Volume 6 • 2019 • Issue 8

12 | 2019 | Issue 8 CDA at W ork Though reviewers work all year round, the CDA Seal Program committee meets in Ottawa annually. Some years there are many applications, others fewer. “I remember, one year we had 12 products to review. Another year, we had two. The oral health product industry has only a few major companies, so it makes a difference if one of them reformulates a product line,” says Dr. Brothwell. Impacts of the Program Dr. Brothwell recalls a fluoridated toothpaste for which a manufacturer applied for a CDA Seal. According to the scientific studies, it was effective, and the manufacturing process was well designed. “But, as dentists, we had a problem with the information being portrayed on the packaging,” says Dr. Brothwell. In the photograph on the toothpaste box, there was too much toothpaste applied to the toothbrush—“a big double swirl of toothpaste on the toothbrush bristles.” Children should only have a minimal to pea-sized amount of fluoride toothpaste at most, depending on age. “We told the manufacturer that the photograph demonstrated an inappropriately large amount of fluoridated toothpaste and the image would need to change before we could consider awarding the product the Seal,” says Dr. Brothwell. The manufacturer resubmitted the packaging with the same photo, printed smaller. “We turned it down again,” says Dr. Brothwell. “And finally, the image was changed and showed an appropriate amount of toothpaste.” Working collaboratively, the committee succeeded in educating the manufacturer, who then changed its product’s entire marketing campaign. Children’s use of fluoride was a factor in another product that the committee didn’t feel it could endorse. “We were considering a product that was a toothpaste and mouthwash, all-in-one,” says Dr. Wiseman. “But the viscosity was too fluid and couldn’t be measured by parents.” Dr. Wiseman knew, from his clinical experience, how often children swallowed toothpaste, so he couldn’t recommend the product. Sometimes products show an effect in the lab that won’t be meaningful to the user. The committee reviewed a whitening product that showed efficacy that could be measured by a machine. “But the change wasn’t visible to the human eye,” says Dr. Brothwell. “Is a consumer going to be happy with that product? We didn’t think they would, so it didn’t get the Seal.” 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. Manufacturers can use the CDA Seal in their marketing efforts. “When the public sees a tube of toothpaste, a power toothbrush, a mouthwash, or floss with our emblem on it, it speaks for itself,” says Dr. Wiseman. “The public knows that the product has real therapeutic benefits preventing or treating oral disease.” Why Dentists Do It Reviewing scientific studies and manufacturing material can be time consuming, especially at the beginning of a reviewer's tenure. “A good reviewer is someone who has attention for details, knowledge of scientific research methods and knowledge of evidence-based decision making,” says Dr. Brothwell. Dr. Wiseman says that the committee includes dentists with different and complimentary backgrounds. “Our committee is comprised of specialists, public heath dentists, academics, clinicians like myself, and we come together from across the country,” says Dr. Wiseman. Dr. Brothwell says that he joined the committee out of a desire to give back to his profession and to the public, but what kept him coming back for 19 years was the collegiality that the work offered. “We became fast friends,” he says. “It was wonderful to meet dedicated people who were doing the same thing as I was.” Dr. Brothwell says that he also enjoyed the insight provided by reading detailed description of both science and product manufacturing. “I certainly learned new things,” he says. Dr. Wiseman agrees that getting to know his colleagues was enriching. “There is a real sustained friendship amongst us.” “I think when you do something just for altruistic reasons, after a while you feel like you’ve done enough,” says Dr. Brothwell. “To do something for 19 years, you have to enjoy it.” Do you have a background in material science, chemistry, or research? The CDA Seal Program is looking for new reviewers . If you are interested in getting involved contact: cdaseal@cda-adc.ca