CPP-ACP Paste's Effect on Salivary Conditions in Removable-Denture Patients

Objectives: Denture-wearing older adults experience high rates of both caries (when natural dentition remains) and xerostomia. While many dental therapeutics targeting these two interrelated challenges are commercially available, none have been labeled for use on the intaglio of removable dentures. The peripheral seal of dentures has been hypothesized to provide a unique advantage of retaining therapeutics within the oral cavity for extended time periods. The current clinical trial investigated an off-label use of MI Paste® (GC America), a dental therapeutic containing casein-phosphopeptide-amorphous-calcium-phosphate (CPP-ACP), under complete dentures and its subsequent effects on salivary buffering capacity and flow rates.
Methods: After screening participants for properly fitting complete denture(s), salivary flow rate and pH were recorded at baseline and 15 minutes following the application of CPP-ACP-paste to the intaglio of patients’ dentures. To assess buffering capacity, samples were titrated with equivalent volumes of 0.01M lactic acid, and pH reduction was measured. Comparisons of salivary parameters between baseline and post-intervention or between subjects with and without reported xerostomia were conducted using a paired-sample t-test, Wilcoxon signed-rank test, or two-sample t-test as appropriate (alpha=0.05).
Results: Of the 28 participants (mean age=70.3±13.7 years, 17 males), 11 reported xerostomia. CPP-ACP-paste-intervention was associated with decreased pH reduction during titration compared to baseline (0.953±0.241 vs. 1.540±0.526, p<0.001), and increased pH following titration (5.925 ± 0.343 vs. 5.395 ± 0.660, p<0.001). The difference in flow rate between baseline and post-intervention was marginally significant (0.547±0.342 vs. 0.666±0.443, p=0.053). No significant differences in either salivary parameter were found between participants with and without reported xerostomia.
Conclusions: The current investigation demonstrates a novel use of CPP-ACP-paste as a potential caries-risk-management tool and dry-mouth aid in a population with complex oral-health challenges. The findings highlight positive effects to salivary conditions. However, determining the caries-preventive clinical significance of the described technique will require longer-term trials; further research is ongoing.