The Mouthwash War - Chlorhexidine vs. Herbal Mouth Rinses: A Meta-Analysis

Manipal, Sunayana; Hussain, Sajjid; Wadgave, Umesh; Duraiswamy, Prabu; Ravi, K

doi:10.7860/jcdr/2016/16578.7815

Cited by 33 publications

(41 citation statements)

References 19 publications

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“…Lowering CHX concentration, in combination with herbal extract additives, might be a good approach as shown in the few studies. In some trials, herbal extracts have been compared to CHX solutions, whereby slight clinical benefits were found [58][59][60]. No in vivo trials could be found evaluating a mixed herbal/CHX solution, however.…”

Section: Discussionmentioning

confidence: 99%

Efficacy of chlorhexidine rinses after periodontal or implant surgery: a systematic review

et al. 2018

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BACKGROUND: Biofilm management and infection control are essential after periodontal and implant surgery. In this context, chlorhexidine (CHX) mouth-rinses are frequently recommended post-surgically. Despite its common use and many studies in this field, a systematic evaluation of the benefits after periodontal or implant surgery is-surprisingly-still missing. OBJECTIVES: To evaluate the benefits of chlorhexidine rinsing after periodontal or implant surgery in terms of plaque and inflammation reduction potential. Furthermore, to screen whether the concentration changes or additives in CHX solutions reduce side effects associated with its use. MATERIALS AND METHODS: A systematic literature search was performed for clinical trials, which compared CHX rinsing after periodontal or implant surgery with rinsing using placebo, non-staining formulations, or solutions with reduced concentrations of the active compound. Four databases (Medline, PubMed, Embase, Cochrane) were searched up to June 2018. Two reviewers independently identified and screened the literature. RESULTS: From 691 titles identified, only eleven publications met the inclusion criteria and were finally included. Mainly early publications assessed the benefits of CHX over placebo rinsing, whereas more recent publications focused more on the evaluation of new formulations with regard to effectiveness and side effects. The use of CHX after surgery showed in general significant reduction in plaque (means of 29-86% after 1 week) and bleeding (up to 73%) as compared to placebo. No consensus, however, was found regarding the most beneficial CHX formulation avoiding side effects. CONCLUSION: Chlorhexidine rinsing helps to reduce biofilm formation and gingival inflammation after surgery. However, no additional reduction of periodontal probing depth over any given placebo or control solution could be found irrespective of whether CHX was used or not. The use of additives such as antidiscoloration systems (ADS) or herbal extracts may reduce side effects while retaining efficacy. CLINICAL RELEVANCE: Within the limitations of this review, it can be concluded that CHX may represent a valuable chemo-preventive tool immediately after surgery, during the time period in which oral hygiene capacity is compromised. To reduce the side effects of CHX and maintain comparable clinical effects, rinsing with less concentrated formulations (e.g., 0.12%) showed the most promising results so far.

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Section: Discussionmentioning

confidence: 99%

Efficacy of chlorhexidine rinses after periodontal or implant surgery: a systematic review

et al. 2018

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“…Considering this, we employed ex vivo antimicrobial testing of dental plaque samples from an oral cavity of humans similar to the studies in the past. [ 21 37 38 ] The dental plaque obtained represents the polymicrobial community similar to the dental plaque in clinical samples. The entire spectrum of cultivable polymicrobial species from the plaque samples was tested against the CHX and herbal mouthwash similar to the previous study by Srinivasan et al .…”

Section: Discussionmentioning

confidence: 99%

“…Several herbal mouthwash and herbal extracts have been tested in vitro and in vivo in search of a suitable adjunct to mechanical therapy for long-term use. [ 6 7 8 9 ] In the present study, one such herbal mouthwash was selected which has proved to be promising antimicrobial agent in the past studies. The herbal mouthwash chosen in this study contains Pilu ( Salvadora persica ) Bibhitaka ( Terminalia bellirica ), Nagavalli ( Piper betle ), essential oils, namely, Gandhapura taila ( Gaultheria fragrantissima ), Ela ( Elettaria cardamomum ), flavoring agents Peppermint satva ( Mentha ), and Yavani satva ( Trachyspermum ammi ).…”

Section: Introductionmentioning

confidence: 99%

Comparative evaluation of the efficacy of a herbal mouthwash and chlorhexidine mouthwash on select periodontal pathogens: An in vitro and ex vivo study

Pathan¹,

Bhat

Joshi

2017

J Indian Soc Periodontol

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Background:Several herbal mouthwash and herbal extracts have been tested in vitro and in vivo in search of a suitable adjunct to mechanical therapy for long-term use. In this study, we aimed to look at the antimicrobial effect of the herbal mouthwash and chlorhexidine (CHX) mouthwash on select organisms in in vitro test and an ex vivo model.Materials and Methods:The antimicrobial effects were determined against standard strains of bacteria that are involved in different stages of periodontal diseases. The in vitro tests included determination of minimum inhibitory concentration (MIC) using broth dilution and agar diffusion. In the ex vivo part of the study supragingival dental plaque were obtained from 20 periodontally healthy adult volunteers. Descriptive analysis was done for the entire quantitative and qualitative variable recorded.Results:The MIC by broth dilution method found no statistically significant difference between the mouthwashes. The agar dilution method showed CHX was more effective as compared to the herbal mouthwash against standard strains of Streptococcus mutans, Streptococcus sanguinis, and Aggregatibacter actinomycetemcomitans. However, no difference was observed between the mouthwashes for Porphyromonas, Pseudomonas aeruginosa, and Fusobacterium nucleatum. The ex vivo results conclude that none of the selected mouthwashes were statistically significantly different from each other.Conclusion:In the present study, CHX showed higher levels of antimicrobial action than the herbal mouthwash against bacterial species. The results reinforce the earlier findings that the in vitro testing is sensitive to methods and due diligence is needed when extrapolating the data for further use. However, long-term use and in vivo effectiveness against the periopathogens need to be tested in well-planned clinical trials.

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“…15 As the number increases the questions that frequently arise is which one is better. 8 The aim of this study is to compare the antigingivitis and antiplaque efficacy of Hiora with Chlorhexidine mouthwash at clinical level.…”

Section: Introductionmentioning

confidence: 99%

“…7 It was observed that in the 18 th century urine served as a key active ingredient due to the presence of ammonia that rendered the oral cavity free from oral pathogens especially sulphur producing organisms. 8 Since then a variety of herbal remedies are available triphala, tulsi patra, jyestiamadh, neem, clove oil, pudina, ajwain, white oak bark, horsetail herb, plantain leaf, aloe vera, organic echinacea angustifolia root, myrrh gum, organic lobelia herb and seed, organic peppermint leaf, wildcrafted goldenseal root, clove essential oil, peppermint essential oil, tea tree essential oil. 9 Things changed after Anton van Leeuwenhoek, discovered live bacterial organisms in the deposits of his own teeth.…”

Section: Introductionmentioning

confidence: 99%

Comparison of the Antigingivitis and Antiplaque Efficacy of the Herbal Mouthwash With Allopathic Mouthwash: A Clinical Study

Aspalli¹,

Pal²,

Desai³

et al. 2018

Int. J. Res. Ayurveda Pharm.

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Introduction-Mouthwashes are often prescribed in dentistry for prevention and treatment of several oral conditions. Chlorhexidine gluconate mouthwash has earned eponym of gold standard to treat and/or prevent periodontal disease. In the recent times naturally occurring products are used on a large scale. Objective-The aim of this study is to compare the anti-gingivitis and antiplaque efficacy of herbal mouthwash (Hiora) with allopathic mouthwash (Chlorhexidine). Methodology-A total of 20 patients aged between 18 to 50 years, with gingivitis was selected for this study. After baseline scaling, 10 patients were advised to use 0.2% chlorhexidine mouthwash twice daily in 1:1 dilution and other 10 patients used Hiora mouthwash twice daily. Plaque index, gingival index, bleeding on probing was recorded at baseline and after 21 days. Result-There were no statistically significant differences between the two groups with regard to the clinical parameters. Herbal mouth rinses may be as effective as chlorhexidine as chemical antiplaque agents with fewer side effects Conclusion-Herbal mouth rinses may be as effective as chlorhexidine as chemical anti-plaque agents with fewer side effects. However, alternative study designs using larger sample sizes and longer duration are needed to further reiterate its benefits.

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The Mouthwash War - Chlorhexidine vs. Herbal Mouth Rinses: A Meta-Analysis

Cited by 33 publications

References 19 publications

Efficacy of chlorhexidine rinses after periodontal or implant surgery: a systematic review

Efficacy of chlorhexidine rinses after periodontal or implant surgery: a systematic review

Comparative evaluation of the efficacy of a herbal mouthwash and chlorhexidine mouthwash on select periodontal pathogens: An in vitro and ex vivo study

Comparison of the Antigingivitis and Antiplaque Efficacy of the Herbal Mouthwash With Allopathic Mouthwash: A Clinical Study

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