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A randomised, controlled, trial investigating the effect of tooth brushing with a sodium bicarbonate toothpaste for
Nicola X West1, Jianhong Qiu2, Alexander J Pollard1
1Clinical Trials Unit, Periodontology Department, Bristol Dental School, University of Bristol, Lower Maudlin Street, Bristol, BS1 2LY, United Kingdom.
Objectives:
To determine the effect on gingival inflammation of toothbrushing with sodium bicarbonate toothpaste for 12 weeks compared to brushing with a conventional fluoride toothpaste.
Methods:
An ethically-approved, single-centre, controlled, examiner-blind, randomized, two-treatment arm, parallel study in consenting healthy ≥18yr participants with ≥20 teeth diagnosed with localised gingivitis. Approximately 200 eligible participants brushed for 2weeks with a fluoride acclimatization toothpaste before randomization to brushing 2/daily with a sodium bicarbonate (test) or fluoride (control) toothpaste. No pre-prophylaxis was conducted prior to study start. Modified gingival index (MGI), bleeding index (BI) and Turesky plaque index (TPI), were measured at baseline, 3, 6 and 12weeks. Participants completed a diary for compliance monitoring.
Results:
190 participants were randomised, 188 completed the study. The test group demonstrated a statistically significant reduction in number of bleeding sites from baseline to 12-weeks (p = 0.0032), 6-weeks (p = 0.0031) and 3-weeks (p = 0.0091), and compared to control group from baseline to 12-weeks (p = 0.0013). The test group showed significantly (all p < 0.0001) decreased mean MGI score from baseline to 3-weeks, 6-weeks, and 12-weeks compared to control group; significantly decreased mean overall TPI score from baseline to 3-weeks (p = 0.0012), 6-weeks (p = 0.0058), and 12-weeks (p < 0.0001) compared to control; and significantly reduced mean interproximal TPI scores compared to control group from baseline to 3-weeks (p = 0.0022), 6-weeks (p = 0.0099) and 12-weeks (p < 0.0001).
Conclusions:
Twice daily toothbrushing with a sodium bicarbonate toothpaste significantly improved oral health reducing localised gingivitis compared to brushing with a conventional fluoride toothpaste, measured by BI, MGI and TPI over 12 weeks.
Clinical Significance:
Localised, gingivitis can be resolved or prevented with excellent home-use oral hygiene measures, but this is rarely achieved with mechanical brushing alone. Twice daily toothbrushing with sodium bicarbonate toothpaste demonstrated added value in reducing localised gingivitis and improving oral health compared to brushing with a conventional fluoride toothpaste.
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