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Indian Journal of Dental Research :... Oct 2023Chlorhexidine (CHX) is a chemical mouthwash that has been considered the gold standard, but has its drawbacks. When used for a longer duration, it produces taste... (Comparative Study)
Comparative Study Randomized Controlled Trial
INTRODUCTION
Chlorhexidine (CHX) is a chemical mouthwash that has been considered the gold standard, but has its drawbacks. When used for a longer duration, it produces taste alteration and staining on the tooth surfaces. Nowadays, herbal extracts from plants have been widely used as they possess anti-inflammatory, antimicrobial and analgesic actions.
MATERIAL AND METHODS
A group of 45 healthy subjects in the age group of 19-35 years were selected and randomly divided into three groups, Group A - Himalaya complete care mouthwash, Group B - CHX mouthwash, Group C - Distilled water as a control group. Gingival index and plaque index, OHI-s index, and Ainamo and Bay index for bleeding were recorded. Subjects received complete supragingival scaling at baseline and were instructed to use 10 ml of mouthwashes twice a day in their group. Variables were again recorded on the seventh and 14th day after the use of mouthwashes, and data obtained was subjected to statistical analysis. Posthoc and ANOVA tests were used for statistical analysis.
RESULTS
It was found that both CHX and herbal mouthwash proved to be more effective than placebo in maintaining gingival health. There was no significant difference between the test group on gingival health.
CONCLUSION
Herbal mouthwash is an effective alternative to CHX mouthwash, in the light of the reported side effects of CHX mouthwash.
Topics: Humans; Mouthwashes; Chlorhexidine; Adult; Young Adult; Male; Periodontal Index; Female; Plant Extracts; Anti-Infective Agents, Local; Phytotherapy; Dental Plaque Index; Gingivitis
PubMed: 38739820
DOI: 10.4103/ijdr.ijdr_293_22 -
British Dental Journal Jun 2020
Topics: Mouthwashes; Povidone-Iodine
PubMed: 32591671
DOI: 10.1038/s41415-020-1794-1 -
The Journal of Evidence-based Dental... Jun 2020It has been shown that the risk of developing oral cancer is closely related to the intensity and duration of exposure to alcohol and tobacco. Even so, the use of... (Meta-Analysis)
Meta-Analysis
BACKGROUND
It has been shown that the risk of developing oral cancer is closely related to the intensity and duration of exposure to alcohol and tobacco. Even so, the use of mouthwashes with alcohol in their compositions and the increased risk of oral cancer has been a source of controversy for decades.
OBJECTIVE
This study proposes a systematic review and a meta-analysis of the literature, to assess the possible relationship between the use of mouthwashes with alcohol and the development of oral and pharyngeal cancers.
MATERIALS AND METHODS
A systematic search was done using the Medline and PubMed databases. Exclusion criteria were as follows: articles published in languages other than English or Spanish, systematic reviews, and expert opinions. No limitations were used for publication date.
RESULTS
A total of 14 articles were obtained, 11 case-control studies and 3 clinical trials. Three case-control studies found no statistically significant evidence between the relationship of mouthwash use and oral cancer and the remaining 8 case-control studies found statistically significant evidence. The 3 clinical trials observed a relationship between the use of mouthwashes with alcohol and the possibility of developing cancer due to the genotoxicity and mutagenic capacity of alcohol in chronic contact with oral tissues and mucous membranes. The meta-analysis resulted in an OR = 1.480 and a P-value = .161 (95% CI: 0.855; P-value = 2.561) for the analysis of studies of cancer risk and consumption of mouthwashes with alcohol and OR = 1.057 0.364 (95% CI: 0.951; P-value = 1.174) for studies that related the risk of cancer and mouthwash use without taking into account the presence of alcohol.
CONCLUSIONS
There is no sufficient evidence to accept the proposition that the use of mouthwashes containing alcohol can influence the development of oral cancer.
Topics: Carcinogenesis; Case-Control Studies; Humans; Mouth Neoplasms; Mouthwashes
PubMed: 32473798
DOI: 10.1016/j.jebdp.2020.101407 -
International Journal of Environmental... Jan 2022This study provides a safe and low-cost in-house protocol for RT-qPCR-based detection of SARS-CoV-2 using mouthwash-saliva self-collected specimens to achieve clinical...
This study provides a safe and low-cost in-house protocol for RT-qPCR-based detection of SARS-CoV-2 using mouthwash-saliva self-collected specimens to achieve clinical and epidemiological surveillance in a real-time web environment applied to ambulatory populations. The in-house protocol comprises a mouthwash-saliva self-collected specimen, heat virus inactivation, and primers to target virus N-gene region and the human RPP30-gene. Aligning with 209 SARS-CoV-2 sequences confirmed specificity including the Alpha variant from the UK. Development, validation, and statistical comparison with official nasopharyngeal swabbing RT-qPCR test were conducted with 115 specimens of ambulatory volunteers. A web-mobile application platform was developed to integrate a real-time epidemiological and clinical core baseline database with mouthwash-saliva RT-qPCR testing. Nine built-in algorithms were generated for decision-making on testing, confining, monitoring, and self-reports to family, social, and work environments. Epidemiological and clinical follow-up and SARS-CoV-2 testing generated a database of 37,351 entries allowing individual decision-making for prevention. Mouthwash-saliva had higher sensitivity than nasopharyngeal swabbing in detecting asymptomatic and mild symptomatic cases with 720 viral copy number (VCN)/mL as the detection limit (Ct = 37.6). Cycling threshold and viral loading were marginally different ( = 0.057) between asymptomatic (35 Ct ± 2.8; 21,767.7 VCN/mL, range 720-77,278) and symptomatic (31.3 Ct ± 4.5; 747,294.3 VCN/mL, range 1433.6-3.08 × 10). We provided proof-of-concept evidence of effective surveillance to target asymptomatic and moderate symptomatic ambulatory individuals based on integrating a bio-safety level II laboratory, self-collected, low-risk, low-cost detection protocol, and a real-time digital monitoring system. Mouthwash-saliva was effective for SARS-CoV-2 sampling for the first time at the community level.
Topics: COVID-19; COVID-19 Testing; Female; Humans; Mouthwashes; SARS-CoV-2; Saliva; Specimen Handling
PubMed: 35162294
DOI: 10.3390/ijerph19031271 -
BMC Oral Health Oct 2023Recurrent Aphthous Stomatitis (RAS) is painful oral ulceration frequently treated with topical steroids. There is limited published evidence for the efficacy of any... (Randomized Controlled Trial)
Randomized Controlled Trial
BACKGROUND
Recurrent Aphthous Stomatitis (RAS) is painful oral ulceration frequently treated with topical steroids. There is limited published evidence for the efficacy of any treatment for RAS and there remains a need for longitudinal randomised clinical trials to evaluate and compare the effectiveness of different therapies in the management of RAS. The aim of the current project was to assess the efficacy of betamethasone mouthwash and colchicine tablets, individually and combined, for the treatment of RAS, and to establish the optimum treatment period necessary for a significant reduction in the disease severity.
METHODOLOGY
A randomised, prospective, parallel-group clinical trial was conducted over one year, to compare the efficacy of three therapies in RAS. One hundred and six patients were randomized into three groups; 35 received betamethasone mouthwash, 35 had colchicine tablets and 36 received both therapies. The response was evaluated quantitatively every 3 months for 1 year, using the Ulcer Severity Score (USS).
RESULTS
For all three treatment regimes, the mean USS decreased by about 30% in the first 3 months (p < 0.001). Further improvement was noted for up to 9 months. At the end of the study, the mean USS had improved by 50% from 34.9 ± 7.2 before treatment to 17.5 ± 8.9 after treatment (p < 0.001). Of included participants, 86% showed significant clinical improvement by the end of the study. There were no significant differences in outcomes between the three regimes (p < 0.05).
CONCLUSIONS
This clinical trial has provided evidence for the efficacy of betamethasone mouthwash and for colchicine tablets in the treatment of RAS and has shown that at least six months of treatment may be required for optimum effect.
CLINICAL TRIAL REGISTRATION NUMBER
ISRCTN3267716. Date of clinical trial registration: 15/04/2018.
Topics: Humans; Stomatitis, Aphthous; Colchicine; Mouthwashes; Prospective Studies; Betamethasone
PubMed: 37789351
DOI: 10.1186/s12903-023-03335-x -
Canadian Journal of Dental Hygiene :... Oct 2021Research has revealed that periodontal diseases are caused by inflammation that results from a dysbiosis of the oral microbiome where oral bacteria multiply into larger... (Review)
Review
BACKGROUND
Research has revealed that periodontal diseases are caused by inflammation that results from a dysbiosis of the oral microbiome where oral bacteria multiply into larger communities referred to as dental biofilm. To help control this overgrowth of bacteria, a variety of toothpastes, dentifrices, and mouthwashes have been developed. Although not as common in North American toothpastes, propolis as an active ingredient in dentifrices has begun to emerge, as laboratory studies have suggested it has anti-inflammatory, immunomodulatory, antioxidant, antimicrobial, and antidiabetic properties. The purpose of this scoping review was to explore the literature on the effectiveness of propolis in maintaining oral health.
METHODS
This review used the following criteria: studies involving healthy humans; propolis in the form of toothpaste, dentifrice, and mouthwash; fluoride, chlorohexidine, and placebo; plaque and gingival indices, improvement in oral hygiene, and inhibition of bacteria. Relevant research articles were selected from Web of Science, PubMed, MEDLINE, and Scopus databases using the search parameter "propolis[tw] AND (toothpaste*[tw] OR dentifrice*[tw] OR mouthwash*[tw])". Only original articles published after 2009 and written in the English language were included.
RESULTS
A total of 19 original papers met the criteria and showed varying levels of success achieved with the use of propolis. It was responsible for a significant lowering of specific plaque and gingival indices, inhibited the growth of bacteria, reduced oral flora diversity, and consistently improved periodontal condition, oral hygiene, and oral health.
CONCLUSION
Propolis may play a role in initiating, sustaining, and maintaining oral health as its desirable properties have the potential to improve various oral hygiene related indices.
Topics: Dental Plaque; Humans; Mouthwashes; Oral Health; Oral Hygiene; Propolis
PubMed: 34925517
DOI: No ID Found -
Journal of the Formosan Medical... May 2022The COVID-19 pandemic, caused by the spread of SARS-CoV-2 infection that is mainly through the airborne transmission, is a worldwide health concern. This review seeks to... (Review)
Review
The COVID-19 pandemic, caused by the spread of SARS-CoV-2 infection that is mainly through the airborne transmission, is a worldwide health concern. This review seeks to assess the potential effectiveness of mouthwash in reducing the oropharyngeal load of SARS-CoV-2 based on the available evidence. Articles related to mouthwash and COVID-19 in PubMed were electronically searched in July, 2021. After manually excluding articles lacking sufficient scientific evidence or validation processes, those with inaccessible online full text, those that did not test the effectiveness of mouthwash against SARS-CoV-2, and those not written in English, 17 original and 13 review articles were chosen for this review. The eligible articles revealed that the main virucidal mechanism of mouthwash was via interactions with the viral envelope. Povidone-iodine (PVP-I), cetylpyridinium chloride (CPC), and essential oils with ethanol showed virucidal effects on SARS-CoV-2 in vitro, potentially by interfering with the viral envelope. A few clinical studies demonstrated that PVP-I, CPC, hydrogen peroxide, and chlorhexidine reduced the oropharyngeal load of SARS-CoV-2. Although the available evidence is limited, mouthwash containing PVP-I or CPC shows potential for reducing the oropharyngeal load of SARS-CoV-2 and thus may present a risk-mitigation strategy for COVID-19 patients.
Topics: COVID-19; Humans; Mouthwashes; Pandemics; Povidone-Iodine; SARS-CoV-2
PubMed: 34666923
DOI: 10.1016/j.jfma.2021.10.001 -
Chlorhexidine mouthwash and sodium lauryl sulphate dentifrice: do they mix effectively or interfere?International Journal of Dental Hygiene Feb 2016What is the effectiveness of a chlorhexidine (CHX) mouthwash used in combination with a sodium lauryl sulphate (SLS) dentifrice on the parameters of plaque and... (Review)
Review
FOCUSED QUESTION
What is the effectiveness of a chlorhexidine (CHX) mouthwash used in combination with a sodium lauryl sulphate (SLS) dentifrice on the parameters of plaque and gingivitis?
MATERIAL AND METHODS
MEDLINE-PubMed, Cochrane-CENTRAL, EMBASE and other electronic databases were searched up to July 2014. The inclusion criteria were (randomized) controlled clinical trials, subjects ≥18 years of age with good general health. Papers evaluating the effect of CHX mouthwash used in combination with SLS dentifrice or a dentifrice slurry compared with CHX mouthwash as a single oral hygiene intervention or in combination with an SLS-free dentifrice were included. From the eligible studies, data were extracted, and a meta-analysis was performed when feasible.
RESULTS
Independent screening of 83 unique papers resulted in four eligible publications, with nine comparisons. The meta-analysis showed that when an SLS dentifrice was used as a slurry rinse, the interference on the plaque-inhibiting effect of a CHX mouthwash was significantly decreased (MD 0.33; P ≤ 0.00001; 95% CI: <0.24; 0.42>). No significant difference was observed when SLS dentifrice was applied as a paste in combination with CHX mouthwash (MD 0.08; P = 0.42; 95% CI: <-0.26; 0.11>). Descriptive and subgroup analyses support these findings. Moreover, the observed effect for the dentifrice paste occurred regardless of the order of use.
CONCLUSION
This review demonstrates that when CHX mouthwash is recommended, it can be used in combination with an SLS dentifrice without any interference regarding its inhibiting effect on dental plaque, regardless of the order of use. Consequently, the collective evidence indicates that the combined use of dentifrice and CHX mouthwash is not contraindicated. However, this recommendation has been graded as moderate taking into account a potential publication bias because three of the four included studies emerged from the same research group.
Topics: Chlorhexidine; Dental Plaque; Dentifrices; Drug Interactions; Humans; Mouthwashes; Randomized Controlled Trials as Topic; Sodium Dodecyl Sulfate
PubMed: 25880828
DOI: 10.1111/idh.12125 -
Molecular Oral Microbiology Jun 2023COVID-19 is a transmissible respiratory and multisystem disease caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Viral transmission occurs mainly... (Review)
Review
INTRODUCTION
COVID-19 is a transmissible respiratory and multisystem disease caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Viral transmission occurs mainly through the spread of salivary droplets or aerosol from an infected subject. Studies suggest that salivary viral load is correlated with disease severity and probability of transmission. Cetylpyridinium chloride mouthwash has been found to be effective in reducing salivary viral load. The aim of this systematic review of randomized controlled trials is to evaluate the efficacy of the mouthwash ingredient cetylpyridinium chloride on salivary viral load in SARS-CoV-2 infection.
METHODS
Randomized controlled trials comparing cetylpyridinium chloride mouthwash with placebo and other mouthwash ingredients in SARS-CoV-2 positive individuals were identified and evaluated.
RESULTS
Six studies with a total of 301 patients that met the inclusion criteria were included. The studies reported the efficacy of cetylpyridinium chloride mouthwashes in reduction on SARS-CoV-2 salivary viral load compared to placebo and other mouthwash ingredients.
CONCLUSION
Mouthwashes containing cetylpyridinium chloride are effective against salivary viral load of SARS-CoV-2 in vivo. There is also the possibility that the use of mouthwash containing cetylpyridinium chloride in SARS-CoV-2 positive subjects could reduce transmissibility and severity of COVID-19.
Topics: Humans; Cetylpyridinium; Mouthwashes; SARS-CoV-2; Chlorides; Dental Plaque; COVID-19; Randomized Controlled Trials as Topic
PubMed: 36808889
DOI: 10.1111/omi.12408 -
BMC Oral Health Sep 2023The effects of a low concentration of hypochlorous acid (HOCl) mouthwash on salivary bacteria remained unclear. We aimed to evaluate the antibacterial effects of... (Randomized Controlled Trial)
Randomized Controlled Trial
BACKGROUND
The effects of a low concentration of hypochlorous acid (HOCl) mouthwash on salivary bacteria remained unclear. We aimed to evaluate the antibacterial effects of 100 ppm HOCl mouthwash on salivary bacteria, including Staphylococcus aureus (S. aureus), in patients with periodontal disease (PD).
METHODS
Patients with PD were randomized into mouthwash-only (MW, n = 26) and mouthwash with periodontal flosser (MWPF, n = 27) groups. Patients without PD were selected for the control group (n = 30). S. aureus culture and saliva samples (before and after the intervention) were collected for bacterial DNA extraction. A real-time polymerase chain reaction assay and serial dilutions of S. aureus culture and saliva samples were used to measure the salivary bacteria total count (SBTC) and confirm the antibacterial effects of the mouthwash using S. aureus.
RESULTS
No significant difference in demographic data was observed among the three groups. Before the intervention, the baseline SBTC of the MW and MWPF groups was significantly higher than that of the control group. After the mouthwash rinses, the SBTC data significantly changed in the MW and MWPF groups only (by 62.4% and 77.4%, respectively). After the base-2 log-transformation of the SBTC data, a similar trend was observed. Linear regression revealed that baseline SBTC and the MWPF intervention significantly affected SBTC reduction percentage by volume. After incubation with 10% (v/v) of mouthwash, the survival rates of 10 and 10 colony-forming units/mL of S. aureus were 0.51% ± 0.06% and 1.42% ± 0.37%, respectively.
CONCLUSIONS
These study results indicated that 100 ppm HOCl mouthwash treatment could effectively reduce SBTC in patients with PD and the abundance of S. aureus. It provides that the HOCl mouthwash can be an option for individuals to help control SBTC, especially in patients with PD.
TRIAL REGISTRATION
The study protocol was approved by the Institutional Review Board of Kaohsiung Medical University Hospital (KMUHIRB-F(I)-20200042) on 20/03/2020 and retrospectively registered at ClinicalTrial.gov (NCT05372835) on 13/05/2022.
Topics: Humans; Mouthwashes; Staphylococcus aureus; Hypochlorous Acid; Saliva; Bacteria; Periodontal Diseases; Anti-Bacterial Agents
PubMed: 37770865
DOI: 10.1186/s12903-023-03358-4