Randomized trial of Plaque identifying Toothpaste: Dental Plaque and Inflammation

Abstract Background Randomized data are sparse about whether a plaque identifying toothpaste reduces dental plaque and nonexistent for inflammation. Inflammation is intimately involved in the pathogenesis of atherosclerosis and is accurately measured by high sensitivity C- reactive protein (hs-CRP), a sensitive marker for cardiovascular disease. The hypotheses that Plaque HD™ (TJA Health LLC, Joliet IL), a plaque identifying toothpaste, produces statistically significant reductions in dental plaque and hs-CRP were tested in this randomized trial. Methods Sixty-one apparently healthy subjects aged 19 to 44 years were assigned at random to this plaque identifying (n=31) or placebo toothpaste (n=30) for 60 days. Changes from baseline to follow up in dental plaque and hs-CRP were assessed. Results In an intention to treat analysis, the plaque identifying toothpaste reduced mean plaque score by 49% compared to a 24% reduction in placebo (p=0.001). In a pre-specified subgroup analysis of 38 subjects with baseline levels > 0.5 milligrams per liter, the plaque identifying toothpaste reduced hs-CRP by 29% compared to a 25% increase in placebo toothpaste (p=0.041). Conclusion This plaque identifying toothpaste produced statistically significant reductions in dental plaque and hs-CRP. The observed reduction in dental plaque confirms and extends a previous observation. The observed reduction in inflammation supports the hypothesis of a reduction in risks of cardiovascular disease. The direct test of this hypothesis requires a large scale randomized trial of sufficient size and duration designed a priori to do so. Such a finding would have major clinical and public health implications.