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Prevention and Arrest of Root Caries Lesions with High Fluoride Concentration Mouthwash Versus Normal Fluoride Concentration Mouthwash in Elderly Patients

NCT ID: NCT06723054

Last Updated: 2024-12-09

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

ACTIVE_NOT_RECRUITING

Clinical Phase

NA

Total Enrollment

69 participants

Study Classification

INTERVENTIONAL

Study Start Date

2023-02-01

Study Completion Date

2025-03-31

Brief Summary

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The study evaluats the effectiveness of regular fluoride 220 ppm F with erythritol and high fluoride 500 ppm F with erythritol mouthwashes against a placebo (regular fluoride 220 ppm F mouthwash) in the prevention of new root caries lesions.

Detailed Description

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Preserving natural teeth becomes essential to avoid complex restorative procedures in old age. For this the concepts of preventive treatment constitute an important point. The method of topical application via fluorides is a widely used and well-known technique for prevention of caries. Numerous studies have demonstrated the preventive effect of fluorides on caries. The prevention of root caries and the effectiveness of fluorides will depend mainly on two factors used: first is the fluoride agent, and the second is fluoride content. There is abundant evidence with regard to the preventive effect of high fluoride applications on the root caries. Furthermore, it has also been recommended on the regular use of high fluoride 5000 ppm F toothpaste twice daily in the prevention and inactivating the root caries in adults. However, high fluoride toothpastes are fairly expensive and not available as over-the-counter (OTC) products and require a prescription. This may be an aspect when the elders have limited access. A more economical solution and one which can be easily procured is deemed necessary.

Mouth rinses are considered as cosmetic products and are available as OTC products and do not require prescriptions. They are also relatively less expensive in comparison to the high fluoride toothpastes. Fluoridated mouthwashes are generally recommended in moderate-high caries risk population or individual. The normal fluoride range in a mouth wash is normally between 100 ppm to 500 ppm F. This may not be sufficient to bring a preventive effect in high risk individuals. It has been demonstrated that a small positive trend for sodium fluoride (NaF) mouth rinses against placebo in reducing the initiation of coronal and root caries.

Erythritol is a natural sugar substitute and is frequently used as a sweetener. It is easily excreted by the kidneys and does not increase the blood sugar. It is often an additive in mouthwashes as a sweetening agent. It is known to have anti-plaque aggregating and bacteriostatic effect.

Perhaps, the use of erythritol in regular fluoride mouthwash (220 ppm F) in combination with high F mouthwash (500 ppm F) might be beneficial and augment the preventive effect of fluoride in mouth rinses. This may be a viable alternative to expensive and prescription options.

Therefore, the primary objective of this study is to evaluate the effectiveness of regular fluoride 220 ppm F with erythritol and high fluoride 500 ppm F with erythritol mouthwashes against a placebo (regular fluoride 220 ppm F mouthwash) in the prevention of new root caries lesions.

The secondary endpoints/outcome set for this study is the number of arrested root surface caries after intervention with the test products (i.e., a change of root surface caries from ICDAS classification 1 to 2 and 3 to 4, respectively will be considered as arresting).

The tertiary endpoint/outcome set for this study are as follows: 1. Incidence of new coronal caries after the intervention with the test products and 2. the number of arrested coronal caries after the intervention with the test products.

Conditions

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Root Caries

Keywords

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Elders Root caries lesions Prevention Mouthwash

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

This study is designed to be a double-blind, randomized, controlled, parallel, single-center, intention-to treat (ITT), trial with an allocation ratio of 1: 1: 1 and of a non-inferiority framework. The participants will be randomly allotted to one of the three study groups.
Primary Study Purpose

PREVENTION

Blinding Strategy

DOUBLE

Participants Investigators
The participants and the investigators will be blinded to the randomization sequence as well as the prevention group. They will both not be aware of which mouthwash was used by the participant.

Study Groups

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Control group (CG)

Regular fluoride 220 ppm F mouthwash without erythritol

Group Type PLACEBO_COMPARATOR

regular fluoride 220 ppm F mouthwash without erythritol

Intervention Type OTHER

The participants will be asked to rinse once daily with a regular fluoride 220 ppm F mouthwash without erythritol.

Intervention group #1 (IG1)

220 ppm F mouthwash with erythritol

Group Type ACTIVE_COMPARATOR

regular fluoride 220 ppm F mouthwash with erythritol

Intervention Type OTHER

The participants will be asked to rinse once daily with a regular fluoride 220 ppm F mouthwash with erythritol.

Intervention group #2 (IG2)

500 ppm F mouthwash with erythritol

Group Type ACTIVE_COMPARATOR

high fluoride 500 ppm F mouthwash with erythritol

Intervention Type OTHER

The participants will be asked to rinse once daily with a high fluoride 500 ppm F mouthwash with erythritol.

Interventions

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regular fluoride 220 ppm F mouthwash without erythritol

The participants will be asked to rinse once daily with a regular fluoride 220 ppm F mouthwash without erythritol.

Intervention Type OTHER

regular fluoride 220 ppm F mouthwash with erythritol

The participants will be asked to rinse once daily with a regular fluoride 220 ppm F mouthwash with erythritol.

Intervention Type OTHER

high fluoride 500 ppm F mouthwash with erythritol

The participants will be asked to rinse once daily with a high fluoride 500 ppm F mouthwash with erythritol.

Intervention Type OTHER

Eligibility Criteria

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Inclusion Criteria

* Adults ≥60 years
* Dentinal root caries lesions with no painful symptomology
* Minimum of 3 teeth present in the mouth
* Can follow instructions for oral hygiene

Exclusion Criteria

* Symptomatic carious teeth
* Root surface active lesion which is easily penetrated by sharp probe with light force (ICDAS Grade 3 and soft needs to be filled)
* Non-carious attrition, erosion or abrasion cavities
* Periodontally compromised teeth with Grade 3 mobility, and active signs of infections.
* Not willing or able to sign informed consent
Minimum Eligible Age

60 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

Yes

Sponsors

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Murali Srinivasan, Dr. med. dent., BDS, MDS, MBA, MAS

OTHER

Sponsor Role lead

Responsible Party

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Murali Srinivasan, Dr. med. dent., BDS, MDS, MBA, MAS

Prof. Dr. med. dent.

Responsibility Role SPONSOR_INVESTIGATOR

Locations

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University of Zurich, Center for Dental Medicine, Clinic of General, Special care, and Geriatric Dentistry

Zurich, , Switzerland

Site Status

Countries

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Switzerland

Other Identifiers

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UZH_ABS_2021_9

Identifier Type: OTHER

Identifier Source: secondary_id

UZH_ABS_2021_9

Identifier Type: -

Identifier Source: org_study_id