Periodontal effects of 0.25% sodium hypochlorite twice‐weekly oral rinse. A pilot study

Abstract

The study aimed to evaluate the effect of 0.25% sodium hypochlorite twice-weekly oral rinse on plaque and gingivitis in patients with minimally treated periodontitis. The study included 30 patients with periodontitis, it lasted 3mo, and it was performed as a randomized, controlled, single-blinded, clinical trial in parallel groups. Fifteen patients rinsed for 30s with 15mL of a fresh solution of 0.25% sodium hypochlorite (test) and 15 patients rinsed with 15mL of water (control). Clorox(®) regular bleach was the source of the sodium hypochlorite. At baseline and at 2wk, the study patients received professional subgingival irrigation for 5min with either 0.25% sodium hypochlorite or water, but no subgingival or supragingival scaling. The presence or absence of supragingival plaque on facial and lingual surfaces was determined by visual inspection; each tooth was dried with air and mouth mirror rotation was used to provide light reflection to identify plaque on smooth surfaces and at the tooth line angles. Gingival bleeding within 30s after probing to full pocket depth was assessed in six sites of each tooth. Adverse events were evaluated by questionnaire and visual examination. All 30 patients in the study completed the baseline and the 2wk parts of the study and a subset of 12 participants completed the 3mo part of the study. The sodium hypochlorite rinse group and the water rinse group, respectively, showed increases from baseline to 3mo of 94% and 29% (3.2-fold difference) in plaque-free facial surfaces, of 195% and 30% (6.5-fold difference) in plaque-free lingual surfaces, and of 421% and 29% (14.5-fold difference) in number of teeth with no bleeding on probing. The differences in clinical improvement between the sodium hypochlorite rinse group and the water rinse group were statistically significant. No adverse events were identified in any of the study patients, except for minor complaints about the taste of bleach. A twice-weekly oral rinse with 0.25% sodium hypochlorite produced marked decreases in dental plaque level and bleeding on probing and may constitute a promising new approach to the management of periodontal disease. Long-term controlled studies on the effectiveness of sodium hypochlorite oral rinse are needed and encouraged.