Can plaque-identifying toothpastes inspire better oral hygiene among orthodontic patients?

A COMMENTARY ON: Van Doornik SP, van Kammen L, Ren Y, Manton D J, Kuijpers-Jagtman A M. Effect of a plaque-identifying toothpaste on plaque amount in 12-16-year-olds with fixed orthodontic appliances: a randomised, double-blind, controlled clinical trial. Orthod Craniofac Res 2025; https://doi.org/10.1111/ocr.12904 . DESIGN: The study aimed to evaluate the effectiveness of a plaque-identifying toothpaste in improving plaque removal among adolescents undergoing fixed orthodontic treatment. This was a double-blind, parallel-group RCT with active-control, having two groups with equal allocation ratio. CASE SELECTION: Participants were healthy adolescents aged 12-16 years with fixed orthodontic appliances in both arches for a minimum of three months. Another inclusion criterion was presence of permanent teeth (canine to canine), while exclusion criteria included toothpaste allergies, syndromic conditions, craniofacial abnormalities, and participants from the same household. A total of 77 participants were included, and were randomized into the intervention (plaque-identifying toothpaste) and control groups (conventional toothpaste). DATA ANALYSIS: The intervention group was provided with a toothpaste containing disclosing dyes (Mara Expert) intended for plaque-identification, while the control group was provided with a standard toothpaste (Colgate Fresh Gel). The patients were instructed to use the toothpastes for a period of 4-7 weeks, following which assessments were done. The primary outcome included evaluation of changes in the plaque accumulation from baseline to follow-up, as assessed by determining change in fluorescence, which was evaluated using Quantitative Light-Induced Fluorescence (QLF). Secondary outcomes were assessed through a structured questionnaire focusing on user experience and self-perceived oral hygiene behaviours. RESULTS: Patients in both groups showed plaque reduction over time. But the difference observed in plaque reduction between the two groups was not found to be statistically significant (F = 0.211; p = 0.647). However, in the questionnaire, users of the plaque-disclosing toothpaste felt 'they are removing more plaque with their new toothpaste' (p = 0.018), and some participants found its colour to be unappealing (p = 0.028). Overall compliance was good, and no adverse effects were reported. CONCLUSIONS: Plaque-identifying toothpaste did not demonstrate a superior clinical reduction in plaque levels compared to the control, though increased awareness of plaque removal was observed in the intervention group.