Effect of mixed chlorhexidine and hydrogen peroxide mouthrinses on developing plaque and stain in gingivitis patients: a randomized clinical trial.

AIMS: To evaluate the effects of mixed chlorhexidine (CHX)/hydrogen peroxide (H2O2) mouthrinses compared with CHX mouthrinse alone on plaque, tooth stain, and gingivitis. MATERIALS AND METHODS: This study was a double-blind, randomized two group parallel experiment, using a 14-day non-brushing half-mouth model. The test group was randomly assigned to the mixed 0.12% CHX and 1.5% H2O2 mouthrinse, whereas the control group used 0.12% CHX. Sixty healthy volunteers were enrolled in the study and received scaling and polishing 2 weeks prior to the experiment and then rinsed with the allocated mouthrinses twice daily for 2 weeks. The plaque, stain, and gingivitis scores were evaluated and recorded by a calibrated investigator. RESULTS: Fifty-two subjects completed the study (CHX + H2O2n = 25/CHX n = 27). There were significant differences between the control and test groups for plaque index (CHX 0.64 ± 0.41 vs. CHX + H2O2 0.46 ± 0.36, p = 0.035) and stain intensity at proximal areas (CHX 0.26 ± 0.36 vs. CHX + H2O2 0.09 ± 0.14, p = 0.019) at the end of the experimental non-brushing side. However, the gingival indices did not differ significantly (CHX 0.61 ± 0.34 vs. CHX + H2O2 0.62 ± 0.31, p = 0.938) between groups. CONCLUSIONS: In the absence of oral hygiene practice, the mixed CHX + H2O2 mouthrinse was slightly superior in reducing plaque scores and stain compared with CHX alone. CLINICAL RELEVANCE: The clinical effectiveness of CHX + H2O2 is comparable with CHX mouthwash alone. Therefore, the use of the mixed mouthrinse is beneficial compared with CHX for minimizing biofilm and tooth staining.

Hydrogen peroxide masks the bitterness of chlorhexidine mouthwash without affecting its antibacterial activity.

BACKGROUND: Chlorhexidine (CHX) is an antiseptic mouthwash widely used as the gold standard for inhibiting plaque formation. However, the bitter taste of CHX limits patient compliance. We developed a 0.12% CHX and 1.5% hydrogen peroxide (H2O2) mouthwash that masked the bitter taste of CHX. This study evaluated the antibacterial activity and subject satisfaction of the developed mouthwash. MATERIALS AND METHODS: Three mouthwashes were used as follows: (1) a commercial 0.12% CHX mouthwash, (2) a prepared 0.12% CHX mouthwash containing 1.5% H2O2, and (3) a prepared 0.12% CHX mouthwash. A disc diffusion assay was performed to determine the antibacterial activity of each mouthwash against Porphyromonas gingivalis and Aggregatibacter actinomycetemcomitans. To assess subject satisfaction with each mouthwash, a satisfaction questionnaire was completed immediately after rinsing with each mouthwash. RESULTS: The antibacterial activities of the three mouthwashes were similar. Moreover, the questionnaire results revealed that the level of satisfaction was significantly higher for the 0.12% CHX/1.5% H2O2 mouthwash compared with the other mouthwashes. CONCLUSION: The 0.12% CHX/1.5% H2O2 mouthwash revealed a similar antibacterial activity as the CHX standard against periodontal disease pathogens. In addition, the subjects were more satisfied with the new formula compared with 0.12% CHX alone. These data suggest that the 0.12% CHX/1.5% H2O2 formulation is an alternative antibacterial mouthwash to avoid the unpleasant CHX side effects.