Could this plaque identifying toothpaste prevent a heart attack or stroke?

February 24, 2020

For decades, researchers have suggested a link between oral health and inflammatory diseases affecting the entire body -- in particular, heart attacks and strokes. Inflammation is intimately involved in the pathogenesis of atherosclerosis and is accurately measured by high sensitivity C-reactive protein (hs-CRP), a sensitive marker for future risks of heart attacks and strokes.

Researchers from Florida Atlantic University's Schmidt College of Medicine, Marshfield Clinic Research Institute, and the University of Wisconsin School of Medicine and Public Health, collaborated on a randomized trial titled, "Correlation between Oral Health and Systemic Inflammation" (COHESION), to further explore whether Plaque HD®, a plaque identifying toothpaste, reduces hs-CRP.

Results of the randomized pilot trial, published online ahead of print in the American Journal of Medicine, showed that Plaque HD® produced a statistically significant reduction in hs-CRP among those with elevations at baseline. Plaque HD® is the first toothpaste that identifies plaque so that it can be removed with directed brushing. In addition, the product's proprietary formulation contains unique combinations and concentrations of cleaning agents that weaken the core of the plaque structure to help the subject visualize and more effectively remove the plaque.

In this trial, all randomized subjects were given the same brushing protocol and received a 30-day supply of toothpaste containing either Plaque HD® or an identical non-plaque identifying placebo toothpaste. To assess hs-CRP, levels were measured by Quest Diagnostics using an enzyme linked immunosorbent assay.

"The current findings are similar to those from our previous pilot trial," said Charles H. Hennekens, M.D., Dr.P.H., senior author, first Sir Richard Doll Professor, and senior academic advisor in FAU's Schmidt College of Medicine. "Whether this plaque-identifying toothpaste decreases heart attacks or strokes requires a large-scale randomized trial of sufficient size and duration. These results provide a stronger rationale to conduct such trials. If positive, the results of these trials would have significant potential clinical and public health implications."

Based on these findings, Hennekens and colleagues at FAU and the University of Wisconsin School of Medicine and Public Health are drafting an investigator-initiated research grant proposal to the National Institutes of Health (NIH). Their proposed randomized trial will test whether Plaque HD® reduces progression of atherosclerosis in the coronary and carotid arteries, for which systemic inflammation is an important precursor.

A report from the United States Centers for Disease Control and Prevention found that 47.2 percent of American adults aged 30 years and older have some form of periodontal disease, a pathological inflammatory condition of the gums and tissues surrounding the teeth. Periodontal disease increases with age affecting more than 70 percent of adults 65 years and older. Prior research has suggested that periodontal disease may be connected to variety of other diseases, including heart disease and stroke and other inflammatory diseases such as rheumatoid arthritis. Inflammation throughout the body may be a crucial link between periodontal and other systemic diseases.

Further, two years ago, the prestigious New England Journal of Medicine ranked the original manuscript published in 1997 by Hennekens and colleagues on aspirin, inflammation and cardiovascular disease, as their most influential original report of the last 20 years. Those randomized data derived from the landmark Physician's Health Study, in which Hennekens was the founding principal investigator, and suggested that hs-CRP predicted future heart attacks and strokes.
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Co-authors of this randomized pilot trial are Amit Acharya, Ph.D., Marshfield Clinic Research Center and the University of Wisconsin School of Medicine and Public Health; Ingrid Glurich, Ph.D, Marshfield Clinic Research Center; and Scott Hetzel, M.S., KyungMann Kim, Ph.D., Matthew C. Tattersall, D.O., F.A.C.C.; and David L. DeMets, Ph.D., all with the University of Wisconsin School of Medicine and Public Health.

About the Charles E. Schmidt College of Medicine:

FAU's Charles E. Schmidt College of Medicine is one of approximately 152 accredited medical schools in the U.S. The college was launched in 2010, when the Florida Board of Governors made a landmark decision authorizing FAU to award the M.D. degree. After receiving approval from the Florida legislature and the governor, it became the 134th allopathic medical school in North America. With more than 70 full and part-time faculty and more than 1,300 affiliate faculty, the college matriculates 64 medical students each year and has been nationally recognized for its innovative curriculum. To further FAU's commitment to increase much needed medical residency positions in Palm Beach County and to ensure that the region will continue to have an adequate and well-trained physician workforce, the FAU Charles E. Schmidt College of Medicine Consortium for Graduate Medical Education (GME) was formed in fall 2011 with five leading hospitals in Palm Beach County. The Consortium currently has five Accreditation Council for Graduate Medical Education (ACGME) accredited residencies including internal medicine, surgery, emergency medicine, psychiatry, and neurology.

About Florida Atlantic University:

Florida Atlantic University, established in 1961, officially opened its doors in 1964 as the fifth public university in Florida. Today, the University, with an annual economic impact of $6.3 billion, serves more than 30,000 undergraduate and graduate students at sites throughout its six-county service region in southeast Florida. FAU's world-class teaching and research faculty serves students through 10 colleges: the Dorothy F. Schmidt College of Arts and Letters, the College of Business, the College for Design and Social Inquiry, the College of Education, the College of Engineering and Computer Science, the Graduate College, the Harriet L. Wilkes Honors College, the Charles E. Schmidt College of Medicine, the Christine E. Lynn College of Nursing and the Charles E. Schmidt College of Science. FAU is ranked as a High Research Activity institution by the Carnegie Foundation for the Advancement of Teaching. The University is placing special focus on the rapid development of critical areas that form the basis of its strategic plan: Healthy aging, biotech, coastal and marine issues, neuroscience, regenerative medicine, informatics, lifespan and the environment. These areas provide opportunities for faculty and students to build upon FAU's existing strengths in research and scholarship. For more information, visit fau.edu.

Florida Atlantic University

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