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PubMed2003

Antiplaque and antigingivitis effectiveness of a hexetidine mouthwash.

OBJECTIVE: To assess the antiplaque/antigingivitis efficacy of a hexetidine-containing mouthwash. METHODS: This examiner-blind, parallel group, controlled clinical study examined the effectiveness of a hexetidine (0.1%) mouthwash both in inhibiting the development of supragingival plaque and in reducing gingivitis. One hundred and thirty-four adult subjects completed the 2-week experimental gingivitis model study. Following baseline examinations, which included plaque index, modified gingival index and gingival bleeding index, subjects received a full dental prophylaxis. Subjects were randomly assigned to one of three mouthwashes (hexetidine 0.1%, chlorhexidine 0.12% (positive control) or a 5% hydroalcohol negative control) and commenced three times daily supervised rinsing as their sole method of oral hygiene. All indices were rescored after 2 weeks. RESULTS: Compared to the negative control group, the hexetidine group demonstrated a statistically significant inhibition and reduction of supragingival plaque and gingival inflammation with reductions of 6.3%, 33.5% and 56% for gingivitis, plaque and gingival bleeding, respectively. The results of the chlorhexidine group were used to validate the study. CONCLUSION: The study confirms the efficacy of a hexetidine rinse in reducing supragingival plaque and gingival inflammation.

Adolescent↗

PubMed2003

Penetrating the plaque biofilm: impact of essential oil mouthwash.

The interaction between saliva-coated tooth surfaces and pathogenic bacteria is partly governed by electrostatic and hydrophobic interactions, providing a solid rationale for using chemical agents as part of a plaque-control routine. Chlorhexidine works in several ways. For example, it binds to salivary mucins on the bacterial cell membrane, and penetrates the plaque biofilm. Essential oil (EO) mouthwashes kill micro-organisms by disrupting their cell walls and inhibiting their enzymic activity. They prevent bacterial aggregation, slow multiplication and extract endotoxins. Recent studies have shown that bacterial phenotypes are altered when organisms change from a planktonic to a sessile state. This suggests that an effective mouthwash must also penetrate the plaque biofilm. Two studies have demonstrated the ability of an EO mouthwash to penetrate the plaque biofilm.

Anti-Infective Agents, Local↗

PubMed1991

The use of an oxidising mouthwash to reduce staining associated with chlorhexidine. Studies in vitro and in vivo.

Discolouration of the teeth, tongue and dental restorative materials associated with the use of cationic antiseptics is still the limiting factor in long-term usage of antiplaque agents such as chlorhexidine. Oxidising agents have been used successfully to remove dental stain in animals, but products and regimens have not been evaluated in humans. These pilot studies in vitro and in vivo assessed a long-established oxidising mouthwash, based on peroxyborate, for stain removal from teeth and acrylic. The laboratory studies measured chlorhexidine tea stain removal from tooth and acrylic specimens. The oxidising agent markedly reduced staining on specimens. In a short-term clinical experiment, dental staining was forced over a 2 1/2-day period by reciprocal chlorhexidine and tea rinsing. 5 rinses with the oxidising mouthwash during the next 1 1/2 days dramatically reduced staining compared with water after rinses. Additionally, a single rinse with peroxyborate following the 5 water after rinses, again considerably reduced the residual staining. Effects on tongue staining were less impressive. Both experimental models produced findings consistent with those from the animal model. The results suggest proprietary oxidising mouthwashes could have a place in the control of dental stain associated with the use of chlorhexidine. Further studies to evaluate such products in a more conventional chlorhexidine regimen are indicated.

Adult↗

PubMed1993

One-year trial of the effect of rinsing with an amine fluoride-stannous-fluoride-containing mouthwash on gingival index scores and salivary microbial counts in lymphoma patients receiving cytostatic drugs.

This double-blind study was undertaken to evaluate the effect of twice-daily use of a mouthwash containing 0.025% of fluoride as amine fluoride-stannous fluoride (AmF + SnF) or 0.05% of fluoride as sodium fluoride (NaF) on visible plaque index (VPI) and gingival bleeding index (GBI) and on some salivary micro-organisms in patients suffering from non-Hodgkin or Hodgkin lymphomas. 79 patients were allocated at random to the two mouthwash groups. Mouthwashing began at the start of cancer chemotherapy. Results relating to 45 patients who completed a 1-year rinsing protocol showed a significant decrease in VPI and GBI in the AmF + SnF group. An increase was found in the NaF group. Mean values for stimulated salivary secretion rates and buffering capacities mostly did not differ significantly from baseline values during the study. In both groups, mutans streptococci counts decreased significantly after the study began and remained low in the AmF + SnF group. No corresponding effect was seen in relation to lactobacilli and yeast counts. In the NaF group, lactobacilli counts increased significantly over a year. Significantly more patients reported adverse or unpleasant effects in the AmF + SnF group (52%) than in the NaF group (6%), although both solutions had the same colour and taste. However, all patients continued with rinsing.

Adult↗

PubMed2004

The effect of two different dental gels and a mouthwash on plaque and gingival scores: a six-week clinical study.

AIM: To evaluate the clinical efficacy of two gel formulations containing chlorhexidine gluconate and neem extract with a commercially available chlorhexidine gluconate mouthwash. METHOD: An open labelled randomised six-week clinical study with parallel group design in 48 subjects divided into four groups. Plaque accumulation and gingival condition were recorded using plaque index and gingival index. On the basis of mean baseline plaque and gingival scores, subjects were allocated to four different groups, using their assigned products twice a day, before bed and after breakfast. Plaque and gingival scores were recorded after three and six weeks. RESULTS: Mean plaque and gingival scores were reduced over the six-week trial period for experimental and control groups. Chlorhexidine gluconate gel reduced the plaque and gingival scores significantly more (p<0.05) than the chlorhexidine gluconate mouthwash. Neem extract gel also showed significant (p<0,05) reduction in plaque and gingival scores when compared with the control group. But there was no significant difference between the groups treated with chlorhexidine gel and neem extract gel. CONCLUSION: The results of this clinical study indicate that better therapeutic efficacy can be achieved using gels for treating oral infections than conventional treatments using mouthwash.

Adult↗

PubMed1975

The effect of an antimicrobial mouthwash on dental plaque and gingivitis in yound adults.

The effectiveness of an antimicrobial mouthwash (alexidine, 2-ethylhexyl bisbiguanidine dihydrochloride) in preventing plaque and gingivitis was evaluated in 45 young male adults. In a study using a double-blind cross-over design, subjects received a thorough prophylaxis and refrained from all routine oral hygiene for 2 weeks. During this period, subjects rinsed twice daily with either a treatment (alexidine) or placebo mouthwash. Plaque and gingivitis were assessed on selected teeth on days 2, 7 and 14. The characteristics of plaque that were recorded include: surface area score, dry weight and differential counts of microorganisms. After the 14th day, subjects resumed their regular oral hygiene practices for 3 weeks before starting the second experimental period. Aftter a second prophylaxis, the treatment and placebo groups from the first 2 weeks were crossed over and the procedures followed previously were repeated during the sixth and seventh weeks. The alexidine mouthwash was statistically and clinically effective in decreasing plaque scores and plaque weight, and statistically but not clinically effective in decreasing gingivitis scores. No systemic side effects were observed, but an asymptomatic brown tongue stain was observed in about half of the subjects. There was no evidence to suggest that alexidine disturbed the relative composition of the microorganisms in plague, but there was a suggestion that it decreased the number of microorganisms almost 2-fold when compared with the placebo group.

Adult↗

PubMed1989

Comparison of chlorhexidine delivery by mouthwash and spray on plaque accumulation.

The delivery of chlorhexidine by spray systems have been found useful in controlling plaque in handicapped individuals. This study using a single blind crossover design compared chlorhexidine delivery by mouthwash and spray for plaque inhibitory effects. A group of 14 volunteers participated in two 4 day, no oral hygiene regimens. During one regimen chlorhexidine was professionally sprayed onto the teeth twice a day and during the other chlorhexidine was rinsed twice a day under supervision. Plaque regrowth from a zero baseline was recorded using a plaque index and by area. Little plaque accumulated during the two periods. There was no significant difference in plaque measurements following the use of the spray or mouthwash. This study demonstrated that chlorhexidine when sprayed under optimal conditions was as effective as a mouthwash at controlling plaque despite only requiring one seventh of a dose from a rinse. The results have implications for the use and delivery of chlorhexidine for plaque control and are relevant to the proposed mode of action of this antiseptic.

Adult↗

PubMed2001

Efficacy of a 3% potassium nitrate desensitizing mouthwash in the treatment of dentinal hypersensitivity.

BACKGROUND: Potassium nitrate has been used previously in a dentifrice or gel to alleviate dentinal hypersensitivity. The aim of this study was to compare a 3% potassium nitrate/0.2% sodium fluoride mouthwash with a 0.2% sodium fluoride control mouthwash in a 6-week double-blind study. METHODS: Fifty subjects were evaluated using 2 tactile methods and cold air sensitivity (dental air syringe), along with subjective perception of pain (0 to 10 scale) at baseline and at 2 and 6 weeks. RESULTS: There was a general decrease in dentinal hypersensitivity levels in both groups over the 6-week study period as demonstrated by all 4 methods of assessment. There was also a statistically significant difference in decrease in sensitivity between the groups. CONCLUSIONS: This study showed that a 3% potassium nitrate/0.2% sodium fluoride mouthwash appears to have therapeutic potential to alleviate dentinal hypersensitivity.

Adolescent↗

PubMed1999

Extensive oral mucosal ulcerations caused by misuse of a commercial mouthwash.

This case report describes severe mucosal injuries following misuse of an undiluted over-the-counter mouthwash with a high alcohol content (70%), oil of peppermint and arnica. The mouthwash was to be diluted 5:1 with water. The patient used undiluted solution to better treat her self-diagnosed "contagious gum infection." She experienced burning sensation with each rinse and developed severe mucosal injuries subsequently. Her oral condition improved within 48 hours following discontinuation of use of the mouthwash and application of a mixture of Benadryl Elixir, Maalox Plain, and 2% viscous Lidocaine. A detailed history and review of a patient's medical condition will help to differentiate self-induced mucosal injuries from those caused by an allergic reaction or skin diseases.

Burns, Chemical↗

PubMedDate not supplied

[Double blind placebo-controlled study on efficacy, acceptability and safety of mouthwash diclofenac in oral or periodontal postoperative period].

BACKGROUND: In a double blind clinical study the efficacy, acceptability and safety of a mouthwash containing diclofenac 0.074% DI-CO in patients undergone to oral or periodontal surgery was evaluated compared to placebo. METHODS: The design was a randomised double blind controlled clinical study. The patients rinsed for 1 min twice a day with diclofenac mouthwash or placebo (15 mL) at least after 1 hour since the chlorhexidine rinse for 7 days. Indistinguishable bottles and same appearance of the formulations guaranteed the reliability of the blindness. Pain at 8.00 pm the day of surgery and at 8.00 am the following day, inflammatory condition 24 hours after intervention, acceptability and safety were the parameters evaluated. Fifty (30 M, 20 F), mean aged 31.7 years, with pain score at the end of anaesthesia effect equivalent to 3.25 (semi-quantitative scale) were treated. At baseline the vital characteristics and the severity of the clinical condition were homogeneous in the two groups. RESULTS: The mean severity score was significantly lower on DI-CO than the one showed on placebo both at 8.00 pm the day of surgery (p=0.003) and at 8.00 am the following day (p= 0.001). The gingival inflammatory condition were significantly improved by DI-CO versus placebo (p<0.001). The good safety and pleasant palatability were similar for both treatments. CONCLUSIONS: Diclofenac mouthwash presented very good efficacy and safety in the treatment of oral cavity phlogosis due to oral or periodontal surgery.

Adult↗

PubMed2000

[Research of compound cyclosporin A mouthwash in the treatment of oral lichen planus].

Thirty patients of oral lichen planus(OLP) were treated with compound CyA mouthwash, while the control group was treated with KouTai. The results showed that the rate of success and total rate of success of patients treated with compound CyA mouthwash were 63 percent and 97 percent respectively, but those of the control group treated with kouTai were 10 percent and 63 percent respectively. There was a statistically significant difference(P < 0.01). No side-effects were found. The mouthwash is an effective, safe and local drug used in the treatment of OLP.

Adolescent↗

PubMed2002

Effects of a potassium nitrate mouthwash on dentinal tubules--a SEM analysis using the dentine disc model.

The concept of tubular occlusion as a method of dentine desensitisation is a logical conclusion from the hydrodynamic hypothesis put forth by Brannström. The aim of this study was therefore to investigate qualitatively by SEM whether a 3% potassium nitrate/0.2% sodium fluoride mouthwash occluded tubule orifices, and by x-ray microanalysis, to characterise the nature of the deposits if any, following application. Following the 'dentine disc model' methodology 1mm thick tooth sections from unerupted molars were obtained. These were treated with the test and control mouthwashes and subjected to scanning electron microscopy. If any deposits were seen, they were to be subjected to elemental analysis using the energy dispersive x-ray analyser. Examination of all the dentine disc surfaces, treated by water (control), active and control mouthwashes demonstrated that none of the treatments, at any of the time intervals, had any visible effect on the dentinal tubule orifices i.e. there was no dentinal tubular occlusion seen. The results suggest that potassium nitrate does not reduce dentinal hypersensitivity, at least by tubule occlusion. This could mean that there is a different mechanism of action, which could not be detected by this in vitro model.

Dentin↗

PubMedDate not supplied

Mouthwash and oral cancer.

Recently, a small but significant relationship has been identified between the use of over-the-counter mouthwash preparations containing greater than 25 percent alcohol and the development of oral cancer. This paper reviews the medical and dental literature, discusses the implications of long-term, excessive mouthwash use and makes recommendations regarding the use of mouthwash with a high alcohol content.

Animals↗

PubMedDate not supplied

[Inhibitory effect of mouthwashes on Streptococcus mutans growth].

The efficacy of 10 mouthwashes available in Bangkok in inhibiting Streptococcus mutans growth in vitro was studied. After one-minute incubation with the bacterium, most mouthwashes, at concentrations recommended by the manufacturers, demonstrated the antimicrobial effect; three exhibited a complete while five a partial but varying degree of inhibition. Only two mouthwashes were found that did not significantly show any detrimental effect on the bacterial viability.

Mouthwashes↗

PubMed1990

Inhibition of dental plaque formation by mouthwash containing an endo-alpha-1, 3 glucanase.

The effect of mouthrinsing with the purified endo-alpha-1, 3 glucanase (mutanase) from a Pseudomonas sp. strain on the formation of dental plaque was investigated. Twenty-two college students participated in the clinical trial. After the labial and lingual surfaces of the 12 front teeth had been subjected to a thorough prophylaxis, the participants were instructed to cease all active oral hygiene practices and to rinse their mouths with either the mutanase or placebo mouthwashes for one minute, up to four times daily, in all, eight times for three days. No restriction regarding meals was given during the experimental period. After a 5-day recess, a second experiment was performed using the same procedures, except the placebo and active mouthwashes were switched. The amount of dental plaque formed on the front teeth was scored according to the criteria of Quigley and Hein. Mean plaque scores were significantly lower for the mutanase (p less than 0.05-0.001) than for the placebo group. In the intraparticipant comparison, most plaque scores were also significantly reduced in general (p less than 0.05-0.0010) by rinsing with the mutanase mouthwash. These data indicate that mutanase is able to suppress the accumulation of dental plaque in humans.

Adult↗

PubMedDate not supplied

Sodium retention from mouthwashes.

Sodium intake from food and other sources must be carefully monitored in patients with hypertension and other disorders. Retention of sodium was measured during routine use of three commercially available, nonprescription mouthwashes: Cepacol, Plax, and Viadent. A test group of 17 adults rinsed with 15 ml of the three mouthwashes, and with 5% saline and distilled water as experiment controls. Sodium not recovered in the expectorate was considered to be retained for absorption by oral or other tissues. The sodium in each product (in mg/l) varied widely: Viadent, 144; Cepacol, 410; and Plax 5320. The analyzed expectorate revealed approximately 33% of the sodium in the 15 ml used for rinsing was retained, amounting to 0.7 mg for Viadent, 1.9 mg for Cepacol, and 28.3 mg for Plax. The results indicate that persons on sodium-restricted diets should be aware that some brands of mouthwash may be a potentially significant source of sodium.

Adult↗

PubMedDate not supplied

[Clinical evaluation of a new mouthwash during orthodontic therapy].

The purpose of this clinical study was to value the efficacy of a new mouthwash (Oradyne-Z), with an antiseptic agent, alkyl-dimethyl-benzyl-ammonium-saccarinate, against the formation of bacterial oral plaque, in patients during orthodontic treatment. The test procedure was based on observation of 24 subjects (male and female, aged 14 to 50) and divided into 3 equal groups (group A, B and C) during orthodontic therapy. In six (6) weeks, the first group (A), used Oradyne-Z mouthwash, the second group used a placebo solution (B) ant the third (C), used Chlorhexidine mouthwash. The comparison of the results obtained in this clinical and statistical study, confirms the efficacy of Oradyne-Z and chlorhexidine solutions, against supra-gengival plaque. On the contrary no specific result about antiseptical effects, was observed against subgengival oral plaque. The reduction of gengival clinical indices and periodontal pocket dept, was only connected to the scaling and root-planning treatment.

Adolescent↗

PubMed1989

[The effect of mouthwash on oral malodour production].

Volatile sulphur compounds (VSC), hydrogen sulphide, methyl mercaptan and dimethyl sulphide are by-products derived in oral cavity through putrefactive activity of microorganisms. VSC are the principal cause of physiological oral malodour. There are indications that these compounds are cytotoxic to oral tissues. Hence, it has been considered that the prevention of oral malodour has an important role in preventive dentistry. The objective of this study is to ascertain the effect of two mouthwashes, sodium azulenesulphonic acid and povidone-iodine, which are frequently used in dental clinics, on concentration of VSC in mouth air. The VSC were analyzed using VSC analysis system. VSC were determined at immediately after rince and at one, two and three hours after rince. The results indicated that neither mouthwash was very effective in controlling VSC production. No reduction in VSC was observed at one and two hour post-rinsing with sodium azulenesulphonic acid mouthwash, and only 39% reduction of total sulphur of VSC was observed at one hour following the use of the povidone-iodine containing products. However, this effect was lost within two hours post-rinsing.

Azulenes↗