Antibacterial Action, Substantivity and Anti-plaque Effect of Different Toothpaste Slurries - A Randomised Controlled Trial

Abstract

Purpose: This single-center, clinically controlled, double-blinded, randomised, crossover study aimed to evaluate and compare the antibacterial effect, substantivity and patients' acceptance of three toothpaste slurries after a single application on established biofilms observed for 24 h.

Materials and methods: Twenty-four participants started a test cycle after refraining from oral hygiene for 48 h, with a baseline plaque sample measuring biofilm vitality (in %; VF0) using vital fluorescence (VF). They were instructed to rinse for 1 min with either an amine fluoride, stannous chloride (ASC), an herbal (SBC) or a sodium fluoride (SFL) toothpaste prepared as slurries. Every two hours up to 12 and after 24 h, plaque samples were harvested (VF2-VF24%). Plaque-covered areas (PA in %) were evaluated after 24 h using digital photographs. Patients' acceptance was determined by visual analogue scale (VAS) questionnaire.

Results: All participants (16 women, 8 men; 27.5 ± 7.9 years) completed all cycles. Two hours after application (VF2), all toothpastes showed a statistically significant reduction in bacterial vitality (p < 0.05), maintained up to 12 h. ASC revealed statistically significantly lower vitality values compared to SBC at VF2, VF4, VF8, VF12 and VF24, and at VF4, VF12 and VF24 compared to SFL (p < 0.05), while SBC and SFL did not differ statistically significantly at any time point. The preferred toothpastes were SFL (18/24 participants) and ASC (15/24 participants).

Conclusions: All toothpastes showed statistically significant anti-plaque effects on established plaque biofilm and a substantivity up to 24 h compared to their baseline, while ASC still presented a statistically significant effect after 12 and 24 h compared to SBC and SFL.

Keywords: anti-plaque agents; biofilm vitality; chemical plaque control; substantivity; toothpaste.

Fig 1

Study flowchart including the sampling schedule: pre-defined teeth for plaque samples timepoints (VF₀%-VF₂₄%).