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Effects of a 50+ Toothpaste on Halitosis and Oral Comfort in Healthy Adults (HALI-50PLUS)

18 augusti 2026 uppdaterad av: Andrea Scribante, University of Pavia

Clinical, Instrumental, and Subjective Evaluation of the Anti-Halitosis Efficacy, Effects on Oral Comfort, and Sensory Acceptability of a 50+ Toothpaste Compared With a Standard Toothpaste in Orally Healthy Adults: A Randomized, Controlled, Double-Blind, Crossover Clinical Trial

The goal of this clinical trial is to compare a toothpaste designed for adults aged 50 years and older with a standard toothpaste in orally healthy adults. The main question is whether the 50+ toothpaste reduces bad breath more than the standard toothpaste after 14 days of twice-daily use. The study will also assess tongue coating, dry mouth symptoms, saliva production, oral comfort, oral health-related quality of life, taste, acceptability, and unwanted effects.

About 30 adults aged 18 to 65 years will take part. Each participant will use both toothpastes for 14 days each, in a randomly assigned order, with a 14-day break between the two treatment periods. Neither the participants nor the examiner performing the assessments will know which toothpaste is being used during each period.

At the study visits, bad breath will be measured using a device that detects volatile sulfur compounds in the mouth. Participants will also undergo an examination of the tongue, provide saliva samples, and complete questionnaires. Before each assessment visit, participants will be asked not to perform oral hygiene for 24 hours and to avoid food, drinks other than water, smoking, chewing gum, and oral care products for 3 to 4 hours.

Studieöversikt

Status

Har inte rekryterat ännu

Detaljerad beskrivning

This study will evaluate whether a toothpaste formulated for adults aged 50 years and older provides greater control of oral malodor and improved oral comfort compared with a standard commercially available fluoride toothpaste. Oral malodor will be assessed under standardized conditions using a reversible physiological model based on the temporary suspension of oral hygiene. No chemical substance will be used to induce malodor.

The study will use a randomized crossover design. Each participant will receive both study products in a randomly assigned sequence. Each treatment period will last 14 days and will be separated by a 14-day washout period, during which participants will return to their usual oral hygiene routine while avoiding products specifically intended for halitosis or dry mouth. Participants will brush twice daily for 2 minutes using only the assigned toothpaste. Tongue brushing and the use of mouthwashes or other products that could affect oral malodor or dry mouth will not be permitted during the treatment periods.

The test and control toothpastes will be supplied in neutral, indistinguishable packaging. Participants and the examiner responsible for the clinical and instrumental assessments will remain unaware of product identity. The treatment codes will be disclosed only after the study database has been finalized, unless disclosure is required for participant safety.

Assessments will be performed at baseline and after 7 and 14 days of each treatment period. Before each assessment, participants will suspend oral hygiene for 24 hours and follow standardized restrictions concerning food, beverages, smoking, chewing gum, and oral care products. This approach is intended to reduce measurement variability and allow each participant to serve as their own control.

Studietyp

Interventionell

Inskrivning (Beräknad)

30

Fas

  • Inte tillämpbar

Kontakter och platser

Det här avsnittet innehåller kontaktuppgifter för dem som genomför studien och information om var denna studie genomförs.

Studiekontakt

Studieorter

    • Lombardy
      • Pavia, Lombardy, Italien, 27100
        • Section of Dentistry - Department of Clinical, Surgical, Diagnostic and Paediatrics - University of Pavia
        • Kontakt:

Deltagandekriterier

Forskare letar efter personer som passar en viss beskrivning, så kallade behörighetskriterier. Några exempel på dessa kriterier är en persons allmänna hälsotillstånd eller tidigare behandlingar.

Urvalskriterier

Åldrar som är berättigade till studier

  • Vuxen
  • Äldre vuxen

Tar emot friska volontärer

Ja

Beskrivning

Inclusion Criteria:

  • Age between 18 and 65 years.
  • Male or female.
  • Orally healthy according to clinical examination, with no active oral condition that could interfere with study outcomes.
  • At least 20 natural teeth.
  • No active periodontitis.
  • No clinically relevant untreated cavitated caries.
  • No acute oral mucosal disease.
  • Any existing systemic condition must be stable, controlled, and considered unlikely to interfere with the study outcomes.
  • Willingness to use only the oral care products provided during each treatment period.
  • Willingness to refrain from oral hygiene procedures for 24 hours before each assessment visit.
  • Willingness to refrain from food, beverages other than water, smoking, chewing gum, candies, oral sprays, mouthwashes, and oral hygiene procedures for 3 to 4 hours before each assessment.
  • Ability to understand the study objectives and procedures.
  • Provision of written informed consent.

Exclusion Criteria:

  • Active oral or dental disease that could interfere with the study outcomes. Active periodontitis.
  • Periodontal probing depths greater than 3 mm at multiple sites, according to clinical judgment.
  • Clinically relevant generalized gingival bleeding.
  • Clinically relevant untreated cavitated caries.
  • Oral candidiasis.
  • Oral ulceration, stomatitis, symptomatic oral mucosal lesions, or acute oral infection.
  • Clinical signs of severe xerostomia or pathological hyposalivation.
  • Fewer than 20 natural teeth.
  • Acute systemic disease or uncontrolled chronic systemic disease. Uncontrolled diabetes mellitus.
  • Active autoimmune or systemic inflammatory disease.
  • Gastrointestinal, respiratory, otorhinolaryngological, or metabolic conditions associated with clinically significant extraoral halitosis.
  • Use of systemic antibiotics within 4 weeks before enrollment.
  • Habitual use of antiseptic mouthwashes, anti-halitosis products, or dry-mouth products within 2 weeks before enrollment.
  • Use of medications with a strong xerostomic effect that, in the investigator's judgment, could interfere with study outcomes.
  • Smoking more than 10 cigarettes per day.
  • Inability to refrain from smoking for 3 to 4 hours before assessment visits.
  • Pregnancy or breastfeeding.
  • Known or suspected allergy to any component of the study products.
  • Professional dental cleaning or invasive dental procedures within 2 weeks before enrollment.
  • Inability or unwillingness to comply with the study procedures.
  • Participation in another clinical study within 4 weeks before enrollment.

Studieplan

Det här avsnittet ger detaljer om studieplanen, inklusive hur studien är utformad och vad studien mäter.

Hur är studien utformad?

Designdetaljer

  • Primärt syfte: Förebyggande
  • Tilldelning: Randomiserad
  • Interventionsmodell: Crossover tilldelning
  • Maskning: Dubbel

Vapen och interventioner

Deltagargrupp / Arm
Intervention / Behandling
Experimentell: 50+ Toothpaste Followed by Standard Toothpaste
Participants will use the 50+ toothpaste twice daily for 14 days, followed by a 14-day washout period. They will then use the standard toothpaste twice daily for 14 days. Each brushing session will last 2 minutes.
A toothpaste formulated for adults aged 50 years and older. Participants will use approximately 2 cm of toothpaste to brush their teeth for 2 minutes, twice daily, for 14 consecutive days. The product will be supplied in neutral, coded packaging to maintain masking. Participants will not use other toothpastes, mouthwashes, tongue-cleaning procedures, or products intended for halitosis or dry mouth during the treatment period.
Andra namn:
  • Biorepair Advanced Complete Protection 50+ Toothpaste
A commercially available fluoride toothpaste intended for routine oral hygiene, without specific claims for halitosis or dry mouth and without ingredients specifically intended to neutralize volatile sulfur compounds. Participants will use approximately 2 cm of toothpaste to brush their teeth for 2 minutes, twice daily, for 14 consecutive days. The product will be supplied in neutral, coded packaging, and the same oral hygiene restrictions used for the 50+ toothpaste will apply.
Experimentell: Standard Toothpaste Followed by 50+ Toothpaste
Participants will use the standard toothpaste twice daily for 14 days, followed by a 14-day washout period. They will then use the 50+ toothpaste twice daily for 14 days. Each brushing session will last 2 minutes.
A toothpaste formulated for adults aged 50 years and older. Participants will use approximately 2 cm of toothpaste to brush their teeth for 2 minutes, twice daily, for 14 consecutive days. The product will be supplied in neutral, coded packaging to maintain masking. Participants will not use other toothpastes, mouthwashes, tongue-cleaning procedures, or products intended for halitosis or dry mouth during the treatment period.
Andra namn:
  • Biorepair Advanced Complete Protection 50+ Toothpaste
A commercially available fluoride toothpaste intended for routine oral hygiene, without specific claims for halitosis or dry mouth and without ingredients specifically intended to neutralize volatile sulfur compounds. Participants will use approximately 2 cm of toothpaste to brush their teeth for 2 minutes, twice daily, for 14 consecutive days. The product will be supplied in neutral, coded packaging, and the same oral hygiene restrictions used for the 50+ toothpaste will apply.

Vad mäter studien?

Primära resultatmått

Resultatmått
Åtgärdsbeskrivning
Tidsram
Change From Baseline in Oral Volatile Sulfur Compound Concentration After 14 Days
Tidsram: Baseline (T0), after 7 days of treatment (T1), and after 14 days of treatment (T2) in each treatment period
Oral volatile sulfur compound concentration will be measured using a Halimeter Plus and expressed in parts per billion (ppb). At each assessment, three valid consecutive measurements will be obtained, and their mean will be used for analysis. For each treatment period, change from baseline will be calculated as the value after 14 days minus the baseline value. Lower values and greater reductions indicate improvement in oral malodor. The primary comparison will assess the within-participant difference in change between the 50+ toothpaste and the standard fluoride toothpaste.
Baseline (T0), after 7 days of treatment (T1), and after 14 days of treatment (T2) in each treatment period

Sekundära resultatmått

Resultatmått
Åtgärdsbeskrivning
Tidsram
Percentage Change From Baseline in Oral Volatile Sulfur Compound Concentration
Tidsram: Baseline (T0), after 7 days of treatment (T1), and after 14 days of treatment (T2) in each treatment period
Oral volatile sulfur compound concentration will be measured using a Halimeter Plus and expressed in parts per billion (ppb). The percentage reduction will be calculated as: [(baseline value - follow-up value) / baseline value] × 100. A higher positive percentage indicates a greater reduction in oral malodor. Percentage changes obtained with the 50+ toothpaste and the standard fluoride toothpaste will be compared within participants.
Baseline (T0), after 7 days of treatment (T1), and after 14 days of treatment (T2) in each treatment period
Change From Baseline in Tongue Coating Severity Score
Tidsram: Baseline (T0), after 7 days of treatment (T1), and after 14 days of treatment (T2) in each treatment period
Tongue coating will be assessed clinically using a 4-point severity score: 0, no visible coating; 1, thin coating with the underlying mucosal color visible; 2, moderate coating; and 3, thick coating with marked mucosal coverage. Lower scores indicate less tongue coating. The predominant location of the coating will also be recorded as anterior, middle, posterior, or diffuse.
Baseline (T0), after 7 days of treatment (T1), and after 14 days of treatment (T2) in each treatment period
Change From Baseline in Participant-Reported Oral Malodor
Tidsram: Baseline (T0), after 7 days of treatment (T1), and after 14 days of treatment (T2) in each treatment period
Participants will rate their perceived oral malodor using an 11-point numerical rating scale ranging from 0 to 10, where 0 indicates no perceived bad breath and 10 indicates the worst perceived bad breath. Lower scores indicate improvement.
Baseline (T0), after 7 days of treatment (T1), and after 14 days of treatment (T2) in each treatment period
Change From Baseline in Summated Xerostomia Inventory Score
Tidsram: Baseline (T0), after 7 days of treatment (T1), and after 14 days of treatment (T2) in each treatment period
Subjective dry mouth symptoms will be assessed using the 5-item Summated Xerostomia Inventory. Each item is scored from 1, never, to 5, almost always. The item scores are summed to produce a total score ranging from 5 to 25. Higher scores indicate more severe subjective dry mouth symptoms.
Baseline (T0), after 7 days of treatment (T1), and after 14 days of treatment (T2) in each treatment period
Change From Baseline in Participant-Reported Oral Dryness
Tidsram: Baseline (T0), after 7 days of treatment (T1), and after 14 days of treatment (T2) in each treatment period
Participants will rate their perceived oral dryness using an 11-point numerical rating scale ranging from 0 to 10, where 0 indicates no oral dryness and 10 indicates the greatest possible oral dryness. Lower scores indicate improvement.
Baseline (T0), after 7 days of treatment (T1), and after 14 days of treatment (T2) in each treatment period
Change From Baseline in Participant-Reported Oral Comfort
Tidsram: Baseline (T0), after 7 days of treatment (T1), and after 14 days of treatment (T2) in each treatment period
Participants will rate their overall oral comfort using an 11-point numerical rating scale ranging from 0 to 10, where 0 indicates no oral comfort and 10 indicates the greatest possible oral comfort. Higher scores indicate better perceived oral comfort.
Baseline (T0), after 7 days of treatment (T1), and after 14 days of treatment (T2) in each treatment period
Change From Baseline in Oral Health Impact Profile-14 Total Score
Tidsram: Baseline (T0) and after 14 days of treatment (T2) in each treatment period
Oral health-related quality of life will be assessed using the 14-item Oral Health Impact Profile. Each item is scored from 0, never, to 4, very often. The scores are summed to obtain a total score ranging from 0 to 56. Higher scores indicate a greater negative impact of oral health on quality of life.
Baseline (T0) and after 14 days of treatment (T2) in each treatment period
Change From Baseline in Unstimulated Salivary Flow Rate
Tidsram: Baseline (T0), after 7 days of treatment (T1), and after 14 days of treatment (T2) in each treatment period
Unstimulated whole saliva will be collected for 5 minutes using the spitting method. The total collected volume will be divided by the collection duration and expressed in milliliters per minute (mL/min). Higher values indicate a greater unstimulated salivary flow rate.
Baseline (T0), after 7 days of treatment (T1), and after 14 days of treatment (T2) in each treatment period
Change From Baseline in Stimulated Salivary Flow Rate
Tidsram: Baseline (T0), after 7 days of treatment (T1), and after 14 days of treatment (T2) in each treatment period
Stimulated whole saliva will be collected for 5 minutes using the spitting method after standardized gustatory stimulation with citric acid. The total collected volume will be divided by the collection duration and expressed in milliliters per minute (mL/min). Higher values indicate a greater stimulated salivary flow rate.
Baseline (T0), after 7 days of treatment (T1), and after 14 days of treatment (T2) in each treatment period
Overall Taste Pleasantness Score
Tidsram: After 14 days of treatment (T2) in each treatment period
Participants will rate the overall pleasantness of the toothpaste taste using a 9-point hedonic scale ranging from 1, extremely unpleasant, to 9, extremely pleasant. Higher scores indicate greater taste pleasantness.
After 14 days of treatment (T2) in each treatment period
Perceived Freshness Score
Tidsram: After 14 days of treatment (T2) in each treatment period
Participants will rate the freshness perceived after brushing using an 11-point numerical rating scale ranging from 0, no perceived freshness, to 10, maximum perceived freshness. Higher scores indicate greater perceived freshness.
After 14 days of treatment (T2) in each treatment period
Perceived Taste Persistence Score
Tidsram: After 14 days of treatment (T2) in each treatment period
Participants will rate the persistence of the toothpaste taste after brushing using an 11-point numerical rating scale ranging from 0, not persistent at all, to 10, extremely persistent. Higher scores indicate greater perceived taste persistence.
After 14 days of treatment (T2) in each treatment period
Unpleasant Aftertaste Score
Tidsram: After 14 days of treatment (T2) in each treatment period
Participants will rate unpleasant aftertaste using an 11-point numerical rating scale ranging from 0, no unpleasant aftertaste, to 10, extremely unpleasant aftertaste. Lower scores indicate better sensory acceptability.
After 14 days of treatment (T2) in each treatment period
Willingness to Continue Using the Toothpaste
Tidsram: After 14 days of treatment (T2) in each treatment period
Participants will rate their willingness to continue using the assigned toothpaste using an 11-point numerical rating scale ranging from 0, not willing at all, to 10, completely willing to continue its use. Higher scores indicate greater willingness to continue using the product.
After 14 days of treatment (T2) in each treatment period
Participant-Reported Product Attribute Ratings
Tidsram: After 14 days of treatment (T2) in each treatment period
Participants will separately rate product odor, color, consistency, sensation of cleanliness, perceived effect on breath, perceived effect on oral dryness, lubricating effect, moisturizing effect, and willingness to reuse the product. Each attribute will be rated using an 11-point numerical rating scale from 0 to 10 and analyzed separately without calculating a combined total score. Higher scores indicate a more favorable assessment of each product attribute.
After 14 days of treatment (T2) in each treatment period
Incidence of Treatment-Emergent Adverse Events
Tidsram: From the first product administration at T0 through the final assessment at T2 of the second treatment period, approximately 6 weeks
The number and percentage of participants experiencing treatment-emergent adverse events will be recorded for each toothpaste. Events of interest include oral burning, mucosal irritation, ulceration, taste alteration, nausea, increased oral dryness, hypersalivation, pain, and oral discomfort. Each event will be classified according to intensity, seriousness, duration, relationship to the study product, and action taken.
From the first product administration at T0 through the final assessment at T2 of the second treatment period, approximately 6 weeks

Samarbetspartners och utredare

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Utredare

  • Huvudutredare: Andrea Scribante, University of Pavia

Studieavstämningsdatum

Dessa datum spårar framstegen för inlämningar av studieposter och sammanfattande resultat till ClinicalTrials.gov. Studieposter och rapporterade resultat granskas av National Library of Medicine (NLM) för att säkerställa att de uppfyller specifika kvalitetskontrollstandarder innan de publiceras på den offentliga webbplatsen.

Studera stora datum

Studiestart (Beräknad)

1 oktober 2026

Primärt slutförande (Beräknad)

1 december 2026

Avslutad studie (Beräknad)

15 december 2026

Studieregistreringsdatum

Först inskickad

18 augusti 2026

Först inskickad som uppfyllde QC-kriterierna

18 augusti 2026

Första postat (Faktisk)

21 augusti 2026

Uppdateringar av studier

Senaste uppdatering publicerad (Faktisk)

21 augusti 2026

Senaste inskickade uppdateringen som uppfyllde QC-kriterierna

18 augusti 2026

Senast verifierad

1 augusti 2026

Mer information

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IPD-planbeskrivning

Data will be available upon motivated request to the corresponding authors.

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