The effect of chlorhexidine (CHX) with or without an anti-discoloration system (ADS) on the development of experimental gingivitis in man

Abstract

Background: Chlorhexidine (CHX) is the most effective antiseptic mouthwash known and yet, side effects such as tooth discolorations and bitter taste exist. A new product of CHX with an anti-discoloration system (ADS) was supposed to minimize these side effects while maintaining the antiseptic effects. The aim of this clinical trial was to evaluate the effectiveness of the CHX with and without an ADS on stains, plaque accumulation and gingivitis development. Material and Methods This double blinded RCCT included 26 healthy dental students. After a preparatory period (3 weeks) of professional prophylaxis and optimal tooth brushing, the participants were randomly assigned to one of three groups: Group P (Placebo), Group T1 (0.12% CHX without ADS) and Group T2 (0.12% CHX with ADS). During 3 weeks of abolished oral hygiene, the participants were asked to rinse with a mouthwash twice daily. Allocation was concealed until after the baseline examination. The clinical parameters were assessed on Days 0, 7, 14 and 21 and included the Discoloration Index (DI), the Plaque Index (PII) and Gingival Index (GI). Results All 26 participants completed the study with good compliance. At baseline, there were no significant differences for any parameters between any of the groups. Throughout the study, there were no significant differences in mean DI, PII or GI between group T2 and group P. However, significant differences in mean DI between group T2 and group T1 on Day 14 (0.19±0.15 vs. 0.87±0.56, p=0.007) and on Day 21 (0.21±0.17 vs. 1.13±0.59, p=0.001) were noted. Also, the mean PII between group T2 and group T1 on Day 7 (0.89±0.40 vs. 0.13±0.09, p<0.001), Day 14 (1.32±0.46 vs. 0.25±0.12, p<0.001) and on Day 21 (1.45±0.39 vs. 0.25±0.19, p<0.001) differed significantly. Likewise, significant differences were found in mean GI between group T2 and group T1 on Day 14 (0.71±0.39 vs. 0.14±0.10, p=0.002) and on Day 21 (1.12±0.41 vs. 0.18±0.19, p<0.001). Conclusions CHX with ADS appeared to be effective in preventing stain on teeth. However, the efficacy of preventing plaque accumulation and gingivitis development was greatly hampered by the addition of ADS. In fact, CHX mouthwash with ADS showed no superior effect over placebo on maintenance of oral hygiene or prevention of gingivitis.