Evaluation of the plaque removal efficacy of chewable toothpaste tablets - a randomized controlled crossover trial

Chewable toothpaste tablets (CTTs) have recently emerged as environmentally sustainable alternatives to conventional toothpaste formulations. However, limited scientific evidence is available regarding their clinical efficacy in plaque control. The present study aimed to compare the antiplaque efficacy and user acceptability of two commercially available chewable toothpaste tablets among young adults.

A randomized double-blind crossover clinical trial was conducted among 196 adults aged 18-35 years. Participants were randomly allocated into two intervention sequence groups (AB and BA). Sequence AB used Apollo Noni CTT for 7 days followed by Teeth-A-Bit after a 7-day washout period, whereas Sequence BA followed the reverse sequence. Plaque scores were recorded using the Modified Turesky-Gilmore-Glickman Plaque Index following 24-h abstinence from oral hygiene procedures at baseline and after each intervention phase. Participant feedback was assessed using a structured questionnaire. Data were analyzed using descriptive statistics, chi-square tests, and linear mixed-effects modeling with restricted maximum likelihood estimation.

A total of 196 participants (95 men, 101 women; mean age 23.42 ± 2.65 years) completed the study. Baseline plaque scores were comparable between the AB and BA treatment sequences (Period 1: 1.82 ± 0.24 vs. 1.77 ± 0.25; Period 2: 1.77 ± 0.26 vs. 1.80 ± 0.19). Following the 7-day intervention, plaque scores decreased in both sequences, with lower post-intervention scores observed for Apollo Noni (1.34 ± 0.27 and 1.32 ± 0.21) than for Teeth-A-Bit (1.54 ± 0.24 and 1.52 ± 0.27). Linear mixed-effects analysis showed baseline plaque score significantly predicted post-treatment score (p < 0.001). After adjustment, Apollo Noni achieved significantly lower plaque scores than Teeth-A-Bit (1.322 ± 0.010 vs. 1.548 ± 0.010; mean difference -0.226, 95% CI: -0.245 to -0.206; p < 0.001). No significant period or sequence effects were found, indicating no carryover bias. Both products were well-accepted, with no adverse effects or significant gender-based differences in user experience or satisfaction (p > 0.05).

Both CTTs reduced dental plaque, but Apollo Noni demonstrated noticeably greater antiplaque efficacy. The results indicate that CTTs may offer viable, eco-friendly substitutes for traditional dentifrices.

https://ctri.nic.in/Clinicaltrials/pmaindet2.php?EncHid=MTEwNTg2&Enc=&userName=, Clinical Trials Registry-India (CTRI/2024/07/070865).