Antibacterial and Antiplaque Effects of a Novel, Alcohol-Free Oral Rinse with Cetylpyridinium Chloride

Abstract

Antimicrobial agents are commonly incorporated into hygiene products for the treatment and prevention of plaque and gingivitis. Recently, a new alcohol-free rinse containing 0.07% cetylpyridinium chloride (CPC) in a high bioavailable matrix (Crest Pro-Health Rinse) was introduced to provide antiplaque and antigingivitis benefits. This paper reviews results from an in vitro pre-clinical study and an in vivo clinical study evaluating the antibacterial and antiplaque benefits of this CPC rinse technology. In the in vitro experiment, a no-alcohol 0.065% high bioavailable CPC prototype rinse was evaluated for its hostility against a broad range of microorganisms commonly associated with plaque and gingivitis. The rinse demonstrated greater than 99% germ kill for all organisms tested individually as well as in whole saliva. The benefit of this antibacterial action on plaque inhibition was assessed in a clinical trial. A double-blinded, 3-period, 6-sequence crossover study was conducted evaluating the antiplaque effect of the novel 0.07% high bioavailable, alcohol-free CPC rinse versus a positive control (Listerine Cool Mint containing essential oils) and a negative control (placebo CPC rinse). A modification of the Addy 4-day plaque model was used for this evaluation. Plaque was measured at baseline (Day 1) of each treatment period and at Day 4 using the Turesky modification of Quigley-Hein index. During the treatment period, subjects brushed only their lingual surfaces twice daily for up to 60 seconds. Following brushing, subjects used 20 mls of the mouthrinse product for 30 seconds in the morning and evening. Fifty-five subjects completed the study. For non-brushed sites, both the essential oils and CPC rinse exhibited a 25% reduction in plaque vs. placebo after four days of product usage, which was statistically significant (p < 0.0001). Both treatments also exhibited a statistically significant benefit versus placebo (p<0.0001) for brushed sites (>38% plaque reduction). These data support the antibacterial action of the high bioavailable, alcohol-free CPC rinse and demonstrate antiplaque effects for Crest Pro-Health Rinse that are "at least as good as" the leading essential oils antiseptic, making it well-suited for a broad range of patients, particularly those who are sensitive to products containing alcohol.