Essential Oil Mouthrinse Research Articles

The effects of natural compounds‐containing mouthrinses on patients with fixed orthodontic appliance treatment: clinical and microbiological outcomes

To investigate the effects of two natural compounds-containing mouthrinses (NCCMs) (a fructus mume (FM) extract-containing mouthrinse and an essential oil (EO)-containing mouthrinse) on gingival health and microbial profiles in young orthodontic patients. This 6-month randomized, single-blinded, parallel-controlled clinical trial consists of 90 patients with fixed appliance treatment. The subjects were allocated to (1) negative control group: oral hygiene instruction (OHI) alone; (2) test group 1: OHI plus EO mouthrinse; and (3) test group 2: OHI plus FM mouthrinse. Clinical examinations included plaque index (PI), bleeding index (BI) and modified gingival index (MGI). Salivary microbial quantifications included total aerobic and anaerobic bacteria, Streptococci and Lactobacilli counts. Clinical and microbiological examinations were conducted at baseline, 3rd and 6th months (T1, T2, and T3). BI was significantly reduced in both the FM mouthrinse and EO mouthrinse groups compared with the negative control group at T3 (P < 0.05). There were no significant intergroup differences in salivary bacteria counts in all groups (P > 0.05). Both NCCMs effectively reduced gingival bleeding without causing significant alterations of microbial profile in young orthodontic patients.

A double‐blind randomized placebo‐controlled study on the clinical and microbial effects of an essential oil mouth rinse used by patients in supportive periodontal care

This 3-month double-blind randomized placebo-controlled study evaluated the clinical and microbial effects of an essential oil mouth rinse used as an adjunct to mechanical plaque control by patients in supportive periodontal care. Fifty patients were randomly allocated to an essential oil group (Listerine(®) Coolmint; Johnson & Johnson, New Brunswick, NJ, USA) or placebo group to rinse twice per day as an adjunct to mechanical plaque control. At baseline and after 3months, plaque index (PI), gingivitis index (GI), probing pocket depth, bleeding on probing (BoP) and clinical attachment level were registered. Subgingival plaque samples were collected for the detection and quantification of Aggregatibacter actinomycetemcomitans, Porphyromonas gingivalis, Tannerella forsythia, Treponema denticola, Micromonas micros, Prevotella intermedia, Fusobacterium genus and Streptococcus mutans by means of real-time PCR (qPCR). Patient's compliance, satisfaction and side effects were registered. Twenty-three patients in the essential oil group (mean age: 57) and 21 in the placebo group (mean age: 55) with acceptable oral hygiene at intake (mean PI <1.5 on a scale of 5) adhered to the study protocol. Gingivitis index, PI and BoP significantly reduced over time (P≤0.029); however, between group analyses revealed no significant differences. There was no significant change over time neither in detection frequency nor load for any of the microbiota. Daily rinsing with an essential oil rinse was found safe and perceived beneficial by the patients. Patients in supportive periodontal care who are fairly compliant with oral hygiene may not benefit from additional mouth rinsing using an essential oil solution.

Validation of the anti-bacteremic efficacy of an essential oil rinse in a Brazilian population: a cross-over study

This cross-over study was conducted to assess the germ-killing efficacy of an essential oil mouthrinse (EOM) by determining the blood levels of microorganisms associated with induced bacteremia and investigating the prevalence of this event in Brazilians with mild-to-moderate gingivitis. Thirty four (31.19%) subjects positive for bacteremia induced by chewing a ration of apple were enrolled out of 109 screened subjects (50 males and 59 females). A difference of at least 10 colony forming units between the pre- and post-insult blood samples was defined as a positive result. For the following two weeks patients underwent a toothbrush plus fluoride dentifrice normalization period, and were then scheduled for the Phase I protocol as follows. At baseline I, subjects were instructed to chew a new apple ration, had new blood samples taken before and after this oral stimulus, and were randomly assigned to an experimental essential oil (n = 17) or placebo (P) mouthrinse (n = 17) treatment for 2 weeks. These procedures were repeated at the end of Phase I and then followed by a two-week wash-out period (tooth brushing with fluoride dentifrice). Bacteremia was again induced at baseline and at the end of Phase II, when subjects were crossed-over to the other EOM or placebo groups. Bacterial count differences between baseline and 2-week post-treatment (EOM versus P) in the blood samples collected were assessed by analysis of covariance. Mean aerobic counts decreased by 45.8%, whereas mean anaerobic counts decreased by 63.3% after EOM treatment. After the P treatment, aerobic bacteria increased by 28.4% and anaerobic bacteria decreased by 18.5%. This study validated this novel methodology and showed that the germ-killing action of EOM significantly reduced bacteremia.

The effect of herbal, essential oil and chlorhexidine mouthrinse on de novo plaque formation

Brushing and flossing are the most widely accepted procedures, the 'gold standard', for controlling bacterial plaque, but these mechanical methods have limitations. Based on results derived from several clinical trials, essential oil (EO) mouthrinse (Listerine(®)) and a chlorhexidine mouthrinse have been accepted by ADA to be used as an adjunct to routine mechanical oral hygiene measures however, both of them are associated with side effects, therefore, the present study was undertaken to evaluate the antiplaque efficacy of a new herbal formulation as compared to an EO and chlorhexidine rinse. The study was a single blind parallel randomized controlled trial involving four groups. 48 volunteers refrained from all oral hygiene measures for 4 days, but rinsed instead twice daily with 10 ml of a herbal (HM), EO, chlorhexidine (CHX) or a placebo (PL) solution. Plaque index and plaque area (PA) was assessed on Day 4. The HM and EO showed a significant inhibition of plaque regrowth compared to PL (P<0.001), but the lowest values of PI and PA were obtained with CHX. Statistically significant difference in plaque parameters was observed when CHX was compared to HM and EO, and HM to EO rinse. The new herbal mouthrinse had a promising plaque inhibitory potential but it not as efficacious as chlorhexidine in preventing plaque regrowth.

A randomised crossover trial to compare the potential of stannous fluoride and essential oil mouth rinses to induce tooth and tongue staining

A randomised crossover trial to compare the potential of stannous fluoride and essential oil mouth rinses to induce tooth and tongue staining

A randomised crossover trial to compare the potential of stannous fluoride and essential oil mouth rinses to induce tooth and tongue staining

This study compared the staining potential of two experimental amine fluoride/stannous fluoride mouth rinses (A and B), a phenolic/essential oil rinse (C) and a negative control, water, rinse (D). The study was a single centre, randomized, single-blind, four treatment crossover study design among healthy participants. Prior to each study period, participants received a dental prophylaxis. On the Monday of each period, subjects suspended oral hygiene, and under supervision, rinsed with the allocated mouth rinse immediately followed by a warm black tea solution at hourly intervals eight times a day for 4 days. On Friday, the area and intensity of staining on the teeth, the primary outcome measure and dorsum of tongue were assessed. This regimen was repeated for all the three subsequent treatment periods. Rinse B produced less stain than rinse A, but the difference was not significant (p = 0.20). Rinse B produced significantly more stain than rinse C (p < 0.05) and D (p < 0.001). For tongue staining, rinse B produced significantly more staining than D (p < 0.01) but not A or C. Overall, all test rinses produced more staining than placebo with an overall pattern for more staining with stannous formulations. Individuals using stannous or phenolic/essential oil mouth rinse formulations should be advised of the possible staining side effect and that this can be easily removed by a professional dental cleaning.

Evaluation of two mouth rinses in reduction of oral malodor using a spectrophotometric technique

Background:Various mouth rinses have been used in the treatment of halitosis, but most of the evidence for the efficacy of mouth rinses is anecdotal. In the present study, 0.2% chlorhexidine rinse and an essential oil mouth rinse are compared for their efficacy in reducing the breath mercaptan levels.Materials and Methods:Fifteen patients with the chief complaint of oral malodor were randomly divided into 3 groups and were provided with the respective mouth rinses. Pre rinsing measurements were performed on the Day 1 and no other periodontal treatment was instituted. Post rinsing estimation of mercaptan levels was performed after 7 days.Results:When comparing chlorhexidine with the essential oil mouth rinse, the reduction in VSCs was highly significant in the chlorhexidine group (P<0.01). However, the reduction in the organoleptic scores was not significant among the two groups. Organoleptic scores showed very highly significant correlations with the VSC concentrations measured by the spectrophotometric method.Conclusion:The spectrophotometric technique employed in this study appears to be a promising new method for evaluation of oral malodor. Chlorhexidine still appears to be the agent of choice as a short term regimen in cases of oral malodor.

An investigation of the effect of an essential oil mouthrinse on induced bacteraemia: a pilot study

This pilot study was designed to assess the effect of an essential oil antiseptic mouthrinse (EOM) in reducing bloodstream bacteria after chewing an apple. From a panel of 200, we screened 62 individuals with mild-to-moderate gingivitis. Twenty-two individuals who showed a bacteraemia after chewing an apple were enrolled. Subjects were recalled, instructed to chew an apple, had blood drawn (first baseline), and were randomly assigned EOM or a control (C) treatment for 2 weeks. Subjects were recalled, given an apple, and had blood taken for bacterial counts. Following a 1-week fluoride dentifrice wash-out, subjects were recalled, given the apple challenge, had blood drawn (second baseline), assigned the alternate treatment, and recalled for testing. Differences between baseline and 2-week post-treatment (EOM versus C) in blood-borne bacteria were assessed by analysis of covariance. Mean aerobic blood-borne bacteria decreased by 68.5% (17.7 viable counts from baseline; p<0.001), while anaerobic counts decreased by 70.7% (14.5 mean viable counts from baseline; p<0.001) for the EOM treatment. No reduction was seen for the C treatment. This double-blind, placebo-controlled, randomized, 2-week cross-over study showed that rinsing with essential oils reduced the level of bloodstream bacteria in subjects with mild-to-moderate gingivitis.

In-vitro evidence for efficacy of antimicrobial mouthrinses

Objective The objective of this study was to compare the antimicrobial activity of commercially available antiseptic mouthrinses against saliva-derived plaque biofilms in static and flow-through biofilm systems in vitro. Methods Nine mouthrinses were tested in a recirculating flow-through biofilm model (RFTB) with viability assessment by ATP bioluminescence. In addition, five mouthrinses were evaluated in a batch chamber slide biofilm (BCSB) model, using live/dead staining and confocal laser scanning microscopy. Results In the RFTB model, essential oil (EO) and chlorhexidine (CHX)-containing rinses showed equivalent antimicrobial activity and were more effective than a range of cetyl pyridinium chloride (CPC1) formulations. In the BCSB model, twice-daily mouthrinse exposure demonstrated that the EO rinse was significantly more effective than rinses containing amine and stannous fluorides (AFSF), a combination of CPC/CHX, and another CPC formulation (CPC2). EO showed biofilm kill comparable to the CHX rinse. Conclusions The present studies have shown that mouthrinses vary significantly in their capability to kill plaque biofilm bacteria in BCSB and RFTB models. The EO mouthrinse demonstrated superior antiplaque biofilm activity to AFSF, CPC/CHX, and CPC rinses and comparable activity to CHX. The methods tested may be of value for the in-vitro screening of antiseptic rinses with different modes of antimicrobial action.

Comparison of the effectiveness of essential oil mouthrinse and interdental brush in patients with fixed orthodontic appliances

The objective of this study was to compare the effectiveness of essential oil mouthrinse and interdental brush for oral hygiene in orthodontic patient. 90 patients, with fixed orthodontic appliances, were divided into 3 groups(Group 1: patients who had only used toothbrush, group 2: toothbrush + essential oil mouthrinse, group 3: toothbrush + interdental brush). Then, plaque index(PI) and gingival index(GI) were evaluated at before(T0), 3 weeks after(Tl) and 6 weeks after(T2) the experiment. The present study revealed the following conclusions: (1) There was statistically significant decrease in PI and GI of groups 2 and 3 comparing to those of group 1 during 6 weeks.(p&lt;0.05) (2) There was no significant difference in the level of decrease in PI and GI between group 2 and group 3.(p&lt;0.05) The present study thus implied that use of mechanical or chemical aid such as interdental brush and mouth rinse in addition to toothbrushing may help maintaining oral hygiene in patients undergoing fixed orthodontic treatment for prolonged duration.

Comparative effect of an essential oil mouthrinse on plaque, gingivitis and salivary Streptococcus mutans levels: a double blind randomized study

An open, randomized, controlled study with two parallel treatment groups was done to evaluate the efficacy of a Lippia sidoides essential oil (EO) 1% mouthrinse compared with chlorhexidine 0.12% mouthrinse, applied two times daily for 1 week, in the treatment of dental plaque and gingivitis. Fifty-five patients were included in the study. The efficacy variables were the colony count of Streptococcus mutans from the stimulated saliva and periodontal indices on days 0, 7 and 30 after commencement of therapy. Twenty eight patients received chlorhexidine mouthrinse (Periogard((R))) and 27 Lippia sidoides essential oil mouthrinse (Cepakill((R))). The clinical and microbiological parameters were significantly reduced by both mouthrinses. No significant difference was seen between the two groups (p > 0.05). There was a significant reduction in the colony count of S. mutans in both groups (p < 0.05). Chlorhexidine treatment reduced more efficiently than L. sidoides, however, no statistical difference was seen, the efficacy of both groups was similar (p = 0.3). The results indicate that Chlorhexidine mouthrinse reduced plaque index, gingival bleeding and the number of CFU (colonies forming units) more efficiently than L. sidoides but did not reach statistical significance. This study demonstrated that Lippia sidoides EO mouthrinse is effective in reducing microbial plaque and gingival inflammation.

Essential oil mouth rinse reduces pathogens

Essential oil mouth rinse reduces pathogens

Uncontrolled Randomized Clinical Trial Demonstrates Similar Long-Term (6 months) Antigingivitis and Antiplaque Efficacy for 2 Mouth Rinses: One that Uses Cetylpyridinium Chloride (CPC) as an Active Agent and the Other that Uses Essential Oils (EO) as an Active Agent

Article Title and Bibliographic Information Comparison of the effects of cetylpyridinium chloride with an essential oil mouth rinse on dental plaque and gingivitis—a six-month randomized controlled clinical trial Albert-Kiszely A, Pjetursson BE, Salvi GE, Witt J, Hamilton A, Persson GR, et al. J Clin Periodontol 2007;34(8):658-67 Level of Evidence 2 Purpose/Question The purpose of this study was to compare the long-term (6 months) clinical and microbiological effects of an experimental CPC mouth rinse with that of a commercially available and widely used EO mouth rinse in an unsupervised, uncontrolled 6-month randomized clinical trial. Source of Funding This study was supported by a grant from the manufacture of the experimental CPC mouth rinse, Procter & Gamble Company (Mason, OH), and by the Clinical Research Foundation (CRF) for the Promotion of Oral Health, University of Berne, Switzerland. Type of Study/Design This is a parallel randomized 2-group study that had no negative control.

Antimicrobial Effectiveness of an Herbal Mouthrinse Compared With an Essential Oil and a Chlorhexidine Mouthrinse

The authors investigated mouthrinses' antimicrobial effectiveness against predominant oral bacteria, as determined by the minimum inhibitory concentration (MIC). Specifically, they evaluated an herbal mouthrinse, an essential oil rinse and a 0.12 percent chlorhexidine gluconate rinse. The authors assessed the inhibitory effects of the three test agents against 40 oral bacteria at concentrations of 1, 2, 4, 8, 16, 32, 64, 128, 256 and 512 micrograms per millliter. They inoculated plates containing basal medium and the test agents with suspensions of the test species and incubated them anaerobically at 35 degrees C. The authors interpreted the MIC as the lowest concentration of the agent that completely inhibited the growth of the test species. The herbal mouthrinse inhibited the growth of most of the 40 test species. Compared with the essential oil mouthrinse, the herbal mouthrinse exhibited significantly lower MICs for Actinomyces species, periodontal pathogens Eubacterium nodatum, Tannerella forsythia and Prevotella species, as well as the cariogenic pathogen Streptococcus mutans. The chlorhexidine gluconate rinse had the lowest MICs compared with the essential oil rinse and the herbal rinse for all test species examined. Although less potent than the chlorhexidine gluconate rinse, the herbal rinse was more effective than the essential oil rinse in inhibiting the growth of oral bacteria in vitro. The data suggest that the herbal mouthrinse may provide oral health benefits by inhibiting the growth of periodontal and cariogenic pathogens. In vivo clinical testing is essential to confirm in vitro results.

Effectiveness of an Essential Oil Mouthrinse in Improving Oral Health in Orthodontic Patients

To test the null hypothesis that adding Listerine mouthrinse to the standard oral hygiene regimen has no added benefit for orthodontic patients in maintaining proper oral health. Patients within their first 6 months of orthodontic treatment were assigned either to the brushing + flossing (N = 25) or brushing + flossing + Listerine (N = 25) group. Initially, all of the participants received a prophylaxis and instructions on how to brush and floss. Measurements were recorded for the bleeding, gingival, and plaque indices (BI, MGI, and PI, respectively) that provided baseline values (T1). Subsequent measurements were taken at 3 months (T2) and 6 months (T3). Mean BI, MGI, and PI at T1, T2, and T3 were compared statistically between the groups using repeated measures analysis of variance. The significance level was set at P < or = .05. The response profiles for the BI, MGI, and PI over time were significantly different between the two groups. Patients who had Listerine in their daily oral hygiene regimen exhibited significantly lower scores for all three indices at T2 and T3 than the patients who only brushed and flossed. The hypothesis is rejected. This study shows that use of Listerine mouthrinse can reduce the amount of plaque and gingivitis in patients undergoing orthodontic treatment. Adding Listerine to the standard oral hygiene regimen may be beneficial for orthodontic patients in maintaining proper oral health, thus reducing the likelihood that white spot lesions and gingivitis will develop.

Effect of Rinsing With an Essential Oil–Containing Mouthrinse on Subgingival Periodontopathogens

Studies have shown that the nature and amount of supragingival plaque can influence the composition of the contiguous subgingival flora. The purpose of this study was to investigate the effect of rinsing with an essential oil antimicrobial mouthrinse on levels of representative subgingival bacteria in subjects with mild to moderate periodontitis. This controlled study used a randomized, double-masked, 2 x 2 crossover design. After baseline subgingival sampling, 37 qualifying subjects rinsed with the essential oil mouthrinse or a negative control twice daily for 14 days, with a post-treatment sample obtained on day 15. Following a washout period, the procedure was repeated with the alternative rinse. Target organisms enumerated were Porphyromonas gingivalis, Fusobacterium nucleatum, Veillonella sp., and total anaerobes. Intergroup comparisons of post-treatment log-transformed colony forming unit counts were made using analysis of covariance. After 14 days of twice-daily rinsing, the level of each of the target subgingival organisms was significantly lower in the essential oil group than in the control group (P < 0.001), with percent reductions ranging from 66.3% to 79.2%. Rinsing with the essential oil antiplaque/antigingivitis mouthrinse can have significant antimicrobial activity against subgingival periodontopathogens. Most likely, the antimicrobial effect was mediated primarily by disruption of the contiguous supragingival plaque by the mouthrinse. Because studies have shown that control of supragingival plaque can influence the onset and/or progression of periodontitis, additional studies on non-prescription antimicrobial oral care products may lead to new regimens for decreasing the burden of periodontal diseases in the population.

Comparison of the effects of cetylpyridinium chloride with an essential oil mouth rinse on dental plaque and gingivitis – a six‐month randomized controlled clinical trial

To compare the effects of an experimental mouth rinse containing 0.07% cetylpyridinium chloride (CPC) (Crest Pro-Health) with those provided by a commercially available mouth rinse containing essential oils (EOs) (Listerine) on dental plaque accumulation and prevention of gingivitis in an unsupervised 6-month randomized clinical trial. This double-blind, 6-month, parallel group, positively controlled study involved 151 subjects balanced and randomly assigned to either positive control (EO) or experimental (CPC) mouth rinse treatment groups. At baseline, subjects received a dental prophylaxis procedure and began unsupervised rinsing twice a day with 20 ml of their assigned mouthwash for 30 s after brushing their teeth for 1 min. Subjects were assessed for gingivitis and gingival bleeding by the Gingival index (GI) of Löe & Silness (1963) and plaque by the Silness & Löe (1964) Plaque index at baseline and after 3 and 6 months of rinsing. At 3 and 6 months, oral soft tissue health was assessed. Microbiological samples were also taken for community profiling by the DNA checkerboard method. Results show that after 3 and 6 months of rinsing, there were no significant differences (p=0.05) between the experimental (CPC) and the positive control mouth rinse treatment groups for overall gingivitis status, gingival bleeding, and plaque accumulation. At 6 months, the covariant (baseline) adjusted mean GI and bleeding sites percentages for the CPC and the EO rinses were 0.52 and 0.53 and 8.7 and 9.3, respectively. Both mouth rinses were well tolerated by the subjects. Microbiological community profiles were similar for the two treatment groups. Statistically, a significant greater reduction in bleeding sites was observed for the CPC rinse versus the EO rinse. The essential findings of this study indicated that there was no statistically significant difference in the anti-plaque and anti-gingivitis benefits between the experimental CPC mouth rinse and the positive control EO mouth rinse over a 6-month period.

Effect of a novel essential oil mouthrinse without alcohol on gingivitis: a double-blinded randomized controlled trial

Several different plant extracts have been evaluated with respect to their antimicrobial effects against oral pathogens and for reduction of gingivitis. Given that a large number of these substances have been associated with significant side effects that contraindicate their long-term use, new compounds need to be tested. The aim of this study was to assess the short-term safety and efficacy of a Lippia sidoides ("alecrim pimenta")-based essential oil mouthrinse on gingival inflammation and bacterial plaque. Fifty-five patients were enrolled into a pilot, double-blinded, randomized, parallel-armed study. Patients were randomly assigned to undergo a 7-day treatment regimen with either the L. sidoides-based mouthrinse or 0.12% chlorhexidine mouthrinse. The results demonstrated decreased plaque index, gingival index and gingival bleeding index scores at 7 days, as compared to baseline. There was no statistically significance difference (p>0.05) between test and control groups for any of the clinical parameters assessed throughout the study. Adverse events were mild and transient. The findings of this study demonstrated that the L. sidoides-based mouthrinse was safe and efficacious in reducing bacterial plaque and gingival inflammation.

Effect of an essential oil‐containing antimicrobial mouthrinse on specific plaque bacteria in vivo

This study was conducted to investigate the effect of rinsing with an essential oil-containing mouthrinse on levels of specific supra and subgingival bacteria in subjects with gingivitis. Fifteen subjects meeting entry criteria completed this randomized, controlled, double-blind, crossover study. Subjects were required to have >or=1000 target organisms per millilitre in pooled samples from two subgingival sites. Following sampling of supra and subgingival plaque, subjects began twice-daily rinsing for 14 days with either an essential oil-containing mouthrinse (Cool Mint Listerine Antiseptic) or a negative control. Supra and subgingival plaque was again sampled on day 15, and the procedure repeated after a 1-week washout period with subjects using the alternate rinse. Compared with the negative control, the essential oil mouthrinse produced significant reductions in supragingival plaque levels of Veillonella sp., Capnocytophaga sp., Fusobacterium nucleatum, and total anaerobes ranging from 52.3 to 88.5% (p<0.001 except for Veillonella, p=0.002); respective reductions in subgingival plaque ranged from 54.1 to 69.1% (p<0.001). Rinsing with the essential oil mouthrinse can have an impact on the subgingival plaque flora. This study provides additional evidence indicating that reduction in supragingival plaque can reduce levels of subgingival plaque.

The Effects of an Essential Oil Mouthrinse on Oral Health in the Community Indwelling Elderly

The purpose of this study was to investigate the effects of an essential oil mouthrinse with gingival massage on oral health in community indwelling elderly. The subjects were composed of 61 healthy elderly at a Senior Welfare Center in J city. Thirty subjects in the experimental group were given toothbrushing education ongingival massage toothbrushing with an essential oil mouthrinse for 2 weeks(4 times per day, 3 minutes per session). The 31 subjects in the control group were given toothbrushing education ongingival massage toothbrushing. The effects of the treatment were measured by salivary pH, salivary IgA level, halitosis, oral subjective symptoms, and oral self care behavior scores before, right after and 2 weeks after the experiment. Salivary pH was significantly increased(p=0.018) in the experimental group. Salivary IgA levels were not significantly different between the experimental and control groups; however, IgA levels of the experimental group were significantly increased(p=0.006) after time had passed. Halitosis was significantly decreased(p=0.002) in the experimental group. Oral subjective symptom scores were significantly decreased(p=0.000) and oral self care behavior scores were significantly increased(p=0.000) in the experimental group. Regular gingival massage toothbrushing with an essential oil mouthrinse could be an effective oral health nursing intervention for the elderly.