title: Mouthwashes for the control of supragingival biofilm and gingivitis in orthodontic patients: evidence-based recommendations for clinicians.
abstract: Properly performed daily mechanical biofilm control is the most important prevention strategy for periodontal diseases. However, proper mechanical biofilm control is not performed effectively by the majority of the population, mainly due to lack of motivation and of manual dexterity. Local biofilm retention factors may aggravate home oral hygiene quality. For this reason, patients wearing fixed orthodontic appliances comprise a group that may benefit from the daily use of mouthwashes. The purpose of this review was to perform a systematic search in the literature on antiseptics used to control supragingival biofilm and gingivitis in orthodontic patients. Six studies investigating the effect of chlorhexidine and 5 studies evaluating the effect of the daily use of antiseptics were found. Chlorhexidine showed better results in reducing plaque and gingivitis. However, because of its adverse effects after continuous use, it should not be indicated for long-term periods. Among the agents considered for daily use, the fixed combination of essential oils was the only one evaluated in a clinical trial, in which a comparative group presented a statistically significant clinical impact. There is no direct evidence supporting the indication of antiseptic agents for orthodontic patients other than chlorhexidine and essential oils. It can be concluded that, for patients undergoing orthodontic treatment, chlorhexidine should be considered for treating acute gingival inflammation, whereas essential oils should be indicated for long-term daily use in controlling supragingival biofilm.
authors: Periodontology Department, School of Dentistry, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil.
authors: Alex Nogueira
authors: AN
authors: Haas
authors: Periodontology Department, School of Dentistry, Faculdades Metropolitanas Unidas, São Paulo, SP, Brazil.
authors: Claudio Mendes
authors: CM
authors: Pannuti
authors: Periodontology Department, School of Dentistry, Faculdades Metropolitanas Unidas, São Paulo, SP, Brazil.
authors: Ana Karina Pinto de
authors: AK
authors: Andrade
authors: Periodontology Department, School of Dentistry, Faculdades Metropolitanas Unidas, São Paulo, SP, Brazil.
authors: Elaine Cristina
authors: EC
authors: Escobar
authors: Epidemiology and Pediatric Dentistry Department, School of Dentistry, Universidade Cruzeiro do Sul, São Paulo, SP, Brazil.
authors: Eliete Rodrigues de
authors: ER
authors: Almeida
authors: Periodontology Department, School of Dentistry, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil.
authors: Fernando Oliveira
authors: FO
authors: Costa
authors: Periodontology Department, School of Dentistry, Universidade de Taubaté, Taubaté, SP, Brazil.
authors: José Roberto
authors: JR
authors: Cortelli
authors: Dental Materials and Prosthesis Department, Instituto de Ciência e Tecnologia, Univ Estadual Paulista, São José dos Campos, SP, Brazil.
authors: Sheila Cavalca
authors: SC
authors: Cortelli
authors: Dental Materials and Prosthesis Department, Instituto de Ciência e Tecnologia, Univ Estadual Paulista, São José dos Campos, SP, Brazil.
authors: Sigmar de Melo
authors: SD
authors: Rode
authors: Dental Materials and Prosthesis Department, Faculdade de Odontologia de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, SP, Brazil.
authors: Vinicius
authors: V
authors: Pedrazzi
authors: Periodontology Department, School of Dentistry, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil.
authors: Rui Vicente
authors: RV
authors: Oppermann