Stannous fluoride toothpastes reduce the gingival index more than sodium fluoride toothpastes

Medline and the Cochrane Central Register of Controlled Trials were used to identify sources of data.

Title and abstracts were screened independently. Randomised controlled clinical trials of >6 months duration that used gingivitis or plaque levels as outcome measures were selected.

The mean values and standard deviations were extracted. In studies where standard errors of the mean were reported, standard deviations were calculated by the authors based on the sample size. Weighted means of baseline and of end of trial were calculated with the software Cochrane Collaboration Review Manager (version 4.2; The Cochrane Collaboration, Oxford, England) using a random-effects model. A meta-analysis for stannous fluoride (SnF) mouth rinse and dentifrice/ mouthrinse formulations was not performed because there were insufficient data.

Fifteen papers were included in the review. For SnF dentifrices, a statistically significant reduction in gingivitis was noted in comparison with control [weighted mean difference (WMD), 0.15 (gingival index) and 0.21 (gingivitis severity index); test for heterogeneity P<0.00001, I(2)=91.1% and P 50.03, I(2)= 80.1%, respectively]. There were inconsistent results for plaque reduction. On using the plaque index, no differences were found, whereas meta-analysis of the Turesky index gave a WMD of 0.31 (P 50.01; test for heterogeneity P 0.0001, I(2)=91.7%).

The use of SnF dentifrices results in greater gingivitis and plaque reduction compared with a conventional dentifrice. The precise magnitude of this effect was difficult to assess because of a high level of heterogeneity in study outcomes.