Enhancement of plaque removal by baking soda toothpastes from less accessible areas in the dentition.

OBJECTIVE To determine if baking soda toothpastes are relatively more effective than non-baking soda toothpastes in promoting plaque removal from less accessible sites in the dentition. METHODS Several single-brushing comparisons of baking soda and non-baking soda toothpastes for their overall ability to remove plaque have been published. In this study, individual comparisons of these published data, comparing the plaque removal performance of baking soda and non-baking soda toothpastes at various sites in the dentition, were examined to see if there were any site-dependant performance trends. The site-specific single-brushing data were then combined and analyzed in two ways. Meta-analyses of the clinical studies were performed to compare baking soda's relative plaque removal advantage at various sites in the mouth using paired t-testing at p <0.05. Also, plaque index reductions at various sites due to brushing with baking soda toothpastes were graphically compared with plaque index reductions due to brushing with non-baking soda dentifrices. The percent relative plaque removal advantage for baking soda toothpastes at various sites were plotted against the reduction in plaque index due to brushing with non-baking soda toothpastes. RESULTS Individual comparisons showed that brushing with the toothpastes containing baking soda generally removed significantly more plaque from each site than brushing with toothpastes without baking soda. The relative efficacy advantage for baking soda toothpastes was consistently higher at sites where the non-baking soda toothpastes removed less plaque. Meta-analytical comparisons confirmed baking soda toothpastes to be relatively more effective in enhancing plaque removal from sites where less plaque was removed compared to brushing with non-baking soda toothpastes (p < 0.05). Graphically, the baking soda toothpastes' relative plaque removal advantage could be seen to increase hyperbolically with decreasing plaque removal by the non-baking soda toothpastes with which they were compared. We presuppose that the reason less plaque is removed by non-baking soda toothpastes at some sites than others is that these sites are less accessible to the toothbrush. CONCLUSION These results show that baking soda toothpastes are relatively more effective in enhancing plaque removal from harder-to-reach areas of the dentition (p <0.05), i.e., from lingual than facial surfaces, from posterior than anterior areas, and from proximal than mid-surface sites.