Dentifrice performance in the removal of dental plaque is influenced by the interactions of dentifrice components with tooth surfaces. This randomized controlled clinical study assessed the effectiveness and safety of a novel fluoride dentifrice formulation that included a micro-fibrillated cellulose network with entangled microcrystalline cellulose and silica particles (ProtegeraTM), and compared this to a positive control fluoride dentifrice (Crest Cavity Protection™). Whole mouth dental plaque levels in 82 healthy adults were measured after the first supervised use, and following a week of twice daily use at home. Overall, the novel dentifrice was at least three times more effective in whole mouth plaque reductions than the reference dentifrice (p < 0.001), with a 38.6% reduction on first use, a 30.9% reduction at day 7, and a 41.6% reduction from day 1 to day 7, compared to reductions of 12.0%, 9.6%, and 11.6% respectively for the positive control. No safety issues arose from the use of the novel dentifrice. These results indicate that including micro-fibrillated cellulose enhances plaque removal effectiveness, without causing adverse changes to oral soft tissues.

Objectives: This study assessed the performance of a novel fluoride dentifrice containing micro- fibrillated cellulose (MFC) and 7% silica (Protegera™) versus common fluoride dentifrices. Methods: Removal of extrinsic stains was assessed using the pellicle cleaning ratio (PCR) method, and radioactive dentin abrasivity (RDA) was measured, to calculate a cleaning efficiency index (CEI). Fluoride efficacy was evaluated using widely used remineralization and fluoride uptake methods. Results: The MFC dentifrice removed stained pellicle significantly more effectively than the ADA reference material, Crest Cavity Protection™ and Sensodyne Pronamel™, and had equal performance to three known marketed stain-removing dentifrices (Arm & Hammer™ Advanced Whitening, Crest ProHealth™, and Colgate Optic White™). The MFC dentifrice vehicle had a low RDA (88), which was significantly less than Crest ProHealth (166) and Crest 3D-White™ (183). Based on PCR and RDA data, the CEI was 31% greater for the MFC product than for Crest ProHealth. In a 10-day pH cycling study, the fluoride efficacy of the MFC product was superior to a non-fluoridated control and was not significantly different from Sensodyne Pronamel and Crest Cavity Protection. The MFC dentifrice was superior for promoting fluoride uptake into incipient enamel lesions than the USP reference dentifrice. Conclusion: The low dentin abrasivity MFC dentifrice is highly effective in removing stained pellicle, and is an efficacious fluoride source when compared to other relevant commercially available fluoride dentifrices with high dentin abrasivity. Clinical Significance: Including micro-fibrillated cellulose into a fluoride dentifrice may enhance cleaning performance for the removal of external stain, while lowering abrasivity, and providing an effective fluoride source. This combination of benefits seems well suited to enamel protection and caries prevention.