Purpose: To assess use of a two-step dentifrice/gel sequence versus chlorhexidine gluconate mouthrinse on gingivitis prevention after dental prophylaxis.
Methods: A 12-week, randomized controlled trial was conducted to compare the effectiveness and safety of a two-step dentifrice/gel sequence to a positive control in healthy adults with established gingivitis. After informed consent, gingivitis and stain levels were assessed by clinical examination. Eligible subjects received a dental prophylaxis and were randomly assigned to twice daily unsupervised use of either (1) two-step oral hygiene sequence:0.454% stannous fluoride dentifrice followed by 3.0% hydrogen peroxide whitening gel for the test group; or (2) 0.12% chlorhexidine gluconate oral rinse and 0.76% sodium monofluorophosphate dentifrice for the control group. Clinical measurements of gingivitis bleeding sites and tooth stain area/intensity were collected after 4, 8 and 12 weeks use, while safety was assessed via clinical examination and oral status interview of the subjects.
Results: A total of 44 subjects were enrolled and 35 completed the 12-week study. At baseline, bleeding sites ranged from 10-33. After prophylaxis and assigned treatment, both groups exhibited significant (P≤ 0.0001) reductions in bleeding sites. Responses were directionally better in the two-step sequence at all post-baseline timepoints, with groups differing significantly (P < 0.05) at Week 8. Tooth stain measurements demonstrated that the two-step dentifrice/gel sequence did not contribute to any significant (P> 0.13) stain accumulation. In contrast, stain accumulation was evident (P< 0.003) in the chlorhexidine group beginning at the Week 4 visit. Adverse events were more common in the positive control, and contributed to early termination.
Clinical significance: Twice daily use of a two-step stannous fluoride dentifrice and peroxide whitening gel sequence after prophylaxis provided comparable or superior gingivitis benefits to chlorhexidine gluconate rinse without the concomitant side effect of staining.
Copyright©American Journal of Dentistry.