Tooth brushing with stannous fluoride dentifrice stabilized with zinc phosphate may prevent plaque induced gingivitis

Stannous fluoride dentifrice is well established for its beneficial clinical effects. In this study, we evaluated the effects of stannous fluoride on inflammation and oral microbiome.

Plaque-induced gingivitis is a clinical presentation secondary to persistent inflammation in gingivae. It is a precursor to periodontitis but can be reversed to mitigate risk of periodontitis development. Due to the reversible nature of gingivitis and clinicians’ ability to objectively determine its presence and severity by simple, cost-effective, and reproducible oral examinations, interventions aimed at reversing gingivitis are important for promoting oral health at the population level.

Induced gingivitis (experimental gingivitis model) can show a diverse range of inflammatory responses and shifts in the oral microbiome among individuals. This model can be used to build a comprehensive understanding of gingivitis system biology, particularly host–microbe interactions, and test clinical response of interventions at reducing gingival inflammation.

In this randomized, parallel-arm, double-blind, controlled clinical trial, we compared clinical resolution of experimental gingivitis by evaluating bleeding on probing, gingival index, and plaque index between stannous fluoride stabilized with zinc phosphate (test) and sodium fluoride (control) dentifrices. Further, these groups were compared for oral neutrophil counts, systemic priming of neutrophils, gingival crevicular fluid (GCF) expression of inflammatory markers, and the oral microbiome.

Results

Researchers found a significant reduction in bleeding on probing in the test group compared to the control group in experimental gingivitis when participants used the test dentifrice prior to induction of experimental gingivitis. The test group also showed significant reductions in GCF levels of inflammatory markers (matrix metalloproteinase 8 [MMP8], receptor activator of nuclear factor kappa-Β ligand [RANKL]), oral polymorphonuclear neutrophil (PMN) counts, and systemic neutrophil priming (CD11b expression) during experimental gingivitis. Further, significant reductions in the gram-negative genera Porphyromonas, Tannerella, and Treponema were noted in the test group.

The stannous fluoride stabilized with zinc phosphate dentifrice formulation demonstrated clinical reduction in gingival inflammation and a beneficial effect on microbiome and immune markers. This intervention should be explored as a preventive aid in the progression of plaque-induced gingivitis to periodontitis.

Reference:

Fine, N, Barbour, A, Kaura, K, et al. Effects of a stabilized stannous fluoride dentifrice on clinical, immunomodulatory, and microbial outcomes in a human experimental gingivitis model. J Periodontol. 2023; 1-11. https://doi.org/10.1002/JPER.22-0710

Keywords:

Tooth, brushing, stannous, fluoride, dentifrice, stabilized, zinc, phosphate, effectively, prevents, plaque-induced, gingivitis,Fine, N, Barbour, A, Kaura, Km Journal of Periodontology