The website for the Sensodyne dental brand www.sensodyne.co.uk, seen on 8 July 2016, promoted the toothpaste, Sensodyne True White. The headline of the web page was “Sensodyne True White”, with the sub-headings “Sensodyne True White” and “Sensodyne True White Science”. The ad featured an image of the toothpaste alongside an image of its outer packaging, with the brand name “TRUE White” visible on both. The ad featured the headline claim "Now you can have sensitive tooth care and whiter teeth*”, with the asterisked qualification “*With twice daily brushing” underneath. The ad featured a second headline claim “BREAKTHROUGH. SENSITIVE TOOTH CARE AND STAIN REMOVAL In an ultra-low abrasion formulation”. Further text stated “10 x less abrasive. Many everyday whitening toothpastes have higher abrasivity. Sensodyne True White is 10 x less abrasive than many everyday whitening toothpastes” and “With sodium tripolyphosphate to gently remove and prevent extrinsic tooth stains. Sensodyne True White helps restore the true white* of sensitive teeth, whilst minimising the wear that many other higher abrasivity whitening toothpastes may cause”. An asterisked qualification stated “*With twice daily brushing”.
Colgate Palmolive Ltd, who understood that the toothpaste’s whitening effect was not greater than that of standard non-whitening toothpastes, challenged whether the claims that the toothpaste was effective at whitening teeth were misleading.
GlaxoSmithKline Consumer Healthcare (UK) Trading Ltd (GSK) explained that their Sensodyne True White formulation was specially developed for people with sensitive teeth, and provided stain prevention and stain removal to help restore the natural colour of the teeth. They explained the toothpaste whitened through the chemical cleaning action of sodium tripolyphosphate (STP), rather than dental abrasives common in other whitening toothpastes in order to help minimise the abrasion of the exposed teeth.
GSK submitted five randomised controlled clinical studies which they said showed that the product was a specialist whitening toothpaste for sensitive teeth. They said the studies showed that the product provided stain removal with an efficacy similar to regular non-whitening toothpastes with moderate abrasivity and an established daily whitening toothpaste with a much stronger abrasivity.
GSK acknowledged Colgate’s concern that the toothpaste had the same whitening effect as standard non-whitening toothpastes. However, they pointed out that two of the studies found that the toothpaste had a similar whitening effect to an everyday standard whitening toothpaste, with one study reporting that it had a greater whitening effect than that of standard whitening toothpaste.
GSK said they did not test the toothpaste against other Sensodyne toothpastes because standard everyday whitening and non-whitening toothpastes were more abrasive, and therefore represented more rigorous and robust comparators than Sensodyne toothpastes. They said those comparators were selected to show whitening efficacy per se as opposed to superior whitening efficacy.
GSK argued that the ad did not suggest that product was more effective at whitening teeth than non-whitening Sensodyne toothpastes, but made clear that the product had been specifically formulated with a specific stain removal ingredient and that the whitening benefit was available in an innovative ultra-low abrasive format. They said each of the claims in the ad related solely to the fact that the toothpaste was able to whiten, while none of the whitening claims in the ad were comparative claims with Sensodyne-base toothpastes or other non-whitening toothpastes. They said all of the whitening claims in the ad were entrenched in the innovative context of ultra-low abrasivity. They believed there was no reason why consumers would compare the whitening efficacy of the toothpaste, which was specifically formulated to meet the need-state of ultra-low abrasivity, with other toothpastes which were not formulated to meet that specific need-state, including base Sensodyne toothpastes. They also believed that the claims relating to the whitening benefit of the toothpaste were secondary to the primary claims in the ad which related to sensitivity care and the low abrasivity of the product.
GSK said publicly available studies showed that polyphosphates such as STP helped to detach stains from the tooth surface and reduce the adhesion of stains on to the tooth surface. In addition, after brushing with repeated use, the chemicals stayed on the tooth surface to form a protective coating, helping to prevent new stains from forming. They said base Sensodyne non-whitening toothpastes did not contain STP and were not specifically formulated to provide a whitening benefit. They said the toothpaste had a Relative Dentine Abrasion score of 12. It was therefore the lowest abrasion toothpaste marketed by Sensodyne and considerably lower than many everyday whitening toothpastes.
The ASA understood that the Sensodyne dental brand was generally understood by consumers to contain products that were designed specifically for those with sensitive teeth. The ad in question appeared on the Sensodyne website, the first heading of which was “About Sensitive Teeth”. The ad was the product page for the toothpaste Sensodyne True White and was linked to from the product listings page where consumers could view the range of different Sensodyne toothpastes. The ad featured the headline “Sensodyne True White”, with the brand name “True White” appearing in multiple places on the ad, including on a prominent image of the toothpaste and on its outer packaging. The ad featured several other references to the toothpaste’s whitening ability, which included “now you can have sensitive tooth care and whiter teeth”, “Breakthrough - sensitive tooth care and stain removal” and “to gently remove and prevent extrinsic tooth stains, Sensodyne True White helps to restore the true white of sensitive teeth”.
We considered that consumers were likely to understand from the brand name “Sensodyne True White” and from those accompanying claims about whitening, which appeared in the context of toothpastes designed for sensitive teeth and other Sensodyne toothpastes advertised on the website that did not feature whitening claims in the brand name, that Sensodyne True White was particularly effective at whitening teeth. We considered that consumers would infer that the toothpaste was able to whiten teeth to a perceptibly greater extent than ordinary Sensodyne toothpastes that were not marketed as whitening toothpastes would be able to.
We reviewed the five clinical studies provided by GSK, three of which had been published in full or in abstract and two of which had not been published. The studies used the MacPherson modification of Lobene stain index (MLSI) to measure the stain removal and prevention capacity of the toothpaste. The method measured stains through visual inspection which involved observers using an index to provide a score for the intensity and area of stain on every assessable incisor and canine tooth before and after treatment. We acknowledged that all of the studies were controlled, randomised, observer-blinded and contained sufficient sample sizes and appropriate exclusion criteria. We considered that, while the method did involve an element of subjectivity, there was consistency in the results across the five studies that indicated the results of the studies using the MLSI method could be relied upon.
The studies compared the stain removal and stain prevention performance of Sensodyne True White with control groups which included several standard non-whitening toothpastes and (in three of the studies) one standard whitening toothpaste that were not designed for sensitive teeth. One of the studies reported statistically significant greater stain removal for True White compared with the whitening and non-whitening standard toothpastes, but the other four studies reported no statistically significant difference. While the studies did report a statistically significant difference between the results at the beginning and end of the studies, we considered that the only relevant comparison in a randomised controlled trial was with the control groups.
In addition, none of the studies compared the toothpaste to a non-whitening Sensodyne toothpaste, meaning that no evidence was provided to show that this toothpaste was more effective at whitening than other Sensodyne toothpastes that were not marketed as whitening toothpastes.
Because consumers were likely to understand from the ad that Sensodyne True White was particularly effective at whitening, when we had not seen evidence that it had a perceptibly greater whitening effect than Sensodyne non-whitening toothpastes, we concluded that the ad was misleading.
The ad breached rule 3.1 3.1 Marketing communications must not materially mislead or be likely to do so. (Misleading advertising) 3.7 3.7 Before distributing or submitting a marketing communication for publication, marketers must hold documentary evidence to prove claims that consumers are likely to regard as objective and that are capable of objective substantiation. The ASA may regard claims as misleading in the absence of adequate substantiation. (Substantiation) and 3.11 3.11 Marketing communications must not mislead consumers by exaggerating the capability or performance of a product. (Exaggeration).
The ad must not appear again in its current form. We told GSK not to mislead consumers by implying that Sensodyne True White was perceptibly more effective at whitening teeth than other Sensodyne non-whitening toothpastes, unless they held adequate evidence that it was.