ORAL HEALTH EVIDENCE-BASED PRACTICE PROGRAM
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Title Patients At High Caries Risk Due To having Poor Oral Hygiene Would Benefit Equally In Plaque Reduction From Using Triclosan Containing or Stannous Fluoride-Containing Toothpastes
Clinical Question Would patients at high caries risk due to poor oral hygiene achieve more plaque reduction by using triclosan-containing toothpaste compared to stannous fluoride-containing toothpaste?
Clinical Bottom Line There was no difference between triclosan-containing and stannous fluoride-containing anti-microbial tooth pastes for plaque reduction.
Best Evidence (you may view more info by clicking on the PubMed ID link)
PubMed ID Author / Year Patient Group Study type
(level of evidence)
#1) 9083900Binny/1997There was no difference between triclosan-containing and stannous fluoride- containing anti-microbial tooth pastes for plaque 12 healthy dentate patients. Single blinded, cross over study
Key resultsAfter 4 days usage without brushing, there was no statistically significant difference in chemical plaque reduction between triclosan/zinc- (2.26±0.08), triclosan/copolymer- (2.13±0.08), and stannous fluoride-containing (2.14±0.08) tooth pastes. The greatest effect in using the tooth pastes was 0.36 of a unit reduction in plaque compared to rinsing with water (2.49±0.08).
Evidence Search ("Triclosan"[Mesh]) AND "Fluorides"[Mesh]
Comments on
The Evidence
The evidence is based on a study conducted under non-brushing conditions, the magnitude of the differences among the products (including water-rinsing) were possibly too small to be of clinical significance in normal home use situations involving brushing. The evidence is single blinded crossover study. Twelve subjects were used that allowed 3 replicates and a 90% power to detect a difference in plaque score of 0.3.
Applicability Either Stannous Fluoride containing or Triclosan containing toothpaste can be selected while choosing a product to help reduce plaque growth in patients not complying with oral hygiene advice.
Specialty/Discipline (Public Health) (General Dentistry) (Pediatric Dentistry) (Periodontics) (Restorative Dentistry) (Dental Hygiene)
Keywords Triclosan-containing toothpaste, stannous fluoride toothpaste, antimicrobial toothpastes, plaque reduction.
ID# 2267
Date of submission: 04/13/2012spacer
E-mail rabata@livemail.uthscsa.edu
Author Ahmad Rabata
Co-author(s)
Co-author(s) e-mail
Faculty mentor/Co-author Bennett T. Amaechi, BDS, MSc, PhD & John Gildersleeve, DDS
Faculty mentor/Co-author e-mail Amaechi@uthscsa.edu, gildersleev@uthscsa.edu
Basic Science Rationale
(Mechanisms that may account for and/or explain the clinical question, i.e. is the answer to the clinical question consistent with basic biological, physical and/or behavioral science principles, laws and research?)
post a rationale
None available
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Comments and Evidence-Based Updates on the CAT
(FOR PRACTICING DENTISTS', FACULTY, RESIDENTS and/or STUDENTS COMMENTS ON PUBLISHED CATs)
post a comment
by Samantha J. Whitten, Garrett Howze (San Antonio, TX) on 11/29/2017
A PubMed search was conducted on the above terms on 11/27/17, and more recent research that significantly changes the answer was found. In contrast to the previous clinical bottom line, two articles published in 2013 (PMID: 23547492 and 24640432) show that use of a stannous fluoride-containing toothpaste results in a statistically significant greater reduction in plaque than a triclosan-containing toothpaste. In the Sharma study, which used 120 patients in a randomized, double-blind, 2-treatment, parallel-group design, SnF2 toothpaste group resulted in a 36.5% greater reduction in Week 3 and 6 combined adjusted mean plaque in the whole mouth versus the triclosan group. The study by He et al. used digital plaque imaging to find that the adjusted mean change in plaque from baseline was three times greater in reduction for the SnF2 group than the triclosan group at the end of 3 weeks. Although there is a systematic review by Salzer et al. (PMID: 24945592) that concluded there was no clinically significant difference between the two types of dentrifices, the Parma and He studies are more recent than the articles included in that meta-analysis.
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