Can Green Toothpaste Fight Tooth Decay?

The Ache: Since plaque isn’t easily visible on teeth, it is hard to know where you missed brushing. You can chew red dye tablets after brushing to see the spots you missed, but the tablets can be messy and add a step.

The Claim: A new, green toothpaste binds to plaque and shows it as a teal green. The manufacturer says it can improve oral hygiene, particularly in children, elderly people with reduced dexterity and people with braces that are hard to clean around.

The Verdict: A small short-term study by researchers at the University of Illinois at Chicago shows the new toothpaste, called Plaque HD, resulted in a 51.3% reduction in plaque after brushing. So far there’s been no testing of long-term benefits.

Plaque is a soft, sticky bacterial matrix that adheres to teeth. If it isn’t effectively removed, it can harden into tartar and contribute to gum disease and cavities.

“A lot of people think they are doing a great job brushing, but in reality they are missing things,” says Boca Raton, Fla., orthodontist Jennifer Statler, who says she has seen an improvement in dental hygiene of her patients since she began selling the toothpaste in her office when it hit the market in 2014.

A tube of Plaque HD. ENLARGE
A tube of Plaque HD. PHOTO: PLAQUE HD
The toothpaste, from TJA Health LLC of Joliet, Ill., contains a plant-based dye that sticks to plaque left on the teeth. The professional version, sold in dentist offices and online, costs $21 for 4.1 ounces; a consumer version with a less-concentrated dye, coming out later in February, costs $14.95. To use Plaque HD, brush normally then spit out the toothpaste without rinsing, leaving the dye behind on areas that were missed, says TJA Chief Executive Lawrence Hier, an orthodontist who invented the product.

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The idea of using a dye to show plaque has been around for decades, but many patients take disclosing tablets or solutions home and don’t use them, dentists say. In a three-month study of 32 denture wearers, published in Gerodontology in 2009, use of a disclosing solution didn’t increase plaque removal. This was in part probably because subjects didn’t comply with the regimen, which added a step to their routine, says study co-author Raphael F. Souza, an associate professor at University of São Paulo’s Ribeirão Preto School of Dentistry in Brazil.

The toothpaste “could be a consistent reminder without having [patients] do extra steps or remember extra things,” says Chicago pediatric dentist Mary Hayes, a spokeswoman for the American Dental Association. The most commonly missed areas are right at the gumline and between the teeth, adds Dr. Hayes, who uses a disclosing solution as an educational tool in her office but hasn’t yet tried the toothpaste.

Compared with red disclosing solution, the toothpaste dye doesn’t show up as dramatically, dentists and hygienists say. San Antonio dentist Tito Norris says the toothpaste has been a “game-changer” in his practice, but says he wishes the green was easier to see. The manufacturer recently changed the formula to make the green darker, Dr. Hier says, adding that the original lighter version is being sold as a less-expensive consumer product.

To test Plaque HD, I ate a candy bar after dinner and didn’t brush my teeth before bed. The next morning I did a cursory brushing and was surprised to see only a very thin line of dye around my gums after spitting out the foam. Overnight was probably not long enough for significant amounts of plaque to form, dentists say.

In a study of 31 adults published online in January in the International Journal of Dentistry and Oral Science, researchers at the University of Illinois at Chicago College of Dentistry compared Plaque HD to a control toothpaste that was identical but with no dye. To measure how well subjects brushed, researchers used a fluorescent disclosing dye and a digital camera, feeding the results into a software program that calculated the number of pixels of plaque. On the first test day, everyone brushed with the control toothpaste. At a follow-up visit seven to 10 days later, the people who brushed with Plaque HD had a 51.3% reduction in plaque compared with the first visit, while those brushing with the control paste had only an 8.3% reduction.

Study co-author Ben Belavsky, a resident at the dental school, says the toothpaste can be a “very effective teaching tool.”

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