Influence of additional active ingredients on the effectiveness of non-alcoholic chlorhexidine mouthwashes: a randomized controlled trial.
BACKGROUND
Non-alcoholic chlorhexidine mouthwashes are equally effective and have fewer potential risks than hydroalcoholic solutions. Nowadays, other active ingredients are added to these mouthwashes in an attempt to improve their effectiveness and reduce side effects. Following an experimental gingivitis model, this study examined three non-alcoholic commercial mouthwashes having 0.12% chlorhexidine digluconate (CHX) in common.


METHODS
Using a double masked, cross-over design, 30 subjects underwent three consecutive experimental phases with three mouthwashes: CHX, CHX + 0.05% sodium fluoride (CHXNaF), and CHX + 0.05% cetylpyridinium chloride (CHX-CPC). In each one of these 21-day phases, the subjects discontinued all oral hygiene measures and were treated exclusively with the experimental mouthwash randomly assigned (an oral rinse twice a day). Each experimental phase was preceded by a 14-day washout period. Levels of gingivitis, dental plaque, supragingival calculus, and dental staining were assessed at baseline and end (day 21) of experimental phases.


RESULTS
The evolution of gingival and dental staining indices did not show statistically significant differences between the treatments. Differences were noticed in the plaque index (P = 0.0002), with CHX-NaF the treatment with the greatest increase. Differences were also observed in the supragingival calculus index (P = 0.0136), with CHX-CPC showing a smaller increase. Tongue staining was more frequent with CHX-CPC (P = 0.0141).


CONCLUSIONS
In non-alcoholic 0.12% chlorhexidine mouthwashes, the addition of other active ingredients does not produce beneficial effects, but may even reduce the antiplaque effectiveness or increase tongue staining.
Bascones
Antonio
A
Department of Medicine and Buccofacial Surgery, Faculty of Dentistry, Complutense University, Madrid, Spain. antbasco@arrakis.es
Morante
Sergio
S
Mateos
Leopoldo
L
Mata
Montserrat
M
Poblet
Jorge
J
D000328:Adult; D000891:Anti-Infective Agents, Local / Q000627:therapeutic use*; D002594:Cetylpyridinium / Q000627:therapeutic use*; D016009:Chi-Square Distribution; D002710:Chlorhexidine / Q000009:adverse effects / Q000627:therapeutic use*; D018592:Cross-Over Studies; D003773:Dental Plaque / Q000517:prevention & control; D004311:Double-Blind Method; D005260:Female; D005891:Gingivitis / Q000188:drug therapy / Q000517:prevention & control; D006801:Humans; D008297:Male; D009067:Mouthwashes / Q000009:adverse effects / Q000627:therapeutic use*; D012969:Sodium Fluoride / Q000627:therapeutic use*; D018709:Statistics, Nonparametric
D000891:Anti-Infective Agents, Local; D009067:Mouthwashes; D012969:Sodium Fluoride; D002594:Cetylpyridinium; D002710:Chlorhexidine