Long-term efficacy of a 0.07% cetylpyridinium chloride mouth rinse in relation to plaque and gingivitis: a 6-month randomized, vehicle-controlled clinical trial.

OBJECTIVE: To evaluate the effectiveness of 0.07% cetylpyridinium chloride (CPC) mouth rinse for reduction of gingival inflammation and inhibition of plaque compared to a vehicle control (VC) mouth rinse over a 6-month period. MATERIALS & METHODS: Participants (n = 62) used their randomly assigned product as adjunct to toothbrushing. Bleeding, plaque and staining scores were assessed at baseline, 3 and 6 months. Plaque and saliva samples were taken at each assessment monitoring possible shifts in the composition of the microbiota. RESULTS: A significant difference (P = 0.002) in favour of the CPC mouth rinse, with respect to plaque scores, was found. Bleeding scores at 6 months were not significantly different (P = 0.089). However, when correcting for baseline values, a tendency towards a significant difference in bleeding scores at end trail was observed in favour of the CPC mouth rinse (P = 0.061). Regarding staining at 3 and 6 months, a small but significant difference (8.6% and 10.4%, respectively) (P < 0.0001) was observed with lower scores for the VC group. There was a significant reduction in total anaerobic count in the CPC group at 6 months (P < 0.05). The ratio of aerobes/anaerobes was markedly increased at 3 months, especially in the CPC group. No further differences were observed between groups at 6 months. CONCLUSIONS: The use of 0.07% CPC mouth rinse was significantly more effective in reducing plaque scores than the vehicle control. Bleeding scores were not different at 6 months. The test product was well accepted and did not cause any serious clinical side effects or negatively affected the microbiota.

The effect of an essential-oils mouthrinse as compared to a vehicle solution on plaque and gingival inflammation: a systematic review and meta-analysis.

OBJECTIVE: The purpose of this review was to systematically evaluate the effects of an alcohol vehicle solution (V-Sol) compared with an essential-oils mouthwash (EOMW) and if available with a water-based control (WC) on plaque, gingival inflammation parameters and extrinsic tooth staining. MATERIALS AND METHODS: The PubMed-MEDLINE, Cochrane-CENTRAL and EMBASE databases were searched. Where appropriate, a meta-analysis was performed, and difference of means (DIFFM) as calculated. RESULTS: In total, 971 unique papers were found of which five met the eligibility criteria. The DIFFM of the meta-analysis of four 6-month studies showed that the EOMW provided significantly better plaque control (DIFFM = 0.39, P < 0.00001) and gingival inflammation reduction as measured by the Löe and Silness Index (DIFFM = 0.36, P = 0.00001) as compared to the V-Sol. Regarding extrinsic tooth staining, a small but significant difference (DIFFM = -0.08, P = 0.03) was observed. CONCLUSION: Limited data, but with a low risk of bias, were available to assess the potential benefit of the alcohol-containing V-Sol. 'High'- and 'moderate'-quality data were available for the analysis of plaque and gingivitis, respectively. Within these limitations, EOMW appears to provide a significant oral health benefit during the 6 months of use. The data retrieved for this review suggest that the essential oils produce an effect on plaque and gingivitis that extends beyond the V-Sol. Furthermore, the V-Sol proved to be no different from a WC.

Essential oils compared to chlorhexidine with respect to plaque and parameters of gingival inflammation: a systematic review.

BACKGROUND: The purpose of this review is to systematically evaluate the effects of an essential-oil mouthwash (EOMW) compared to a chlorhexidine mouthwash with respect to plaque and parameters of gingival inflammation. METHODS: PubMed/MEDLINE and Cochrane CENTRAL databases were searched for studies up to and including September 2010 to identify appropriate articles. A comprehensive search was designed, and the articles were independently screened for eligibility by two reviewers. Articles that evaluated the effects of the EOMW compared to chlorhexidine mouthwash were included. Where appropriate, a meta-analysis was performed, and weighted mean differences (WMDs) were calculated. RESULTS: A total of 390 unique articles were found, of which 19 articles met the eligibility criteria. A meta-analysis of long-term studies (duration ≥ 4 weeks) showed that the chlorhexidine mouthwash provided significantly better effects regarding plaque control than EOMW (WMD: 0.19; P = 0.0009). No significant difference with respect to reduction of gingival inflammation was found between EOMW and chlorhexidine mouthwash (WMD: 0.03; P = 0.58). CONCLUSION: In long-term use, the standardized formulation of EOMW appeared to be a reliable alternative to chlorhexidine mouthwash with respect to parameters of gingival inflammation.