Clinical efficacy of BioHAP for the prevention of early childhood caries


Milk teeth need special care. The enamel of the primary dentition is thinner than that of permanent teeth. Children often do not brush their teeth thoroughly enough because not all of them have the ability for this yet. Furthermore, children swallow a lot of the toothpaste. It is therefore important that parents help their children by brushing their teeth again afterwards. It is also important to use an effective toothpaste as well as a suitable toothbrush. What is key here is that the toothpaste is safe if swallowed and also prevents caries.


How effective is Kinder Karex with BioHAP in preventing caries compared to a children’s fluoride toothpaste?

Material and methods

214 children participated in this multicentre, double-blind, randomised clinical trial. They were equally divided in the the two groups. One group used a children’s fluoride toothpaste for one year, while the second group used Kinder Karex with BioHAP for the same time duration.

Caries was assessed using the ICDAS (International Caries Detection and Assessment System). The focus was on the early stages of caries (ICDAS code 1 and 2) and a comparison was made between the two groups regarding the development of new caries during the study period. The children were examined at the start and end of the study, as well as at 4 visits during the study period. In addition to recording caries lesions and other parameters, the method of plaque removal was also recorded.


The results show that the teeth were brushed equally in both groups. Plaque decreased in both groups, too. The increase in caries was also comparable in both groups. An early stage of caries (ICDAS 1) was detected in around ¾ of the children. The proportion in the BioHAP group was slightly lower (not statistically significant) than in the fluoride group. When looking at ICDAS 2, fewer caries was detected in the BioHAP group than in the fluoride group.

Fig. 1: Increase in ICDAS ≥ ∆2 in the fluoride, and HAP-group. In both groups, the proportion of children who developed at least on one tooth a caries lesion of ICDAS ≥ ∆2 is not significantly different. Hydroxyapatite is as effective as fluoride in caries prevention.
Fig. 2: PCR-values from visit 2 to visit 6. A represents the HAP-group, while B shows the fluoride-group. In both groups the PCR-values decreased significantly (Friedman-test, p < 0.001). There was no difference between the HAP and the fluoride-group. (Schematic figure adapted from Paszynska et al.)


Kinder Karex with BioHAP is not inferior to a fluoride toothpaste in prevention of caries. This long-term study showed that BioHAP protects against caries at least as effective as a children’s fluoride toothpaste. Kinder Karex with BioHAP is suitable for daily use in caries prevention. BioHAP is effective against caries and safe if swallowed.

The publication of the study can be read as full text here.

Source  Paszynska, E. et al. Impact of a toothpaste with microcrystalline hydroxyapatite on the occurrence of early childhood caries: a 1-year randomized clinical trial. Scientific reports 11, 2650 (2021).