Clinical Effects of Tooth Powder on Gingivitis
Condition: Gingivitis; Mouth Diseases
MeSH terms: Gingivitis; Mouth Diseases
Study type: Interventional
Phase: Phase 2

Summary: 
      Dental plaque, known as dental biofilm, is implicated as the primary etiological agent
      responsible for oral inflammatory diseases. Matured form of dental plaque plays a major role
      in the pathogenicity of gingivitis; if not managed in early stages it results in a cascade of
      events leading to the destruction of periodontal tissues.

      Effective plaque control techniques have been suggested that maintain dental biofilm at
      levels compatible with oral health and is the cornerstone for all preventive strategies to
      control oral diseases particularly gingivitis. To clean teeth and ensure effective plaque
      control, different mechanical means have been in use since centuries. However because of an
      inadequacy in plaque removal, different antimicrobial and antiplaque agents have been
      introduced in oral-care products.

      The use of dentifrices has been recommended over the years as the ultimate way of preventing
      the incidence of oral diseases. Dentifrices have the anti-plaque and the anti-gingivitis
      capabilities due to their composition. Toothpastes and to a lesser extent toothpowders are
      common oral-care products used to eliminate plaque and other deposits from tooth surfaces.
      Existent literature has focused more on toothpaste and mouth rinse and derelicts toothpowder
      despite its difference owing to the absence of humectants. With the intention to advance the
      knowledge on this issue as well as close the research gap, this study was conducted to
      evaluate the efficacy of toothpowder in alleviating gingivitis, controlling dental plaque,
      and inhibiting extrinsic stains.

      A single-blind, parallel arm randomized controlled trial (RCT) evaluated the efficacy of
      toothpowder against toothpaste through oral hygiene parameters of plaque and stain deposits
      on teeth and gingival inflammation. Plaque Index, Lobene Stain Index and Gingival Index were
      used as measures of oral hygiene.

      The current RCT revealed that toothpowder and toothpaste were equally effective in both
      treatment and control groups from clinical perspective however toothpowder showed a
      statistically significant effectiveness as compared to toothpaste. Toothpowder, composed of
      calcium carbonate and essential oils, has demonstrated to be statistically more effective
      than toothpaste in controlling extrinsic dental staining, dental plaque and gingival
      inflammation.
    

Detailed description: 
      A single-blind randomized controlled trial was conducted during November 2010 and October
      2011. After screening and consent, eligible subjects received mechanical periodontal therapy.
      Subjects were then randomized to Test group and Control group at a 1:1 ratio. The test group
      was provided tooth powder and a control group received toothpaste. Healthy subjects with
      plaque induced gingivitis and who fulfilled the inclusion criteria were recruited from the
      Department of Periodontology, Fatima Jinnah Dental College Hospital, Karachi, Pakistan.77
      subjects with gingivitis were randomized to test group and 77 subjects to the control group.
      Therefore, to complete the randomized controlled trial, a total of 154 subjects were
      recruited and randomized.

      Outcome measure gingivitis was measured through plaque index, gingival index and Lobene stain
      index.
    

Intervention name(s): Tooth powder; Tooth paste (control)
Intervention type(s): Device; Device
Intervention description(s): Each participant was handed over a sealed pack containing a teeth cleaning kit that included tooth powder (test) or toothpaste (control) and a new soft toothbrush along with written and verbal instructions of usage. They were advised to brush their teeth twice a day with the given dentifrices and tooth brush for two weeks.; Active Comparator
Other intervention name(s): Tooth paste
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: Single (Investigator)
Primary purpose: Prevention
Keywords: tooth pastes; tooth powders; Stain Index