Frontiers in Public Health (Jul 2023)

Caries-preventing effect of a hydroxyapatite-toothpaste in adults: a 18-month double-blinded randomized clinical trial

  • Elzbieta Paszynska,
  • Malgorzata Pawinska,
  • Joachim Enax,
  • Frederic Meyer,
  • Erik Schulze zur Wiesche,
  • Theodor W. May,
  • Bennett T. Amaechi,
  • Hardy Limeback,
  • Amadeusz Hernik,
  • Justyna Otulakowska-Skrzynska,
  • Anna Krahel,
  • Inga Kaminska,
  • Joanna Lapinska-Antonczuk,
  • Ewa Stokowska,
  • Maria Gawriolek

DOI
https://doi.org/10.3389/fpubh.2023.1199728
Journal volume & issue
Vol. 11

Abstract

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BackgroundDental caries is a worldwide challenge for public health. The aim of this 18-month double-blinded, randomized, clinical trial was to compare the caries-preventing effect of a fluoride-free, hydroxyapatite toothpaste (test) and a toothpaste with sodium fluoride (1450 ppm fluoride; positive control) in adults.MethodsThe primary endpoint was the percentage of subjects showing no increase in overall Decayed Missing Filled Surfaces (DMFS) index. The study was designed as non-inferiority trial. Non-inferiority was claimed if the upper limit of the exact one-sided 95% confidence interval for the difference of the primary endpoint DMFS between test and control toothpaste was less than the predefined margin of non-inferiority (Δ ≤ 20%).ResultsIn total, 189 adults were included in the intention-to-treat (ITT) analysis; 171 subjects finished the study per protocol (PP). According to the PP analysis, no increase in DMFS index was observed in 89.3% of subjects of the hydroxyapatite group and 87.4% of the subjects of the fluoride group. The hydroxyapatite toothpaste was not statistically inferior to a fluoride toothpaste with regard to the primary endpoint.ConclusionHydroxyapatite was proven to be a safe and efficient anticaries agent in oral care.Clinical trial registrationNCT04756557.

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