A study to look at the protective effect of two toothpastes against tooth erosion

ISRCTN ISRCTN55537791
DOI https://doi.org/10.1186/ISRCTN55537791
Secondary identifying numbers 2015077
Submission date
22/05/2016
Registration date
27/05/2016
Last edited
07/04/2020
Recruitment status
No longer recruiting
Overall study status
Completed
Condition category
Oral Health
Prospectively registered
Protocol
Statistical analysis plan
Results
Individual participant data

Plain English summary of protocol

Background and study aims
One of the effects of the growth of the food and drinks industry is the huge increase in the consumption of soft drinks, fruit juices and sport drinks. Many drink products are acidic in nature, for example, citrus fruit drinks such as orange or grapefruit juice or certain fruit squashes and fizzy drinks. Such drinks, if taken in excess, will promote erosion of the tooth surface, erosion being a loss of tooth substance by a chemical process not involving bacteria. The incidence of tooth erosion by drinks is becoming an ever-increasing problem and has led to an increased scientific awareness within the dental community. Stannous fluoride has been shown to provide some protection for the enamel against acid attack. This study will evaluate the protective effects of a toothpaste containing stannous compared to a conventional toothpaste. The aim is to compare the effectiveness of the two toothpastes to protect against enamel erosion after 10 days of use.

Who can participate?
Healthy volunteers aged 18 and over

What does the study involve?
Participants are fitted with an appliance that fits in the roof of their mouth. The appliance is similar in design to a removable orthodontic appliance (brace). The appliance contains two human enamel samples that have been properly sterilized to meet human clinical testing standards. Participants are randomly allocated to use one of the two toothpastes across four study periods lasting 10 days each. Each participant uses each toothpaste twice during the study. Each day participants brush their teeth in the morning using an assigned non-treatment toothpaste and toothbrush (at home). At the clinical site participants collect their oral appliance to wear for about 6 hours. At the site, participants perform supervised ‘swishing’ with their assigned treatment toothpaste slurry (toothpaste swished around in their mouth) twice a day for 60 seconds. Participants also rinse their mouths with orange juice (acid challenge) four times each treatment day with their appliance in their mouth. Acid challenges are done by swishing 25 ml orange juice in their mouth for one minute, spitting it out and repeating for a total of 10 swishes in each challenge. Participants’ oral appliances are placed in a moist pot for overnight storage. On Day 10 of each treatment period the enamel samples are removed from the participant’s appliance, to assess whether the toothpastes protect against enamel loss. New enamel samples are inserted into the appliance for each treatment period. Within two weeks of completing the last treatment period, participants attend a follow-up assessment, including a brief interview and oral examination.

What are the possible benefits and risks of participating?
Not provided at time of registration

Where is the study run from?
Bristol Dental School and Hospital (UK)

When is the study starting and how long is it expected to run for?
April 2016 to July 2016

Who is funding the study?
Proctor and Gamble Company (UK)

Who is the main contact?
Prof. Nicola West

Contact information

Prof Nicola West
Scientific

Clinical Trials Unit
Bristol Dental School and Hospital
Lower Maudlin Street
Bristol
BS1 2LY
United Kingdom

ORCiD logoORCID ID 0000-0002-9127-5530

Study information

Study designSingle-centre double-blind randomised supervised-usage two-treatment four-period crossover trial
Primary study designInterventional
Secondary study designRandomised cross over trial
Study setting(s)Other
Study typePrevention
Participant information sheet Not available in web format, please use contact details to request a participant information sheet
Scientific titleA clinical study to measure the anti-erosion properties of two dentifrices
Study objectivesTo compare the enamel protection efficacy (loss of tooth enamel as measured by surfometry) of two dentifrices in a 10-day in situ erosion model.
Ethics approval(s)NRES Committee South West – Central Bristol, REC Ref: 15/SW/0266
Health condition(s) or problem(s) studiedEnamel erosion
Intervention1. Participants will wear a palatal appliance that is positioned in the roof of their mouth and contains 2 enamel samples
2. Participants are asked to rinse one of the study toothpastes (a slurry of 3g toothpaste:10ml water) around for 60 seconds, twice per day
3. Participants are required to rinse their mouth with orange juice (250ml over a 10 minute period) four times a day
4. Participants are provided with toothpaste and a toothbrush to use at home from screening until the end of the study and will be required to brush their teeth twice per day, in the morning and in the evening
Intervention typeOther
Primary outcome measureDental erosion measured by profilometry at baseline and Day 10
Secondary outcome measuresN/A
Overall study start date06/04/2016
Completion date22/07/2016

Eligibility

Participant type(s)Healthy volunteer
Age groupAdult
Lower age limit18 Years
SexBoth
Target number of participants36
Total final enrolment36
Key inclusion criteria1. Provide written informed consent to participate in the study, and receive a copy of the signed consent form
2. Agree not to participate in any other oral/dental product studies during the course of the study
3. Agree to delay any elective dentistry (including dental prophylaxis) until the study has been completed
4. Agree to refrain from the use of any non-study dentifrice or other oral hygiene products for the duration of the study
5. Agree to return for all scheduled visits and follow study procedures
6. Be at least 18 years of age
7. Agree to refrain from taking an acidic medication (pH <5.3) during the course of the study
8. Be in good general health, as determined by the Investigator/designee based on a review of the health history/update for participation in the study
Key exclusion criteria1. Have a susceptibility to acid regurgitation
2. Have recurrent or regular aphthous ulcers
3. Have dental erosion or a previous history of being susceptible to high dental erosion after drinking sports drinks or juices
4. Have excessive gingival inflammation
5. Have severe periodontal disease, as characterized by purulent exudate, generalized mobility, and/or severe recession
6. Have any pre-existing oral or medical condition that the examiner determines may place the subject at increased health risk from study participation
7. Have unremovable mouth or tongue jewelery
8. Any subject who in the opinion of the investigator (or medically qualified designee) should not participate in the study
9. Are personnel – an employee of the Sponsor, member of the study site or family relative
Date of first enrolment06/04/2016
Date of final enrolment15/04/2016

Locations

Countries of recruitment

  • England
  • United Kingdom

Study participating centre

Bristol Dental School and Hospital
Clinical Trials Unit
Lower Maudlin Street
Bristol
BS1 2LY
United Kingdom

Sponsor information

Proctor & Gamble Technical Centres Ltd (UK)
Industry

Rusham Park
Whitehall Lane
Egham
TW20 9NW
United Kingdom

ROR logo "ROR" https://ror.org/02a8cv967

Funders

Funder type

Industry

Proctor and Gamble Company (UK)

No information available

Results and Publications

Intention to publish date
Individual participant data (IPD) Intention to shareNo
IPD sharing plan summaryNot expected to be made available
Publication and dissemination planCurrent publication and dissemination plan as of 11/02/2019:
A paper has been written and submitted to the International Journal of Dental Hygiene.

Previous publication and dissemination plan:
Conference presentation and publish the study in a peer-reviewed journal
IPD sharing plan

Study outputs

Output type Details Date created Date added Peer reviewed? Patient-facing?
Results article results 01/08/2019 07/04/2020 Yes No
HRA research summary 28/06/2023 No No

Editorial Notes

07/04/2020: The following changes were made to the trial record:
1. Publication reference added.
2. The total final enrolment was added.
11/02/2019: The publication and dissemination plan was updated.