Comparative Effectiveness of Probiotic Toothpaste vs. Regular Toothpaste on Gingival Health in Adult Orthodontic Patients

Background: Maintenance of gingival health is a major challenge in adult orthodontic patients due to the presence of fixed appliances, which increase plaque accumulation and gingival inflammation. Conventional toothpastes primarily focus on mechanical plaque removal and fluoride delivery but may not sufficiently control gingival inflammation in orthodontic patients. Probiotic toothpaste has emerged as a novel preventive approach that may improve gingival health by modulating the oral microbiota and suppressing pathogenic bacteria. Objectives: To compare the effectiveness of probiotic toothpaste versus regular toothpaste on gingival health among adult orthodontic patients. Study Design & Setting: This randomized controlled comparative study was conducted over a period of six months in the Departments of Dentistry Orthodontics Department Sharif Medical and Dental College Lahore from May 2025 to October 2025. Methodology: A total of 120 adult patients aged 18–40 years undergoing fixed orthodontic treatment were enrolled and randomly allocated into two equal groups. Group A was instructed to use probiotic toothpaste, while Group B used regular fluoridated toothpaste. All participants were advised to brush twice daily using the modified Bass technique and were given standardized oral hygiene instructions. Gingival health was assessed at baseline and after four weeks using Plaque Index, Gingival Index, and Bleeding on Probing scores. Data were analyzed using SPSS version 25.0, and intergroup and intragroup comparisons were performed using appropriate statistical tests, with a p-value of <0.05 considered statistically significant. Results: Baseline plaque index, gingival index, and bleeding on probing scores were comparable between the two groups. After four weeks, Group A showed greater reductions in plaque index, gingival index, and bleeding on probing compared to Group B. The differences between the probiotic toothpaste group and the regular toothpaste group at follow-up were statistically significant for all assessed parameters. Intragroup analysis also demonstrated significant improvement in gingival health indicators in both groups over time. Conclusion: Probiotic toothpaste was more effective than regular toothpaste in improving gingival health among adult orthodontic patients. Its use may be recommended as an adjunctive oral hygiene measure during fixed orthodontic treatment to reduce gingival inflammation and plaque accumulation