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Efficacy of Sodium Bicarbonate Toothpastes on Gingivitis and Plaque
Abstract
Objective: To evaluate the efficacy of 67%w/w and 62%w/w sodium bicarbonate toothpastes on gingivitis and dental plaque control compared to a control toothpaste (0% sodium bicarbonate).
Method: This was a single-centre, randomized, examiner blind, three treatment, parallel group, stratified design. Following informed consent and screening there was a 1-2 week washout period. Following baseline examinations and dental prophylaxes, subjects were randomized to one of three treatment groups (67%, 62% or 0% sodium bicarbonate). They then brushed twice daily for one timed minute for 12 weeks with their randomized toothpaste at home. Examinations using the Gingival Index (GI) and Turesky Plaque Index (TPI) were performed after 6 and 12 weeks. Gingivitis Severity Index (GSI) was calculated based on GI score. GI, TPI and GSI were compared between treatments using analysis of covariance (ANCOVA).
Result: Three hundred and thirty-six subjects were included in the efficacy analysis. Relative to the 0% sodium bicarbonate control toothpaste group the 67% sodium bicarbonate toothpaste exhibited statistically significant reductions in GI of 4.76%, TPI of 7.73% and GSI of 23.64% after 12 weeks, respectively. Relative to the 0% sodium bicarbonate control toothpaste group the 62% sodium bicarbonate toothpaste exhibited a non signficant reduction in GI of 2.15% and GSI of 12.50%, respectively. However, the 62% sodium bicarbonate toothpaste compared to the 0% sodium bicarbonate toothpaste and exhibited statistically significant reductions in plaque of 6.47% after 12 weeks.
Conclusion: The results of the present clinical study demonstrate that the use of 67% sodium bicarbonate toothpaste over a 12 week period provides statistically significant superior gingivitis and plaque control to a 0% sodium bicarbonate control toothpaste.
Objective:
The objective of this study was to investigate the antigingivitis and antiplaque treatment effect of a toothpaste containing 67% w/w sodium bicarbonate, at the individual tooth site, tooth region and whole mouth (overall) level, by way of a pooled analysis of data from similarly designed clinical trials.
Methods:
Six randomized controlled GSKCH clinical trials, 12 to 24 weeks in duration, were selected based on pre-specified criteria which included access to patient level data, pre-treatment dental prophylaxis, >20 bleeding sites and mild-moderate gingivitis at screening and use of 67% sodium bicarbonate toothpaste and non-sodium bicarbonate (regular) toothpaste (negative control) for ≥4 weeks. Efficacy outcomes comprised plaque index (TPI), modified gingival index (MGI) and gingival bleeding (bleeding index (BI), number of bleeding sites (BS)). Treatment comparisons were made using ANCOVA for whole mouth (overall) scores and by tooth site region (facial overall, lingual overall; margin/body overall, facial margin/body, lingual margin/body; papillae/interproximal overall, facial papillae/interproximal, lingual papillae/interproximal). Pooled data for BI, MGI, and TPI at individual tooth sites was plotted as a mouthmap to summarise treatment response (change from baseline) by tooth site, at the 24-week timepoint.
Results:
For all measures, whole mouth and for all tooth regions at all post-treatment timepoints, significant (p<0.001) differences in favor of the 67% sodium bicarbonate toothpaste compared to control were observed. At the 24-week timepoint, facial regions demonstrated greater improvements than lingual regions, with the greatest between treatment improvement seen for the facial-papillae regions for bleeding (BS/BI), facial-margin regions for MGI and facial-body regions for TPI. All individual tooth sites demonstrated numerically greater reductions from baseline for the 67% sodium bicarbonate toothpaste than the control toothpaste following 24 weeks use, with the greatest improvements (change from baseline) seen for posterior and papillae tooth sites for bleeding, margin tooth sites for MGI and body tooth sites for TPI.
Conclusion:
This pooled analysis of patient level-data, limited to GSKCH long-term gingivitis clinical studies, demonstrates that twice daily use of a 67% sodium bicarbonate toothpaste effectively removes plaque from all tooth sites, and results in clinically significant improvements in measures of gingival health, overall and for all the tooth regions investigated, compared to a non-sodium bicarbonate (regular) toothpaste following 24 weeks twice daily use.
Dentifrices traditionally have been formulated as pastes or gels. However, liquid varieties recently have become available The authors conducted a study to determine whether a fluoridated liquid product with added triclosan and a polyvinyl methyl ether/maleic acid, or PVM/MA, copolymer delivery system is efficacious for the control of supragingival plaque and gingivitis.
The authors conducted a six-month, double-blind, parallel, stratified clinical study in accordance with American Dental Association guidelines for the clinical evaluation of antiplaque/antigingivitis products. Subjects who qualified with a suitable amount of existing plaque and gingivitis were given one of two dentifrices: an "experimental" liquid dentifrice containing 0.3 percent triclosan, 2.0 percent PVM/MA copolymer and 0.243 percent sodium fluoride, or NaF, in a silica base; or a "placebo" dentifrice containing 0.243 percent NaF in a silica base. The authors collected subjects' plaque and gingival index scores at baseline, three months and six months.
The results of the study indicate that the use of the experimental liquid dentifrice provided a significant reduction in existing levels of plaque and gingivitis as compared with the placebo standard dentifrice. At six months, the experimental group demonstrated a 34.9 percent reduction in plaque formation and a 25.7 percent reduction in gingivitis as compared with the placebo group (P < .001).
When compared with the placebo, the experimental dentifrice had a significantly better ability to reduce plaque and gingivitis. When compared with results reported in the literature, this new form of dentifrice achieved results comparable in efficacy to those of traditional dentifrice pastes with matching active ingredients.
This study confirms that a liquid dentifrice containing a triclosan/copolymer/NaF delivery system is efficacious in its ability to reduce existing plaque and gingivitis.
The purpose of this paper is to discuss the changed trends of population, oral diseases and their effects on Chinese dentistry.
The demographic and epidemiologic data published in recent books and journals were reviewed and analyzed.
As the 21st century approached, dentistry in China would face many changing trends and challenges. 1. a growing population and an aging population: The two sub-populations with the greatest need for prevention and treatment were children and old patients who were outpacing the supply of dental manpower. 2. The changed dental disease patterns: The prevalence of caries was increasing and more than two thirds of Chinese suffered from periodontal disease. The traditional dental approaches have not been able to satisfy the needs of Chinese.
The challenge created by these demographic, economic and advances in dental technology is changing Chinese dentistry.
Report of the third national oral health survey in China
- X Qi
Qi, X. Q. "Report of the third national oral health survey in China". People's Medical Publishing House (2008): 11-12.