To achieve good oral hygiene, it is imperative to disrupt plaque biofilm. Mechanical removal via toothbrushing has been shown to be effective. Besides the ant-caries benefit of fluoridated toothpastes, are there other advantages to using toothpaste? A systematic review and meta-analysis published in the International Journal of Dental Hygiene in 2019 compared the use of toothpaste with water and saline to determine if plaque regrowth was inhibited by toothpaste use.
To eliminate the Hawthorne effect, after a professional prophylaxis, participants did not brush for 4 days. The participants were only permitted to swish with a toothpaste slurry, while control groups swished with water or saline. The antimicrobial agents included in this review are sodium fluoride, monofluorophosphate, stannous fluoride, triclosan, and baking soda. Almost all toothpastes included in the study showed significant inhibiting effects on plaque regrowth, with triclosan showing the highest inhibition of plaque regrowth. It should be noted that triclosan has been banned in many countries and removed from toothpaste due to potential long-term concerns.
Though we know from previous studies that toothpaste does not aid in the removal of plaque biofilm, we now have evidence that it aids in oral hygiene by inhibiting the regrowth of plaque biofilm. This is a huge step in understanding the importance of toothpaste and ingredients for better management of plaque biofilm.
Dry brushing has been recommended for better plaque removal in the past. After reading this systematic review do you still agree with that recommendation? Can you see the long-term benefits to using toothpaste instead of just dry brushing? Which toothpastes do you recommend that has shown the best benefit for your patients? What is your preferred anti-microbial ingredient in toothpaste?