ORAL HEALTH EVIDENCE-BASED PRACTICE PROGRAM
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Title Herbal mouthwash more effective than OTC mouthwash and may be as effective as chlorhexidine rinse
Clinical Question Can herbal mouthwash be as effective as OTC mouthwash at preventing gum disease?
Clinical Bottom Line In vivo, both herbal mouth and gum therapy and Peridex were significantly more effective at inhibiting microbial growth than Listerine. In vitro, Chlorhexidine rinse was the most effective; herbal rinse was less effective than chlorhexidine but more effective than an essential oil rinse. (See Comments on the CAT below)
Best Evidence (you may view more info by clicking on the PubMed ID link)
PubMed ID Author / Year Patient Group Study type
(level of evidence)
#1) 18451378Haffajee/2008120 inoculated platesIn vitro study
Key resultsIn vitro, Chlorhexidine rinse was the most effective, herbal rinse was less effective than chlorhexidine but more effective than an essential oil rinse.
#2) 10518852Gultz/199820 humansComparative Study
Key resultsIn vivo, both Herbal mouth and gum therapy and Peridex were significantly more effective at inhibiting microbial growth than Listerine when grown in petri dishes.
#3) 10518858Scherer/199840 humansRandomized Controlled Trial
Key resultsHerbal mouth and gum therapy significantly decreased bleeding on probing and gingivitis compared to water used as a control (ANOVA p<0.01).
Evidence Search Herbal Mouth and Gum Therapy;[Substance Name]
Comments on
The Evidence
In vivo studies need to be done to confirm or dispute the data from the in vitro study in 2008. Also, long term follow-up should be conducted. The amount of significance in the Gultz article is not noted and should have been.
Applicability Any patient looking for alternatives to traditional mouthwash.
Specialty/Discipline (Public Health) (Periodontics) (Dental Hygiene)
Keywords Chlorhexidine, mouthwash, herbal mouthwash, essential oil, peridex
ID# 479
Date of submission: 01/08/2010spacer
E-mail cooperrb@uthscsa.edu
Author R. Bryn Cooper
Co-author(s)
Co-author(s) e-mail
Faculty mentor/Co-author Barbara MacNeill, DMD
Faculty mentor/Co-author e-mail macneill@uthscsa.edu
Basic Science Rationale
(Mechanisms that may account for and/or explain the clinical question, i.e. is the answer to the clinical question consistent with basic biological, physical and/or behavioral science principles, laws and research?)
post a rationale
None available
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Comments and Evidence-Based Updates on the CAT
(FOR PRACTICING DENTISTS', FACULTY, RESIDENTS and/or STUDENTS COMMENTS ON PUBLISHED CATs)
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by Kristi Johnson (San Antonio, Texas) on 04/09/2012
I conducted a PubMed search on this topic on April 9, 2012 and found contradictory findings in a recent publication: PMID 16451766. This RCT of 63 patients studied the effect of chlorhexidine, herbal mouth rinse, and a placebo, and found that CHX was the only rinse to have a statistically significant effect on gingival index, plaque index, and bleeding on probing. The herbal mouth rinse did not have a statistically significant effect on any of these measures.
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