ABSTRACT
Bacterial plaque is the most important factor in periodontal diseases and plaque control is effective in the prevention of periodontitis. Mechanical plaque control is the most reliable method in plaque reduction but because insufficient mechanical plaque control is usually performed by most patients, chemical plaque control beside mechanical plaque control is more desirable. Several chemical agents for chemical plaque control are used and chlorhexidine is the most effective agent in chemical plaque control and it causes plaque and gingival inflammation reduction. However, chlorhexidine side effects, the most common of which being tooth staining and dorsal tongue staining, are the main factors in inadequate compliance among patients. Scientists suggest the use of oxidating mouthrinses such as hydrogen peroxide and carbamide peroxide for reduction of chlorhexidine staining. The purpose in this study was to compare the induced stain and plaque and gingivitis reduction between chlorhexidine alone and hydrogen peroxide as adjunct to chlorhexidine. In this interventional Study, 30 patients with mild to moderate gingivitis referred to periodontic clinic of Mashhad Dental School [26 males, 4 females], were randomly assigned in a double-blind, 2 group parallel design study. At the beginning of the study, all subjects received scaling and root planing and polishing. After two weeks, PI, GI, and GBI were examined. Gluconate chlorhexidine 0.2% mouhrinse was prescribed for control group to be used for 30 seconds twice a day for 14 days. Subjects in the test group rinsed their mouth with hydrogen peroxide 1.5% for 30 seconds prior to chlorhexidine use twice a day for 14 days. During the study, the patients refrained from brushing. After 14 days, PI, GI, GBI and stain index were recorded again for both groups.The data were statistically analysed by t-test using SPSS 10 software. PI scores for both groups were approximately equal at the end of study. GI and GBI scores were also approximately equal at the end of the study however, reduction in these scores was slightly greater for the control group. The residual inflammation in the test group might be attributed to the used of hydrogen peroxide. The considerable reduction in both severity and extend of staining score in body region in test group was significantly lower than control group but there was no significant difference between two groups in stain severity scores in gingival region. We conclude that use of hydrogen peroxide prior to chlorhexidine may cause significant reduction in tooth staining. Moreover, hydrogen peroxide does not have negative effects on plaque and gingivitis reduction ability of chlorhexidine