A randomised, controlled, trial investigating the effect of tooth brushing with a sodium bicarbonate toothpaste for 12 weeks compared to a conventional fluoride toothpaste on gingivitis

West, Nicola X., Qiu, Jianhong, Pollard, Alexander J., Davies, Maria, Smith, Gary, Gomez-Pereira, Paola and Seong, Joon 2025. A randomised, controlled, trial investigating the effect of tooth brushing with a sodium bicarbonate toothpaste for 12 weeks compared to a conventional fluoride toothpaste on gingivitis. Journal of Dentistry 160 , p. 105886. 10.1016/j.jdent.2025.105886

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Abstract

Objectives To determine the effect on gingival inflammation of toothbrushing with sodium bicarbonate toothpaste for 12 weeks compared to brushing with a conventional fluoride toothpaste. Methods An ethically-approved, single-centre, controlled, examiner-blind, randomized, two-treatment arm, parallel study in consenting healthy ≥18yr participants with ≥20 teeth diagnosed with localised gingivitis. Approximately 200 eligible participants brushed for 2weeks with a fluoride acclimatization toothpaste before randomization to brushing 2/daily with a sodium bicarbonate (test) or fluoride (control) toothpaste. No pre-prophylaxis was conducted prior to study start. Modified gingival index (MGI), bleeding index (BI) and Turesky plaque index (TPI), were measured at baseline, 3, 6 and 12weeks. Participants completed a diary for compliance monitoring. Results 190 participants were randomised, 188 completed the study. The test group demonstrated a statistically significant reduction in number of bleeding sites from baseline to 12-weeks (p = 0.0032), 6-weeks (p = 0.0031) and 3-weeks (p = 0.0091), and compared to control group from baseline to 12-weeks (p = 0.0013). The test group showed significantly (all p < 0.0001) decreased mean MGI score from baseline to 3-weeks, 6-weeks, and 12-weeks compared to control group; significantly decreased mean overall TPI score from baseline to 3-weeks (p = 0.0012), 6-weeks (p = 0.0058), and 12-weeks (p < 0.0001) compared to control; and significantly reduced mean interproximal TPI scores compared to control group from baseline to 3-weeks (p = 0.0022), 6-weeks (p = 0.0099) and 12-weeks (p < 0.0001). Conclusions Twice daily toothbrushing with a sodium bicarbonate toothpaste significantly improved oral health reducing localised gingivitis compared to brushing with a conventional fluoride toothpaste, measured by BI, MGI and TPI over 12 weeks. Clinical Significance Localised, gingivitis can be resolved or prevented with excellent home-use oral hygiene measures, but this is rarely achieved with mechanical brushing alone. Twice daily toothbrushing with sodium bicarbonate toothpaste demonstrated added value in reducing localised gingivitis and improving oral health compared to brushing with a conventional fluoride toothpaste.

Item Type:	Article
Date Type:	Publication
Status:	Published
Schools:	Schools > Dentistry
Publisher:	Elsevier
ISSN:	0300-5712
Date of First Compliant Deposit:	18 July 2025
Date of Acceptance:	5 June 2025
Last Modified:	18 Jul 2025 10:30
URI:	https://orca.cardiff.ac.uk/id/eprint/179909

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