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Anti-Plaque Efficacy of Herbal and 0.2% Chlorhexidine Gluconate Mouthwash: A Comparative Study.

Prasad KA, John S, Deepika V, Dwijendra KS, Reddy BR, Chincholi S - J Int Oral Health (2015)

Bottom Line: There was no significant difference in the gingival index (GI) and plaque index (PI) scores of the pre-rinsing scores of three groups and mean age of subjects in the three age groups, suggesting selected population for the three groups was homogenous.The difference of post rinsing PI and GI scores between Group A and Group B were statistically non-significant, which means anti-gingivitis and plaque inhibiting properties are similar for both.Within the limitations of this study chlorhexidine gluconate and herbal mouthwash (Hiora) showed similar anti plaque activity with latter showing no side effects.

View Article: PubMed Central - PubMed

Affiliation: Professor, Department of Periodontics, MNR Dental College and Hospital, Sangareddy, Telangana, India.

ABSTRACT

Background: Mouthwashes are an adjunct to, not a substitute for, regular brushing and flossing. Chlorohexidine is cationic bis-biguanide broad spectrum antiseptic with both anti-plaque and antibacterial properties. It has side-effects like brownish discoloration of teeth and dorsum of the tongue, taste perturbation, oral mucosal ulceration, etc. To compare the antiplaque efficacy of herbal and chlorohexidine gluconate mouthwash.

Materials and methods: A double-blinded parallel, randomized controlled clinical trial was conducted in the Department of Periodontics, MNR Dental College. Totally 100 preclinical dental students were randomized into three groups (0.2% chlorohexidine, Saline and herbal mouthwash). All the groups were made to refrain from their regular mechanical oral hygiene measures and were asked to rinse with given respective mouthwashes for 4 days. The gingival and plaque scores are evaluated on 1(st) day, and 5(th) day, and differences were compared statistically.

Results: There was no significant difference in the gingival index (GI) and plaque index (PI) scores of the pre-rinsing scores of three groups and mean age of subjects in the three age groups, suggesting selected population for the three groups was homogenous. Mean GI and PI scores at the post rinsing stage were least for the Group A, followed by B and C. The difference of post rinsing PI and GI scores between Group A and Group B were statistically non-significant, which means anti-gingivitis and plaque inhibiting properties are similar for both.

Conclusion: Within the limitations of this study chlorhexidine gluconate and herbal mouthwash (Hiora) showed similar anti plaque activity with latter showing no side effects.

No MeSH data available.


Related in: MedlinePlus

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Mentions: Ayurvedic drugs have been used to treat oral diseases including periodontal diseases. Oral rinses with herbal composition are used in periodontal therapy to control plaque and inflammation (Figure 4). According to Dalirsani et al.,11 Anupama et al.12 herbal mouth wash have advantages such as decreased side-effects and more economical when compared to chlorhexidine. (Nagavalli Piper betle) shows anti-inflammatory, anti-oxidant, anti-microbial properties. Pilu (Salvadora persica) shows anti-oxidant activity, it has peppermint that contains menthol, which activates cold sensitive TRPM8 receptors in mucosa and it is also used as primary agent in toothpastes and chewing gums, peppermint in Wikipedia). Here an attempt was made to use herbal mouth wash (Hiora) and study was conducted to evaluate the efficacy of herbal mouth wash containing pilu (S. persica), bibhitaka (Terminalia bellirica), Nagavalli, ela (cardamom), pipperment satva, bellenic myrobalan (vibhitaki compared to chlorhexidine digluconate). Chlorhexidine was developed in 1950, which is considered as gold standard6 till date and most anti plaque agent. However the long-term use of chlorhexidine is limited by altered taste perception and staining of tooth with prolonged usage, as reported by Fardal and Turnbull.13 To overcome the limitation of chlorhexidine usage, herbal mouthwash was advocated to the patients and the plaque gingival diseases are measured. The results of the present study showed there was no significant difference in pre rinsing scores of 3 groups there was no significant difference in mean age of subjects in all three groups indicating homogenous distribution. Mean GI and PI scores at the post rinsing stage were least for the group A, followed by Group B and Group C. In all the three groups’ reformation of plaque was evident in all individuals within 24 h after thorough oral prophylaxis by self-evaluation patient and same reported in the questionnaire given. Because of its effervescent property could have better access into the interproximal areas and embrasures where the plaque could be thin and incompletely organized. A major drawback of chlorhexidine was staining of tongue. The antiplaque efficacy of CHXG was attributed by the retention of the compound CHXG in the oral cavity and its slow release.14 Although the effect of the plaque re growth and gingival inflammation observed with CHXG was superior to herbal mouthwash, the latter did not exhibit any other side effects. The similar antiplaque activity was observed as the post rinsing PI and GI scores showed no significant difference statistically. In contrast to this study Almas et al.15 conducted a study antimicrobial activity of about eight mouthwashes and concluded that mouthwash containing CHXG were with maximum antibacterial activity and mouthwash with miswak extract containing CHXG were with maximum antibacterial activity and mouthwash with miswak extract (pilu) with low antibacterial activity. In accordance with our study Scherer et al.16 compared herbal mouthwash and water and concluded that herbal mouthwash has better efficacy when compared to normal distilled water. Within limitations of the study, such as insufficient period of time to evaluate the anti-gingivitis property of herbal mouthwash as the 4 day plaque model was considered and further are directed towards anti-plaque, and gingivitis efficacy of herbal mouthwash. The anti-plaque activity of herbal and CHXG mouthwashes can even further help in post rinsing of periodontal surgeries.


Anti-Plaque Efficacy of Herbal and 0.2% Chlorhexidine Gluconate Mouthwash: A Comparative Study.

Prasad KA, John S, Deepika V, Dwijendra KS, Reddy BR, Chincholi S - J Int Oral Health (2015)

Disclosing agent.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4588801&req=5

Figure 5: Disclosing agent.
Mentions: Ayurvedic drugs have been used to treat oral diseases including periodontal diseases. Oral rinses with herbal composition are used in periodontal therapy to control plaque and inflammation (Figure 4). According to Dalirsani et al.,11 Anupama et al.12 herbal mouth wash have advantages such as decreased side-effects and more economical when compared to chlorhexidine. (Nagavalli Piper betle) shows anti-inflammatory, anti-oxidant, anti-microbial properties. Pilu (Salvadora persica) shows anti-oxidant activity, it has peppermint that contains menthol, which activates cold sensitive TRPM8 receptors in mucosa and it is also used as primary agent in toothpastes and chewing gums, peppermint in Wikipedia). Here an attempt was made to use herbal mouth wash (Hiora) and study was conducted to evaluate the efficacy of herbal mouth wash containing pilu (S. persica), bibhitaka (Terminalia bellirica), Nagavalli, ela (cardamom), pipperment satva, bellenic myrobalan (vibhitaki compared to chlorhexidine digluconate). Chlorhexidine was developed in 1950, which is considered as gold standard6 till date and most anti plaque agent. However the long-term use of chlorhexidine is limited by altered taste perception and staining of tooth with prolonged usage, as reported by Fardal and Turnbull.13 To overcome the limitation of chlorhexidine usage, herbal mouthwash was advocated to the patients and the plaque gingival diseases are measured. The results of the present study showed there was no significant difference in pre rinsing scores of 3 groups there was no significant difference in mean age of subjects in all three groups indicating homogenous distribution. Mean GI and PI scores at the post rinsing stage were least for the group A, followed by Group B and Group C. In all the three groups’ reformation of plaque was evident in all individuals within 24 h after thorough oral prophylaxis by self-evaluation patient and same reported in the questionnaire given. Because of its effervescent property could have better access into the interproximal areas and embrasures where the plaque could be thin and incompletely organized. A major drawback of chlorhexidine was staining of tongue. The antiplaque efficacy of CHXG was attributed by the retention of the compound CHXG in the oral cavity and its slow release.14 Although the effect of the plaque re growth and gingival inflammation observed with CHXG was superior to herbal mouthwash, the latter did not exhibit any other side effects. The similar antiplaque activity was observed as the post rinsing PI and GI scores showed no significant difference statistically. In contrast to this study Almas et al.15 conducted a study antimicrobial activity of about eight mouthwashes and concluded that mouthwash containing CHXG were with maximum antibacterial activity and mouthwash with miswak extract containing CHXG were with maximum antibacterial activity and mouthwash with miswak extract (pilu) with low antibacterial activity. In accordance with our study Scherer et al.16 compared herbal mouthwash and water and concluded that herbal mouthwash has better efficacy when compared to normal distilled water. Within limitations of the study, such as insufficient period of time to evaluate the anti-gingivitis property of herbal mouthwash as the 4 day plaque model was considered and further are directed towards anti-plaque, and gingivitis efficacy of herbal mouthwash. The anti-plaque activity of herbal and CHXG mouthwashes can even further help in post rinsing of periodontal surgeries.

Bottom Line: There was no significant difference in the gingival index (GI) and plaque index (PI) scores of the pre-rinsing scores of three groups and mean age of subjects in the three age groups, suggesting selected population for the three groups was homogenous.The difference of post rinsing PI and GI scores between Group A and Group B were statistically non-significant, which means anti-gingivitis and plaque inhibiting properties are similar for both.Within the limitations of this study chlorhexidine gluconate and herbal mouthwash (Hiora) showed similar anti plaque activity with latter showing no side effects.

View Article: PubMed Central - PubMed

Affiliation: Professor, Department of Periodontics, MNR Dental College and Hospital, Sangareddy, Telangana, India.

ABSTRACT

Background: Mouthwashes are an adjunct to, not a substitute for, regular brushing and flossing. Chlorohexidine is cationic bis-biguanide broad spectrum antiseptic with both anti-plaque and antibacterial properties. It has side-effects like brownish discoloration of teeth and dorsum of the tongue, taste perturbation, oral mucosal ulceration, etc. To compare the antiplaque efficacy of herbal and chlorohexidine gluconate mouthwash.

Materials and methods: A double-blinded parallel, randomized controlled clinical trial was conducted in the Department of Periodontics, MNR Dental College. Totally 100 preclinical dental students were randomized into three groups (0.2% chlorohexidine, Saline and herbal mouthwash). All the groups were made to refrain from their regular mechanical oral hygiene measures and were asked to rinse with given respective mouthwashes for 4 days. The gingival and plaque scores are evaluated on 1(st) day, and 5(th) day, and differences were compared statistically.

Results: There was no significant difference in the gingival index (GI) and plaque index (PI) scores of the pre-rinsing scores of three groups and mean age of subjects in the three age groups, suggesting selected population for the three groups was homogenous. Mean GI and PI scores at the post rinsing stage were least for the Group A, followed by B and C. The difference of post rinsing PI and GI scores between Group A and Group B were statistically non-significant, which means anti-gingivitis and plaque inhibiting properties are similar for both.

Conclusion: Within the limitations of this study chlorhexidine gluconate and herbal mouthwash (Hiora) showed similar anti plaque activity with latter showing no side effects.

No MeSH data available.


Related in: MedlinePlus