Triclosan Slows the Progression of Periodontal Disease in Cardiovascular Patients

Method: 438 patients with CVD and a minimum of 12 teeth (78% males and 22% females: mean age 61.1 +/- 8.5 years) were randomized to receive triclosan (n=223) or placebo (n=215) toothpaste. Six sites per tooth were examined annually for 5 years for probing pocket depth (PPD) and relative attachment level using the Florida Probe. Subgingival plaque was collected from interproximal sites, pooled and RT-PCR used to detect periodontal pathogens (Aggregatibacter actinomycetemcomitans, Porphyromonas gingivalis).  Data on numbers of sites showing PPD ≥4mm and loss of attachment (LOA) ≥2mm at each examination were analysed using transition modeling and Markov chain modeling of binary responses (<4/≥4 sites with PPD ≥4mm defining healthy/diseased states).

Result: Triclosan significantly reduced the number of proximal sites showing LOA ≥2mm between examinations by 21% on average (p<0.01). There was a smaller and only marginally significant (p=0.10) effect of triclosan in reducing the number of sites showing PPD ≥4mm, with this effect lessened for patients on anti-inflammatory medication.  Triclosan also significantly increased the rate of regression from the diseased to the healthy state (p<0.05) but smoking negated this effect. There were no significant main effects of the periodontal pathogens and hypertension (p>0.10) on any of the responses. 

Conclusion: The present study has shown that using triclosan toothpaste over five years slowed the progression of periodontal disease in this cardiovascular population and confirmed the effect of triclosan shown in previous studies.