Volume 6 • 2019 • Issue 8

11 Issue 8 | 2019 | CDA at W ork “The CDA Seal program builds trust,” says Dr. Michael Wiseman, associate professor with the Faculty of Dentistry at McGill. “Consumers trust that they can use products with the Seal because we’ve verified that they are effective. And manufacturers trust that we are going to evaluate their products without commercial interest.” The review process is completed by a committee, which currently has 7 members, supported by 3 CDA staff. “It’s not a rubber stamp. Indeed, the process is rigorous,” says Dr. Brothwell, who was on the committee for 19 years and served 6 years as chair before moving on in 2017. “We’ve rejected applications that don’t meet our standards because we had a responsibility to help consumers make informed choices about their oral health and their purchasing behaviour.” Dr. Wiseman explains that dentistry is an evidence-based profession, so products that make oral health claims must be backed up by evidence. “We look at the evidence, the proof, to see if the claims are true,” says Dr. Wiseman, who has been on the committee since 1998 and is the current chair. “And sometimes the science just doesn’t substantiate the claim. Other times, as a clinician, a practising dentist who knows about patient behaviour, you know whether a product will meet patients’ needs.” The Review Process Manufacturers can apply for the CDA Seal for any product that makes an oral health claim. The application includes providing materials relating to scientific studies that provide evidence for any claims as well as information about the manufacturing process and quality control measures. Those materials then go to two anonymous reviewers on the CDA Seal committee who evaluate it. “As a reviewer, I looked at the science first,” says Dr. Brothwell. “Often, there would be two independent studies that showed whether the product was effective.” For example, if a product claims to reduce gingivitis, studies need to show that, among the 60 or more people who used the product for at least 2 months, the mean gingivitis scores were lower—a statistically significant amount—than those who didn’t use the product. For toothbrushes, Dr. Brothwell would determine if they had the flexibility and thickness of bristles to meet the ISO standard, a set of requirements established by the International Standards Organization, among other factors. Dr. Brothwell would also assess the manufacturing process and quality control measures because the effectiveness of a product depended on its quality and consistency. “If it works and it’s manufactured appropriately, then the product can be considered for the Seal,” he says. Dr. Brothwell says that when he first joined the committee, manufacturers could only apply for certain claims in categories that were designed by the committee, including prevention of decay and prevention of gum disease, among others. In the last 5 years, the Seal program was redesigned as a validation program and now manufacturers can make new claims or multiple claims—as long as it relates to an oral health benefit and the manufacturer can provide evidence for its scientific basis. “Often new products make a number of claims: this toothpaste will not only fight cavities, but it will also whiten your teeth and prevent sensitivity,” says Dr. Brothwell. Dr. Wiseman adds that it can be helpful for consumers to know when a product offers multiple therapeutic actions. “There are also more kinds of products on the market. There are denture adhesives, denture cleaners, and oral moisturizers. For instance, wouldn’t it be great to have an oral moisturizer for people who suffer from dry mouth that provided long-term relief of dryness, a neutral PH, anti-cavity properties and remineralized teeth at the same time?” When a product receives the CDA Seal, it communicates to consumers that it meets the rigorous standards of dentists, and that the intended oral health benefits are backed by science.