Study to Investigate a New Prebiotic Toothpaste to Help Treat Gingivitis

The Centre for Oral Health Research (COHR) at Melbourne Dental School is conducting a study to evaluate the effectiveness of a new prebiotic toothpaste containing CPP-ACP in treating mild to moderate gingivitis. If you or someone you know may have gingivitis, the study is seeking participants to assess the toothpaste’s impact on oral health.

Bleeding gum

At the Centre for Oral Health Research, we are conducting a study to determine the effectiveness of a new prebiotic toothpaste (containing CPP-ACP) in treating mild to moderate gingivitis.

Gingivitis is a common and mild form of gum disease. It occurs when plaque builds up on your teeth along your gum line, which causes inflammation of the gums. Your gums, that normally appear pink, become red and swollen and may bleed easily when you brush or floss your teeth. For some people, the first sign that they have gingivitis is when they either notice blood on their toothbrush or in the sink after they rinse their mouths after toothbrushing or flossing. Gingivitis can also cause halitosis (bad breath).

The COHR study lead, Laureate Professor Eric Reynolds, said that fortunately, gingivitis can be treated and prevented with good oral hygiene at home and regular check-ups and cleans by a dentist. However, when left untreated, gingivitis can advance to periodontitis where the inflammation in the gums becomes destructive.

The milk protein, called casein phosphopeptide-amorphous calcium phosphate (CPP-ACP), has been shown clinically to slow the progression of dental caries (tooth decay) and to regress early stages of dental caries and erosion. The major anticariogenic mechanism of CPP-ACP is through its ability to provide bioavailable calcium and phosphate ions to promote remineralization of enamel subsurface lesions. Dental plaque has been shown to take up and retain CPP-ACP after participants chewed sugar-free gum containing CPP-ACP.

Professor Reynolds said “Results from recent clinical studies conducted by the COHR study team with CPP-ACP sugar-free chewing gum have demonstrated a CPP-ACP dose-response reduction in gingivitis. This was strongly associated with an increase in the relative abundance of beneficial commensal nitrate-reducing bacteria and a decrease in the relative abundance of Gram-negative inflammogenic bacteria. It is anticipated that similar results will be obtained with a toothpaste containing CPP-ACP.”

CPP contains arginine and other nitrogen-rich amino acids like glutamine and asparagine that are metabolized by plaque bacteria to maintain a neutral plaque pH and homeostasis. This improves the fitness of beneficial commensal bacteria, which can prevent pathogenic bacteria from colonizing and/or emerging in dental plaque which is similar to the established probiotic bacterial effects in other parts of the gastro-intestinal tract. A prebiotic is defined as a nutrient that stimulates the growth of probiotic bacteria to produce a health benefit. “In this context CPP-ACP has the potential to be an intra-oral prebiotic delivering an oral health benefit” Professor Reynolds said.

Toothbrush on a sink

This study will compare the results on gum health from using a toothpaste containing CPP-ACP with the current market-leading toothpaste for gingivitis.  Participants in this study with mild to moderate gingivitis will be randomly assigned to one of the two toothpastes and will be asked to brush their three times a day for three weeks. Participants will have a dental examination to check their gum health and plaque levels at the start and end of the three-week trial period, and they will also have some plaque collected from their teeth at each examination. These plaque samples will be used to investigate changes in the bacterial composition of the plaque following use of the toothpastes. At the end of the study participants will be offered a free professional cleaning of their teeth and will be reimbursed $100 for participation.

If you think you or someone you know may have gingivitis, and are interested in hearing more, please contact us.

For more information, contact the COHR study team on (03) 9341 1569 or by email

This study has been approved by the University of Melbourne Human Research Ethics Committee (Project ID: 27515).