Mouthwashes in the 21stcentury: a narrative review about active molecules and effectiveness on the periodontal outcomes.
Poor oral hygiene is a major risk factor for oral diseases. Regular home-based care is essential to maintain good oral hygiene. In particular, mouthrinses can support conventional tooth brushing in reducing accumulation of oral plaque. Areas covered: The most common molecules contained in mouthrinses (chlorhexidine, essential oils, cetyl pyridinium chloride, triclosan, octeneidine, delmopinol, polyvinylpyrrolidone, hyaluronic acid, natural compounds) are discussed, together with relevant clinical and in vitro studies, focusing on their effects on periodontal health. Currently, chlorhexidine is the most efficacious compound, with both antiplaque and antibacterial activities. Similar results are reported for essential oils and cetyl pyridinium chloride, although with a somewhat reduced efficacy. Considering the adverse effects of chlorhexidine and its time-related characteristics, this molecule may best be indicated for acute/short-term use, while essential oils and cetyl pyridinium chloride may be appropriate for long-term, maintenance treatment. Expert opinion: The literature has not clearly demonstrated which compound is the best for mouthrinses that combine good efficacy and acceptable side effects. Research should focus on substances with progressive antibacterial activity, prompting a gradual change in the composition of oral biofilm and mouthrinses that combine two or more molecules acting synergistically in the mouth.
a Department of Biomedical Sciences for Health, Functional Anatomy Research Center (FARC) , Università degli Studi di Milano , Milano , Italy.|b SST Dental Clinic , Segrate , Italy.
Gianluca M
GM
Tartaglia
c Population and Social Health Research Programme, Menzies Health Institute Queensland and School of Dentistry and Oral Health, Griffith University , Gold Coast , Australia.
Santhosh
S
Kumar
b SST Dental Clinic , Segrate , Italy.
Claudia Debora
CD
Fornari
d Department of Regulatory Affairs , Biokosmes srl , Bosisio Parini , Italy.
Eleonora
E
Corti
e Department of Veterans Affairs Medical Center , San Francisco , CA , USA.
Stephen Thaddeus
ST
Connelly
D004202:Disinfectants / Q000627:therapeutic use; D006801:Humans; D009067:Mouthwashes / Q000627:therapeutic use*; D010510:Periodontal Diseases / Q000188:drug therapy*; D016896:Treatment Outcome
D004202:Disinfectants; D009067:Mouthwashes
Clinical outcomes; chemical compounds; efficacy; mouthrinse; oral health