Title Hydrogen Peroxide or Chlorhexidine Mouth Rinse After Scaling and Root Planing Are Equally Effective in Improving Clinical Attachment and Gingival Inflammation Levels in Adult Patients with Chronic Periodontitis
Clinical Question In an adult patient with chronic periodontitis, is home use of hydrogen peroxide rinse as an adjunct to scaling and root planing more effective in improving clinical attachment level than chlorhexidine home rinse after scaling and root planing?
Clinical Bottom Line Neither a 10-day course of hydrogen peroxide mouth rinse or chlorhexidine mouth rinse after scaling and root planing yielded significant improvements in clinical attachment levels in adult patients with chronic periodontitis compared to scaling and root planing alone. This is based on a single randomized clinical trial with 45 male patients over a 90-day trial period.
Best Evidence  
PubMed ID Author / Year Patient Group Study type
(level of evidence)
27382535Rashed/201645 male adults with chronic periodontitisRandomized Controlled Trial
Key resultsThere were no significant differences in clinical attachment level among the study groups as compared to the baseline (p=.98). Additionally, daily rinses of hydrogen peroxide or chlorhexidine combined with scaling and root planing failed to have a statistically significant added benefit on the plaque index and probing depths compared to scaling and root planing alone. However, there was a trend toward increased probing depth reduction for the group receiving the chlorhexidine rinse (p=0.06). The only significant difference was a reduction in the gingival index for both home use rinses compared to scaling and root planning alone with no difference between the two products otherwise.
Evidence Search chronic[Title] AND periodontitis[Title] AND hydrogen[Title] AND peroxide[Title] AND chlorhexidine[Title]
Comments on
The Evidence
Validity: This is a relatively well-designed randomized controlled clinical trial, with the treatment and control groups similar at the start and containing the same sample size. All groups were treated the same way throughout the 90-day study, and there was a 100% completion rate. Additionally, no conflicts of interest were reported to confound the results of the study. Perspective: The main limitation of the study is represented by the limited sample size (n=15) for each treatment arm tested. The lack of statistically significant treatment effect of the two home-use mouth rinses may be due to this limited sample size.
Applicability The addition of a 10-day course of home-use mouth rinse in the form of hydrogen peroxide or chlorhexidine after scaling and root planing may have a positive effect in reducing gingival inflammation parameters. The evidence is weak to support the usage of these mouth rinses to improve periodontal parameters beyond those yielded by scaling and root planning alone. The study suggests that there is no harm in prescribing these mouth rinses. Therefore, if anything, the home use of hydrogen peroxide or chlorhexidine will not harm the patient and may improve their gingival conditions.
Specialty (General Dentistry) (Periodontics)
Keywords chlorhexidine mouth rinse, hydrogen peroxide mouth rinse, clinical attachment level
ID# 3147
Date of submission 03/15/2017
E-mail woodsja@livemail.uthscsa.edu
Author Jacob Woods
Co-author(s) e-mail
Faculty mentor Guy Huynh-Ba, DDS
Faculty mentor e-mail HuynhBa@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?)
None available
Comments and Evidence-Based Updates on the CAT
None available