Effectiveness of Plaque Removal Using Indicating-Dye Toothpaste Versus Traditional Toothpaste

Inadequate oral hygiene practices lead to gingivitis, periodontitis, and tooth decay. There are numerous oral care products on the market which aim to assist the general public to improve plaque removal efficacy at home, such as disclosing tablets, mouth rinses, and toothpastes containing antimicrobials. Plaque-A-Way (TJA Health, Joliet, IL) is a newly developed dentifrice which incorporates a disclosing agent into the formulation. The purpose of this study was to compare the plaque removal efficacy of Plaque-A-Way to that of a placebo toothpaste. There are several methods for measuring plaque in the oral cavity. These include conventional plaque indices, which measure the presence, absence, or amount of plaque in designated tooth locations; planimetry, which maps the outline of plaque and calculates the percentage of coverage; quantitative light-induced fluorescence (QLF), which illuminates the oral cavity with ultraviolet light that results in red auto-fluorescence of plaque deposits; and digital plaque imaging analysis (DPIA), which discloses plaque with fluorescein causing deposits to glow yellow-green when exposed to ultraviolet light followed by a computerized photo analysis. Thirty-five subjects completed this study. After a period of refraining from oral hygiene, subjects were asked to brush their teeth with either the test toothpaste (Plaque-A-Way) or a placebo toothpaste at two separate appointments. No special brushing instructions were given to the subjects. A rinse sequence was completed using fluorescein to disclose any remaining plaque after brushing. An intraoral photo was captured and analyzed for percentage plaque coverage using custom made DPIA software. The changes of plaque percentages between appointments for the control and test groups were calculated and there were no statistically significant differences found between the two. This suggests that the use of Plaque-A-Way did not result in a significant amount of plaque removal compared to the placebo with the testing protocol used. This may have been due to several limitations to this study including: non-specific brushing instructions, small sample size, inconsistent lighting parameters, and investigator subjectivity during photo processing. Despite inconclusive results obtained from the present study, the test toothpaste (Plaque-A-Way) demonstrates potential as a valuable over-the counter (OTC) oral hygiene aid for the general public.