Comparison of the Anti-Caries Effect of a Newly Developed Non-Fluoridated Toothpaste with Fluoridated Toothpaste: An In Vitro Study

Abstract Aim: To evaluate and compare the antimicrobial (anti-caries) efficacy of a newly developed non-fluoridated toothpaste containing theobromine and nano-hydroxyapatite (Nano HAP) with a commercially available fluoridated toothpaste. Materials and Methods: An in vitro study was conducted using the agar well diffusion method to assess the antimicrobial activity of both the formulations against five microorganisms associated with dental caries: Streptococcus mutans, Lactobacillus sp, Staphylococcus aureus, Candida albicans , and Enterococcus faecalis . For each organism, 10 plates were tested, with both the toothpastes placed in separate wells to allow direct comparison. The diameter of the inhibition zone (in millimeters) was measured to assess the antimicrobial efficacy. Data were analyzed using the Mann–Whitney U test, with effect sizes and 95% confidence interval calculated. Results: The non-fluoridated Nano HAP theobromine toothpaste demonstrated statistically comparable efficacy to the fluoridated toothpaste against Lactobacillus ( P = 0.51), Streptococcus mutans ( P = 0.27), and Enterococcus faecalis ( P = 0.87). Significantly greater antimicrobial activity was observed against Staphylococcus aureus ( P = 0.014) and Candida albicans ( P = 0.01). Effect sizes ranged from small to medium for significant comparisons. Conclusion: The novel nano-hydroxyapatite theobromine toothpaste shows similar anti-caries efficacy as compared to the fluoridated toothpaste and, hence, can be used as an alternative to fluoridated tooth paste.