Comparative effect of a stannous fluoride toothpaste and a sodium fluoride toothpaste on a multispecies biofilm

Arch Oral Biol. 2017 Feb:74:5-11. doi: 10.1016/j.archoralbio.2016.10.030. Epub 2016 Oct 29.


Objectives: This paper aimed to compare the mode of action of a stannous fluoride-containing toothpaste with a conventional sodium fluoride-containing toothpaste on anti-biofilm properties.

Methods: A three-species biofilm model that consists of Streptococcus mutans, Streptococcus sanguinis and Porphyromonas gingivalis was established to compare the anti-biofilm properties of a stannous fluoride-containing toothpaste (CPH), a conventional sodium fluoride-containing toothpaste (CCP) and a negative control (PBS). The 48h biofilms were subjected to two-minute episodes of treatment with test agents twice a day for 5 consecutive days. Crystal violet staining and XTT assays were used to evaluate the biomass and viability of the treated biofilm. Live/dead staining and bacteria/extracellular polysaccharides (EPS) double-staining were used to visualize the biofilm structure and to quantify microbial/extracellular components of the treated biofilms. Species-specific fluorescent in situ hybridization and quantitative polymerase chain reaction (qPCR) were used to analyze microbial composition of the biofilms after treatment.

Results: The biomass and viability of the biofilms were significantly reduced after CPH toothpaste treatment. The inhibitory effect was further confirmed by the live/dead staining. The EPS amounts of the three-species biofilm were significantly reduced by CCP and CPH treatments, and CPH toothpaste demonstrated significant inhibition on EPS production. More importantly, CPH toothpaste significantly suppressed S. mutans and P. gingvalis, and enriched S. sanguinis in the three-species biofilm. In all experiments CPH had a significantly greater effect than CCP (p<0.05) and CCP had a greater effect than PBS (p<0.05).

Conclusions: Stannous fluoride-containing toothpaste not only showed better inhibitory effect against oral microbial biofilm, but was also able to modulate microbial composition within multi-species biofilm compared with conventional sodium fluoride-containing toothpaste.

Keywords: Biofilm; Fluoride; Microbial ecology; Oral diseases; Stannous; Toothpaste.

MeSH terms

  • Biofilms / classification
  • Biofilms / drug effects*
  • Drug Screening Assays, Antitumor
  • In Situ Hybridization, Fluorescence / methods
  • Microbial Viability / drug effects
  • Models, Biological
  • Porphyromonas gingivalis / drug effects
  • Porphyromonas gingivalis / growth & development
  • Real-Time Polymerase Chain Reaction / methods
  • Sodium Fluoride / antagonists & inhibitors*
  • Species Specificity
  • Streptococcus mutans / drug effects
  • Streptococcus mutans / growth & development
  • Streptococcus sanguis / drug effects
  • Streptococcus sanguis / growth & development
  • Time Factors
  • Tin Fluorides / antagonists & inhibitors*
  • Toothpastes / chemistry
  • Toothpastes / pharmacology*


  • Tin Fluorides
  • Toothpastes
  • Sodium Fluoride