Types Of Mouthwashes Research Articles

Effect of Single Rinsing With Three Different Types of Mouthwash on VSC Levels in Morning Breath

Effect of Single Rinsing With Three Different Types of Mouthwash on VSC Levels in Morning Breath

Effect of aloe vera mouthwash on dental plaque and gingivitis indices in children: A randomized controlled clinical trial

BackgroundThere is a tendency nowadays to encourage the use of natural substances in dentistry. Aloe vera is one of these substances, which has recently gained great importance in clinical research. ObjectivesTo evaluate the effectiveness of Aloe vera mouthwash in improving plaque, gingival and gingival bleeding indices in children. Materials and methodsThe study sample consisted of (17) children [age: (8) to (12) years]. The crossover design was applied, which means that the three types of mouthwashes (experimental “Aloe vera”, positive control “chlorhexidine”, and negative control “placebo”) would be used for all participants, with a washout period of (12) days. A special plaque guard was fabricated to facilitate localized plaque accumulation for (3) days. After that period, the mouthwashes were applied for (5) days. Plaque, gingival and gingival bleeding indices were studied before plaque accumulation (T0), after plaque accumulation (T1), and after applying the mouthwashes (T2). The values of plaque index (PI), gingival index (GI) and gingival bleeding index (GBI) were measured at each studied time point (T0, T1, and T2). Then, the differences between the values at the beginning of the use of each type of the mouthwashes and at the end of the period of there use were compared. ResultsThe results showed the efficacy of Aloe vera mouthwash in improving plaque, gingival and gingival bleeding indices, which was similar to chlorhexidine mouthwash effectiveness when both compared to the placebo mouthwash. ConclusionsThe use of Aloe vera mouthwash is effective in improving oral health and preventing gingivitis.

An In-vitro analysis of the staining effect of different chemical mouthwashes

Aim: To evaluate the staining potential of three commercially available types of mouthwashes. Materials and Methodology: Sixty extracted maxillary central incisor teeth were used for the study. The teeth were divided into three groups (N=30). Teeth were immersed in three different mouthwash solutions for 2 months. The color change was measured with a spectrophotometer before immersion in solution (baseline) and after 2 months. L*a*b* values were used to calculate color changes (ΔE). Statistical analysis was done using ANOVA test and Paired T-test. Results: Greater staining was caused by Listerine and Chlorhexidine mouth was has compared to Chlorhexidine mouthwash with ADS after 2months. Conclusion: Chlorhexidine mouthwash with ADS is a better choice as a mouthwash to minimize tooth staining

Comparative Evaluation of Ion Release in Bonded and Nonbonded Stainless Steel Brackets with Use of Different Mouthwashes: An In vitro Study.

Background:Orthodontic treatment is a long-term procedure that involves the usage of brackets and archwires which are mainly metallic in nature. This study evaluated the levels of metal ions release from bonded and nonbonded orthodontic brackets after immersion in distilled deionized water and three different types of mouthwash.Materials and Methods:Eighty premolar stainless steel brackets (3M, Unitek) were divided into Group A (bonded brackets) and Group B (nonbonded brackets). Each group was further subdivided into four subgroups to analyze the release of ions from three different types of mouthwash along with the control group. All the samples were incubated at 37°C for 45 days, and immersion solutions were tested in inductively coupled plasma-optical emission spectrometer for the release of free metal ions.Results:Mean ion release in the bonded bracket group was less than that of nonbonded bracket group. Ion release in control subgroup of both groups was 0.18 ± 0.08 μg/dl (A1) and 0.17 ± 0.06 μg/dl (B1); in Phos-Flur mouthwash subgroup was 0.12 ± 0.06 μg/dl (A2) and 0.13 ± 0.05 μg/dl (B2); in chlohex mouthwash subgroup was 0.13 ± 0.06 μg/dl (A3) and 0.14 ± 0.06 μg/dl (B3); in Hiora mouthwash subgroup was 0.10 ± 0.06 μg/dl (A4) and 0.12 ± 0.05 μg/dl (B4).Conclusions:The mean ion release was the highest in deionized water (control group) followed by chlohex, Phos-Flur, and Hiora in both Group A and Group B. Ion leaching from bonded brackets was less compared to nonbonded brackets in all different mouthwashes except in the control group. However, this difference was statistically insignificant (P > 0.05) between all the groups.

PH of Commercially Available Brands of Toothpaste and Mouthwashes in Sulaimani/ Iraq Markets: An In-vitro Study

Objective: The pH of the daily used toothpaste and mouthwashes dramatically affects the balance of the demineralization and remineralization processes on the tooth structure. Yet, its value is not labeled on the container for public.The aim of this study is to measure the pH values of various toothpaste and mouthwashes those are commercially available in Sulaimani market. 
 Methods: The pH value of twenty-one toothpastes and fifteen types of mouthwash commercially available in Sulaimani were measured twice by using JENWAY pH meter. The electrode immersed inside the tested sample (10 mL mouthwash and 2mg/10 mL toothpaste) for 3 minutes. The pH mean value for each sample was calculated.
 Results: The pH mean value for toothpaste and mouthwashes were 7.67 and 6.33, respectively. Low pH values were reported in Vitis- ortho (4.94), and Desensin repair toothpaste (6.99) and high values reported in A.ME menton &calcium toothpaste (8.85) and Nano- whitening mouthwash (7.855).
 Conclusions: The pH of toothpaste was neutral to slightly basic. Thus their repeated use is considered as none erosive. While the pH of mouthwashes was acidic or somewhat optimal, that indicates the possibility of enamel erosion with frequent use. Thus a careful mouthwash’s type selection is required.

The Effects of Various Mouthwashes on Osteoblast Precursor Cells.

This study examined whether or not various mouthwashes have significant effects on the viability or morphology of mouse osteoblast-like cells. Mouse calvarial preosteoblast cells were cultured and prepared, then treated with a 0.12% chlorhexidine digluconate solution containing essential oils with or without alcohol, and a cetylpyridinium chloride solution, and sodium fluoride, respectively. Each well was treated with one of six mouthwashes for either 30 sec, 1.5 min, or 4.5 min. The viability of the treated cells was quantitatively analyzed by a Cell Counting Kit-8. The viability of osteogenic progenitor cells decreased significantly irrespectively of the types of mouthwashes. The changes of cell morphology were seen in all groups of mouthwashes; however, they were more noticeable on the chlorhexidine digluconate-treated group. A progressive increase in treatment time over 30 sec did not seem to deteriorate cellular viability. There was no significant difference in viability or morphological change between different formulations of the same brand. Although various mouthwashes without alcohol as an ingredient are available, nonalcoholic mouthwashes were not likely to be less harmful to the cells. Collectively, commercially available mouthwashes could inhibit cell viability and alter the morphology of osteoblastic precursor cells irrespectively of brands, treatment time, or alcohol content.

Evaluation of Herbal Mouthwashes Containing Zataria Multiflora Boiss, Frankincense and Combination Therapy on Patients with Gingivitis: A Double-Blind, Randomized, Controlled, Clinical Trial.

Background: Dental plaques as adhesive microbial aggregates on tooth surfaces are considered the first stage of tooth decay as well as gingivitis. Accordingly, the effect of different antimicrobial mouthwashes on removing dental plaques and preventing their formation has been evaluated in various studies. This study aimed to evaluate the efficacy of herbal mouthwashes containing hydro-alcoholic extract of Zataria multiflora (ZM), Frankincense (FR), and a combination of both (ZM+FR) and compare it with chlorhexidine (CHX) mouthwash in subjects with gingivitis. Materials and Methods: In this randomized, controlled, clinical trial a total of 140 patients with gingivitis were divided into four groups including CHX (control group), ZM, FR, and ZM+FR groups. Plaque index (PI), gingival index (GI), and gingival bleeding index (GBI) were measured in days 1, 14, and 21. Results: All three herbal types of mouthwash significantly improved plaque, gingivitis, and gingival bleeding throughout days 14 to 21 (P<0.001). There was no difference between herbal mouthwash with CHX groups. CHX mouthwash showed the most side effects (54.3%), while ZM mouthwash showed the least side effects and the highest consumer satisfaction (5.7% and 94%, respectively). Conclusion: All of the herbal mouthwashes can be good candidates for controlling gingivitis. Comparing with CHX mouthwash, herbal mouthwashes have lower side effects and negligible alcohol content. Among the herbal mouthwashes, ZM outperforms FR and FR+ZM due to its lower side effects and higher levels of patients’ satisfaction.

Evaluation of Herbal Mouthwashes Containing Zataria Multiflora Boiss, Frankincense and Combination Therapy on Patients with Gingivitis: A Double-Blind, Randomized, Controlled, Clinical Trial

Background: Dental plaques as adhesive microbial aggregates on tooth surfaces are considered the first stage of tooth decay as well as gingivitis. Accordingly, the effect of different antimicrobial mouthwashes on removing dental plaques and preventing their formation has been evaluated in various studies. This study aimed to evaluate the efficacy of herbal mouthwashes containing hydro-alcoholic extract of Zataria multiflora (ZM), Frankincense (FR), and a combination of both (ZM+FR) and compare it with chlorhexidine (CHX) mouthwash in subjects with gingivitis. Materials and Methods: In this randomized, controlled, clinical trial a total of 140 patients with gingivitis were divided into four groups including CHX (control group), ZM, FR, and ZM+FR groups. Plaque index (PI), gingival index (GI), and gingival bleeding index (GBI) were measured in days 1, 14, and 21. Results: All three herbal types of mouthwash significantly improved plaque, gingivitis, and gingival bleeding throughout days 14 to 21 (P&lt;0.001). There was no difference between herbal mouthwash with CHX groups. CHX mouthwash showed the most side effects (54.3%), while ZM mouthwash showed the least side effects and the highest consumer satisfaction (5.7% and 94%, respectively). Conclusion: All of the herbal mouthwashes can be good candidates for controlling gingivitis. Comparing with CHX mouthwash, herbal mouthwashes have lower side effects and negligible alcohol content. Among the herbal mouthwashes, ZM outperforms FR and FR+ZM due to its lower side effects and higher levels of patients’ satisfaction. [GMJ.2019;8:e1366]

Nickel ion release from dental alloys in two different mouthwashes.

Background. Mouthwashes are widely used as adjuncts to mechanical oral hygiene procedures. Nonetheless, there is little information regarding the effect of various mouthwashes on the amount of ions released from the nickel-chromium (Ni‒Cr) alloys used in the fabrication of fixed prostheses. Therefore, the present study was conducted to evaluate the effect of two types of mouthwash on the release of Ni ions from dental alloys. Methods. Forty-two disk-shaped specimens were prepared with a diameter of 10 mm and a height of 2 mm. Two mouthwashes were examined in this study: Oral B and Listerine. A control group was also considered using distilled water. Each Ni‒Cr disk was immersed in the mouthwashes and distilled water in polypropylene test tubes, and then incubated at 37°C to simulate the oral temperature. After 45 days of incubation, the samples were tested for Ni ions using inductively coupled plasma mass spectroscopy. Data were analyzed using ANOVA. Results. In the Halita group subjects exhibited 2.04±0.65 reduction in OLS. OLS reduction in the chlorhexidine group was 1.95±0.74. Statistical analysis showed no significant difference between the two groups (P>0.05). Conclusion. As the results indicated, the amount of ion release was within the safe limits in the two experimental groups. However, it is recommended that prescribe Listerine mouthwash should not be prescribed for the patients with a history of Ni allergy.

Effect of mouthwashes on the discolouration of restorative materials commonly used in paediatric dentistry.

This was to investigate the effects of Klorhex, Tantum Verde, Kloroben, and Listerine on the discolouration of composite resin, compomer, giomer, and resin-modified glass ionomer. Fifty disc-shaped specimens from each restorative material (n = 50) were prepared; initial colour values were measured with a spectrophotometer. Forty specimens from each group were placed in the four different types of mouthwashes (n = 10), while the remaining 10 specimens were immersed in distilled water for 2min, twice a day for a period of 3weeks. Colour change (ΔE*) values were obtained and the results were evaluated statistically. The ΔE* of composite resin in Klorhex (0.84 ± 0.37) was significantly lower than that of the other mouthwash groups. Moreover, composite resin showed the least colour change when compared with the other materials in all four mouthwashes. Resin-modified glass ionomer values were significantly higher in Tantum Verde (6.36 ± 2.82) when compared with the other mouthwashes (p < 0.05). Clinically appreciable discolourations were observed in the resin-modified glass ionomer specimens placed in Tantum Verde and Listerine. Nano-filling composite resins are the most successful aesthetic restorative materials, whereas the commonly used resin-modified glass ionomers exhibit more aesthetically divergent results following the use of mouthwashes.

Clinical efficacy of new α-bisabolol mouthwashes in postoperative complications of maxillofacial surgeries: a randomized, controlled, triple-blind clinical trial.

The present study aimed to evaluate the efficacy of α-bisabolol (BISA)-based mouthwashes in the oral hygiene of patients submitted to oral and maxillofacial surgery. A randomized, controlled, triple-blind clinical trial was conducted with 30 patients, undergoing oral and maxillofacial surgery. Three types of mouthwashes were developed, based at 0.12% chlorhexidine, 0.5% BISA, and 0.12% chlorhexidine + 0.5% BISA. The patients were evaluated in the preoperative and postoperative period, divided into three groups according to the mouthwash to be used. In the postoperative period, the oral hygiene quality of the patients was evaluated through the simplified oral hygiene index; the healing of the wounds was evaluated observing the presence of suture dehiscence and/or infection, and the pain was established using the Visual Analogue Scale. The antiseptic effect of the mouthwashes was evaluated in vitro. There were no differences in the efficacy of BISA-containing mouthwashes for oral hygiene, healing, and pain, compared to chlorhexidine based at 0.12%. There were no differences in the antiseptic activity of chlorhexidine and chlorhexidine + α-bisabolol-based mouthwashes. The results indicate that BISA-based mouthwashes have clinical efficacy, in the improvement of oral hygiene and wound healing, as well as in the reduction of postoperative pain. Considering that BISA has analgesic, antimicrobial, and anti-inflammatory properties, it is relevant to evaluate the efficacy of BISA-based mouthwashes in the oral hygiene of patients undergoing oral and maxillofacial surgery, seeking a better postoperative recovery.

Mechanical properties of Easy Fill composites after storage in mouthwashes

Purpose: The aim of the presented work was to investigate the influence of different mouthwashes on the chosen mechanical properties of different dental restorative composites. The null hypothesis was that the mouthwashes have influence on these properties. Design/methodology/approach: Four different restorative composites were used (Easy Fill Nano, Easy Fill Micro Hybrid, Easy Fill Flowable, Easy Fill Bulk). Samples were conditioned in different media: mouthwashes (Listerine Total Care with ethanol, Listerine Total Care Sensitive – alcohol-free) and distilled water. The samples were polymerized in Teflon moulds. The compressive strength, diametral tensile strength (DTS) and Vickers microhardness were examined. Findings: The research showed that the surface of composite materials was particularly sensitive to the action of mouthwashes. Both types of solutions, containing ethanol and without it lowered the microhardness values. The mouthwashes may also decrease other mechanical properties, like compressive strength of diametrical tensile strength. The results of the carried out investigations showed good mechanical properties of the tested materials, analogous to other materials of this type. Research limitations/implications: Other important properties of dental filling storied in mouthwashes should be analysed in future, including microgap between tooth and filling. Practical implications: The result contradicts the popular view that mouthwashes that do not contain ethanol are in general safer for composites in the context of reduction of mechanical properties. Both types of mouthwashes may reduce mechanical properties. Originality/value: The results of mechanical properties investigations of Easy Fill composites were presented and compared to other commercial materials. The changes of mechanical properties were also analysed after storing in different types of mouthwashes. So far, there has been no such research for these materials.

Effectiveness of three mouthwashes - Manuka honey, Raw honey, and Chlorhexidine on plaque and gingival scores of 12-15-year-old school children: A randomized controlled field trial.

Objectives:The aim of this study is to compare the effectiveness of three types of mouthwashes manuka honey (MH), raw honey (RH), and chlorhexidine (CHX) on plaque and gingival scores of 12–15-year-old government school children.Study Design:This study was a double-blind, randomized controlled field trial conducted in Belagavi city, India.Materials and Methods:One hundred and thirty-five government school children aged 12–15 years were randomly selected and allocated into three groups, RH, MH, and CHX mouthwash groups. Ten milliliters each of honey-based mouthwash formulation and CHX mouthwashes (0.2%) were administered according to the group allocation twice daily for 21 days. All the children were examined at baseline, 22nd day (after discontinuation of mouthwash) and 28th day (1 week after discontinuation of mouthwash) for Gingival (Loe and silness 1963) and Plaque Index (Silness and Loe, 1964).Results:Descriptive statistics was applied for distribution of study participants according to age and gender. One-way ANOVA followed by Tukey's post hoc test and repeated measures ANOVA test followed by Bonferroni's post hoc were applied for inter- and intragroup comparison, respectively. Statistically significant reductions (P < 0.001) in plaque and gingival scores were observed in all the three types of mouthwash groups at the end of the 22nd day and 28th day. MH and RH mouthwash demonstrated equal effectiveness, whereas CHX mouthwash showed the maximum reduction in clinical parameters.Conclusion:Honey-based mouthwash showed a promising antimicrobial effect on dental caries and plaque and gingival scores.

Effect of Different Fluoridated Mouth Rinses on the Surface Characterization of Nano-Filled Resin Composite Materials

Background: The influence of recently marketed fluoridated mouth rinses on the surface roughness of the newly nano-filled composite resins has not yet been adequately investigated. Objectives: This study aiming at evaluating the effects of different types of mouthwashes on surface roughness of different types of composite resins. Materials and Methods: This experimental in vitro study included 3 types of mouthwashes (Colgate Plax, Listerine, and Aloe Dent) and 3 types of composite resins (Z350, Z250, and Art). Six specimens were prepared for each material in each group. All specimens were fabricated at room temperature 23°C. Pre-test measurements were recorded for all specimens in the three test groups using the profilometer after storing all specimens in distilled water for 24 hours. Post- test measurements were recorded after storing each specimen for 1 minute/day for 1 week. Means and standard deviations were calculated and the differences in means (before and after) between the tested groups were performed using Paired Sample t-test with p value <0.05 as a significant level. Results: The pre-test means and SDs for the tested groups according to the type of mouthwash were 140.7±53.86 for group B, 159.63±44.34 for group C, and 166.55±51.16 for group D. The after-test readings were 158.42±47.63, 176.11±49.30, and 171.49±31.81 for the same group, respectively. The highest difference in means between before and after measurements was found in group B with a value of 17.73±10.82 with high significant level (P 0.05). Conclusion: Among the tested storage mouth rinses, Aloe Dent was found to have the least effect on surface roughness.

Self-Reported Use of Mouthwash and Pharyngeal Gonorrhoea Detection by Nucleic Acid Amplification Test

Use of alcohol-containing mouthwash has been found to have an inhibitory effect against pharyngeal gonorrhoea. The aim of this study was to investigate the association between self-reported mouthwash use and pharyngeal gonorrhoea detection among men who have sex with men (MSM). A cross-sectional survey was conducted between March 23, 2015, and June 30, 2015 among MSM attending the Melbourne Sexual Health Centre in Australia. Men who have sex with men were invited to complete a short questionnaire on mouthwash use and they were also tested for pharyngeal gonorrhoea by nucleic acid amplification test. Multivariate logistic regression was performed to examine the association between mouthwash use and pharyngeal gonorrhoea detection. Of the 823 MSM, pharyngeal gonorrhoea detection decreased significantly with increasing age group (≤24 years, 14.5%; 25-34 years, 10.7%; ≥35 years, 6.0%; ptrend = 0.003). The proportion reporting daily use of mouthwash increased significantly with increasing age group (from 10.1% to 14.5% to 19.8%; ptrend = 0.005). However, there was no significant association between pharyngeal gonorrhoea detection and daily use of mouthwash after adjusting for age, number of male sexual partners, human immunodeficiency virus status, and type of mouthwash use. Although the proportion of daily use of mouthwash increased with age, and pharyngeal gonorrhoea detection decreased with age, the association between self-reported mouthwash use and pharyngeal gonorrhoea detection by nucleic acid amplification test was not statistically significant.

Color Stability of Different Aesthetic Arch-Wires after Immersion into Different Types of Mouthwashes : In Vitro Study

Color Stability of Different Aesthetic Arch-Wires after Immersion into Different Types of Mouthwashes : In Vitro Study

Nickel and chromium ion release from stainless steel bracket on immersion various types of mouthwashes

The stainless steel bracket is widely used in orthodontics because of its mechanical properties, strength, and good biocompatibility. However, under certain conditions, it can be susceptible to corrosion. Studies have reported that the release of nickel and chromium ions because of corrosion can cause allergic reactions in some individuals and are mutagenic. The condition of the oral environment can lead to corrosion, and one factor that can alter the oral environment is mouthwash. The aim of this study was to measure the nickel and chromium ions released from stainless steel brackets when immersed in mouthwash and aquadest. The objects consisted of four groups of 17 maxillary premolar brackets with .022 slots. Each group was immersed in a different mouthwash and aquadest and incubated at 37 °C for 30 days. After 30 days of immersion, the released ions were measured using the ICP-MS (Inductively Coupled Plasma-Mass Spectrometer). For statistical analysis, both the Kruskal-Wallis and Mann-Whitney tests were used. The results showed differences among the four groups in the nickel ions released (p < 0.05) and the chromium ions released (p < 0.5). In conclusion, the ions released as a result of mouthwash immersion have a small value that is below the limit of daily intake recommended by the World Health Organization.

Antiplaque and remineralizing effects of Biorepair mouthwash: A comparative clinical trial

ObjectivesThe aim of this study was to compare the effectiveness of Biorepair, fluoride and chlorhexidine mouthwashes in controlling plaque accumulation and gingivitis, in addition to their remineralizing effect on the initial carious lesions. Methodsabout 81 children aged 7–12 years were participated in this study. They were randomly allocated in 3 groups according to the type of the used mouthwash. At baseline, each child was examined for plaque and gingival indices. DIAGNOdent was used to determine the mineral content in the incipient lesions. Children were instructed to use their specific mouthwash twice daily for 2 weeks, then they were recalled after 1, 2, 4, and 6 weeks for recording the same parameters. ResultsAll the three types of mouthwashes showed significant reduction in plaque accumulation and gingivitis compared to the baseline. However, Biorepair and fluoride mouthwashes only showed significant remineralization of early carious lesions. ConclusionBiorepair mouthwash can serve as a better alternative to different mouthwashes including both fluoride and chloehexidine. This single mouthwash can serve as a multi-purpose mouthwash.

Comparative Evaluation of Antimicrobial Activity of Pomegranate-Containing Mouthwash Against Oral-Biofilm Forming Organisms: An Invitro Microbial Study.

Pomegranate is considered "A pharmacy unto itself". Hydrolysable tannins called punicalagins which have free scavenging properties are the most abundant polyphenols found in pomegranate-containing mouthwash. To evaluate antimicrobial effect of pomegranate- containing mouthwash on oral biofilm-forming bacteria. The mouthwashes used were divided into three groups- Group A: Chlorhexidine mouthwash (Hexidine); Group B: Herbal Mouthwash (Hiora) and Group C: Pomegranate-containing Mouthwash (Life-extension). Each mouthwash was diluted to five different concentrations. Reference strains of Streptococcus mutans (S.mutans) (ATCC 25175), Streptococcus salivarius (S.salivarius) (ATCC 7073), and Aggregatibacter actinomycetemcomitans (A.a) (NCTC 9710) were selected as being colonizers in dental biofilm formation. On each culture plate, five wells of 5mm were prepared and mouthwashes with different concentrations were added, followed by incubation in a CO2 jar for 24 hours at 37°C. Inhibition zone diameters were measured using a digital caliper. Chlorhexidine (0.12%) presented a zone of inhibition between 38.46% to 96.15% for all the three organisms, while Hiora presented zone of inhibition ranging from 33.33% to 69.23% but was resistant at <10 ml of dilution. Pomegranate mouthwash presented a zone of inhibition ranging from 38.48 to 57.69%, but was resistant at <10ml for S.mutans, and <25ml for A.a and S.salivarius. ANOVA test was done to compare the dilution of mouthwashes for a particular organism and Tukey's multiple comparison tests were done to find the exact difference. A significant difference was seen between all the three groups at 50ml and 75 ml of dilution. At 75 ml concentration, a statistical difference was found between Groups B & C and Groups A & B; and at 50 ml between Groups A&C. All the three types of mouthwash exhibit anti-microbial activity against biofilm forming organisms but at varying concentrations. Although Chlorhexidine still continues to be the gold standard, pomegranate-containing or herbal mouthwashes can be easily substituted for long term use, avoiding the side effects of chlorhexidine.

Sodium Bicarbonate Containing Mouthwash for Preventing Radiotherapy-Induced Oral Mucositis in Patients With Locally Advanced Head and Neck Cancer

Background: In spite of all complications and disabilities due to advanced head and neck malignancies, treatment of oral mucositis following radiotherapy is mainly supportive and oral hygiene is the mainstay of treatment. In this context, mouthwash containing sodium bicarbonate can have a major role in the treatment of this complication. Objectives: The present trial assessed the value of this type of mouthwash for preventing oral mucositis following radiotherapy in patients suffered locally advanced head and neck squamous cell carcinoma. Patients and Methods: Twenty nine patients suffered locally advanced squamous cell carcinoma were consecutively entered into the study. All patients had stage III to IV head and neck malignancies. The patients were randomly assigned to receiving bicarbonate mouthwash (20 ml every 6 hours per day from the beginning to the end of the treatment) (n = 18) or placebo (n = 11). The mouthwash assessed was containing 1 vial of sodium bicarbonate, 500 ml of normal saline, and diphenhydramine 25 mg/kg). Results: A significant difference was revealed in the mucositis scoring between the intervention and placebo group so that mucositis grade III or more was observed in 7 patients in intervention group (38.9%) and in 9 patients in control group (81.8%) that the observed discrepant was significant (p = 0.024). The first evidences of oral mucositis in intervention group was found in forth weeks of treatment (sessions of 16 to 17 of treatment schedule), while the appearance of mucositis in placebo group was occurred in the middle of the third week (sessions of 13 to 14 of treatment). Conclusions: Oral care by mouthwash containing sodium bicarbonate for head and neck cancer patients undergoing radiotherapy is an effective interventional option to prevent oral mucositis.