eficiencia Colgate Plax Menta Fresh Mint País de procedencia Brasil Contenido neto 250 ml Contenido de flúor 222 mg/kg Ingredientes activos fluoruro de sodio, triclosán, gantrez Precio por cantidad recomendada $1.80 Eficiencia

Astringosol Fresca Protección Concentrado País de Procedencia: México Contenido neto: 220 ml Ingredientes activos: cloruro de cetilpiridinio, salicilato de metilo y cloruro de zinc Precio por cantidad recomendada $0.60 No contiene flúor Eficiencia

Colgate Plax Overnight País de procedencia: Brasil Contenido neto 250 ml Contenido de flúor: 226 mg/kg Ingredientes activos: fluoruro de sodio, cloruro de cetilpiridinio Precio por cantidad recomendada $1.80 Eficiencia

Astringosol Protección Intensiva Concentrado País de procedencia México Contenido neto 220 ml Ingredientes activos cloruro de cetilpiridino, salicilato de metilo y cloruro de zinc Precio por cantidad recomendada $0.60 No contiene flúor Eficiencia Colgate Plax Peppermint País de procedencia Brasil Contenido neto 500 ml Contenido de flúor 229 mg/kg Ingredientes activos fluoruro de sodio, triclosán, gantrez Precio por cantidad recomendada $1.80 Eficiencia

Equate antiséptico sabor menta País de procedencia: EU Contenido neto: 1.5 L Ingredientes activos: timol, eucaliptol, metil salicilato y mentol Precio por cantidad recomendada $0.80 No contiene flúor Eficiencia Listerine Whitening pre-cepillado País de procedencia Canadá Contenido neto 473 ml Ingredientes activos peróxido de hidrógeno Precio por cantidad recomendada $1.95 No contiene flúor Eficiencia

Colgate Plax Whitening País de procedencia Brasil Contenido neto 250 ml Ingredientes activos peróxido de hidrógeno Precio por cantidad recomendada $2.00 No contiene flúor Eficiencia

Listerine Freshmint Antiséptico País de procedencia EU Contenido neto 250 y 500 ml Ingredientes activos eucaliptol, salicilato de metilo, timol y mentol Precio por cantidad recomendada $2.30 No contiene flúor Eficiencia

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Consumidor • Febrero 2009

Excelente

Muy bueno

Pobre

Listerine defensa de dientes y encias País de procedencia Colombia Contenido neto 250 ml Contenido de flúor 102mg/kg Ingredientes activos eucaliptol, salicilato de metilo, timol, mentol y fluoruro de sodio Precio por cantidad recomendada $2.90 Eficiencia Listerine Anti-Sarro Advanced País de procedencia EU Contenido neto 250 ml Ingredientes activos eucaliptol, cloruro de zinc, salicilato de metilo, timol y mentol Precio por cantidad recomendada $2.90 No contiene flúor Eficiencia Scope País de procedencia EU Contenido neto 250 ml Ingredientes activos cloruro de cetilpiridinio Precio por cantidad recomendada $3.35 No contiene flúor Eficiencia

Equate pre-cepillado País de procedencia EU Contenido neto 710 ml Ingredientes activos pirofosfato tetrasódico Precio por cantidad recomendada $1.00 No contiene flúor Eficiencia

Vié Wild Mint Concentrado País de procedencia México Contenido neto 350 ml Contenido de flúor 394 mg/kg. Tuvo hasta 38% menos de lo declarado Ingredientes activos fluoruro de sodio Precio por cantidad recomendada $0.30 Eficiencia Dental-bright Soriana País de procedencia México Contenido neto 300 ml y 1.5 l * Contenido de flúor tuvo desde 60 a 254. Se desvió hasta con 73% menos de lo declarado Ingredientes activos fluoruro de sodio Precio por cantidad recomendada $1.25 Eficiencia

Dental Max País de procedencia No indica Contenido neto 350 ml ** Contenido de flúor desde 349 a 361 mg/kg Excedió hasta el 33% el valor declarado Ingredientes activos fluoruro de sodio Precio por cantidad recomendada $0.80 Eficiencia

Oral-B para gingivitis País de procedencia Colombia Contenido neto 350 ml Ingredientes activos gluconato de clorhexidina Precio por cantidad recomendada $5.30 Eficiencia No contiene flúor
Nota: no es un enjuague convencional; se recomienda como parte de tratamientos prescritos por un dentista * Ostenta las leyendas: “Ayuda a eliminar gérmenes” “Ayuda a reducir la placa dentobacteriana y a reducir la gingivitis”, “Aliento fresco” y “Satisfacción Soriana”, las cuales no justifica ya que su desempeño demostró que su calidad no es uniforme porque dos de tres lotes analizados resultaron con eficiencia bacteriana pobre. **Ostenta las leyendas: “Contiene un agente antibacterial que ayuda a eliminar los microorganismos que causan el mal aliento, placa dentobacteriana y caries” y “Evita la gingivitis (inflamación de las encías causada por bacterias)”, las cuales no justifica ya que en su desempeño resulto con eficiencia bacteriana pobre.

Vié Freeze País de procedencia México Contenido neto 350 ml Contenido de flúor 400 mg/kg. Excedió 26% el valor declarado Ingredientes activos fluoruro de sodio y triclosan Precio por cantidad recomendada: $0.55 Eficiencia

Febrero 2009 • Consumidor

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Enjuagues bucales sin alcohol

Ideario del buen cepillado
• Cepíllese los dientes por lo menos tres veces al día, utilice hilo dental y enjuague bucal diariamente para eliminar la placa depositada entre los dientes y debajo de la encía. • Revise la etiqueta, existen enjuagues bucales (las marcas Listerine Whitening precepillado y Equate) que indican su uso antes del cepillado y cuyo fin es ayudar a remover la placa dentobacteriana antes del lavado dental. • Con excepción de las marcas Astringosol sin alcohol y Oral B con flúor sin alcohol, Colgate Plax sin alcohol y Freshdent, todos contienen alcohol. Al no tener alcohol, disminuyen la sensación de picazón al momento del enjuague. • Sométase a revisiones dentales periódicas. La atención preventiva ayuda a evitar que ocurran problemas menores que, posteriormente puede que se conviertan en mayores. • Recuerde que cuando come entre comidas también debe enjuagar los dientes. • Tome en cuenta que también la etiqueta indica las instrucciones de uso, es conveniente seguirlas para obtener los beneficios completos que el producto ofrece. • En general todos tienen leyendas precautorias, entre ellas: la no ingestión del producto, no dejar al alcance de los niños, prescripción para edad determinada, entre otras. Revise la etiqueta. • En México se conocen zonas con una elevada concentración de fluoruro en el agua, en estados como Aguascalientes, Chihuahua, Durango, Jalisco, Sonora, Tamaulipas, San Luis Potosí, Guanajuato y Baja California Norte, ha habido reportes de fluorosis dental (que se caracteriza por la presencia de manchas blancas o amarillas, opacas y sin brillo en el esmalte), por lo que los enjuagues bucales con fluor en estas zonas sólo deben emplearse si el dentista lo recomienda.

Freshdent sabor menta País de procedencia México Contenido neto 350 ml Contenido de flúor 215 mg/kg Ingredientes activos fluoruro de sodio y cloruro de cetilpiridinio Precio por cantidad recomendada $0.60 Eficiencia Oral-B con flúor para dientes y encías País de procedencia Colombia Contenido neto 350 ml Contenido de flúor 226 mg/kg Ingredientes activos cloruro de cetilpiridinio, fluoruro de sodio Precio por cantidad recomendada $1.70 Eficiencia

Astringosol País de procedencia México Contenido neto 300 ml * Ingredientes activos fluoruro de sodio, cloruro de cetilpiridinio Precio por cantidad recomendada $1.35 Eficiencia

Colgate Plax País de procedencia Brasil Contenido neto 500 ml Contenido de flúor 224 mg/kg Ingredientes activos fluoruro de sodio, cloruro de cetilpiridinio Precio por cantidad recomendada: $1.60 Eficiencia

Excelente Muy bueno Pobre
* Ostenta en su etiquetado la leyenda: “Reduce la caries”, la cual no se justifica técnicamente, ya que previene, más no reduce la caries.

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Consumidor • Febrero 2009

¿Salieron limpios de nuestro estudio?
• Los resultados muestran comportamientos favorables en la evaluación de la eficacia de desinfección de la mayoría de los productos. De todos los productos analizados, sólo la marca Dental Max y dos lotes de tres analizados de la marca Dental Bright Soriana tuvieron una pobre desinfección bucal.

• En cuanto a la veracidad de información, la marca Dental Max declara que“contiene un agente antibacterial que ayuda a eliminar los microorganismos que causan el mal aliento, placa dentobacteriana y caries, evita la gingivitis”, pero su desempeño en la eficiencia de la desinfección fue pobre. • La marca Astringosol sin alcohol ostenta la leyenda “Reduce la Caries”, aunque técnicamente se demostró que previene la caries, no la reduce como presume.

• En cuanto a la veracidad de la información declarada, se destacan incumplimientos en el contenido de flúor en las marcas: Dental Max y Vié Freeze que, aunque presentan un excedente en su declaración, parecen no tener un control sobre el producto. Y muestras de las marcas Vié Wild Mint y Dental-bright Soriana tuvieron menor contenido del indicado.

• De los productos analizados, sólo la marca Oral B gingivitis, que no es un enjuague bucal común y que es utilizado en tratamientos médicos prescritos, contiene como ingrediente activo gluconato de clorhexidina, que ya está más determinado para fines terapéuticos para eliminar la gingivitis.

• Sobre el contenido neto, todos los productos cumplieron con lo ostentado en el envase.

• Por otro lado, la marca Dental-bright Soriana ostenta las leyendas “Ayuda a eliminar gérmenes”,“Ayuda a reducir la placa dentobacterina y a reducir la gingivitis”, “Aliento fresco” y “Satisfacción Soriana”; sin embargo su desempeño en dos de tres lotes analizados resultó con eficiencia bacteriana pobre.

Fotos José Rodríguez

Febrero 2009 • Consumidor

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...Modeled after the Scopes Monkey Trial, Inherit the Wind has the citizens of Hillsboro remain intransigent in their observance to Christianity and reject the concept of evolution, resulting in the trial that would bring attention from everywhere in the country. Referred to as the “buckle on the Bible Belt” (Act 1. Scene 1), the town is known for its strict adherence to its religion and puts a school teacher named Bert Cates on trail with the intent of imprisoning him for teaching evolution since it was illegal to do so. Although characters such as prosecuter Matthew Harrison Brady condemn Cates as a sinner and blame him for spoiling the minds of the town’s youth, he has never read the works of Darwin to understand why evolution would be taught. When questioned by the defense attorney Drummond, Brady...

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Chapter 21: The Scopes Monkey Trial

...Chapter 21: Scopes Monkey Trial The scopes monkey trial occurred because religious fundamentalists, who believed that God created life, believed that the theory of evolution was heretic. In early in 1925 state legislature of Tennessee passed a law forbidding public school teachers to teach the theory of evolution instead of teaching the story of Adam and Eve. John Scopes was a high school teacher in Dayton Tennessee who was a modernist, meaning that he believed in social sciences and evolution. In 1925 Scopes volunteered to serve in a test case and was arrested for teaching evolution in school. Scopes trial that summer became a headline event and though he won the trial, fundamentalism remained popular. 2nd Kkk In 1915, William J. Simmons,...

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The Scopes Monkey Trial: An American Legal Case

...The Scopes “Monkey” Trial was an American legal case in 1925 which involved a 24-year old high school teacher named John Thomas Scopes who was prosecuted for teaching the theory of evolution. The trial took place in Dayton, Tennessee on July 25th 1995. Scopes was accused of violating the Tennessee’s Butler Act by teaching Charles Darwin’s Theory of Evolution. The Butler Act forbids the teaching of theory that goes against the biblical story of Creationism. Scopes was found guilty and was charged a fine of $100. In 1925, the Tennessee legislature passed the Butler Act which prohibits the teaching of the theory of evolution in all the universities, normal and all other public school in Tennessee. Any teacher who fails to abide the law would be fined not less than a $100 or more than $500. Other southern states followed suit. The ACLU (American Civil Liberties Union) offered to defend the teaching of evolution. Scopes agreed to purposefully incriminate himself so the ACLU could challenge the Butler’s Act....

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...block is a set of statements that belong together as a group, and are performed any time the function is executed. When a function is executing, what happens when the end of the function block is reached?When a function is executing, it 'returns' when the end of the block is reached - meaning the interpreter jumps back to the part of the program that called the function, and the program resumes execution at that point. What is a local variable? What statements are able to access a local variable?A local variable is a variable that is declared inside of a function. Only statements in the same function can access a local variable. What is a local variable's scope?A local variable's scope is the part of a program in which the variable may be accessed and is only visible to the statements in the variable's scope. Why do global variables make a program difficult to debug?Global variables make a program difficult to debug because any statement in a program file can change the value of a global variable. If you find that the wrong value is being stored in a global variable, you have to track down every statement that accesses it to determine where the bad value is coming...

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