Title

CHX Mouthwash is More Effective in Plaque Removal Than an Essential Oil or Listerine Mouthwash

Clinical Question

In adults (ages 18-60) is an essential oil (Listerine) or CHX mouthwash more effective in plaque removal?

Clinical Bottom Line

CHX mouthwashes are more effective in plaque removal than essential oil or Listerine mouthwashes, but whether the difference in efficacy is large enough to alter treatment from one wash to the other is still disputed.

Best Evidence

PubMed ID	Author / Year	Patient Group	Study type (level of evidence)
12787197	Santos/2003	Adults from 9 RCTs	Systematic Review
Key results	Both CHX and EO mouthwashes are effective at reducing plaque, though CHX may have slightly higher plaque reduction percentages. Chlorhexidine mouthwashes (ranging from 0.1-0.12% CHX) had a range of 16-45% plaque reduction, while Listerine reduced plaque 22-36%. Santos concludes that both agents display efficacy over six months and are viable supplements to reduce plaque in hard to reach areas.
17138709	Gunsolley/2006	Adults from 14 clinical trials	Systematic Review
Key results	Studies of essential oils was the largest group of studies supporting mouthwash efficacy, as measured in anti-gingivitis and anti-plaque parameters. A smaller subset of studies displayed the strong anti-plaque effects of a 0.12% CHX mouthwash. Gunsolley asserts that multiple agents can be used effectively to reduce plaque as part of a daily oral hygiene regiment.
21043801	Van Leeuwen/2011	Adults from 17 RCTs	Systematic Review-meta-analysis
Key results	A meta-analysis of studies over 4 weeks long showed a statistically significant (P=0.0009) result that CHX mouthwash provided better plaque control than EO. Van Leeuwen suggests that EO mouthwashes may be a viable alternative to chlorhexidine mouthwashes with regards to gingival inflammation but not with regard to plaque.

Evidence Search

“EO or Listerine, CHX mouthwashes” Filters: “Humans” “Full Text Available” “Randomized Controlled Trial, Systematic Review or Meta-Analysis” “English”

Comments on
The Evidence

These reviews generally focused on the anti-gingivitis and the anti-plaque effects of mouthwashes, but the anti-plaque effects presented in each article can be reviewed individually. Also note, the Gunsolley JADA review was partially supported by a grant from Pfizer, Morris Plains, N.J (manufactures Listerine).

Applicability

A CHX mouthwash may produce slightly better results at reducing plaque than Listerine, but an EO or Listerine mouthwash is still effective in removing plaque when compared to no intervention. If plaque control is your only concern you may prefer a CHX mouthwash, but if you want a reduction in plaque and gingivitis control Listerine may be the best choice.

Specialty

(General Dentistry) (Periodontics) (Dental Hygiene)

Keywords

CHX mouthwash, Listerine, EO mouthwash, plaque

ID#

2508

Date of submission

07/22/2013

E-mail

devincen@ohsu.edu.

Author

Caroline DeVincenzi

Co-author(s)

Co-author(s) e-mail

Faculty mentor

Ronald Sakaguchi, DDS, MS, PhD, MBA & Eli Schwarz, DDS, MPH, PhD

Faculty mentor e-mail

sakaguch@ohsu.edu, schwarz@ohsu.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?)

None available

Comments and Evidence-Based Updates on the CAT
(FOR PRACTICING DENTISTS', FACULTY, RESIDENTS and/or STUDENTS COMMENTS ON PUBLISHED CATs)

None available