CITROX®: A closer look at Perio Plus+’ secret ingredient

The unique formulation of CURAPROX’s Perio Plus+ series is largely thanks to the work of two men: Christoph Fiolka, manager of chemical products at Curaden, and Howard Thomas, a prolific microbiologist with a passion for natural health products, who sadly passed away this past October. The new formulation’s secret ingredient? Citrox.

“We were looking for a natural antibacterial to use in dental products,” says Richard Thomas, managing director of CURAPROX UK and Howard’s son. “There were only three main existing ones that were very old and they all had a number of negative aspects. In 2004, I came across the substance we now call Citrox and immediately started thinking about its benefits from a dental point of view.”

Howard spent the following thirteen years trying to understand exactly what the bioflavonoid does and what makes it such a potent antibacterial. The first purely Citrox-based mouthwashes followed shortly afterwards and proved to work amazingly well. Shortly before his death, Howard updated the formulas and presented them to Christoph, who perfected them and developed the Perio Plus+ product series.

In memory of Howard Thomas

“During the Perio Plus+ project, I mostly worked with Howard, and I have always experienced the collaboration as very exciting, instructive and constructive,” Christoph says. “Howard had already studied a variety of Citrox’ features and applications, so needless to say, he had an incredible wealth of experience. From him I received three basic formulations for the mouthwash, the gel and the toothpaste, which I then expanded to a total of six recipes and adapted to our needs, such as a pleasant taste. Also, the combination of Citrox and polylysine, another natural antibacterial, keeps Citrox in the mouth for a longer period of time, and actively prevents irritation, a common side-effect of purely chlorhexidine-based products. There is still a lot of Howard’s approach in the formula, if not mostly his, and his formulations are the basis for the whole Perio Plus+ range we now have.”

Christoph Fiolka, developer of the final formulation of the Perio Plus+ product series. (Photograph: Curaden)

A natural alternative

With a move towards more natural products in the market, Citrox sets a new gold standard. “The substance is sourced from bitter oranges, which people have been using as food for centuries,” Christoph explains. “This means that people have already gotten used to the ingredients and no side effects are expected.” As subsequent cytotoxicity studies have shown, this is exactly the case. What’s more, there seems to be no resistance to the product range, which makes the introduction of Citrox even more exciting, as it could theoretically limit the use of antibiotics and the rampant problem of antibiotic resistance.

“Citrox ticks all the boxes”

“Apart from being all-natural, organic and hypo-allergenic, the beauty of Citrox is that it is very effective at killing bacteria at very low levels,” Richard said. “Citrox ticks all the boxes. Most importantly, it has the amazing ability to break down biofilm, the beginning of all oral disease.” As a result, Citrox, combined with chlorhexidine, is more effective than chlorhexidine on its own. Take plaque for example—bacteria hide in plaque. Citrox breaks down the biofilm and the remaining bacteria are left exposed to the chlorhexidine, which is why Perio Plus+ is more effective than any other antiseptic that only uses chlorhexidine. Or as Richard concludes: “It’s a double whammy”.