Control Mouthwash Research Articles

Efficacy of a mouthwash containing 0.8% arginine, PVM/MA copolymer, pyrophosphates, and 0.05% sodium fluoride compared to a negative control mouthwash on dentin hypersensitivity reduction. A randomized clinical trial

ObjectiveThe objective of this eight week, single-center, two-cell, double-blind, and randomized clinical study was to evaluate the dentin hypersensitivity reduction efficacy of a mouthwash using Pro-Argin™ Mouthwash Technology containing 0.8% arginine, PVM/MA copolymer, pyrophosphates, and 0.05% sodium fluoride in an alcohol-free base (“Arginine Mouthwash”) compared to an ordinary mouthwash without any active ingredients (“Negative Control”). MethodsQualifying subjects who presented two hypersensitive teeth with a tactile hypersensitivity score between 10 and 50g of force, and an air blast hypersensitivity score of 2 or 3 participated in this study and were randomized into one of two treatment groups. Subjects brushed with the toothbrush and fluoride toothpaste provided and then rinsed with 20mL of their assigned mouthwash for 30s twice daily. Subjects refrained from eating or drinking for 30min after rinsing. Dentin hypersensitivity assessments, as well as examinations of oral hard and soft tissues, were conducted at the baseline visit and again after two weeks, four weeks and eight weeks of product use. ResultsNinety (90) subjects entered and completed the eight week study. After two weeks, four weeks and eight weeks of product use, subjects in the Arginine Mouthwash group exhibited statistically significant (p<0.05) improvements in mean tactile and air blast hypersensitivity scores as compared to the Negative Control Mouthwash. ConclusionThe results of this study support the conclusion that the Arginine Mouthwash provides a significant reduction in dentin hypersensitivity after eight weeks of product use as compared to a Negative Control mouthwash.

The development of a new desensitising mouthwash containing arginine, PVM/MA copolymer, pyrophosphates, and sodium fluoride—A hydraulic conductance study

ObjectiveTo investigate the ability of a novel mouthwash comprised of 0.8% arginine, PVM/MA copolymer, pyrophosphates, and 0.05% sodium fluoride in an alcohol-free base (Pro-Argin™ Mouthwash Technology) to reduce dentine permeability. MethodsHydraulic conductance was used to assess the dentine permeability effects of the arginine mouthwash. Aqueous solutions containing arginine and PVM/MA copolymer were studied in the initial stage of the method development. The acid resistance was tested with a cola drink challenge. Finally, a blinded study was carried out to determine the occlusion of the arginine mouthwash in comparison to a negative control mouthwash. ResultsDentine discs treated with the arginine mouthwash showed an average fluid reduction of 42%, which was statistically, significantly better than the fluid reduction for the negative control mouthwash. In addition, experiments using simple solutions of arginine and PVM/MA copolymer, alone and in combination, demonstrated that the combination of the two was required to provide a relevant occlusion benefit. Finally, the occlusion provided by the arginine mouthwash was maintained after exposure to an acid challenge. ConclusionThe exclusive combination of ingredients in the arginine mouthwash has been proven to be efficacious in decreasing dentine fluid flow as measured by hydraulic conductance. The new mouthwash works by occlusion, due to the unique combination of arginine, PVM/MA copolymer and pyrophosphates.

Evaluation of Calendula officinalis as an anti-plaque and anti-gingivitis agent

Background:Calendula officinalis (C. officinalis), commonly known as pot marigold, is a medicinal herb with excellent antimicrobial, wound healing, and anti-inflammatory activity.Aim:To evaluate the efficacy of C. officinalis in reducing dental plaque and gingival inflammation.Materials and Methods:Two hundred and forty patients within the age group of 20-40 years were enrolled in this study with their informed consent. Patients having gingivitis (probing depth (PD) ≤3 mm), with a complaint of bleeding gums were included in this study. Patients with periodontitis PD ≥ 4 mm, desquamative gingivitis, acute necrotizing ulcerative gingivitis (ANUG), smokers under antibiotic coverage, and any other history of systemic diseases or conditions, including pregnancy, were excluded from the study. The subjects were randomly assigned into two groups – test group (n = 120) and control group (n = 120). All the test group patients were advised to dilute 2 ml of tincture of calendula with 6 ml of distilled water and rinse their mouths once in the morning and once in the evening for six months. Similarly, the control group patients were advised to use 8 ml distilled water (placebo) as control mouthwash and rinse mouth twice daily for six months. Clinical parameters like the plaque index (PI), gingival index (GI), sulcus bleeding index (SBI), and oral hygiene index-simplified (OHI-S) were recorded at baseline (first visit), third month (second visit), and sixth month (third visit) by the same operator, to rule out variable results. During the second visit, after recording the clinical parameters, each patient was subjected to undergo a thorough scaling procedure. Patients were instructed to carry out regular routine oral hygiene maintenance without any reinforcement in it.Results:In the absence of scaling (that is, between the first and second visit), the test group showed a statistically significant reduction in the scores of PI, GI, SBI (except OHI-S) (P < 0.05), whereas, the control group showed no reduction in scores when the baseline scores were compared with the third month scores. Also, when scaling was performed during the third month (second visit), there was statistically significant reduction in the scores of all parameters, when the third month scores were compared with the sixth month scores in both groups (P < 0.05), but the test group showed a significantly greater reduction in the PI, GI, SBI, and OHI-S scores compared to those of the control group.Conclusion:Within the limits of this study, it can be concluded that calendula mouthwash is effective in reducing dental plaque and gingivitis adjunctive to scaling.

Efficacy of essential oil mouthwash with and without alcohol: a 3-Day plaque accumulation model

BackgroundThe aim of this study was to evaluate the antiplaque effect of a new alcohol free essential oil mouthwash with respect to a control of an essential oil with alcohol mouthwash, using an in vivo plaque regrowth model of 3-days.MethodsThe study was designed as a double-masked, randomized, crossover clinical trial, involving 30 volunteers to compare two different essential oil containing mouthwashes, during a 3-day plaque accumulation model. After receiving a thorough professional prophylaxis at the baseline, over the next 3-days each volunteer refrained from all oral hygiene measures and had two daily rinses with 20 ml of the test mouthwash (alcohol free essential oil) or the control mouthwash (essential oil with alcohol). At the end of the each experimental period, plaque was assessed and the panelists filled out a questionnaire. Each subject underwent a 14 days washout period and there was a second allocation.ResultsThe essential oil mouthwash with ethanol shows a better inhibitory effect of plaque regrowth in 3-days than the mouthwash test with only essential oil in the whole mouth (plaque index = 2.18 against 2.46, respectively, p < 0.05); for the lower jaw (plaque index = 2.28 against 2.57, respectively, p < 0.05); for the upper jaw (plaque index = 2.08 against 2.35, respectively, p < 0.05); for the incisors (plaque index = 1.93 against 2.27, respectively, p < 0.05); and the canines (plaque index = 1.99 against 2.47, respectively, p < 0.05).ConclusionThe essential oil containing mouthwash without alcohol seems to have a less inhibiting effect on the plaque regrowth than the traditional alcoholic solution.Trial RegistrationClinicalTrials.gov NCT01411618

The effects of hydrogen peroxide mouthwashes on the prevention of plaque and gingival inflammation: a systematic review

The purpose of this review was to describe systematically the effects of hydrogen peroxide mouthwashes as an adjunct to daily oral hygiene or as a mono-therapy in the prevention of plaque accumulation and gingival inflammation. PubMed-MEDLINE and the Cochrane-CENTRAL were searched up to December 2009 to identify appropriate papers. The primary outcome measures included plaque accumulation and parameters of gingivitis. Independent screening of titles and abstracts of 229 articles resulted in 10 publications that met the criteria for eligibility. Descriptive comparisons are presented for hydrogen peroxide mouthwash as compared with control mouthwashes or no oral hygiene. Mean values and standard deviations were obtained by data extraction. Based on a quality assessment, three studies, of which one evaluated H(2)O(2) over a period of 6 months, were considered to represent a low risk of bias. This 6-month study showed a positive effect of the use of H(2)O(2) on the modified gingival index. The results of the studies included in this review showed that H(2)O(2) mouthwashes do not consistently prevent plaque accumulation when used as a short-term mono-therapy. When used as a long-term adjunct to daily oral hygiene, the results of one study indicate that oxygenating mouthwashes reduce gingival redness.

The effect of hexetidine mouthwash on the prevention of plaque and gingival inflammation: a systematic review

To review the literature concerning hexetidine-containing mouthwash as a monotherapy or as an adjunct to oral hygiene in the prevention of plaque accumulation and gingival inflammation. PubMed-MEDLINE and the Cochrane-CENTRAL were searched through January 2010 to identify appropriate studies. The primary outcome measurements were plaque accumulation and gingivitis parameters. Independent screening of titles and abstracts of 168 papers resulted in six publications that met the eligibility criteria. Mean values and standard deviations were obtained by data extraction. Descriptive comparisons are presented for hexetidine mouthwash and control mouthwashes (chlorhexidine and placebo). Considering the potential benefits in the light of the observed side effects, hexetidine appears to be a poor alternative to chlorhexidine.

Chlorhexidine with an anti discoloration system after periodontal flap surgery: a cross‐over, randomized, triple‐blind clinical trial

The use of chlorhexidine (CHX) has been recommended for a number of clinical applications including plaque control in the post-operative period. However, the use of CHX is burdened by some side effects that could affect the compliance of the patient. The aim of this clinical trial was to evaluate the side effects, the staining in particular, the patient acceptance, and the efficacy of a 0.2% CHX mouthwash containing an anti discoloration system (ADS) compared with a 0.2% CHX alone, after periodontal flap surgery. This single-centre, cross-over, triple-blind randomized clinical trial was carried out on 48 consecutive patients. After periodontal flap surgery, the patients were prescribed to rinse two times per day for 1 min for 1 week with 10 ml of test or control CHX, contained in anonymous bottles coded K or M and assigned randomly. No brushing and interdental cleaning of the surgical area was allowed. At week 1, after suture removal, patients received full-mouth prophylaxis and were given a second anonymous bottle, reversing the products, with the same instructions as at baseline. Patients resumed tooth-brushing but not interdental cleaning. At the end of week 2, prophylaxis was repeated, mouth rinsing was discontinued and patients resumed normal oral hygiene. At weeks 1 and 2, the following variables were recorded: presence of pigmentation, gingival parameters at the surgically treated sites (gingival inflammation, tissue inflammation around the sutures, gingival swelling and presence of granulation tissue), patient perception and acceptance of the 2 mouthwashes. Forty-seven patients completed the study. The difference between treatments related to gingival variables was not statistically significant. The test CHX caused consistently less pigmentations than the control CHX in all the evaluated areas of the dental surfaces (odds ratio (OR)=0.083 p<0.0001 in the incisal area, OR=0.036 p<0.0001 in the approximal area and OR=0.065 p<0.0001 in the gingival area). The CHX ADS was found to be more tolerated by patients than the control mouthwash and to cause less food alteration, less alterations to the perception of salt and to be less irritant for the oral tissues. (1) CHX ADS caused less pigmentation, was burdened by less side effects and was more agreeable than the control CHX; (2) CHX ADS was as effective as CHX without ADS in reducing gingival signs of inflammation in the post-surgical early healing phase; (3) the use of CHX ADS could be of value in treatment protocols in which the patient compliance with a CHX mouthwash prescription is relevant.

The Effect of German Chamomile Mouthwash on Dental Plaque and Gingival Inflammation

Dental plaque is a well known etiologic factor for gingivitis. Recently, herbal extracts are a matter of scientific interest to inhibit plaque accumulation on teeth. The purpose of this study was to evaluate the effects of German Chamomile (GC) mouth wash on plaque and gingival indices. Twenty five gingivitis patients (15 female and 10 male, mean age 27±7.76 years) participated in this controlled, double blind cross-over study. The subjects used either GC or a control rinse for 2 min twice a day during a 4 weeks period. The other mouth rinse was used after a wash-out period of 4 weeks in the same way. The plaque and gingival indices were recorded at baseline and after each experimental or wash-out period. Furthermore, stain indices for intensity and extend were recorded to evaluate the tooth staining effects of the mouthrinses. The mean reduction in plaque and gingival scores were determined by using the test or control mouthwash and statistically analyzed by paired sample t- test. The stain intensity and extend in each period of the study were also analyzed by the two-way ANOVA. The GC mouthwash lowered both plaque and gingival scores significantly in comparison to the control rinse (p≤0.001), whilst there was no significant difference in stain intensity or extend between the baseline and after each period of the study. There was also no report of any adverse reactions during the use of mouth rinses in this the study. Using GC mouthwash appears to offer benefit in plaque and gingival reduction without any significant adverse effects on tooth staining.

Formation of nitrosamines during consumption of nitrate- and amine-rich foods, and the influence of the use of mouthwashes.

We studied the formation of carcinogenic nitrosamines during consumption of food rich in nitrate and amines, and its possible inhibition by use of an antibacterial mouthwash. Twelve volunteers were fed a diet containing the high-nitrate vegetables lettuce or spinach during two periods of four consecutive days, in combination with fish products containing high levels of amines as nitrosatable precursors. During the two periods, the subjects used an antibacterial mouthwash containing chlorhexidine or a control mouthwash without antibacterial activity. Twenty-four-hour urine samples were collected after consumption of the meals, and saliva samples were collected 1 h after each meal. The nitrate and nitrite contents of the urine and saliva samples were determined by spectrophotometry (for nitrite) and HPLC (for nitrate). The concentrations of volatile nitrosamines in the urine samples were determined by gas chromatography-mass spectrometry. Significant increases in mean urinary nitrate levels (from 59 to 135 mg/24 h) and in mean salivary nitrate levels (from 10 to 56 microg/ml) and salivary nitrite levels (from 2 to 11 microg/ml) were observed during the consumption of food rich in nitrate and amines, as well as a significant increase in the mean urinary excretion of total examined volatile nitrosamines (from 2 to 7 nmol/24 h) and of N-nitrosodimethylamine (from 1.2 to 2.9 nmol/24 h). Use of the antibacterial mouthwash resulted in a decrease in mean salivary nitrite levels from 16 to 3 microg/ml and a decrease in mean urinary excretion of N-nitrosomorpholine (from 7.0 to 0.3 nmol/24 h). For the whole data set, significant correlations were observed between nitrate intake in food and urinary nitrate (p = 0.01; r2 = 0.07) and between urinary nitrate and urinary N-nitrosodimethylamine (p = 0.002; r2 = 0.11). In conclusion, consumption of a diet rich in nitrate and amines increases the risk of formation of carcinogenic nitrosamines. Use of an antibacterial mouthwash containing chlorhexidine can result in inhibition of nitrosamine formation.

Hibitane in the treatment of aphthous ulceration

In the absence of a known aetiology the management of recurrent aphthous ulceration is symptomatic with the removal of predisposing factors where possible. Since the severity and duration of ulcers may be increased by bacterial contamination, the effect of chlorhexidine gluconate in mouthwash and gel forms on the natural history of the condition has been studied. The mouthwash study employed a 0.2% chlorhexidine gluconate solution, a 0.5% astringent solution and a control mouthwash. Each mouthwash was used by all of the patients, with 5 ml of each preparation being diluted with 5 ml of water for use three times a day. The gel study employed a 1% chlorhexidine gluconate and a placebo gel with approximately a 1 inch of the gel from the tubes being placed in the mouth three times a day. Both studies were carried out in the double-blind crossover manner with each preparation used for 5 weeks with a 2-week interval between preparations. In the mouthwash trial chlorhexidine gluconate significantly reduced the incidence, duration and severity of ulcers, whereas in the gel trial chlorhexidine significantly reduced the severity and duration but not the incidence of ulceration. Since the dosage regimes for chlorhexidine in the two studies were comparable, the mode of delivery would appear to be important in the therapeutic effectiveness.