A Randomised Clinical Study to Evaluate Efficacy on Gingival Health of 62% and 67% Sodium Bicarbonate Toothpastes

Overview

Journal Oral Health Prev Dent

Date 2021 Dec 7

PMID 34874138

Authors

Stephen Mason

Pranati Patil

Vaishali Karad

Affiliations

Soon will be listed here.

Abstract

Purpose: This randomised, examiner-blind, parallel study compared gingival bleeding and plaque control following 12 weeks' twice-daily use of 67%, 62% or 0% sodium bicarbonate (NaHCO3)-containing toothpastes.

Materials And Methods: Adults with mild-to-moderate gingivitis, ≥ 20 gingival bleeding sites and bleeding after brushing were randomised to toothpastes containing 923 ppm sodium fluoride and either 67% NaHCO3, 62% NaHCO3 + 5% w/w silica, or 0% NaHCO3. Gingival bleeding was assessed with the Saxton and van der Ouderaa Bleeding Index (BI), plaque was assessed with the Turesky modification of the Quigley-Hein Plaque Index (TPI).

Results: There were significantly fewer bleeding sites at Week 12 (primary endpoint) for 67% NaHCO3 (n = 110) and 62% NaHCO3 (n = 110) groups compared with the 0% NaHCO3 group (n = 110) (treatment differences: -3.1 [97.5% confidence interval (CI) -5.5, -0.7] P = 0.0068 and -2.4 [-4.8, 0.0] P = 0.0448, respectively). Statistically significant differences were also seen at Week 6 (P = 0.0361 for 67% NaHCO3, P = 0.0044 for 62% NaHCO3 compared to 0% NaHCO3). Compared with the 0% NaHCO3 group, BI was significantly lower in the 67% NaHCO3 group at Weeks 6 and 12 (P = 0.0477 and P = 0.0066, respectively). TPI was significantly lower in the 67% NaHCO3 and 62% NaHCO3 groups at Week 6 (P = 0.0336 and 0.0009, respectively) but not at Week 12. No statistically significant differences were found between the 67% NaHCO3 and 62% NaHCO3 toothpastes for any variable. No treatment-related adverse events were reported.

Conclusion: Twice-daily brushing over 12 weeks with toothpastes containing 67% NaHCO3 or 62% NaHCO3 significantly improved plaque control and reduced indices of bleeding in participants with mild-to-moderate gingivitis.

References

Sharma N, Goyal C, Qaqish J, Vorwerk L, Hooper W, Ghassemi A . Enhanced plaque removal to improve gingival health: 3-month randomized clinical study of the effects of baking soda toothpaste on plaque and gingivitis. Am J Dent. 2020; 33(5):258-264. View

Kinane D, Stathopoulou P, Papapanou P . Periodontal diseases. Nat Rev Dis Primers. 2017; 3:17038. DOI: 10.1038/nrdp.2017.38. View

Bhate D, Jain S, Kale R, Muglikar S . The comparative effects of 0.12% chlorhexidine and herbal oral rinse on dental plaque-induced gingivitis: A randomized clinical trial. J Indian Soc Periodontol. 2015; 19(4):393-5. PMC: 4555795. DOI: 10.4103/0972-124X.153478. View

Mankodi S, BERKOWITZ H, Durbin K, Nelson B . Evaluation of the effects of brushing on the removal of dental plaque. J Clin Dent. 1999; 9(3):57-60. View

Marsh P . Dental plaque as a microbial biofilm. Caries Res. 2004; 38(3):204-11. DOI: 10.1159/000077756. View

Sreenivasan P, Prasad K . Distribution of dental plaque and gingivitis within the dental arches. J Int Med Res. 2017; 45(5):1585-1596. PMC: 5718714. DOI: 10.1177/0300060517705476. View

Pratten J, Wiecek J, Mordan N, Lomax A, Patel N, Spratt D . Physical disruption of oral biofilms by sodium bicarbonate: an in vitro study. Int J Dent Hyg. 2015; 14(3):209-14. DOI: 10.1111/idh.12162. View

Samaranayake L, Matsubara V . Normal Oral Flora and the Oral Ecosystem. Dent Clin North Am. 2017; 61(2):199-215. DOI: 10.1016/j.cden.2016.11.002. View

Wilder R, Bray K . Improving periodontal outcomes: merging clinical and behavioral science. Periodontol 2000. 2016; 71(1):65-81. DOI: 10.1111/prd.12125. View

10.

Chapple I, Van der Weijden F, Doerfer C, Herrera D, Shapira L, Polak D . Primary prevention of periodontitis: managing gingivitis. J Clin Periodontol. 2015; 42 Suppl 16:S71-6. DOI: 10.1111/jcpe.12366. View

11.

Thong S, Hooper W, Xu Y, Ghassemi A, Winston A . Enhancement of plaque removal by baking soda toothpastes from less accessible areas in the dentition. J Clin Dent. 2012; 22(5):171-8. View

12.

Aspalli S, Shetty V, Devarathnamma M, Nagappa G, Archana D, Parab P . Evaluation of antiplaque and antigingivitis effect of herbal mouthwash in treatment of plaque induced gingivitis: A randomized, clinical trial. J Indian Soc Periodontol. 2014; 18(1):48-52. PMC: 3988643. DOI: 10.4103/0972-124X.128208. View

13.

Kumar S . Evidence-Based Update on Diagnosis and Management of Gingivitis and Periodontitis. Dent Clin North Am. 2018; 63(1):69-81. DOI: 10.1016/j.cden.2018.08.005. View

14.

Yankell S, Emling R . Two month evaluation of Parodontax dentifrice. J Clin Dent. 1988; 1 Suppl A:A41-3. View

15.

El-Fawal G . Preparation, characterization and antibacterial activity of biodegradable films prepared from carrageenan. J Food Sci Technol. 2014; 51(9):2234-9. PMC: 4152529. DOI: 10.1007/s13197-013-1255-9. View

16.

Mason S, Karwal R, Bosma M . Two Randomized Clinical Studies to Confirm Differential Plaque Removal by Sodium Bicarbonate Dentifrices in a Single Timed Brushing Model. J Clin Dent. 2017; 28(3):44-48. View

17.

Ghassemi A, Hooper W, Vorwerk L, Petrovicova E, Goyal C, Qaqish K . The effects of two baking-soda toothpastes in enhancing mechanical plaque removal and improving gingival health: A 6-month randomized clinical study. Am J Dent. 2020; 33(5):265-272. View

18.

Ghassemi A, Vorwerk L, Hooper W, Putt M, Milleman K . A four-week clinical study to evaluate and compare the effectiveness of a baking soda dentifrice and an antimicrobial dentifrice in reducing plaque. J Clin Dent. 2009; 19(4):120-6. View

19.

Jose A, Pratten J, Bosma M, Milleman K, Milleman J, Wang N . Six-Month Evaluation of a Sodium Bicarbonate-Containing Toothpaste for Reduction of Established Gingivitis: A Randomized USA-Based Clinical Trial. J Clin Dent. 2018; 29(1):33-39. View

20.

TURESKY S, GILMORE N, GLICKMAN I . Reduced plaque formation by the chloromethyl analogue of victamine C. J Periodontol. 1970; 41(1):41-3. DOI: 10.1902/jop.1970.41.41.41. View