salicylates and Dental-Plaque

The purpose of this review was to systematically evaluate the effects of an alcohol vehicle solution (V-Sol) compared with an essential-oils mouthwash (EOMW) and if available with a water-based control (WC) on plaque, gingival inflammation parameters and extrinsic tooth staining.. The PubMed-MEDLINE, Cochrane-CENTRAL and EMBASE databases were searched. Where appropriate, a meta-analysis was performed, and difference of means (DIFFM) as calculated.. In total, 971 unique papers were found of which five met the eligibility criteria. The DIFFM of the meta-analysis of four 6-month studies showed that the EOMW provided significantly better plaque control (DIFFM = 0.39, P < 0.00001) and gingival inflammation reduction as measured by the Löe and Silness Index (DIFFM = 0.36, P = 0.00001) as compared to the V-Sol. Regarding extrinsic tooth staining, a small but significant difference (DIFFM = -0.08, P = 0.03) was observed.. Limited data, but with a low risk of bias, were available to assess the potential benefit of the alcohol-containing V-Sol. 'High'- and 'moderate'-quality data were available for the analysis of plaque and gingivitis, respectively. Within these limitations, EOMW appears to provide a significant oral health benefit during the 6 months of use. The data retrieved for this review suggest that the essential oils produce an effect on plaque and gingivitis that extends beyond the V-Sol. Furthermore, the V-Sol proved to be no different from a WC.

Topics: Dental Plaque; Drug Combinations; Gingivitis; Humans; Mouthwashes; Oils, Volatile; Periodontal Index; Pharmaceutical Vehicles; Phenols; Salicylates; Terpenes

The aim of this investigation through post-hoc analyses was to determine the ability to achieve gingival health in the short term with daily rinsing with an essential oil containing antimicrobial mouthrinse.. Conventional Analysis of Covariance (ANCOVA) on whole mouth mean plaque and gingivitis scores were originally conducted to demonstrate efficacy of adjunctive use of Cool Mint® LISTERINE® Antiseptic (EO) compared to negative control [brushing (B) or brushing/flossing (BF)] in each of 5 studies containing a 4 week evaluation. The Modified Gingival Index (MGI) was split into 2 categories: healthy (scores 0, 1) and unhealthy (≥2). Data, reflecting subjects that completed 4 weeks of treatment from 5 studies, were evaluated to determine the mean percent of healthy sites and mean percent of more inflamed "affected" areas (MGI≥3).. At baseline, the mean percent healthy gingival sites ranged from 0.1 to 3.2%. At 4 weeks, up to 29.3% and 16.1% of sites were healthy for the EO group and negative control group, respectively. Three and 6 month data from 2 of the 5 studies resulted in up to 39.6% and 62% at 3 and 6 month mean percent healthy sites per subject for EO and up to 17.2% and 15.6% at 3 and 6 months, respectively, for negative control. Virtually plaque free sites (PI=0, 1) at 4 weeks ranged up to 34.3% and 8.1% for EO and control groups, respectively.. Significantly more healthy gingival sites and virtually plaque free tooth surfaces can be achieved as early as 4 weeks with use of an essential oil antimicrobial mouthrinse. This finding continues through 6 months twice daily use as part of oral care practices compared to mechanical oral hygiene alone.

Topics: Adult; Anti-Infective Agents, Local; Cariostatic Agents; Dental Devices, Home Care; Dental Plaque; Dental Plaque Index; Drug Combinations; Female; Fluorides; Follow-Up Studies; Gingivitis; Humans; Male; Mouthwashes; Oils, Volatile; Periodontal Index; Placebos; Randomized Controlled Trials as Topic; Salicylates; Terpenes; Toothbrushing; Toothpastes; Treatment Outcome

Periodontal diseases are initiated by subgingival periodontal pathogens in susceptible periodontal sites. The host immune response toward periodontal pathogens helps to sustain periodontal disease and eventual alveolar bone loss. Numerous adjunctive therapeutic strategies have evolved to manage periodontal diseases. Systemic and local antibiotics, antiseptics, and past and future host immune modulatory agents are reviewed and discussed to facilitate the dental practitioner's appreciation of this ever-growing field in clinical periodontics.

Topics: Administration, Oral; Administration, Topical; American Dental Association; Anti-Bacterial Agents; Anti-Infective Agents, Local; Anti-Inflammatory Agents, Non-Steroidal; Chlorhexidine; Chronic Periodontitis; Dental Plaque; Drug Approval; Drug Combinations; Gingivitis; Humans; Immunomodulation; Matrix Metalloproteinase Inhibitors; Mouthwashes; Prostaglandin Antagonists; Salicylates; Terpenes; United States

Topics: Clinical Trials as Topic; Dental Devices, Home Care; Dental Plaque; Drug Combinations; Humans; Mouthwashes; Oils, Volatile; Oral Hygiene; Salicylates; Terpenes; Toothbrushing

Topics: Anti-Infective Agents, Local; Chlorhexidine; Dental Implants; Dental Plaque; Drug Combinations; Gingivitis; Humans; Mouthwashes; Oils, Volatile; Oral Hygiene; Periodontal Attachment Loss; Periodontal Diseases; Periodontal Index; Periodontal Pocket; Salicylates; Terpenes

Periodontal diseases are a group of related inflammatory disorders, initiated by dental plaque and causing destruction of the supporting structures of the teeth. Although the inflammatory response is a fundamental defence mechanism against bacterial infection, its persistence over a long period of time may extensively damage the periodontal tissues: cementum, alveolar bone, periodontal ligament and dentogingival tissues. These disorders, despite recent improvements in oral health are still a major cause of tooth loss in patients over 35 years of age.

Topics: Adult; Anti-Infective Agents, Local; Cetylpyridinium; Child; Child, Preschool; Chlorhexidine; Chlorine; Dental Plaque; Drug Combinations; Fluorides; Gingivitis; Humans; Iodine; Middle Aged; Mouthwashes; Oxides; Periodontal Diseases; Povidone; Salicylates; Terpenes; Triclosan

Topics: Alkaloids; Benzoates; Benzophenanthridines; Benzydamine; Cetylpyridinium; Chlorhexidine; Dental Plaque; Drug Combinations; Fluorides; Gingivitis; Isoquinolines; Mouthwashes; Peroxides; Salicylates; Sodium Bicarbonate; Sodium Dodecyl Sulfate; Terpenes; Triclosan

The Seal of Acceptance of the American Dental Association's Council on Dental Therapeutics has been awarded to Listerine and chlorhexidine gluconate (Peridex). The mechanism of action of Listerine involves bacterial cell wall destruction, bacterial enzymatic inhibition, and extraction of bacterial lipopolysaccharides. Chlorhexidine has the property of substantivity, i.e. the ability to bind to hard and soft tissue with slow release. Antibacterial mouthrinses/dentifrices containing triclosan hold promise for the reduction of plaque and gingivitis but are not yet available in the United States. The quaternary ammonium compounds and sanguinarine compounds (Viadent) have some merit, but studies of their efficacy in plaque and gingivitis reduction are mixed. New products containing various fluorides and oxygenating agents may have potential for the future as antiplaque and antigingivitis agents.

Topics: Alkaloids; American Dental Association; Anti-Infective Agents, Local; Benzoates; Benzophenanthridines; Chlorhexidine; Dental Plaque; Drug Combinations; Fluorides; Isoquinolines; Mouthwashes; Oxidants; Quaternary Ammonium Compounds; Salicylates; Sodium Dodecyl Sulfate; Terpenes; Triclosan; United States

The use of antimicrobial mouthrinses is important to dental professionals and their patients. Listerine Antiseptic was found to greatly decrease the anaerobic and aerobic bacteria associated with bacteremia, when used as a subgingival irrigant prior to scaling. Furthermore, preprocedural rinsing with either Listerine or chlorhexidine gluconate (Peridex) can greatly decrease the number of bacteria aerosolized during many dental procedures. Studies have shown that both Listerine and chlorhexidine have anti-Candida properties and therefore are helpful to patients who are immunosuppressed and subject to the opportunistic infection of candidiasis. Chlorhexidine has also been shown to decrease the incidence and severity of mucositis during cancer chemotherapy. Healing of the wounds and aiding in plaque control following periodontal surgery are further benefits of chlorhexidine and Listerine. Finally, each of these antimicrobials can be adjuncts to implant maintenance.

Topics: Aerosols; Anti-Bacterial Agents; Candidiasis, Oral; Chlorhexidine; Dental Plaque; Drug Combinations; Humans; Mouthwashes; Occupational Exposure; Postoperative Care; Premedication; Prosthesis-Related Infections; Salicylates; Terpenes; Therapeutic Irrigation

Topics: Alkaloids; Bacteremia; Benzophenanthridines; Chlorhexidine; Dental Devices, Home Care; Dental Plaque; Drug Combinations; Gingivitis; Humans; Hydrogen Peroxide; Isoquinolines; Periodontal Diseases; Root Planing; Salicylates; Terpenes; Therapeutic Irrigation; Tin Fluorides

Various hypotheses have been introduced and discussed in the past decade to explain the aetiology of caries and paradontopathies: Non-specific/group-specific/specific plaque hypothesis, exogenic plaque hypothesis, ecological change theory. Principles and strategies of chemotherapy for dental plaque-related ailments are treated on the basis of these theories.

Topics: Amines; Anti-Bacterial Agents; Cariostatic Agents; Chlorhexidine; Dental Caries; Dental Plaque; Drug Combinations; Fluorides; Humans; Periodontal Diseases; Salicylates; Terpenes; Tin Fluorides

Topics: Alkaloids; Benzoates; Benzophenanthridines; Chlorhexidine; Dental Plaque; Drug Combinations; Gingivitis; Humans; Isoquinolines; Mouthwashes; Salicylates; Sodium Dodecyl Sulfate; Terpenes

Plaque control can be achieved by mechanical means. Since plaque removal can be laborious and difficult, chemical agents became important adjuncts to traditional oral hygiene procedures. Chlorhexidine is one of the synthetic antiseptics that has a unique antiplaque effect and 0.2% chlorhexidine can achieve a practically complete plaque control. It has one negative effect namely an extrinsic brown-yellow staining. Listerine has proven its ability to reduce plaque and gingivitis in a moderate way. Hexetidine has a greater antiplaque effect in combination with zinc and can be compared with a 0.1% chlorhexidine. Povidone-iodine can not be used to keep plaque at low levels. Sanguinarine can reduce plaque accumulation when the toothpaste and mouthrinse are used together. H2O2 is an antiplaque agent but has some negative effects such as ulcerations... One can conclude that the use of a chemical agent cannot replace a good mechanical plaque control but is rather an adjunct to oral hygiene under certain conditions.

Topics: Alkaloids; Anti-Infective Agents; Benzophenanthridines; Chlorhexidine; Dental Plaque; Drug Combinations; Hexetidine; Isoquinolines; Mouthwashes; Povidone-Iodine; Salicylates; Terpenes

Topics: Alkaloids; Anti-Infective Agents; Benzophenanthridines; Chlorhexidine; Dental Plaque; Drug Combinations; Gingivitis; Humans; Isoquinolines; Mouthwashes; Salicylates; Terpenes

A number of mouthrinse formulations containing antimicrobials have been evaluated to determine their effectiveness as antiplaque and/or antigingivitis agents. These have included the bis-biguanides, phenols, quaternary ammonium compounds, oxygenating compounds, plant extracts, fluorides, antibiotics and antimicrobial combinations. These mouthrinses have often been tested as adjuncts to normal oral hygiene procedures as well as in the experimental gingivitis model. 2 agents in particularly, chlorhexidine gluconate and listerine, have been shown to both inhibit or reduce plaque accumulation and the severity of gingivitis. Chlorhexidine has been reported to reduce the accumulation of plaque by approximately 60% and the severity of gingivitis by 50-80% as determined by improvements in clinical indices. A 0.12% chlorhexidine gluconate rinse resulted in significant reductions after both 3 and 6 months use in the numbers of total anaerobes, total aerobes, streptococci, and actinomyces recovered from supragingival plaque. Listerine has been reported to retard the development of plaque by 45 to 56% and to reduce existing plaque by 39 to 48%. Gingivitis scores were reduced as much as 59%. Microbial studies have shown that the effect of listerine is exerted against the total microbial mass and results in an overall decrease in both the biomass and the activity. Long-term use of neither mouthrinse, chlorhexidine or listerine, resulted in the emergence of opportunistic or oral pathogens. Preliminary data obtained following the use of a novel mouthrinse consisting of a combination of povidone-iodine and hydrogen peroxide appears promising. This combination was more effective than was more effective than either single component alone in reducing gingivitis scores.(ABSTRACT TRUNCATED AT 250 WORDS)

Topics: Anti-Infective Agents, Local; Bacteria; Chlorhexidine; Dental Plaque; Drug Combinations; Gingivitis; Humans; Hydrogen Peroxide; Mouthwashes; Povidone-Iodine; Salicylates; Terpenes

The objective of this study was to compare the efficacy of an essential oils mouth rinse and dental floss on dental plaque accumulation and gingivitis in interproximal areas.. With informed consent, a parallel randomized controlled clinical trial was developed with 60 third-year dental hygiene students, randomly divided into two non-blind groups of 30 individuals each. For a period of 2 weeks, one group used an essential oils mouth rinse, according to manufacturer's instructions, and the other group flossed twice a day. Both groups received a toothbrush and fluoridated toothpaste for home dental hygiene care. A baseline dental hygiene appointment consisted of tooth scaling, prophylaxis and collection of the study data, using the Lobene modified gingival index; Saxton & Ouderaa gingival bleeding index and the Quigley & Hein modified by Turesky dental plaque index.. At baseline, there was no significant difference between the groups for interproximal gingival inflammation (P = .214), gingival bleeding (P = .829) and dental plaque accumulation (P = .860). After 2 weeks of treatment, no significant differences were found between the essential oils mouth rinse and dental flossing for reduction of interproximal gingival inflammation (P = .938) and bleeding (P = .307). Essential oils mouth rinse showed to be significantly better than dental flossing in reducing interproximal dental plaque accumulation (P = .006).. The use of an essential oils mouth rinse may be advised, as a complement, for patients unable to floss effectively, as it is more effective in reducing interproximal dental plaque accumulation than dental floss.

Topics: Adult; Dental Devices, Home Care; Dental Plaque; Dental Plaque Index; Drug Combinations; Female; Gingivitis; Humans; Male; Mouthwashes; Oils, Volatile; Periodontal Index; Salicylates; Terpenes; Toothpastes; Treatment Outcome

To evaluate the antiplaque effects of an alcohol-free mouthrinse containing essential oils-Listerine Zero (LZ)-and an alcohol-based essential oils mouthrinse (EO+) compared with a positive control of 0.20% chlorhexidine mouthrinse (CHX) and a negative control of a placebo solution (saline), using an in vivo plaque regrowth model of three days.. The study was designed as a double-masked, randomized, crossover clinical trial, involving 21 volunteers to compare four different mouthrinses, using a three-day plaque regrowth model. After receiving thorough professional prophylaxis at baseline, over the next three days each volunteer refrained from all oral hygiene measures and performed two daily rinses with 15 mL of the test mouthrinses. EO+ was compared with LZ. CHX rinse served as a positive control and a placebo solution as a negative control. At the end of each experimental period, the Plaque Index (PI) was assessed and a panelist completed through a visual analogue scale (VAS) questionnaire evaluating the organoleptic properties of each product. Each participant underwent a 14-day washout period and then there was another allocation.. LZ showed the same inhibitory activity on plaque regrowth compared with EO+ in the whole mouth (PI = 1.72 versus 1.65, respectively), but there was less of an effect compared to the CHX (overall PI of 1.07) and a more efficient activity than the saline solution negative control (PI = 2.31). The difference of 0.07 between LZ and EO+ was not statistically significant.. LZ seems to have the same inhibiting effect on plaque regrowth as EO+ and a less inhibiting effect than the CHX control. Both LZ and EO+, as well as the CHX control, show a better inhibiting effect on plaque regrowth than the placebo solution.. ClinicalTrials.gov, NCT02894593 . Registered on 4 September 2016.

Topics: Administration, Oral; Adult; Anti-Infective Agents, Local; Bacteria; Chlorhexidine; Cross-Over Studies; Dental Plaque; Dental Plaque Index; Double-Blind Method; Drug Combinations; Female; Humans; Italy; Male; Mouthwashes; Oils, Volatile; Salicylates; Surveys and Questionnaires; Terpenes; Time Factors; Treatment Outcome; Young Adult

The purpose of this clinical study was to determine the antibacterial and antiplaque efficacy of a recently introduced octenidine-containing mouthrinse (Octenidol®) in comparison with established antiseptic mouthrinses.. In a 4-day plaque-regrowth study employing a four-replicate cross-over design, a 0.1 % octenidine mouthrinse (Octenidol®/OCT-MR) was compared with a 0.12 % chlorhexidine mouthrinse (Paroex®/CHX-MR), an essential oil mouthrinse (Listerine®/EO-MR), and a placebo mouthrinse/P-MR. Plaque regrowth was assessed with a modified Quigley-Hein plaque index. The antibacterial effect was assessed by taking bacterial counts from the tooth surface and oral mucosa after professional tooth cleaning and after first rinsing with the allocated mouthrinse on days 1 and 5. Sixteen volunteers suspended tooth cleaning and rinsed twice daily with the allocated mouthrinse for 4 days.. All tested antiseptic mouthrinses were significantly more effective than the placebo mouthrinse in inhibiting plaque, but no significant differences were observed between OCT-MR and CHX-MR, OCT-MR and EO-MR, and CHX-MR and EO-MR. After 4 days, comparable bacterial count levels were found on both the tooth surface and mucosa applying OCT-MR and CHX-MR, which were significantly lower than that of EO-MR and P-MR.. Octenidol® and Paroex® showed comparable antibacterial and antiplaque efficacy in the human oral cavity.. The recently introduced octenidine-containing mouthrinse Octenidol® may become a suitable alternative to 0.12 % chlorhexidine-containing mouthrinses such as Paroex®.

Topics: Adult; Anti-Bacterial Agents; Anti-Infective Agents, Local; Chlorhexidine; Cross-Over Studies; Dental Plaque; Double-Blind Method; Drug Combinations; Female; Humans; Imines; Male; Mouthwashes; Pyridines; Salicylates; Terpenes; Treatment Outcome

This randomized, single center, examiner-blind, controlled, parallel-group, 6-month clinical study compared the antiplaque/antigingivitis potential of an essential oil (EO) versus a 0.07% cetylpyridinium chloride (CPC)-containing mouthrinse. A 5% hydroalcohol solution was included as a control group.. 354 healthy volunteers (18-71 years of age) were enrolled in this clinical trial; 338 subjects completed the study. At baseline, 1-, 3-, and 6-month visits, subjects received an oral examination, gingivitis (MGI), gingival bleeding (BI) and plaque assessments (PI). Following randomization, subjects received a prophylaxis and began brushing twice daily with the provided fluoride toothpaste and rinsing twice daily with 20 mL of the assigned mouthrinse for 30 seconds.. All rinses were well tolerated by the subjects, with the exception of extrinsic tooth stain complaints in 13 subjects in the CPC group between the 3- and 6-month exams. Statistically significant reductions in gingivitis, bleeding and plaque were observed for both EO and CPC at all post-baseline time-points when compared to the negative control. At 6 months MGI and PI were reduced by 42.6% and 42.0% for EO and by 17.1% and 13.9% respectively, for CPC vs. control. When compared to CPC, EO was statistically significantly superior at all post-baseline time-points. EO showed increasing reductions in MGI of 10.5%, 20.3% and 30.7% as well as reductions in PI of 12.7%, 23.7% and 32.6% at 1, 3 and 6 months, respectively. When analyzing the number of healthy sites (MGI scores of 0 or 1), the beneficial effect of the EO-containing mouthrinse is 45.8% greater than using a CPC-containing mouthrinse and 59.8% greater than placebo.

Topics: Adolescent; Adult; Aged; Anti-Infective Agents, Local; Cetylpyridinium; Dental Plaque; Dental Plaque Index; Drug Combinations; Female; Follow-Up Studies; Gingival Hemorrhage; Gingivitis; Humans; Male; Middle Aged; Mouthwashes; Oils, Volatile; Periodontal Index; Placebos; Salicylates; Single-Blind Method; Terpenes; Tooth Discoloration; Young Adult

To determine whether site-specific mouth rinsing with oral disinfectants can improve oral odor beyond the traditional panoral mouth disinfection with mouth rinses by targeting specifically oral malodor implicated anaerobic bacteria.. Twenty healthy fasting subjects volunteered for a blinded prospective, descriptive correlational crossover cross-section clinical trial conducted during the month of Ramadan between July and August 2013 in Albaha province in Saudi Arabia involving the application of Listerine Cool Mint mouth rinse by either the traditional panoral rinsing method, or a site-specific disinfection method targeting the subgingival and supragingival plaque and the posterior third of the tongue dorsum, while avoiding the remaining locations within the oral cavity. The viable anaerobic and aerobic bacterial counts, volatile sulfur compounds (VSCs) levels, organoleptic assessment of oral odor, and the tongue-coating index were compared at baseline, one, 5, and 9 hours after the treatment.. The site-specific disinfection method reduced the VSCs and anaerobic bacterial loads while keeping the aerobic bacterial numbers higher than the traditional panoral rinsing method.. Site-specific disinfection can more effectively maintain a healthy oral cavity by predominantly disinfecting the niches of anaerobic bacteria within the oral cavity.

Topics: Adolescent; Adult; Aged; Anti-Infective Agents, Local; Bacteria, Aerobic; Bacteria, Anaerobic; Bacterial Load; Cross-Over Studies; Dental Plaque; Double-Blind Method; Drug Combinations; Halitosis; Humans; Male; Microbial Viability; Middle Aged; Odorants; Salicylates; Saudi Arabia; Sulfur Compounds; Terpenes; Tongue; Volatile Organic Compounds; Young Adult

Effective oral hygiene has been proposed as a key factor in the reduction of dental plaque colonisation and subsequent development of ventilator associated pneumonia (VAP). Listerine(®) oral rinse, while used extensively in dental practice has rarely been tested in mechanically ventilated patients. Sodium bicarbonate as an oral rinse has been more commonly utilised in oral hygiene regimens in intensive care patients.. To test the efficacies of the essential oil mouth rinse, Listerine(®) (Pfizer) and sodium bicarbonate in the reduction of dental plaque colonisation with respiratory pathogens and the subsequent development of VAP.. The study design was a prospective, single blind randomised comparative study of adult patients mechanically ventilated for at least 4 days. Patients were randomised to Listerine(®) (Pfizer) oral rinse twice daily, sodium bicarbonate oral rinse 2/24 or sterile water 2/24 (control group). All groups received tooth brushing 3 times a day. Dental plaque colonisation (primary outcome) and incidence of ventilator associated pneumonia (secondary outcome) were studied.. Three hundred and ninety-eight patients were randomised to either the Listerine group (127), sodium bicarbonate group (133) or the control group (138). Baseline characteristics were similar for all groups. There were no significant differences between the control and study groups in colonisation of dental plaque at Day 4 (p=0.243). Ventilator associated pneumonia was diagnosed in 18 patients. The incidence was, Listerine(®) group 4.7%, sodium bicarbonate group 4.5% and control 4.3% [OR, 0.99; 95% CI, 0.31 to 3.16; p=0.92].. Compared to the control group, Listerine(®) or sodium bicarbonate oral rinses were not more effective in the reduction of colonisation of dental plaque or the incidence of VAP. Given the low incidence of VAP, the common factor of a small, soft toothbrush as part of an oral hygiene regimen suggests possible benefit in mechanically ventilated patients.

Topics: Anti-Infective Agents, Local; Dental Plaque; Drug Combinations; Humans; Incidence; Intubation, Intratracheal; Oral Hygiene; Pneumonia, Ventilator-Associated; Prospective Studies; Salicylates; Single-Blind Method; Sodium Bicarbonate; Terpenes

The objective of this randomized, examiner-blind, parallel, controlled clinical study was to compare the antiplaque/antigingivitis efficacy of an essential oil-containing mouthrinse (EO) to a new 0.075% cetylpyridinium chloride mouthrinse (CPC) using a two-week experimental gingivitis model with a 5% hydroalcohol rinse serving as the negative control.. After signing informed consents and completing baseline examinations, 185 subjects were randomized into three groups. Subjects began supervised/recorded rinsing with 20 ml of their assigned rinse for 30 seconds twice daily for two weeks, with no mechanical oral hygiene permitted. Baseline and two-week assessments were conducted as follows: Turesky Modification of the Quigley-Hein Plaque Index (PI), Modified Gingival Index (MGI), and the Gingival Bleeding Index (BI). Analysis of efficacy variables (i.e., mean PI, mean MGI, mean BI, and proportion of bleeding sites derived from the BI) was performed using a one-way analysis of covariance (ANCOVA).. Among the 182 subjects who completed the study, the EO rinse showed statistically significant reductions compared to the negative control within the range previously reported in this model; PI = 36.5% (p < 0.001) and MGI = 17.5% (p < 0.001). A 43.2% reduction in proportion of bleeding sites (p < 0.001) was demonstrated. Mean PI, MGI, and proportion of bleeding sites at two weeks were statistically significantly lower for the EO rinse compared to the CPC rinse (p < 0.001), showing 27.7%, 11.9%, and 30.0% reductions, respectively.. An EO rinse provided superior antigingivitis/antiplaque efficacy compared to a 0.075% CPC rinse in this short-term clinical trial, and demonstrated efficacy within the range shown in previous studies using this model.

Topics: Adolescent; Adult; Aged; Analysis of Variance; Anti-Infective Agents, Local; Cetylpyridinium; Cyclohexanols; Dental Plaque; Dental Plaque Index; Drug Combinations; Eucalyptol; Female; Gingivitis; Humans; Male; Menthol; Middle Aged; Monoterpenes; Mouthwashes; Oils, Volatile; Periodontal Index; Salicylates; Single-Blind Method; Terpenes; Thymol; Young Adult

The use of chlorhexidine and povidone iodine solutions applied as a coolant during ultrasonic root debridement for the treatment of chronic periodontitis has been described. Hitherto, this application has not yet been extensively investigated for essential oil solutions. The goal was to clinically explore this and to compare to water irrigation.. Thirty-five chronic periodontitis patients participated in a single-blind randomized controlled clinical study. Patients were randomly allocated to the control group (n=18) or test group (n=17) receiving oral hygiene instructions and ultrasonic root debridement using water as a coolant, respectively, a pure essential oil solution. Oral hygiene was reinforced if necessary at each occasion, and clinical parameters were collected at baseline and after 1 and 3 months.. Significant pocket reduction (control, 1.02 mm; test, 0.89 mm) and clinical attachment gain (control and test, 0.48 mm) were shown in both groups. However, there were no significant differences between the groups at any point in time for any of the parameters.. Essential oil solutions do not offer a clinical benefit over water when used as a coolant during ultrasonic root debridement for the treatment of chronic periodontitis.

Topics: Adult; Aged; Anti-Infective Agents, Local; Cariostatic Agents; Chronic Periodontitis; Cryotherapy; Dental Plaque; Dental Plaque Index; Diamines; Drug Combinations; Female; Fluorides; Follow-Up Studies; Gingival Hemorrhage; Humans; Male; Middle Aged; Oils, Volatile; Periodontal Attachment Loss; Periodontal Index; Periodontal Pocket; Root Planing; Salicylates; Single-Blind Method; Terpenes; Therapeutic Irrigation; Toothbrushing; Toothpastes; Ultrasonic Therapy; Water

Brushing and flossing are the most widely accepted procedures, the 'gold standard', for controlling bacterial plaque, but these mechanical methods have limitations. Based on results derived from several clinical trials, essential oil (EO) mouthrinse (Listerine(®)) and a chlorhexidine mouthrinse have been accepted by ADA to be used as an adjunct to routine mechanical oral hygiene measures however, both of them are associated with side effects, therefore, the present study was undertaken to evaluate the antiplaque efficacy of a new herbal formulation as compared to an EO and chlorhexidine rinse.. The study was a single blind parallel randomized controlled trial involving four groups. 48 volunteers refrained from all oral hygiene measures for 4 days, but rinsed instead twice daily with 10 ml of a herbal (HM), EO, chlorhexidine (CHX) or a placebo (PL) solution. Plaque index and plaque area (PA) was assessed on Day 4.. The HM and EO showed a significant inhibition of plaque regrowth compared to PL (P<0.001), but the lowest values of PI and PA were obtained with CHX. Statistically significant difference in plaque parameters was observed when CHX was compared to HM and EO, and HM to EO rinse.. The new herbal mouthrinse had a promising plaque inhibitory potential but it not as efficacious as chlorhexidine in preventing plaque regrowth.

Topics: Adult; Anti-Infective Agents, Local; Chlorhexidine; Dental Plaque; Dental Plaque Index; Drug Combinations; Elettaria; Female; Gaultheria; Humans; Male; Mentha piperita; Mouthwashes; Oils, Volatile; Patient Compliance; Phytotherapy; Piper betle; Placebos; Plant Extracts; Salicylates; Salvadoraceae; Single-Blind Method; Terminalia; Terpenes; Young Adult

This 3-month double-blind randomized placebo-controlled study evaluated the clinical and microbial effects of an essential oil mouth rinse used as an adjunct to mechanical plaque control by patients in supportive periodontal care.. Fifty patients were randomly allocated to an essential oil group (Listerine(®) Coolmint; Johnson & Johnson, New Brunswick, NJ, USA) or placebo group to rinse twice per day as an adjunct to mechanical plaque control. At baseline and after 3 months, plaque index (PI), gingivitis index (GI), probing pocket depth, bleeding on probing (BoP) and clinical attachment level were registered. Subgingival plaque samples were collected for the detection and quantification of Aggregatibacter actinomycetemcomitans, Porphyromonas gingivalis, Tannerella forsythia, Treponema denticola, Micromonas micros, Prevotella intermedia, Fusobacterium genus and Streptococcus mutans by means of real-time PCR (qPCR). Patient's compliance, satisfaction and side effects were registered.. Twenty-three patients in the essential oil group (mean age: 57) and 21 in the placebo group (mean age: 55) with acceptable oral hygiene at intake (mean PI <1.5 on a scale of 5) adhered to the study protocol. Gingivitis index, PI and BoP significantly reduced over time (P ≤ 0.029); however, between group analyses revealed no significant differences. There was no significant change over time neither in detection frequency nor load for any of the microbiota. Daily rinsing with an essential oil rinse was found safe and perceived beneficial by the patients.. Patients in supportive periodontal care who are fairly compliant with oral hygiene may not benefit from additional mouth rinsing using an essential oil solution.

Topics: Adult; Aged; Aged, 80 and over; Aggregatibacter actinomycetemcomitans; Anti-Infective Agents, Local; Bacteroides; Dental Plaque; Double-Blind Method; Drug Combinations; Female; Follow-Up Studies; Fusobacterium; Gingival Hemorrhage; Humans; Male; Middle Aged; Mouthwashes; Oils, Volatile; Patient Satisfaction; Peptostreptococcus; Periodontal Attachment Loss; Periodontal Diseases; Periodontal Pocket; Placebos; Porphyromonas gingivalis; Prevotella intermedia; Salicylates; Streptococcus mutans; Terpenes; Treatment Outcome; Treponema denticola

Gingivitis is a chronic inflammatory condition, resulting from gingival bacteria and bacterial byproducts. Antiplaque oral rinses reduce inflammation by removing or inhibiting plaque formation. The purpose of this pilot study was to examine the anti-inflammatory effects of HM-302, a mouth rinse based on natural products, on gingival inflammation.. A prospective, double-blinded, randomized parallel-group controlled trial involving 62 patients was conducted to assess efficacy and safety. During a 2-week period with no dental hygiene, subjects were randomized to receive either the study rinse (HM-302); a cetylpyridinium chloride (CPC) rinse; an essential oils (EO) rinse; or a water-only preparation. The gingival index (GI), plaque index (PI), and number of bleeding sites were measured at baseline and at the end of the study period.. Progression of gingival inflammation resulting from lack of dental hygiene was lowest in patients treated with the HM-302 rinse, and was significantly less marked than in patients treated with the water-only preparation. When compared to the CPC and EO treatments, HM-302 was the only mouth rinse that was significantlybetter than the control, with respect to both the change in absolute GI scores (p = .006) and to the percent increase in GI scores (p = .012). No serious adverse effects were noted in any of the study groups.. HM-302 is a safe and effective treatment for preventing the development of gingival inflammation in an experimental gingivitis model. Further research is needed to evaluate its long-term effects.

Topics: Adolescent; Adult; Anti-Infective Agents, Local; Anti-Inflammatory Agents; Centella; Cetylpyridinium; Dental Plaque; Dental Plaque Index; Double-Blind Method; Drug Combinations; Echinacea; Female; Gingival Hemorrhage; Gingivitis; Humans; Male; Mouthwashes; Oils, Volatile; Periodontal Index; Periodontitis; Phytotherapy; Pilot Projects; Placebos; Plant Extracts; Prospective Studies; Safety; Salicylates; Sambucus nigra; Terpenes; Treatment Outcome; Triterpenes; Young Adult

To evaluate the clinical efficacy of subgingival ultrasonic instrumentation irrigated with essential oils (EOs) of residual periodontal pockets.. Sixty-four individuals with chronic periodontitis were invited to participate in this randomized, double-blind, parallel, and placebo-controlled clinical trial. All subjects received non-surgical periodontal therapy. After re-evaluation (baseline), residual pockets (pocket depth ≥5 mm) received test (ultrasonic instrumentation irrigated with EOs) or control therapy (ultrasonic instrumentation irrigated with negative control). Probing pocket depth (PPD), gingival recession (R), clinical attachment level (CAL), bleeding on probing (BOP), and plaque were assessed at baseline and after 4, 12, and 24 weeks. Differences between groups and changes over the course of time were analysed according to a generalized linear model.. There was a significant reduction in PPD and BOP, as well as a significant CAL gain in the two groups (p<0.001). Nevertheless, there were no differences between the groups at any time of the study. When only initially deep pockets (PPD ≥7 mm) were analysed, a significantly greater CAL gain (p=0.03) and PPD reduction (p=0.01) was observed in the test group.. The adjunctive use of EOs may promote significant CAL gain and PPD reduction in deep residual pockets.

Topics: Adult; Anti-Infective Agents, Local; Chronic Periodontitis; Cyclohexanols; Dental Plaque; Double-Blind Method; Drug Combinations; Ethanol; Eucalyptol; Eucalyptus; Female; Follow-Up Studies; Gingival Hemorrhage; Gingival Recession; Humans; Male; Menthol; Middle Aged; Monoterpenes; Oils, Volatile; Periodontal Attachment Loss; Periodontal Pocket; Placebos; Salicylates; Subgingival Curettage; Terpenes; Therapeutic Irrigation; Thymol; Treatment Outcome; Ultrasonic Therapy

To assess and compare the effect of 0.2% Chlorhexidine mouth rinse, Listerine mouth rinse and 4% Tulsi extract mouth rinse on salivary Streptococcus mutans level.. The present study is an experimental study of cross over type, employing Latin square design. 45 school children aged 14-15 years were divided into three groups/blocks. The baseline unstimulated saliva samples were obtained from each group and assessed for Streptococcus mutans counts. The study was divided in to three phases, each phase lasted for 8 days separated by a washout period of 15 days in between them. Groups A, B and C were treated with 0.2% Chlorhexidine, Listerine and 4% Tulsi extract mouth rinses respectively in the phase I. The study subjects were instructed to use the assigned mouth rinse twice daily for 1 min for 7 days. On day 8th the subjects were instructed to use the mouth rinse only once in the morning. The follow up unstimulated saliva samples were collected 1h after the use of the assigned mouth rinse and assessed for salivary Streptococcus mutans counts. After phase I, mouth rinses were crossed over as dictated by the Latin square design in phase II and III.. All the three mouth rinses have individually shown a statistically significant reduction in the salivary Streptococcus mutans counts. When the three mouth rinses were compared the difference did not reach statistical significance.. Tulsi has stood the test and is as effective as Chlorhexidine and Listerine in reducing the salivary S. mutans levels.

Topics: Adolescent; Anti-Infective Agents, Local; Chlorhexidine; Colony Count, Microbial; Cross-Over Studies; Dental Plaque; Double-Blind Method; Drug Combinations; Female; Follow-Up Studies; Humans; Incidence; India; Male; Mouthwashes; Plant Extracts; Retrospective Studies; Salicylates; Saliva; Streptococcus mutans; Terpenes; Treatment Outcome

Enteromorpha linza, a green alga, has been recognized as a potential source of natural antimicrobial and antifungal compounds. We previously reported that an E. linza extract strongly inhibited the growth of Prevotella intermedia and Porphyromonas gingivalis. The principal objective of this study was to evaluate the clinical effect of a mouth rinse containing the E. linza extract on gingivitis disease, as measured by the plaque index (PI), gingival index (GI), and bleeding on probing (BOP), and on two bacterial strains (P. intermedia and P. gingivalis), in comparison with Listerine(®) (Listerine-Korea, Seoul, Korea), which was used as a positive control. In total, 55 subjects were recruited into active participation in this clinical study. The PI, GI, BOP, and bacterial strains were then evaluated over a test period of 6 weeks. After 1, 2, 4, and 6 weeks, the same clinical indices were recorded, and the levels of P. intermedia and P. gingivalis were quantified via real-time polymerase chain reaction. At the end of the study, the group using the mouth rinse containing the E. linza extract evidenced significant reductions in the clinical indices (PI, GI, and BOP) and P. gingivalis compared with baseline values. Moreover, E. linza extract containing mouth rinse produced effects similar to those of Listerine. Overall, these results indicate that a mouth rinse containing E. linza extract significantly reduces plaque, improves the condition of gingival tissues, and reduces bleeding. Additionally, E. linza extract mouth rinse significantly inhibits P. gingivalis and P. intermedia. Thus, this clinical study demonstrated that the twice-daily use of an E. linza extract mouth rinse can inhibit and prevent gingivitis.

Topics: Adult; Anti-Infective Agents, Local; Dental Plaque; Dental Plaque Index; Double-Blind Method; Drug Combinations; Female; Gingivitis; Humans; Male; Mouthwashes; Periodontal Index; Porphyromonas gingivalis; Prevotella intermedia; Real-Time Polymerase Chain Reaction; Salicylates; Terpenes; Ulva; Young Adult

Assess the effectiveness of chemical-mechanical control associated with orientation and motivation for the control of dental biofilm in orthodontic patients.. Thirty patients between 12 and 21 years of age wearing a fixed orthodontic appliance were divided into three groups. The control group (G1) received orientation regarding oral hygiene. The experimental groups (G2 and G3) received orientation regarding oral hygiene and diet as well as a hygiene kit and mouthwash; the mouthwash given to G2 was a placebo and that given to G3 contained essential oils (Listerine).. In the comparison between T0 and T60, vestibular gingivitis was worse in G1 (p<0.05), with no statistically significant differences regarding lingual gingivitis and biofilm. G2 and G3 exhibited a significant improvement in clinical conditions. In the comparison between groups, G3 had undergone a significantly greater improvement than the other groups.. The use of the commercial mouthwash, together with mechanical oral hygiene, orientation, and motivation, proved to be adequate conduct for the maintenance of oral health in orthodontic patients.. The present study contributes toward the maintenance of oral health in patients who wear a fixed orthodontic appliance through the prevention of dental biofilm buildup.

Topics: Adolescent; Anti-Infective Agents, Local; Biofilms; Child; Dental Devices, Home Care; Dental Plaque; Double-Blind Method; Drug Combinations; Feeding Behavior; Female; Gingival Hemorrhage; Gingivitis; Humans; Longitudinal Studies; Male; Motivation; Mouthwashes; Oral Hygiene; Orthodontic Appliances; Patient Education as Topic; Placebos; Salicylates; Terpenes; Toothbrushing; Young Adult

Transient bacteremia frequently occur secondary to several periodontal procedures. The purpose of the present study is to investigate the effects of irrigation with an essential oil-containing antiseptic (EO) and oral administration of azithromycin (AZM) on bacteremia caused by scaling and root planing (SRP).. Thirty patients with chronic periodontitis were randomly assigned to three groups (control, EO, and AZM). The EO group received quadrant subgingival irrigation with EO, and mouthrinsing was continued at home for 1 week. Oral administration of AZM was started 3 days before SRP in the AZM group. No adjunctive treatment was performed before SRP in the control group. Peripheral blood and subgingival plaque were collected at baseline and after 1 week. The second blood sample was taken 6 minutes after the initiation of quadrant SRP. The blood samples were cultured and analyzed for bacteremia. Quantitative analysis of periodontopathic bacteria in the sulcus was performed using the polymerase chain reaction Invader method.. Bacteremia incidence rates were 90%, 70%, and 20% for the control, EO, and AZM groups, respectively. Significant reduction of the incidence of bacteremia was shown in the AZM group only (P <0.01). Subgingival bacterial counts significantly decreased in both the EO and AZM groups (P <0.01).. Quadrant SRP frequently induced bacteremia. Although AZM was effective in reducing bacteremia incidence, EO showed less effectiveness.

Topics: Administration, Oral; Anti-Bacterial Agents; Anti-Infective Agents, Local; Antibiotic Prophylaxis; Azithromycin; Bacteremia; Bacterial Load; Bacteriological Techniques; Bacteroides; Chronic Periodontitis; Dental Plaque; Dental Scaling; Drug Combinations; Female; Follow-Up Studies; Gingiva; Humans; Male; Middle Aged; Mouthwashes; Oils, Volatile; Porphyromonas gingivalis; Prevotella intermedia; Root Planing; Salicylates; Streptococcus; Terpenes; Therapeutic Irrigation

To evaluate the antiplaque/antigingivitis effectiveness of an essential oils containing mouthrinse as compared to a 0.05% cetylpyridinium chloride mouthrinse.. Generally healthy subjects with mild to moderate levels of plaque and gingivitis participated in a 6-month, examiner-blind, single centre, randomised, parallel-group controlled clinical trial. They were randomised into three mouthrinse groups--control (C), 0.05% cetylpyridinium chloride (CPC), or a fixed combination of essential oils (EO). Subjects received a dental prophylaxis at baseline and rinsed twice daily in addition to their usual oral hygiene for six months. Plaque Index and Modified Gingival Index were determined at 3 and 6 months.. At 6 months, the EO group exhibited statistically significantly lower mean scores for MGI and PI than CPC (32.4% and 56.2% reductions, respectively). Compared to control, EO provided statistically significantly lower mean MGI and PI scores (36.3% and 69.7 %, respectively). The CPC group showed statistically significantly lower mean MGI and PI scores than the C group (5.8% and 30.7%, respectively).. This study demonstrated the superiority of an EO rinse compared to a 0.05% CPC rinse in reducing plaque and gingivitis and confirmed that the daily use of an EO containing mouthrinse can provide a clinically significant benefit in reducing plaque and gingivitis.

Topics: Adult; Anti-Infective Agents, Local; Cetylpyridinium; Dental Plaque; Dental Plaque Index; Dental Prophylaxis; Drug Combinations; Female; Follow-Up Studies; Gingivitis; Humans; Male; Mouthwashes; Oils, Volatile; Oral Hygiene; Periodontal Index; Salicylates; Single-Blind Method; Terpenes; Treatment Outcome

The aim of this randomized double-blinded preliminary study was to evaluate the clinical and microbiological long-term effects of an essential-oil-containing mouth rinse as the active agent utilized in the "one-stage full-mouth disinfection protocol." Probing pocket depth and plaque and gingival indices were evaluated by the same calibrated examiner in all teeth of 20 moderate chronic periodontitis subjects. Presence of Aggregatibacter actinomycetemcomitans, Porphyromonas gingivalis, and Tannerella forsythensis were determined by polymerase chain reaction in nonstimulated saliva, tongue dorsum, and pooled subgingival samples. The subjects were randomized into two groups: full-mouth disinfection plus essential oils (Listerine) or full-mouth disinfection plus placebo. Clinical and microbial parameters were evaluated at baseline (T0), 45 (T1) and 180 (T2) days after therapy and analyzed using analysis of variance, Student t, and Wilcoxon tests (p < 0.05). No significant differences were observed between groups regarding clinical measurements at baseline. However, in the later examinations, T1 and T2, the test group always presented higher reductions of pocket depth, plaque index, and gingival index compared to the control group. The essential-oils group revealed significant reduction on occurrence of P. gingivalis in saliva comparing baseline and 45 days; this difference still remain at 180 days. The essential-oil-containing mouth rinse demonstrated beneficial effects on clinical parameters. Microbiological findings were less consistent. The results of this preliminary study suggest further investigations.

Topics: Aggregatibacter actinomycetemcomitans; Anti-Infective Agents, Local; Bacteroides; Chronic Periodontitis; Dental Plaque; Dental Plaque Index; Dental Scaling; Double-Blind Method; Drug Combinations; Humans; Mouthwashes; Oils, Volatile; Periodontal Index; Pilot Projects; Porphyromonas gingivalis; Salicylates; Saliva; Terpenes; Therapeutic Irrigation

The purpose of the present investigation was to determine if antimicrobial mouthrinses with different formulations could affect the composition of the subgingival microbiota and clinical parameters of adjacent tissues in periodontal maintenance subjects.. One-hundred and sixteen subjects, who had been treated for chronic periodontitis and were in a maintenance program, were randomly assigned one of four mouthrinses, to be used twice daily for three months. The mouthrinses were herbal 1, herbal 2, essential oil, and chlorhexidine. Clinical measurements and subgingival plaque samples were taken at baseline and at three months. Plaque samples were individually evaluated for 18 test species/taxa using checkerboard DNA-DNA hybridization. Significance of differences between baseline and three months for both microbiological and clinical parameters were determined using the Wilcoxon Signed Ranks test. Significance of difference among groups for change in clinical and microbiological parameters was determined using analysis of covariance (ANCOVA), adjusting for baseline values.. Shifts in species proportions differed significantly for 9/18 test species/taxa among the four mouthrinse groups. Streptococcus and Capnocytophaga species were reduced most in the herbal rinse groups, while Veillonella parvula was reduced most in the essential oil and chlorhexidine groups. Actinomyces were also markedly reduced in the chlorhexidine group. Mean Plaque (PI) and Gingival Indices (GI) were reduced between baseline and three months in each group. Results emphasize that chlorhexidine (p < 0.001) and herbal (p < 0.05) rinses significantly reduced PI. Some subjects in each group responded better than others.. All four mouthrinses tested produced shifts in the composition of subgingival microbiota, although the results differed among the groups. The observed microbial changes were accompanied by improvements in clinical parameters in the periodontal maintenance subjects.

Topics: Bacteria; Biofilms; Chlorhexidine; Colony Count, Microbial; Dental Plaque; Dental Plaque Index; DNA, Bacterial; Drug Combinations; Female; Humans; Male; Middle Aged; Mouthwashes; Nucleic Acid Hybridization; Periodontal Index; Phytotherapy; Plant Extracts; Salicylates; Terpenes

The side effects of chlorhexidine (CHX) have stimulated the search for alternative antiplaque agents such as amine fluoride/stannous fluoride (ASF) and essential oils (EO). The aim of the study was to investigate the plaque-inhibiting effects of two commercially available mouthrinses containing ASF and EO, respectively.. The study was an observer-masked, randomized, 5 x 5 Latin square cross-over design, balanced for carryover effects, involving 15 volunteers in a 4-day plaque regrowth model. A 0.12% CHX rinse and a saline solution served as positive and negative controls, respectively. On day 1, subjects received professional prophylaxis, suspended oral hygiene measures, and commenced rinsing with their allocated rinses. On day 5, subjects were scored for disclosed plaque. The ASF rinse was tested at two dosages: 10 and 20 ml (ASF-10 and ASF-20, respectively).. The ASF and EO rinses showed a significant inhibition of plaque regrowth compared to saline (P <0.0001), but the lowest plaque indices were obtained with the CHX product (P <0.01). There were no significant differences among products containing ASF-10, ASF-20, and EO (P >0.05). There was no correlation between the occurrence of side effects and the use of a particular rinse product (P >0.2).. ASF and EO mouthrinses exerted effective and similar plaque inhibition. The two dosages tested for ASF did not differ in plaque reduction. These findings, together with those from long-term trials, suggest that ASF and EO rinses may represent effective alternatives to CHX rinse as adjuncts to oral hygiene.

Topics: Adult; Amines; Anti-Infective Agents, Local; Chlorhexidine; Cross-Over Studies; Dental Plaque; Dental Plaque Index; Drug Combinations; Female; Humans; Male; Mouth Diseases; Mouthwashes; Oils, Volatile; Pain; Salicylates; Single-Blind Method; Taste Disorders; Terpenes; Tin Fluorides

To evaluate using digital plaque image analysis the antiplaque efficacy of oral care regimens including use of antimicrobial toothpaste in combination with antimicrobial mouthrinse.. 16 subjects completed the study protocol including: (1) initial treatment phase, all subjects used a standard sodium fluoride dentifrice with 2x/day brushing, (2) second treatment phase, subjects were randomized to two treatment groups: stannous fluoride/sodium hexametaphosphate dentifrice or sodium fluoride triclosan/copolymer dentifrice; (3) third treatment phase, the group using stannous fluoride dentifrice rinsed with alcohol-free cetylpyridinium chloride mouthrinse and the group using triclosan dentifrice rinsed with essential oil mouthrinse. During each phase, plaque levels were assessed in the morning before toothbrushing (AM), post-brushing in the morning (PB) and in the afternoon (PM).. Stannous fluoride dentifrice was superior to triclosan dentifrice in plaque growth inhibition between toothbrushing. Both mouthrinses provided additional plaque prevention benefits when used with antimicrobial dentifrices. The cetylpyridinium chloride mouthrinse and stannous fluoride dentifrice regimen was particularly effective, building accretive efficacy over time. Average plaque reductions exceeded 50% vs. sodium fluoride dentifrice alone. Chemotherapeutic dentifrices and rinses increase plaque control used alone and particularly in combination. The stannous fluoride-cetylpyridinium chloride regimen showed the greatest benefits.

Topics: Adult; Anti-Infective Agents, Local; Cariostatic Agents; Cetylpyridinium; Complex Mixtures; Dental Plaque; Dentifrices; Drug Combinations; Fluorides; Humans; Image Processing, Computer-Assisted; Mouthwashes; Oils, Volatile; Phosphates; Photography, Dental; Salicylates; Silicic Acid; Sodium Fluoride; Terpenes; Tin Fluorides; Toothpastes; Treatment Outcome; Triclosan

To test the null hypothesis that adding Listerine mouthrinse to the standard oral hygiene regimen has no added benefit for orthodontic patients in maintaining proper oral health.. Patients within their first 6 months of orthodontic treatment were assigned either to the brushing + flossing (N = 25) or brushing + flossing + Listerine (N = 25) group. Initially, all of the participants received a prophylaxis and instructions on how to brush and floss. Measurements were recorded for the bleeding, gingival, and plaque indices (BI, MGI, and PI, respectively) that provided baseline values (T1). Subsequent measurements were taken at 3 months (T2) and 6 months (T3). Mean BI, MGI, and PI at T1, T2, and T3 were compared statistically between the groups using repeated measures analysis of variance. The significance level was set at P < or = .05.. The response profiles for the BI, MGI, and PI over time were significantly different between the two groups. Patients who had Listerine in their daily oral hygiene regimen exhibited significantly lower scores for all three indices at T2 and T3 than the patients who only brushed and flossed.. The hypothesis is rejected. This study shows that use of Listerine mouthrinse can reduce the amount of plaque and gingivitis in patients undergoing orthodontic treatment. Adding Listerine to the standard oral hygiene regimen may be beneficial for orthodontic patients in maintaining proper oral health, thus reducing the likelihood that white spot lesions and gingivitis will develop.

Topics: Adolescent; Adult; Analysis of Variance; Child; Dental Devices, Home Care; Dental Plaque; Dental Plaque Index; Drug Combinations; Female; Gingivitis; Humans; Male; Middle Aged; Mouthwashes; Oils, Volatile; Orthodontic Appliances; Periodontal Index; Salicylates; Single-Blind Method; Terpenes; Toothbrushing

This study was conducted to determine the effect of two mouthrinses elmex and Listerine on plaque accumulation in 12-year-olds.. 30 12-year-old children took part in the clinical study. They were divided into three groups. Group I (10 people) was given Listerine to home use. Group II (10 people) was given elmex to home use. Group III (10 people) did not receive any mouthrinses. Following indices were used in first and base study Plaque Index (PI), Approximal Plaque Index (API) and Sulcus Bleeding Index (SBI). The statistical analysis was performed using T test for related samples and Spearman rank order correlations.. Mean PI lessened in group I (Listerine) from 0.996 to 0.804 and group II (elmex) from 0.807 to 0.698. In group III it stayed almost at the same level. In all children values of API and SBI decreased after two weeks. Reduce of API in participants using Listerine was important statistically and it lessened from 57.4% to 48.1% (reduction by 16.2%). The other results of API and SBI were not statistically important. API in children using elmex lowered by 15.5%. Bleeding (SBI) in Listerine group decreased by 21.5% and in elmex group decreased by 24.5%. In control group diminish of SBI was only by 14.4%.. In summary, this study has demonstrated that additional rinsing helped in reducing plaque and gingivitis in 12-year-olds but it is not as essential as motivation to everyday oral hygiene.

Topics: Amines; Case-Control Studies; Child; Dental Plaque; Diamines; Drug Combinations; Female; Fluorides; Humans; Male; Mouthwashes; Salicylates; Terpenes; Treatment Outcome

The clinical effect of Listerine, a mouth rinse containing a mixture of phenolic compounds, is ascribed to its bactericidal properties. However, phenolic compounds are also known to interfere with the inflammatory process.. The purpose of this clinical trial was to evaluate the effect of regular mouth rinsing with Listerine on plaque and gingivitis during a 2-week period of no mechanical oral hygiene.. Twenty-one subjects were recruited for the study. On Day 0 of each 2-week experimental period, the participants were told to abstain from all mechanical plaque-control measures but to rinse twice a day with 10 ml of the assigned solution (test: Listerine, positive control:0.1% chlorhexidine (CHX), negative control: saline) for 60 s. Each experimental period was preceded by a 2-week period including oral hygiene instruction, scaling and professional mechanical tooth cleaning. Examinations included assessments of plaque and gingivitis (Days 0 and 14), sampling of plaque and collection of gingival crevicular fluid (GCF) (Days 0, 7 and 14). From the supragingival plaque samples, six different morphotypes of bacteria were counted using dark-field microscopy. The GCF collected was analysed with respect to the content of lactoferrin and albumin.. During the experimental periods, it was observed that significantly less plaque formed and less gingivitis developed when the participants rinsed with the Listerine mouthwash than with saline solution. However, significantly more plaque formed during the Listerine than during the CHX rinse period, while there was no significant difference in the development of gingival bleeding between the Listerine and the CHX rinse regimens. Significantly smaller proportions of motile rods and fusiforms were found in the List and CHX groups than in the control (Ctrl) group. The increase of the lactoferrin/albumin ratio in the List group was significantly smaller than that in the Ctrl group but significantly larger than in the CHX group.. It was suggested that the effect of Listerine on gingivitis is more pronounced than on plaque formation. This indicates that the phenolic compound may have anti-inflammatory effects.

Topics: Adult; Analysis of Variance; Chlorhexidine; Cross-Over Studies; Dental Plaque; Drug Combinations; Gingival Crevicular Fluid; Gingivitis; Humans; Mouthwashes; Phenols; Salicylates; Single-Blind Method; Terpenes

To compare the safety and the antiplaque and antigingivitis efficacy of two oral rinses.. A randomized, double-blind, parallel groups, single-center study was conducted to evaluate the safety and efficacy of a high bioavailable, alcohol-free 0.07% cetylpyridinium chloride (CPC) rinse (Crest Pro-Health Rinse) and a positive control rinse containing essential oils (EO) and 21.6% ethyl alcohol (Cool Mint Listerine). Seventy-eight healthy adults were enrolled in a modified experimental gingivitis clinical trial. Four weeks before the baseline visit, subjects received a prophylaxis and were instructed to brush twice daily in a manner to approach optimum gingival health. At the end of the 4-week period, subjects were randomly assigned to treatment and instructed to use 20 ml of their assigned product for 30 seconds after brushing twice daily during a 21-day treatment phase. Plaque removal by brushing was prevented during the treatment phase for one mandibular quadrant (experimental gingivitis region) by means of a specially-manufactured tooth shield. Safety and efficacy measurements were obtained at baseline and at the end-of-treatment using the Modified Gingival Index (MGI), Gingival Bleeding Index (GBI), and Modified Quigley-Hein Plaque Index (MQH). At all visits, an oral soft tissue examination was performed for each subject. The efficacy data obtained in the experimental gingivitis region were analyzed with analysis of covariance.. Seventy-five subjects completed the study and were included in the data analyses. No statistically significant differences were detected between the two treatment groups for MGI, GBI or MQH measures. Results were similar for shielded interproximal sites. Both treatments were well-tolerated.. This randomized, controlled comparative clinical trial demonstrated that rinsing twice daily with the experimental alcohol-free 0.07% CPC rinse provides antiplaque and antigingivitis efficacy similar to that of the positive control EO rinse, a recognized antiplaque and antigingivitis mouthrinse that contains alcohol.

Topics: Adult; Anti-Infective Agents, Local; Cetylpyridinium; Dental Plaque; Dental Plaque Index; Double-Blind Method; Drug Combinations; Gingival Hemorrhage; Gingivitis; Humans; Mouth Mucosa; Mouthwashes; Periodontal Index; Safety; Salicylates; Terpenes

Mechanical methods of oral hygiene can be complemented by the use of chemotherapeutic mouthrinses. The authors sought to quantify the additional benefit provided by an essential oil-, or EO-, containing mouthrinse in reducing plaque and gingivitis in patients who brush and floss regularly.. The authors randomly assigned patients with gingivitis to one of three treatment groups: brushing and rinsing with a control mouthrinse, or BC; brushing, flossing and rinsing with a control mouthrinse, or BFC; or brushing, flossing and rinsing with an EO-containing mouthrinse, or BFEO. Patients received a dental prophylaxis at baseline, and the authors followed them for six months.. Of 246 enrolled subjects enrolled in the study, 237 subjects were evaluable at the study's conclusion. After six months, the subjects using the BFEO regimen had statistically and clinically significant lower mean Modified Gingival Index, or MGI, scores and Plaque Index, or PI, scores than did subjects in the BC group (29.9 percent and 56.3 percent, respectively; P < .001). Subjects in the BFC group had statistically significantly lower mean MGI and PI scores than did subjects in the BC group (11.2 percent and 9.3 percent, respectively; P < .001). Subjects in the BFEO group exhibited statistically and clinically significantly lower mean scores for MGI and PI than did subjects in the BFC group (21 percent and 51.9 percent, respectively; P < .001).. This study confirms that for patients with gingivitis who brush and floss routinely, the adjunctive use of an EO-containing mouthrinse provides a clinically significant and meaningful additional benefit in reducing plaque and gingivitis.. An EO-containing mouthrinse is an effective adjunct to regular brushing and flossing. Therefore, the BFEO regimen can be beneficial for patients with gingival inflammation.

Topics: Adolescent; Adult; Anti-Infective Agents, Local; Chi-Square Distribution; Dental Devices, Home Care; Dental Plaque; Dental Plaque Index; Dentifrices; Drug Combinations; Female; Follow-Up Studies; Gingival Hemorrhage; Gingivitis; Humans; Male; Middle Aged; Mouthwashes; Oils, Volatile; Periodontal Index; Salicylates; Single-Blind Method; Terpenes; Toothbrushing

To assess the irritation potential of an essential oil-containing mouthrinse (Listerine Antiseptic) in a population with objectively documented xerostomia (hyposalivation) using an exaggerated-exposure clinical model.. Following a baseline oral soft tissue examination, 19 qualifying female subjects with a mean age of 61 years and a mean unstimulated baseline salivary flow of 0.06 mL/min were randomly assigned either the essential oil mouthrinse or a negative control rinse. They rinsed under supervision with 20 ml of their assigned rinse for 30 seconds and 5 minutes later a second salivary flow rate was determined. They then rinsed unsupervised with 20 ml for 30 seconds three times daily for the next 14 days, and received soft tissue examinations on days 7 and 14. After a 1-week interim period, subjects switched to the alternate rinse and the examination and rinsing regimens were repeated during the subsequent 2 weeks.. The oral irritation potential of the essential oil mouthrinse was minimal. Oral mucosal abnormalities attributable to the test rinses were seen in only 2 subjects, both at the 7-day examination. These subjects were both using the essential oil mouthrinse. The abnormalities consisted of an asymptomatic "whitish slough" which was readily wiped off leaving a normal appearing, non-erythematous mucosa. In both subjects, the oral mucosa appeared normal at the 14-day examination.

Topics: Aged; Analysis of Variance; Cross-Over Studies; Dental Plaque; Drug Combinations; Female; Humans; Middle Aged; Mouth Mucosa; Mouthwashes; Oils, Volatile; Probability; Salicylates; Saliva; Secretory Rate; Single-Blind Method; Terpenes; Xerostomia

To compare the effectiveness of rinsing with an essential oil-containing antimicrobial mouthrinse with that of dental floss in reducing interproximal gingivitis and plaque in an unsupervised 6-month clinical trial designed in accordance with ADA Acceptance Program Guidelines.. 319 qualifying subjects, aged 18-63, were randomized into one of three groups: essential oil mouthrinse (Listerine Antiseptic); dental floss (Reach Dental Floss); or a negative control rinse. At baseline, subjects received a complete oral soft tissue examination and scoring of the Modified Gingival Index (MGI), modified Quigley-Hein Plaque Index (PI), and bleeding index (BI). Following a complete dental prophylaxis and receiving flossing or rinsing instructions, subjects started on their respective regimen. They continued on their assigned regimen unsupervised at home, in addition to toothbrushing, and were reexamined at 3 and 6 months. The treatment groups were compared with respect to baseline demographic and clinical variables. The primary efficacy variables were mean interproximal MGI and PI at 6 months. Intergroup differences at 3 and 6 months were tested using a one-way analysis of covariance model with treatment as a factor and the respective baseline value as the covariate. In addition, the essential oil mouthrinse was compared to floss for interproximal gingivitis reduction using "at least as good as" statistical criteria.. 301 subjects were considered evaluable. There were no statistically significant differences among the 3 groups at baseline, with the exception of the essential oil mouthrinse group having significantly fewer AfroAmerican subjects than the other two groups. For the interproximal MGI, the essential oil mouthrinse and flossing were both significantly more effective than the negative control (P < 0.001) at 3 and 6 months. The essential oil mouthrinse was shown to be "at least as good as" dental floss for the control of interproximal gingivitis. For the interproximal PI, the essential oil mouthrinse was significantly more effective than the negative control at 3 and 6 months (P < 0.001) while flossing was significantly more effective than the negative control at 3 months (P < 0.05) but not at 6 months. The essential oil mouthrinse was significantly more effective than floss (P < 0.001) at both these time periods.

Topics: Adolescent; Adult; Chi-Square Distribution; Dental Devices, Home Care; Dental Plaque; Dental Plaque Index; Drug Combinations; Female; Gingivitis; Humans; Least-Squares Analysis; Male; Middle Aged; Mouthwashes; Oils, Volatile; Periodontal Index; Salicylates; Terpenes

Topics: Adult; Complex Mixtures; Dental Plaque; Dental Plaque Index; Dentifrices; Drug Combinations; Fluorides; Gingivitis; Humans; Mouthwashes; Periodontal Index; Salicylates; Silicic Acid; Terpenes; Toothpastes; Triclosan

For various clinical applications, polyhexamethylene biguanide hydrochloride (PHMB) has been used for many years as an antiseptic in medicine. Recently, a 0.04% PHMB mouthwash was shown to inhibit plaque regrowth and to reduce oral bacterial counts. In this study, a 0.12% PHMB mouthrinse (A) was compared with a negative control placebo rinse (10% ethanol, flavour) (B), a positive control 0.12% chlorhexidine rinse (C), and a commercially available mouthrinse containing essential oils (Listerine) (D).. The study was a double-blind, randomised 4-replicate 4 x 4 Latin square cross-over design in which plaque regrowth was measured. The in vivo antibacterial effect was assessed by taking bacterial counts from the tooth surface and mucosa 4 h after the first rinse with the preparations on day 1 and prior to the clinical examination on day 5. 16 volunteers participated and, on day 1 of each study period, were rendered plaque-free, ceased toothcleaning, and rinsed 2x daily with the allocated mouthrinse. On day 5, plaque was scored and smears were collected according to the protocol. Washout periods were 9 days. Data were analysed using ANOVA with Bonferroni HSD adjustment for multiple comparisons (significance level alpha=0.05).. The 0.12% PHMB mouthrinse (A) was significantly more effective in inhibiting plaque than the placebo (B) but no significant differences could be observed between A and 0.12% chlorhexidine (C), or between A and Listerine (D). Bacterial count reductions on the tooth surface with PHMB (A) were significantly greater compared to the placebo (B) after 4 h and significantly greater compared to B and D after 5 days. Chlorhexidine (C) was more effective than A after 5 days. On the mucosa, chlorhexidine (C) was significantly more effective in reducing bacterial counts than the other 3 treatments at both time points investigated. PHMB (A) was significantly more effective in reducing bacterial counts than the placebo (B) after 4 h and after 5 days, and than D after 4 h.. Consistent with a previous study, a PHMB mouthrinse was shown to inhibit plaque recolonisation and to reduce oral bacterial counts, indicating that PHMB may find applications in the prevention of plaque-associated diseases.

Topics: Adult; Analysis of Variance; Anti-Infective Agents, Local; Bacteria; Biguanides; Chlorhexidine; Colony Count, Microbial; Cross-Over Studies; Dental Plaque; Double-Blind Method; Drug Combinations; Female; Humans; Male; Mouth Mucosa; Mouthwashes; Normal Distribution; Oils, Volatile; Placebos; Reproducibility of Results; Salicylates; Statistics as Topic; Terpenes; Tooth

There are both anecdotal clinical and laboratory experimental data suggesting that low pH mouthrinses cause dental erosion. This evidence is particularly relevant to acidified sodium chlorite (ASC) formulations since they have plaque inhibitory properties comparable to chlorhexidine but without the well known local side effects.. Studies in situ and in vitro were planned to measure enamel erosion by low pH mouthrinses. The study in situ measured enamel erosion by ASC, essential oil and hexetidine mouthrinses over 15-day study periods. The study was a 5 treatment, single blind cross over design involving 15 healthy subjects using orange juice, as a drink, and water, as a rinse, as positive and negative controls respectively. 2 enamel specimens from unerupted human third molar teeth were placed in the palatal area of upper removable acrylic appliances which were worn from 9 a.m. to 5 p.m., Monday to Friday for 3 weeks. Rinses were used 2x daily and 250 ml volumes of orange juice were imbibed 4x daily. Enamel loss was determined by profilometry on days 5, 10 and 15. The study in vitro involved immersing specimens in the 4 test solutions together with a reduced acid ASC formulation for a period of 4 h under constant stirring; Enamel loss was measured by profilometry every hour.. Enamel loss was in situ progressive over time with the 3 rinses and orange juice but negligible with water. ASC produced similar erosion to orange juice and significantly more than the two proprietary rinses and water. The essential oil and hexetidine rinses produced similar erosion and significantly more than water. Enamel loss in vitro was progressive over time, and the order from low to high erosion was reduced acid ASC, ASC, Essential oil, and hexetidine mouthrinses and orange juice.. Based on the study in situ, it is recommended that low pH mouthrinses should not be considered for long term or continuous use and never as pre-brushing rinses. In view of the plaque inhibitory efficacy of ASC, short- to medium-term applications similar to those of chlorhexidine would be envisaged.

Topics: Adult; Analysis of Variance; Anti-Infective Agents, Local; Beverages; Chlorides; Chlorine Compounds; Citrus; Cross-Over Studies; Dental Enamel; Dental Plaque; Disease Progression; Drug Combinations; Female; Follow-Up Studies; Hexetidine; Humans; Hydrogen-Ion Concentration; Male; Middle Aged; Mouthwashes; Oils, Volatile; Oxides; Salicylates; Single-Blind Method; Statistics as Topic; Statistics, Nonparametric; Terpenes; Tooth Erosion; Water

The efficacy of an essential oil-containing antiseptic mouthrinse (Listerine Antiseptic, Pfizer) and an antiplaque/antigingivitis dentifrice (Colgate Total, Colgate-Palmolive) has been demonstrated in numerous double-blind clinical studies. This study was conducted to determine their comparative efficacy.. Three hundred sixteen subjects with mild-to-moderate gingival inflammation and plaque received a dental prophylaxis and began their randomly assigned brushing and rinsing regimen in an unsupervised setting. Subjects brushed for one minute and rinsed with 20 milliliters for 30 seconds twice daily for six months. The three groups were L (control toothpaste/Listerine rinse), T (Colgate Total toothpaste/control rinse) and P (control toothpaste/control rinse).. Subjects in the L and T groups demonstrated statistically significantly lower (P < .001) Modified Gingival Index, or MGI; Bleeding Index, or BI; and Plaque Index, or PI, at both three and six months than subjects in the P group. The magnitude of reduction for the L group was 22.9 percent, 70 percent and 56.1 percent, respectively, and for the T group, 20.8 percent, 58 percent and 22.1 percent, respectively. Subjects in the L group were not different from subjects in the T group in regard to visual signs of gingivitis (MGI), but were more effective (P < .001) than subjects in the T group in experiencing reduced BI and PI. No product-related adverse events were reported.. Although the Listerine Antiseptic and Colgate Total antiplaque/antigingivitis products produced similar, clinically significant reductions in gingivitis (as measured by MGI and BI), Listerine, when used in conjunction with a fluoride dentifrice and usual oral hygiene, provided a greater benefit in reducing plaque.. When considering an antiplaque/antigingivitis product to recommend to patients, clinicians should consider Listerine Antiseptic, in conjunction with usual oral hygiene, if more rigorous plaque control is desired.

Topics: Adolescent; Adult; Aged; Analysis of Variance; Anti-Infective Agents, Local; Cariostatic Agents; Chi-Square Distribution; Complex Mixtures; Dental Plaque; Dental Plaque Index; Dentifrices; Double-Blind Method; Drug Combinations; Female; Fluorides; Follow-Up Studies; Gingival Hemorrhage; Gingivitis; Humans; Male; Middle Aged; Mouthwashes; Oils, Volatile; Periodontal Index; Salicylates; Silicic Acid; Statistics as Topic; Terpenes; Toothbrushing; Toothpastes; Triclosan

Clinical studies in which antimicrobial mouthrinses were shown to have significant antiplaque activity most frequently have used gingivitis as the clinically relevant endpoint. However, there is evidence to suggest that mouthrinses containing active agents effective against Streptococcus mutans, such as chlorhexidine, may also have a role in inhibiting dental caries. This clinical study was conducted to determine the effect of 2x-daily rinsing with an essential oil-containing antiseptic mouthrinse (Listerine Antiseptic) on levels of recoverable S. mutans and total streptococci in supragingival interproximal plaque and in saliva. Additionally, a follow-up in vitro study is reported which determined whether a differential susceptibility to the antiseptic mouthrinse exists among different strains of streptococci.. Following baseline saliva and plaque sampling for quantification of recoverable S. mutans and total streptococci, 29 qualifying subjects were randomly assigned either the essential oil mouthrinse or a sterile water control. They rinsed with 20 ml for 30s 2 x daily for 11 days and once on the 12th day, in addition to their usual oral hygiene procedures. On day 12, saliva and plaque samples were again collected and microbiological quantification performed. The procedures were repeated with the alternate rinse after a 1-week washout period.. The essential oil mouthrinse produced respective reductions of 69.9% and 75.4% in total recoverable streptococci and in S. mutans in plaque, and corresponding reductions of 50.8% and 39.2% in saliva. The in vitro study revealed that streptococci from the mutans group were more susceptible to the bactericidal activity of the essential oil mouthrinse than streptococci from the mitis group.. As antimicrobial mouthrinses are most frequently recommended to patients whose mechanical oral hygiene procedures are not adequate for the control of supragingival plaque and gingivitis, this study provides an additional rationale for the inclusion of the essential-oil mouthrinse as an adjunct to daily oral hygiene procedures.

Topics: Adult; Analysis of Variance; Anti-Infective Agents, Local; Colony Count, Microbial; Dental Plaque; Drug Combinations; Female; Follow-Up Studies; Humans; Linear Models; Male; Middle Aged; Mouthwashes; Oils, Volatile; Oral Hygiene; Salicylates; Saliva; Streptococcus; Streptococcus mutans; Terpenes

Recent research has indicated that bacteria within a biofilm may undergo changes in susceptibility to antimicrobial agents when compared to planktonic forms. This study was conducted to determine the bactericidal effect of an essential oil-containing mouthrinse (Listerine Antiseptic) on dental plaque bacteria in situ.. 1-day-old plaque in 17 subjects was sampled at baseline from the buccal surfaces of diagonally contralateral maxillary and mandibular bicuspids and 1st molars. Subjects were then randomly assigned either an essential oil mouthrinse or a sterile saline negative control and rinsed under supervision with 20 ml for 30 s. 30 min later, plaque was sampled from the remaining contralateral posterior teeth. Subjects repeated these procedures with their respective alternate rinse after 1 week. Pooled plaque samples from each subject at each sampling period were stained with a commercially-available fluorescent stain which fluoresces live and dead bacteria green and red, respectively. The stained plaque specimens were analyzed using computerized image analysis. A separate in vitro study was conducted to determine the relationship between the % red stain per sample and bacterial viability.. Analysis of vital stained plaque specimens indicated that following rinsing with the essential oil mouthrinse, 78.7% of bacteria were dead compared to 27.9% following rinsing with the negative control (p<0.001). The in vitro findings demonstrated that the % red stain per sample is reflective of actual bacterial kill.. This study confirms the findings of previous in vitro and in vivo studies which demonstrated the essential oil mouthrinse to have significant biocidal activity against oral micro-organisms. These studies all support the primacy of a bactericidal mechanism in producing the plaque and gingivitis reductions observed in numerous clinical trials conducted on the essential oil mouthrinse.

Topics: Anti-Infective Agents, Local; Bacteria; Bicuspid; Biofilms; Colony Count, Microbial; Cross-Over Studies; Dental Plaque; Drug Combinations; Female; Fluorescent Dyes; Gingivitis; Humans; Image Processing, Computer-Assisted; Male; Molar; Mouthwashes; Oils, Volatile; Placebos; Salicylates; Single-Blind Method; Terpenes

This study determined the in vivo interproximal bactericidal efficacy of an essential oil-containing antiseptic mouthrinse (Listerine Antiseptic) following toothbrushing. Thirty-four generally healthy adults, aged 23-64 years, completed this evaluator-blind, randomized, controlled, crossover designed study. Subjects rinsed for 30 seconds with 20 ml of either the essential oil rinse or a negative control rinse. Five minutes later, interproximal plaque was collected using paper points, and recoverable bacterial counts were quantified using both end point dilution and spectrophotometric methods. The results from the end point dilution demonstrated a statistically significant (p < 0.001) 43.8% reduction in recoverable plaque bacteria from interproximal spaces following rinsing with the essential oil mouthrinse. This study suggests that the clinical effectiveness of the essential oil mouthrinse against plaque and gingivitis may be attributable to the rapid kill and plaque permeabilizing properties of the formulation.

Topics: Adult; Anti-Infective Agents, Local; Biofilms; Colony Count, Microbial; Cross-Over Studies; Dental Plaque; Drug Combinations; Humans; Least-Squares Analysis; Microbial Sensitivity Tests; Middle Aged; Mouthwashes; Multivariate Analysis; Oils, Volatile; Salicylates; Single-Blind Method; Streptococcus mutans; Terpenes

To determine the effect of 6 months use of an essential oil-containing (EO) antiplaque/antigingivitis fluoride dentifrice on the balance of the oral microbial flora and on the emergence of resistant microbial forms by analysis of dental plaque and saliva.. The dentifrice essential oils consisted of a fixed combination of thymol, menthol, methyl salicylate, and eucalyptol. An identical fluoride-containing dentifrice without the essential oils served as the control. A subgroup of 66 subjects from a clinical trial population of 321 was randomly selected for characterization of their dental plaque microflora. Saliva was also cultured to monitor for the emergence of opportunistic pathogens. Supragingival plaque and saliva were harvested at baseline, after which subjects received a dental prophylaxis. Subjects were sampled again after 3 and 6 months of product use prior to clinical examination. Plaque was characterized for microbial content by phase contrast microscopy for recognizable cellular morphotypes and by cultivation on nonselective and selective culture media. Determination of the minimum inhibitory concentrations of the test agent against selected Actinomyces and Veillonella isolated bacterial species was conducted at all time points to monitor for the potential development of bacterial resistance.. There were no statistically significant differences between the microbial flora obtained from subjects using the essential oil-containing dentifrice and the vehicle control for all parameters and time periods except for the percentage of spirochetes at 6 months and for percentage of "other" microorganisms at 3 months. The EO group exhibited a lower adjusted mean for both parameters. Additionally, there was no evidence of the development of bacterial resistance to the antimicrobial activity of the essential oils or the emergence of opportunistic pathogens.

Topics: Actinomyces; Adolescent; Adult; Anti-Infective Agents, Local; Bacteria; Cariostatic Agents; Colony Count, Microbial; Culture Media; Cyclohexanols; Dental Plaque; Dentifrices; Double-Blind Method; Drug Resistance, Bacterial; Eucalyptol; Eucalyptus; Female; Fluorides; Follow-Up Studies; Gingivitis; Humans; Male; Menthol; Microscopy, Phase-Contrast; Middle Aged; Monoterpenes; Oils, Volatile; Salicylates; Saliva; Spirochaetales; Terpenes; Thymol; Veillonella

The adjunctive use of antimicrobial mouthrinses to help control supragingival plaque and gingivitis has been shown to contribute significantly to patients' daily oral hygiene regimens. This controlled clinical study used an observer-blind, randomized, cross-over design in a 4-day plaque regrowth model to determine the relative efficacies of an essential oil-containing mouthrinse (Listerine Antiseptic) and an amine fluoride/stannous fluoride-containing mouthrinse (Meridol) in inhibiting the development of supragingival plaque. A 0.1% chlorhexidine mouthrinse (Chlorhexamed-Fluid) was used as a positive control, and a 5% hydroalcohol solution was used as a negative control. Dosing for each of the test mouthrinses was based on the manufacturers' label directions. Because the volume and rinse time for each of the test mouthrinses were different, each test mouthrinse had its own negative control group. On day 1 of each test period, subjects received an oral soft and hard tissue examination and a dental prophylaxis to remove all plaque, calculus, and extrinsic stain. Starting the same day, subjects refrained from all mechanical oral hygiene procedures for the next 4 days and rinsed 2x daily under supervision with their randomly-assigned mouthrinse. On day 5, each subject received a plaque assessment as well as an oral examination to assess side effects. Each test period was separated by a 2-week washout period. 23 volunteers with a median age of 26 years completed the study. Compared to the respective placebos, the median percent plaque reductions at 5 days were 23.0%, 12.2%, and 38.2% for the essential oil, amine/stannous fluoride, and chlorhexidine rinses, respectively. The plaque reductions seen in the essential oil and chlorhexidine rinse groups were statistically significant (p < 0.001), while the plaque reduction in the amine/stannous fluoride rinse group was not statistically significant (p > 0.05). Additionally, the essential oil rinse was significantly more effective (p < 0.001) than the amine/stannous fluoride rinse in inhibiting plaque accumulation in this clinical model.

Topics: Adult; Amines; Anti-Infective Agents; Anti-Infective Agents, Local; Chlorhexidine; Cross-Over Studies; Dental Plaque; Dental Plaque Index; Dental Prophylaxis; Drug Combinations; Female; Humans; Male; Mouthwashes; Placebos; Salicylates; Single-Blind Method; Terpenes; Tin Fluorides; Tooth Discoloration

This double-blind parallel-design clinical study compared the efficacy of a stabilized stannous fluoride dentifrice (Crest Plus Gum Care), baking soda and peroxide (NaF) dentifrice (Mentadent), and essential oil mouthrinse (Listerine) to a conventional NaF dentifrice (Crest) for the control of plaque, gingivitis and gingival bleeding over six months. Following an initial baseline examination and stratification, subjects received a complete oral prophylaxis and were distributed assigned test products. Following three and six months, subjects re-visited the clinic for examinations. Evaluations at baseline and at 3 and 6 months included soft tissue status. Löe-Silness gingivitis/gingival bleeding, Silness-Löe plaque and dental stain. Results subsequent to six months of product use were as follows: At six months, the stabilized stannous fluoride dentifrice was observed to produce statistically significant 17.5% reductions in gingivitis and 27.5% reductions in gingival bleeding relative to the NaF dentifrice. The combination of sodium fluoride dentifrice and essential oil mouthrinse produced statistically significant reductions of 7.4% in gingivitis and 10.8% in plaque as compared with the NaF dentifrice. The stabilized stannous fluoride dentifrice produced statistically significant reductions in both gingivitis (10.8%) and gingival bleeding (23.0%) relative to the combination of sodium fluoride dentifrice and essential oil mouthrinse. The baking soda and peroxide (NaF) dentifrice did not provide reductions in gingivitis, plaque or gingival bleeding as compared with the conventional NaF dentifrice. The stabilized stannous fluoride dentifrice provided statistically significant reductions in gingivitis as compared with the baking soda and peroxide dentifrice following six months of use, and both the essential oil mouthrinse and stabilized stannous fluoride dentifrice provided statistically significant reductions in gingivitis as compared with the baking soda and peroxide dentifrice following three months of use. These results support: 1) the efficacy of stabilized stannous fluoride dentifrice and the combination of sodium fluoride dentifrice and essential oil mouthrinse for the prevention of gingivitis; 2) the superior activity of stabilized stannous fluoride dentifrice as compared with a combination of sodium fluoride dentifrice and essential oil mouthrinse for the control of gingivitis and gingival bleeding; and 3) the lack of efficacy for baking soda and pero

Topics: Adult; Analysis of Variance; Dental Plaque; Dental Plaque Index; Dentifrices; Double-Blind Method; Drug Combinations; Female; Gingivitis; Humans; Hydrogen Peroxide; Male; Mouthwashes; Periodontal Index; Salicylates; Sodium Bicarbonate; Sodium Fluoride; Terpenes; Tin Fluorides; Treatment Outcome

The intraoral antimicrobial activity of four commercial oral products-conventional NaF dentifrice (Crest), baking soda/peroxide/NaF dentifrice (Mentadent), essential oil mouthrinse (Listerine) and SnF2 dentifrice (Crest Plus Gum Care)-have been compared in three test regimens. Formulations were compared for their ability to suppress the regrowth and apical extension of dental plaque following toothbrushing during thirty hours of non-brushing where products were used as oral rinses (30-hour plaque regrowth model). Formulations were also compared for their ability to suppress the colony-forming units (cfu) of facultative anaerobic bacteria sampled from buccal gingival surfaces following use (Gingival Surface Microbial Index-GSMI model). Lastly, formulations were compared for effects in suppressing the glycolytic metabolic activity and regrowth activity of in vivo-treated dental plaques sampled at various periods following topical use and incubated under controlled ex vivo conditions (Plaque Glycolysis and Regrowth-PGRM model). In thirty-hour plaque regrowth testing, the rank ordered antimicrobial efficacy of formulations followed SnF2 > essential oils > NaF = water = baking soda/peroxide. In GSMI testing, all formulations were shown to suppress the cfu of facultative anaerobic bacteria relative to baseline, although SnF2 treatment was observed to reduce bacterial levels to a significantly greater degree than NaF dentifrice or baking soda/peroxide dentifrice up to two hours following brushing. In PGRM testing, the SnF2 dentifrice provided significant inhibition of bacterial metabolism and regrowth following topical application when compared with the NaF dentifrice as control. The baking soda/peroxide dentifrice provided no reduction in either bacterial metabolism or regrowth in PGRM. Previous studies had demonstrated modest effects for essential oil rinse in reducing PGRM plaque regrowth, with no effects for this treatment on plaque metabolism. Overall, these results demonstrate that SnF2 dentifrice provides substantial intraoral antimicrobial effects. The essential oil mouthrinse also exhibits significant intraoral antimicrobial effects, albeit apparently less than SnF2 dentifrice. The baking soda/peroxide dentifrice did not produce any antimicrobial effects following in vivo use compared with conventional dentifrice. These results provide mechanistic rationale for the chemotherapeutic efficacy of SnF2 and essential oil formulations in reducing gingivitis,

Topics: Adult; Analysis of Variance; Bacteria, Anaerobic; Colony Count, Microbial; Cross-Over Studies; Dental Plaque; Dental Plaque Index; Dentifrices; Drug Combinations; Female; Humans; Hydrogen Peroxide; Male; Mouthwashes; Salicylates; Sodium Bicarbonate; Sodium Fluoride; Terpenes; Tin Fluorides

The adjunctive use of antiplaque mouthrinses with normal oral hygiene procedures may produce a significant beneficial effect on gingival health. At present, numerous products are available with various claims for efficacy. Although for many of these products, well-controlled studies have been carried out comparing the products, against a negative control or placebo, very few studies have been carried out directly comparing the efficacy of one commercial product with another. In this observer-blind, 4-day plaque regrowth, crossover study, the efficacy of a commercial triclosan mouthrinse was compared to that of an essential oil mouthrinse and 2 placebo controls. Starting from zero plaque at the commencement of each trial period, 32 volunteers used only the allocated rinses as the method of oral hygiene over 4 days, and on the 5th day returned for measurement of plaque index and area. The essential oil rinse produced a plaque reduction of 52% for plaque area and 17% for plaque index compared to its placebo, whilst the triclosan rinse produced a 45% reduction for plaque area and 12% reduction for plaque index against its placebo. Analysis of variance and construction of 95% confidence intervals showed that both active rinses significantly reduced plaque compared to their respective placebo. In addition, the essential oil rinse significantly reduced plaque compared to the triclosan rinse for plaque index but not for plaque area. The findings of this study would suggest that of the 2 rinses, the essential oil rinse would be expected to be more effective at reducing plaque formation in the longer term.

Topics: Adult; Analysis of Variance; Anti-Infective Agents, Local; Benzoates; Confidence Intervals; Cross-Over Studies; Dental Plaque; Dental Plaque Index; Dental Prophylaxis; Dental Scaling; Drug Combinations; Female; Humans; Male; Mouthwashes; Oils, Volatile; Oral Hygiene; Placebos; Salicylates; Single-Blind Method; Sodium Dodecyl Sulfate; Terpenes; Triclosan

Topics: Dental Plaque; Drug Combinations; Female; Gingivitis; Humans; Middle Aged; Mouthwashes; Osteoporosis, Postmenopausal; Periodontal Diseases; Pilot Projects; Salicylates; Terpenes

The purpose of this controlled double-blind, parallel, randomized clinical study was to determine the effect of antiseptic mouthrinse on parameters important to dental implant maintenance. Plaque, peri-implant gingivitis, gingival bleeding, probing depth, and attachment level were assessed over a 3-month test period. Twenty healthy adult patients each of whom had at least two dental implants, a modified gingival index > 1.5, and a modified Quigley-Hein plaque index score > 1.7 were enrolled into the study. After a thorough oral prophylaxis, patients were randomly assigned to either the antiseptic mouthrinse or a 5% hydroalcohol placebo mouthrinse group and instructed to rinse twice daily for 30 seconds with 20 ml of their assigned mouthrinse as an adjunct to their usual oral hygiene procedures. The baseline examination included plaque index, gingival index, bleeding index, probing depth measurement, and attachment level measurements. The plaque and gingival indices were rescored at 1, 2, and 3 months. Probing depths, attachment levels, and bleeding index were determined again at 3 months only. At the end of 3 months, the antiseptic mouthrinse group had statistically significant reductions in plaque index, gingival index, and bleeding index compared to the placebo group. There were no significant differences between groups in probing depth or attachment level. The results of this clinical study indicate that twice daily use of an antiseptic mouthrinse may provide benefits in the maintenance of dental implants.

Topics: Adult; Aged; Analysis of Variance; Anti-Infective Agents, Local; Dental Implants; Dental Plaque; Dental Plaque Index; Double-Blind Method; Drug Combinations; Female; Gingivitis; Humans; Male; Middle Aged; Mouthwashes; Oral Hemorrhage; Periodontal Index; Salicylates; Terpenes

A new method, the Plaque Glycolysis and Regrowth Method (PGRM), is described for the evaluation of antimicrobial effects on plaque metabolism in vivo. The method relies on the experimental observation that in vivo sampled dental plaques, collected from different quadrants of the dentition, produce equivalent rates of metabolic activity and regrowth when similarly dispersed and normalized into incubation media. In applications of the technique to antimicrobial evaluations, overnight fasted dental plaque is collected from a non-treated quadrant of the dentition along the gingival margin. Topical formulations are used in vivo. Following this, dental plaques are collected from other dentition quadrants at extended times, allowing for the back diffusion, clearance and natural intraoral deactivation of antimicrobials within the oral cavity. In vivo treated and non-treated plaque samples are subsequently tested for metabolic and regrowth activity under controlled and standardized conditions in vitro following normalization for biomass. The technique thus combines the necessary biological factors important to the legitimate evaluation of antimicrobial effects in vivo, while benefiting from the improved precision and control provided by in vitro assessment of plaque activity. In this paper evidence is presented validating the PGRM method, and initial activity screens of commercial antimicrobial mouthrinses and toothpastes, including a new stabilized stannous fluoride dentifrice, are described.

Topics: Analysis of Variance; Anti-Infective Agents, Local; Biofilms; Cetylpyridinium; Chlorhexidine; Cross-Over Studies; Dental Plaque; Dentifrices; Drug Combinations; Fluorides, Topical; Glycolysis; Humans; Hydrogen-Ion Concentration; Microbial Sensitivity Tests; Mouthwashes; Pilot Projects; Quaternary Ammonium Compounds; Reproducibility of Results; Salicylates; Sodium Fluoride; Terpenes; Tin Fluorides

Staining of teeth and mucous membranes is a well-known side-effect with chlorhexidine mouthrinses in which dietary chromogens play an important rôle. The purpose of this study was to determine whether a co-polymer anti-adhesive agent would prevent staining by a low concentration chlorhexidine solution. Additionally, the possibility that an essential oil/phenolic rinse product may cause staining was investigated. The rinses studied were the anti-adhesive alone and combined with 0.02% chlorhexidine and the essential oil/phenolic rinse. These were positioned against a positive control rise, 0.2% chlorhexidine, and a negative control rinse, water. The study was a single blind 5-treatment, randomised Latin square cross-over design, incorporating balance for carry-over effects. 15 volunteers participated and on Day 1 of each study period were rendered stain free by scaling and polishing of the teeth. Oral hygiene was suspended and 8 x per day subjects rinsed under supervision, firstly with the allocated formulation and then with 10 ml of warm black tea. On Day 4, tooth and tongue staining was scored by area and intensity (colour). A washout period of at least 3 1/2 days was permitted between treatment periods when oral hygiene was resumed. Before the study and during washouts, volunteers practised tongue brushing. Tooth and tongue staining was significantly increased with 0.2% chlorhexidine compared to the essential oil/phenolic rinse which in turn was significantly increased compared to the other 3 rinses. The antiadhesive/chlorhexidine rinse produced no more staining than the anti-adhesive or water rise. However, the parallel plaque regrowth study suggests this inhibition of staining resulted from the vitiation of the chlorhexidine activity by the antiadhesive. The methodology would appear a simple and quick way of assessing the propensity of mouthrinses to cause extrinsic staining.

Topics: Anti-Infective Agents, Local; Chlorhexidine; Color; Cross-Over Studies; Dental Plaque; Dental Prophylaxis; Dental Scaling; Drug Combinations; Humans; Male; Mouthwashes; Oils, Volatile; Oral Hygiene; Phenols; Polyethylene Glycols; Polymethacrylic Acids; Salicylates; Single-Blind Method; Surface-Active Agents; Tea; Terpenes; Tongue; Tooth Discoloration; Water

The aim of this double-blind study was to enumerate the total number of living and dead bacteria on defined tooth areas during the application of antibacterial mouthrinses. After prophylaxis, 40 students refrained from all oral hygiene measures for 3 d, during which they rinsed with a phenolic compound (Listerine), an amine fluoride/stannous fluoride solution (Meridol), 0.2% chlorhexidine (CHX) or a control solution (0.02% quinine-hydrochloride). The plaque index (P1I) was recorded at the start and the end of the investigation. Total bacterial counts (BC) and colony-forming units (CFU) of 1d-, 2d- and 3d-old dentogingival plaque were determined. The plating efficiency (PE) was calculated as a percentage of CFU/BC and the portion of vital microflora estimated by a vital fluorescence technique (VF). All groups started with a P1I approximating 0.1. On day 3, the P1I values were 1.21 in the control group and 0.51, 0.37 and 0.14 after Listerine, Meridol and CHX use, respectively. A tremendous variation existed between the numbers of viable bacteria found per mm2 on the enamel surface and day 3 (CHX: 0.2; Meridol: 300; Listerine; 6x10(4); control: 2x10(6)), while higher total numbers of bacteria were concomitantly present (CHX and Meridol: 1-2x10(4); Listerine: 2x10(5); control: 2x10(6)). Both vitality parameters PE and VF reached 92% in the control group at day 3, but only 7% after CHX use. With Meridol and Listerine, the corresponding PE values were 3% and 43%, respectively, while the VF values reached 48% and 54%. The PII, BC, CFU and PE values of the CHX and the Meridol groups differed significantly from those of the control group. In contrast, Listerine showed no difference as compared to the control rinse. Due to the strong antibacterial action of CHX and Meridol during their use, almost only dead or non-proliferating bacteria were found on the tooth surfaces. Thus, only a thin plaque could develop. As a clinical consequence, both substances showed retardation of plaque development as reflected by significantly reduced plaque indices.

Topics: Adolescent; Adult; Amines; Anti-Infective Agents, Local; Bacteria; Chlorhexidine; Colony Count, Microbial; Dental Enamel; Dental Plaque; Dental Plaque Index; Double-Blind Method; Drug Combinations; Female; Fluorescence; Humans; Male; Mouthwashes; Phenols; Quinine; Salicylates; Terpenes; Tin Fluorides

A previous clinical screening study demonstrated that a cetylpyridinium chloride (CPC) essential oil mouthrinse inhibited plaque regrowth to a significantly greater extent than a negative control or a triclosan/copolymer rinse when used without toothbrushing. The purpose of this study was to evaluate the same ingredient combination as a pre-brushing rinse over a 6-week period. The study employed a 4 group parallel design with a minimum of 50 subjects per group. Subjects with a minimum baseline plaque index of 1.95 were recruited. The formulations employed were two variations of a CPC/essential oil rinse, a triclosan/copolymer product, and a hydroalcohol negative control. Subjects were rendered plaque free at baseline and then rinsed twice daily before toothbrushing with their allocated product. Plaque was scored at 6 days and 6 weeks. Plaque scores were reduced at 6 days compared to baseline but there were no significant differences between any of the groups. At 6 weeks, plaque scores were significantly lower in both CPC/essential oil groups compared to control. Although both CPC/essential oil groups showed plaque scores which were lower than the triclosan group, in only one of the groups was the difference significant. The triclosan product was not significantly different from control. The results support the previous findings that a CPC/essential oil rinse could be a useful adjunct to oral hygiene when used prior to normal toothbrushing.

Topics: Adolescent; Adult; Aged; Alcohols; Analysis of Variance; Cetylpyridinium; Cyclohexanols; Dental Plaque; Dental Plaque Index; Double-Blind Method; Drug Combinations; Eucalyptol; Female; Humans; Male; Menthol; Middle Aged; Monoterpenes; Mouthwashes; Oils, Volatile; Oral Hygiene; Salicylates; Terpenes; Thymol; Toothbrushing; Triclosan

Antimicrobial mouthrinses can play an important role in maintaining oral health by killing cariogenic organisms and preventing plaque and gingivitis. The active ingredients are adsorbed by oral tissues and then gradually released into the saliva. In this article, the effectiveness of a substantive chlorhexidine and a nonsubstantive phenolic antimicrobial mouthrinse were tested. When compared, the results indicated that the two types of mouthrinses are equally effective at killing salivary microbes for up to 30 minutes after rinsing. The prescriptive substantive rinse, however, continued its microbicidal effect for a longer duration (up to 5 hours) than the over-the-counter nonsubstantive rinse. The substantive rinse showed pronounced and measurable zones of inhibition around each well in the agar diffusion assay where the nonsubstantive rinse showed no zone around any well at any time. The substantive rinse also showed a superior ability to inhibit the growth of 28 oral microbes, including some putative periodontopathogens, which were assayed.

Topics: Bacteria, Anaerobic; Chlorhexidine; Colony Count, Microbial; Dental Plaque; Drug Combinations; Humans; Microbial Sensitivity Tests; Mouthwashes; Salicylates; Saliva; Terpenes; Time Factors

Fifty chronic adult periodontitis patients completed a 6-week controlled, double-blind, split mouth clinical study to determine the effects of subgingival irrigation with an antimicrobial mouthrinse on periodontal microflora, supragingival plaque, and gingivitis when used as an adjunct to normal oral hygiene. Qualifying subjects had at least four sites, two on each side of the mouth, with probing depths between 4 and 6 mm, which bled on gentle probing. Following baseline examinations, subjects received a half mouth scaling and prophylaxis and full mouth subgingival irrigation with either the antimicrobial mouthrinse or sterile colored water control professionally delivered. Subjects continued irrigation at home once daily for 42 days with their assigned rinse delivered via a subgingival delivery system. All sites in the mouth were scored at baseline and at day 42 for supragingival plaque, bleeding on probing, and redness. For the four selected periodontitis sites, probing depth and attachment level were measured at baseline and on day 42; additionally, supragingival plaque and gingival redness were scored on days 7 and 21. Subgingival plaque samples for microbiological analysis were harvested from the selected periodontal sites at baseline and on days 7, 21, and 42. Microbiologically, irrigation with the antimicrobial mouthrinse resulted in statistically significant reductions compared to control in putative periodontopathogens, including black pigmenting species, which persisted at 42 days. Clinically, subgingival irrigation with the antimicrobial mouthrinse produced a significant reduction in supragingival plaque (P < 0.001), bleeding on probing (P = 0.019), and redness (P = 0.017) compared to the control, whether or not the area irrigated received a prophylaxis.(ABSTRACT TRUNCATED AT 250 WORDS)

Topics: Adult; Analysis of Variance; Anti-Infective Agents, Local; Bacteria, Anaerobic; Bacteroides; Capnocytophaga; Colony Count, Microbial; Dental Plaque; Double-Blind Method; Drug Combinations; Female; Fusobacterium; Humans; Male; Mouthwashes; Periodontal Index; Periodontitis; Porphyromonas gingivalis; Salicylates; Streptococcus sanguis; Terpenes; Treponema

This double-blind, controlled clinical study compared the effectiveness of 30- and 60-s listerine rinses in both inhibiting the development of, and reducing existing, supragingival plaque and gingivitis, using an experimental gingivitis model. 94 subjects completed this study. For each subject, a modified gingival index, modified Quigley-Hein plaque index and Eastman interdental bleeding index were recorded at baseline and at 2 weeks. Following the baseline examinations, subjects received half-mouth prophylaxes, and began 2 x daily supervised rinsing either with listerine for 30 or 60 s or with a control mouthrinse for 30 s as their sole oral hygiene measure. Statistical analysis (ANCOVA) showed that both the 30- and 60-s listerine rinses were significantly (p < 0.01) more effective than the control in inhibiting and reducing plaque, gingivitis and gingival bleeding. Although 60-s rinses with listerine were significantly more effective (p < 0.01) than 30-s rinses in controlling plaque, the 2 rinse durations were similarly effective in controlling interdental bleeding and gingivitis. This study confirms the recommendation of 2x daily rinsing with listerine for 30 s as an effective regimen for gingivitis control.

Topics: Adolescent; Adult; Analysis of Variance; Dental Plaque; Dental Plaque Index; Double-Blind Method; Drug Combinations; Female; Gingivitis; Humans; Male; Middle Aged; Mouthwashes; Oral Hygiene; Periodontal Index; Salicylates; Terpenes; Time Factors

The aim of this study was to evaluate the effect of 3 mouthrinses, Listerine Antiseptic (thymol), Peridex (chlorhexidine), Perimed (povidone iodine and hydrogen peroxide), and a placebo (water) on the development of dental plaque and gingivitis, when used as the only oral hygiene procedure for 14 days. 71 subjects were entered into a randomized, double-blind study. At the baseline examination, papillary bleeding score (PBS), and plaque index (PI) were registered, after which subjects received supragingival prophylaxis and were assigned to 1 of 4 study cells. Subjects were asked to refrain from all oral hygiene procedures except for the supervised 14-day 2 x daily rinsing with the assigned preparation. At day 14, the same clinical parameters were again registered. Statistical analysis was performed by a one-way analysis of variance (ANOVA) to compare the 4 groups, followed by Duncan's multiple range test to determine specific group differences. At baseline, average PBS and PI scores were similar for all 4 groups. After 14 days, the average PBS for Peridex and Perimed was significantly lower than for Listerine Antiseptic and water. The frequency of interdental units with a PBS greater than 2 was significantly lower for Peridex and Perimed than for Listerine Antiseptic and water. We concluded that both Peridex and Perimed were effective in reducing plaque and gingivitis when used as a 2 x daily mouthrinse by subjects refraining from other oral hygiene procedures. In vitro, a synergistic effect was assumed when inhibition was achieved with Perimed at the same or greater dilution than was achieved with povidone-iodine alone.

Topics: Actinomyces viscosus; Adolescent; Aggregatibacter actinomycetemcomitans; Anti-Infective Agents, Local; Bacteroides; Capnocytophaga; Chlorhexidine; Dental Plaque; Double-Blind Method; Drug Combinations; Female; Fusobacterium nucleatum; Gingivitis; Humans; Hydrogen Peroxide; Iodine; Male; Middle Aged; Mouthwashes; Placebos; Porphyromonas gingivalis; Povidone; Salicylates; Terpenes; Water

The anti-plaque, anti-gingivitis and anti-microbial efficacies of a phenolic compound (Listerine) and 2 different amine/stannous fluoride mouthwashes (Meridol I, II) were compared when these solutions were used in addition to usual tooth cleaning. A placebo preparation was utilized as a negative control and a chlorhexidine solution as a positive control in this double-blind study. After professional tooth cleaning, 49 volunteers continued their habitual, self-performed and non-supervised oral hygiene for a period of 2 weeks, in order to have a more standard baseline. At day 0, they began to rinse twice daily with 1 of the 5 mouthwashes. After 3 weeks of rinsing, plaque indices remained the lowest in the chlorhexidine and the Meridol I groups, while subjects using Listerine or Meridol II demonstrated similar indices significantly lower than that of individuals rinsing with the placebo solution. Through this period, the gingival index scores were similar in the Meridol, Listerine and chlorhexidine groups. At day 21, the mean GI scores in the chlorhexidine group were significantly lower than the scores in the placebo group. The plaque vitality scores showed a bacterial effect in vivo of chlorhexidine and, to a lesser extent, of the Meridol solutions. No substantial evidence of an antibacterial effect in vivo was found for Listerine. This study has demonstrated that when mouthrinses are used to supplement habitual mechanical oral hygiene, chlorhexidine remains the most powerful solution. Furthermore, it was also shown that a combination of habitual self-performed and non-supervised oral hygiene with Meridol or Listerine is more beneficial for plaque control than the use of mechanical oral hygiene alone.

Topics: Adult; Amines; Bacteria; Chlorhexidine; Colony Count, Microbial; Combined Modality Therapy; Dental Plaque; Dental Plaque Index; Drug Combinations; Female; Fluorides; Gingivitis; Humans; Male; Mouthwashes; Periodontal Index; Placebos; Quinine; Salicylates; Terpenes; Tin; Tin Fluorides; Toothbrushing

In vitro studies have demonstrated the antiplaque properties of C31G, a potent broad spectrum antimicrobial agent consisting of an equimolar mixture of alkyl dimethyl glycine and alkyl dimethyl amine oxide, buffered with citric acid. In this initial clinical study, C31G at concentrations of 0.05%, 0.1%, 0.2% and 0.5%. Listerine, and placebo were tested in a complete crossover design. Twelve subjects were evaluated, with a minimum of 2 days between treatments. Parameters monitored were salivary bacterial counts and saliva glycolysis. The 0.5% and 0.2% C31G mouthrinses significantly reduced total bacterial counts in saliva samples obtained up to and including three hours after rinsing, compared with counts obtained prerinsing or after placebo rinsing. Both 0.5%, and 0.2% C31G significantly inhibited glycolysis of salivary bacteria for up to 6 hours postrinsing, compared with pH values obtained prerinsing. 0.1% and 0.05% C31G exhibited little or no effect in either assay. Listerine showed a significant reduction in bacterial counts for up to 1 hour postrinsing, compared with prerinse counts, but the effect was less sustained. Listerine showed no significant inhibition of glycolysis at any time point. No tooth staining or altered taste sensation was noted with either product.

Topics: Adult; Analysis of Variance; Anti-Bacterial Agents; Bacteria; Betaine; Dental Plaque; Drug Combinations; Fatty Acids, Unsaturated; Glycolysis; Humans; Mouthwashes; Salicylates; Saliva; Streptococcus; Terpenes

A 6-month double-blind, controlled clinical study was completed with 124 healthy adult subjects to determine the efficacy of 2 mouthrinses, Listerine (LA) and Peridex (PX), used as supplements to regular oral hygiene measures in reducing supragingival dental plaque and gingivitis. Following screening examinations for entry levels of existing gingivitis and plaque, baseline gingival and plaque area indices, extrinsic tooth stain, supragingival calculus, bleeding and soft tissue condition were recorded. All subjects then received a complete dental prophylaxis to remove plaque, calculus and extrinsic stain. Subjects were randomly assigned to 1 of 3 groups and performed supervised rinses twice daily for 30 s in addition to their normal oral hygiene, for 6 months. All indices were again evaluated at 3 and 6 months. After 6 months, LA and PX significantly (p less than 0.001) inhibited development of plaque by 36.1% and 50.3%, respectively, and the development of gingivitis by 35.9% and 30.5%, respectively, compared to a hydroalcohol control. PX was more effective in inhibiting plaque and both mouthrinses appeared to be equally effective in inhibiting gingivitis. LA patients did not develop significant levels of stain or supragingival calculus at 6 months, compared to baseline or control. PX patients developed significant levels of extrinsic stain and supragingival calculus compared to baseline and control. Though PX was more effective than LA in the control of plaque, this study indicates that both LA and PX were effective agents in a regimen for the control of plaque and gingivitis.

Topics: Adult; Chlorhexidine; Dental Calculus; Dental Plaque; Dental Plaque Index; Double-Blind Method; Drug Combinations; Female; Gingivitis; Humans; Male; Middle Aged; Mouthwashes; Periodontal Index; Salicylates; Terpenes; Tooth Discoloration

The experimental gingivitis model was used to compare the anti-plaque, anti-gingivitis and anti-microbial efficacies of a phenolic compound (Listerine) and an amine/stannous fluoride mouthwash (Meridol), using a placebo preparation as negative control and a chlorhexidine solution as positive control in a double-blind study. After professional toothcleaning, 36 volunteers performed optimal oral hygiene for a period of 2 weeks. They then ceased all oral hygiene procedures for 21 days during which they rinsed twice daily with 1 of the 4 mouthrinses. After 3 weeks of rinsing, plaque indices remained the lowest in the chlorhexidine group, while subjects using Listerine or Meridol harbored similar indices significantly lower than that of individuals rinsing with the placebo solution. Up to that time, the gingival index scores were equal in all groups except for the chlorhexidine group in which the values only amounted to half of these encountered in the other groups. The plaque vitality scores showed a bactericidal effect in vivo of chlorhexidine during the entire time of experimental gingivitis. In contrast, the data gave no evidence of an antibacterial effect in vivo of Listerine. The efficacy of Meridol to kill micro-organisms was similar to chlorhexidine during the early stages of plaque accumulation and, with time, became insignificant. This study has demonstrated that chlorhexidine was superior to Listerine and Meridol in its ability to maintain low plaque scores and gingival health during this 3-week period of no mechanical oral hygiene. Moreover, it was also shown that Meridol was as effective as Listerine in reducing plaque accumulation and, in contrast to Listerine, possessed a remarkable but transient antibacterial effect in vivo.

Topics: Adult; Amines; Chlorhexidine; Dental Plaque; Double-Blind Method; Drug Combinations; Female; Fluorides; Gingivitis; Humans; Male; Microbial Sensitivity Tests; Microscopy, Fluorescence; Mouthwashes; Product Surveillance, Postmarketing; Salicylates; Terpenes; Tin Fluorides

Sixty-six adults were examined in a double-bind study which examined the effect of an antimicrobial agent delivered by an oral irrigating device. Each subject received a randomized half mouth dental prophylaxis. The Gingival Index, gingival crevicular fluid volume, Plaque Index, Modified Papillary Bleeding Index, probing pocket depth, and probing attachment levels were determined at baseline, 3 weeks, and 6 weeks. The composition of the subgingival microflora in the prophied and non-prophied quadrants was examined by phase contrast microscopy and by immunofluorescence. This study demonstrates that an antimicrobial product delivered by an oral irrigating device could result in significant reductions in plaque, bacterial cell counts, and gingival bleeding and may, therefore, be an effective adjunct to normal oral hygiene.

Topics: Adult; Anti-Infective Agents, Local; Bacteria; Dental Plaque; Dental Prophylaxis; Double-Blind Method; Drug Combinations; Female; Gingiva; Gingival Crevicular Fluid; Gingival Hemorrhage; Gingivitis; Humans; Male; Mouthwashes; Pilot Projects; Salicylates; Terpenes; Therapeutic Irrigation

Chemotherapeutic mouthrinses are useful adjuncts to normal oral hygiene and regular professional care for patients whose mechanical plaque removal is less than optimal. Recognizing this, the American Dental Association Council on Dental Therapeutics published guidelines for evaluating the safety and efficacy of products for the control of gingivitis. Four 6-month or longer controlled clinical trials have shown Listerine to be significantly effective in helping prevent the development of both supragingival plaque and gingivitis. Two microbiology studies have demonstrated that no resistant microorganisms, opportunistic microorganisms, or presumptive oral pathogens emerge as a result of long-term, daily Listerine use. Listerine is the first nonprescription mouthrinse to receive the Council on Dental Therapeutics Seal of Acceptance as safe and effective in helping to prevent and reduce supragingival plaque accumulation and gingivitis when used in a conscientiously applied program of oral hygiene and regular professional care.

Topics: Clinical Trials as Topic; Dental Plaque; Drug Combinations; Gingivitis; Humans; Mouthwashes; Salicylates; Terpenes

A 6-month double-blind, controlled clinical study was conducted on 107 healthy adult subjects to determine the efficacy of a mouthrinse used as a supplement to regular oral hygiene measures on supragingival dental plaque and gingivitis. 115 healthy adult patients were recruited for the study. Following screening examinations for minimal entry levels of existing gingivitis and plaque in patients with a minimum of 20 sound natural teeth, extrinsic tooth stain, gingivitis and plaque index scores were recorded. Soft tissues were evaluated. All subjects then received a complete dental prophylaxis, removing plaque, calculus and extrinsic stain. Utilizing their normal oral hygiene, subjects began a regimen of rinsing with 20 ml of the randomly assigned rinse, twice daily for 30 s for 6 months. 7 days after prophylaxis, gingivitis was again scored (baseline 2). Soft tissue, gingivitis, plaque area and extrinsic stain were evaluated again at 3 and 6 months. Results demonstrated that after 6 months, listerine produced a 34% inhibition of both plaque and of gingivitis compared to a hydroalcohol control (p less than 0.001).

Topics: Adolescent; Adult; Dental Plaque; Dental Plaque Index; Double-Blind Method; Drug Combinations; Female; Gingivitis; Humans; Male; Middle Aged; Mouthwashes; Periodontal Index; Salicylates; Terpenes; Tooth Discoloration

This study was undertaken to determine whether long-term use (6-months) of an antiseptic mouthrinse (Listerine Antiseptic, Warner Lambert Co., Morris Plains, NJ, USA) led to an undesirable succession of oral pathogens or the emergence of resistant microbial forms. Supragingival plaque was collected from 83 subjects before treatment and after either 3 or 6 months use of either the active antiseptic or a 5% hydroalcohol control. Subjects rinsed with their assigned mouthrinse twice daily under supervision. The plaque samples were analyzed for microbial content by darkfield microscopy, culture on a series of nonselective and selective bacterial media, and by recognition of microbial forms by recognition of distinct colony on a nonselective medium. Statistical analysis of the results revealed no significant microbial shifts including no significant increases in presumptive oral pathogens, spirochetes, black-pigmented Bacteroides, Streptococcus mutans, or Candida albicans. Additionally, no detectable rise in either staphylococci or enteric bacteria, potential opportunistic pathogens, was observed.

Topics: Adolescent; Adult; Bacteria; Culture Media; Dental Plaque; Double-Blind Method; Drug Combinations; Female; Humans; Male; Microscopy; Mouthwashes; Random Allocation; Salicylates; Spirochaetales; Terpenes; Time Factors

A randomized double-blind crossover design study using 25 patients requiring bilateral gingival flap surgery was completed. The effect of rinsing postsurgically three times daily with an antimicrobial mouthrinse or physiological saline on dental plaque formation, gingival inflammation, bleeding, wound healing, and patient comfort was evaluated at 7, 14 and 28 days. The antimicrobial rinse was statistically significantly 28.9% more effective than saline at seven days for reducing plaque. It was also significantly more effective for improving wound healing at day 7 as measured by edema (p less than 0.04). There were no significant differences in gingival index scores or bleeding at any time period. Use of an antimicrobial mouthrinse may be an effective aid in early healing of gingival flap surgery wounds.

Topics: Adult; Aged; Anti-Infective Agents, Local; Dental Plaque; Double-Blind Method; Drug Combinations; Female; Gingiva; Gingival Hemorrhage; Humans; Male; Middle Aged; Mouthwashes; Pain, Postoperative; Periodontitis; Random Allocation; Salicylates; Surgical Flaps; Terpenes; Wound Healing

Topics: Adult; Analysis of Variance; Anthraquinones; Clinical Trials as Topic; Dental Plaque; Double-Blind Method; Drug Combinations; Ethanol; Female; Gingivitis; Humans; Male; Plants, Medicinal; Rheum; Salicylates

In the 19th century, the mouthwash Listerine® was formulated from four essential oils. Later, the oils were replaced by their marker substances. To keep them in solution, 24-27% ethanol was added as a vehicle. This is an update of our previous review on the efficacy and safety of Listerine®.. PubMed was searched for clinical studies on the therapeutic benefits and safety of Listerine® from the end of 2011 to the end of October 2015.. Sixteen studies were found and extracted. Three of the four 6-month studies were of sound confirmatory design. Two of these investigated Listerine® and one Listerine Zero®. The evidence of effectiveness for Listerine®, based on the bulk of three confirmatory studies and numerous exploratory studies carried out so far, is strong, but only moderate for Listerine® Zero and poor for Listerine® Cool Blue. In the three safety studies identified, we found methodological flaws that biased the results.. Evidence is accumulating that Listerine® is effective in improving oral health, but the absence of systematic toxicological studies means that an accurate safety assessment cannot be made.

Topics: Dental Plaque; Drug Combinations; Gingivitis; Humans; Mouthwashes; Oils, Volatile; Oral Health; Salicylates; Terpenes

Dental plaque is a biofilm that forms naturally on the surfaces of exposed teeth and other areas of the oral cavity. It is the primary etiological factor for the most frequently occurring oral diseases, such as dental caries and periodontal diseases. Specific, nonspecific, and ecologic plaque hypothesis explains the causation of dental and associated diseases. Adequate control of biofilm accumulation on teeth has been the cornerstone of prevention of periodontitis and dental caries. Mechanical plaque control is the mainstay for prevention of oral diseases, but it requires patient cooperation and motivation; therefore, chemical plaque control agents act as useful adjuvants for achieving the desired results. Hence, it is imperative for the clinicians to update their knowledge in chemical antiplaque agents and other developments for the effective management of plaque biofilm-associated diseases. This article explores the critical analysis of various chemical plaque control strategies and the current trends in the control and prevention of dental plaque biofilm.

Topics: Aloe; Benzhydryl Compounds; Biofilms; Cetylpyridinium; Chlorhexidine; Dental Plaque; Dextranase; Drug Combinations; Humans; Lippia; Morpholines; Periodontal Diseases; Phenols; Plant Extracts; Povidone-Iodine; Propolis; Salicylates; Terpenes

This study examines the antibacterial properties of sodium hypochlorite (NaOCl), chlorhexidine gluconate (CHX), Listerine®, and high purity chlorine dioxide (Solumium, ClO2) on selected common oral pathogen microorganisms and on dental biofilm in vitro. Antimicrobial activity of oral antiseptics was compared to the gold standard phenol. We investigated Streptococcus mutans, Lactobacillus acidophilus, Enterococcus faecalis, Veillonella alcalescens, Eikenella corrodens, Actinobacillus actinomycetemcomitans and Candida albicans as some important representatives of the oral pathogens. Furthermore, we collected dental plaque from the upper first molars of healthy young students. Massive biofilm was formed in vitro and its reduction was measured after treating it with mouthrinses: CHX, Listerine® or hyper pure ClO2. Their biofilm disrupting effect was measured after dissolving the crystal violet stain from biofilm by photometer. The results have showed that hyper pure ClO2 solution is more effective than other currently used disinfectants in case of aerobic bacteria and Candida yeast. In case of anaerobes its efficiency is similar to CHX solution. The biofilm dissolving effect of hyper pure ClO2 is significantly stronger compared to CHX and Listerine® after 5 min treatment. In conclusion, hyper pure ClO2 has a potent disinfectant efficacy on oral pathogenic microorganisms and a powerful biofilm dissolving effect compared to the current antiseptics, therefore high purity ClO2 may be a new promising preventive and therapeutic adjuvant in home oral care and in dental or oral surgery practice.

Topics: Adolescent; Anti-Infective Agents, Local; Biofilms; Candida albicans; Chlorhexidine; Chlorine Compounds; Dental Disinfectants; Dental Plaque; Drug Combinations; Gram-Negative Bacteria; Gram-Positive Bacteria; Humans; Mouthwashes; Oxides; Phenol; Salicylates; Sodium Hypochlorite; Students; Terpenes; Young Adult

Bonded retainers are used in orthodontics to maintain treatment result. Retention wires are prone to biofilm formation and cause gingival recession, bleeding on probing and increased pocket depths near bonded retainers. In this study, we compare in vitro and in vivo biofilm formation on different wires used for bonded retainers and the susceptibility of in vitro biofilms to oral antimicrobials.. Orthodontic wires were exposed to saliva, and in vitro biofilm formation was evaluated using plate counting and live/dead staining, together with effects of exposure to toothpaste slurry alone or followed by antimicrobial mouthrinse application. Wires were also placed intra-orally for 72 h in human volunteers and undisturbed biofilm formation was compared by plate counting and live/dead staining, as well as by denaturing gradient gel electrophoresis for compositional differences in biofilms.. Single-strand wires attracted only slightly less biofilm in vitro than multi-strand wires. Biofilms on stainless steel single-strand wires however, were much more susceptible to antimicrobials from toothpaste slurries and mouthrinses than on single-strand gold wires and biofilms on multi-strand wires. Also, in vivo significantly less biofilm was found on single-strand than on multi-strand wires. Microbial composition of biofilms was more dependent on the volunteer involved than on wire type.. Biofilms on single-strand stainless steel wires attract less biofilm in vitro and are more susceptible to antimicrobials than on multi-strand wires. Also in vivo, single-strand wires attract less biofilm than multi-strand ones.. Use of single-strand wires is preferred over multi-strand wires, not because they attract less biofilm, but because biofilms on single-strand wires are not protected against antimicrobials as in crevices and niches as on multi-strand wires.

Topics: Analysis of Variance; Anti-Infective Agents, Local; Biofilms; Dental Alloys; Dental Disinfectants; Dental Plaque; Drug Combinations; Electrophoresis, Gel, Two-Dimensional; Female; Gold Alloys; Humans; Male; Mouthwashes; Orthodontic Retainers; Orthodontic Wires; Salicylates; Saliva; Sodium Dodecyl Sulfate; Sodium Fluoride; Stainless Steel; Statistics, Nonparametric; Terpenes; Toothpastes

The aim of this study was to use the Zurich polyspecies biofilm model to compare the antimicrobial effects of chlorhexidine mouth rinses available on the Swiss market. As positive and negative controls, aqueous 0.15% CHX solution and water were used, respectively. In addition, Listerine® without CHX was tested. Biofilms in batch culture were grown in 24- well polystyrene tissue culture plates on hydroxyapatite discs in 70% mixed (1:1 diluted) unstimulated saliva and 30% complex culture medium. During the 64.5-hour culturing period, the biofilms were exposed to the test solutions for 1 minute twice a day on two subsequent days. Thereafter, the biofilms were dip-washed 3 times in physiological NaCl. Following the last exposure, the incubation of biofilms was continued for another 16 h. They were then harvested at 64.5 h. The dispersed biofilms were plated on 2 agar media. After incubation, colonies (CFU) were counted. All solutions containing CHX as well as Listerine ® significantly reduced the number of microorganisms in biofilms. According to their efficacy, the mouth rinses were classified into 2 groups. The two Curasept ADS solutions, Parodentosan, and the Listerine® mouth rinse reduced the number of total CFU by 3 log10 steps. This seems sufficient for a long-lasting prophylactic application. The two PlakOut® mouth rinses and the CHX control fell into the other group, where the number of CFU was reduced by 7 log10 steps. These mouth rinses are predestined for short-term therapeutic use. However, reversible side effects must be taken into account. It has thus far not been possible to formulate CHX products with effective ADS (Anti Discoloration System) additives without reducing antimicrobial activity.

Topics: Analysis of Variance; Anti-Infective Agents, Local; Biofilms; Chlorhexidine; Colony Count, Microbial; Dental Plaque; Drug Combinations; Humans; Mouthwashes; Salicylates; Saliva; Statistics, Nonparametric; Terpenes; Tooth Discoloration

Listerine, a mouthrinse composed of a mixture of essential oils, was created in 1879 and was originally formulated as a surgical antiseptic. In spite of its known antimicrobial properties it was thought of as a product in search of a use and promoted as a deterrent for halitosis and as a floor cleaner. In the last several years Listerine has emerged as a bona fide therapeutic agent for reduction of plaque induced oral diseases. In contrast to the inconsistent history of Listerine, systemic antibiotics discovered in the 1940's were heralded as miracle drugs. However, the value of prophylactic usage of antibiotics has come under scrutiny as a result of increasing resistance and adverse reactions. Moreover, reports by both American and British professional societies have led to a re-evaluation of the relative risks associated with plaque induced bacteremia when twice-yearly visits to dental professionals are compared to daily activities. These new recommendations and revelations open the door for local antimicrobial approaches to reduce the challenge of plaque-induced bacteremias. These issues will be discussed in the context of Listerine, its intricate and complicated past, and its connection to current uses in oral health and beyond.

Topics: Anti-Infective Agents, Local; Bacteremia; Dental Plaque; Drug Combinations; History of Dentistry; History, 19th Century; History, 20th Century; History, 21st Century; Humans; Mouthwashes; Oral Hygiene; Salicylates; Terpenes

The aim of this study was to determine the contribution of plaque and saliva towards the prolonged activity, also called substantivity, of three antimicrobial mouthrinses (Listerine®, Meridol®, Crest Pro Health®), used in combination with a toothpaste (Prodent Coolmint®). Volunteers brushed for 4 weeks with a toothpaste without antimicrobial claims, while during the last 2 weeks half of the volunteers used an antimicrobial mouthrinse in addition to brushing. At the end of the experimental period, plaque and saliva samples were collected 6 h after oral hygiene, and bacterial concentrations and viabilities were determined. The contribution of plaque and saliva towards substantivity was assessed by combining plaque obtained after mechanical cleaning only with plaque and saliva obtained after additional use of an antimicrobial rinse. Subsequently, resulting viabilities of the combined plaques were determined. The viabilities of plaque samples after additional rinsing with mouthrinses were lower than of plaque obtained after mechanical cleaning only, regardless of the rinse involved. Moreover, plaque collected 6 h after rinsing with antimicrobial mouthrinses contained a surplus of antimicrobial activity. Only Listerine showed decreased viability in saliva, but none of the mouthrinses showed any residual antimicrobial activity in saliva. The findings indicate that plaque left behind after mechanical cleaning contributes to the prolonged substantivity of antimicrobial mouthrinses.

Topics: Adult; Amines; Anti-Infective Agents, Local; Bacteria; Bacterial Load; Cetylpyridinium; Coloring Agents; Dental Plaque; Drug Combinations; Female; Humans; Male; Microbial Viability; Mouthwashes; Salicylates; Saliva; Terpenes; Time Factors; Tin Fluorides; Toothbrushing; Toothpastes; Young Adult

Topics: Anti-Infective Agents, Local; Bacteremia; Bacteria; Dental Plaque; Drug Combinations; Gingivitis; Humans; Mouthwashes; Salicylates; Terpenes

The aim of this article is to update the reader on oral hygiene products and techniques. The evidence relating to the range of toothbrushing, interdental cleaning products and chemotherapeutic agents currently on the market will be discussed. It will be seen that choice of many of the oral hygiene products currently on the market is still largely a matter of personal preference.. An inadequate oral hygiene regime may lead to caries and periodontal disease. It is important for clinicians to be able to recommend a preventive programme for dental and periodontal health that is supported by high quality, evidence-based clinical research.

Topics: Anti-Infective Agents, Local; Chlorhexidine; Coloring Agents; Dental Devices, Home Care; Dental Plaque; Drug Combinations; Equipment Design; Humans; Mouthwashes; Oral Hygiene; Orthodontic Appliances; Salicylates; Terpenes; Toothbrushing; Triclosan

Dental caries is a polymicrobial disease and complicated to treat. Understanding the microbiota responses to treatment from different individuals is a key factor in developing effective treatments. The aim of this study was to investigate the 24-h posttreatment effect of two oral antiseptics (chlorhexidine and Listerine) on species composition of microplate plaque biofilms that had been initiated from the saliva of five different donors and grown in both 0.15% and 0.5% sucrose. Plaque composition was analyzed using checkerboard DNA : DNA hybridization analysis, which comprised of a panel of 40 species associated with oral health and disease. The supernatant pH of the plaques grown in 0.15% sucrose ranged from 4.3 to 6 and in 0.5% sucrose, it ranged from 3.8 to 4. Plaque biomass was largely unaffected by either antiseptic. Each donor had a different salivary microbial profile, differentiating according to the prevalence of either caries or periodontal/anaerobic pathogens. Despite similar plaque microbiota compositions being elicited through the sucrose growth conditions, microbiota responses to chlorhexidine and Listerine differentiated according to the donor. These findings indicate that efficacious caries treatments would depend on the responses of an individual's microbiota, which may differ from person to person.

Topics: Anti-Infective Agents, Local; Bacteria, Aerobic; Bacteria, Anaerobic; Biofilms; Biomass; Chlorhexidine; Dental Caries; Dental Plaque; Drug Combinations; Ecosystem; Humans; Mouthwashes; Nucleic Acid Hybridization; Periodontitis; Salicylates; Saliva; Terpenes; Treatment Outcome

Dental plaque bacteria form complex and robust cell aggregates which cannot be counted accurately using epifluorescence microscopy. This causes a significant problem for quantifying their viability. The aim of the investigation was to develop a fluorescence assay to quantify the viable biomass of dental plaque biofilms. Using an artificial mouth system, microcosm plaques were grown under a range of fluoride and mineralizing conditions, and were treated with the oral antiseptics chlorhexidine (CHX) and Listerine. Plaques were harvested, made into suspension and stained in microtitre plates with a di-chromatic fluorescent stain (Live/Dead BacLight). The percentage of viable biomass was calculated from the regression data generated from a viability standard. The standard was constructed using different proportions of viable (green fluorescence) and non-viable (red fluorescence) plaque bacteria, and growth conditions for optimizing green fluorescence were investigated. The results from the assay showed that fluoride at 1000 and 3000 ppm promoted plaque viability by at least 15%, from approximately 45 to 60%, and at 5000 ppm to approximately 87% (P<0.05). Plaques treated with Listerine and CHX from d 0 yielded insufficient biomass to be tested for viability, however 14 d post-treatment, viability was comparable to untreated plaques (approximately 55%, P>0.05). Treatment with Listerine and CHX from d 3 reduced biomass but not viability. Development of this assay enabled viability of plaque bacteria which cannot be resolved with epifluorescence microscopy to be evaluated. It offers a rapid alternative to epifluorescence microscopy and could be applied to nonoral bacteria.

Topics: Anti-Infective Agents, Local; Bacteria; Bacteriological Techniques; Biofilms; Biomass; Chlorhexidine; Culture Media; Dental Plaque; Drug Combinations; Ecosystem; Fluorescence; Humans; Salicylates; Saliva; Terpenes

Topics: Anti-Infective Agents, Local; Dental Plaque; Drug Combinations; Gingivitis; Halitosis; Humans; Mouthwashes; Salicylates; Terpenes

Most adults brush and floss inadequately, and constant education and/or reinforcement is often required. Bacteria are usually left behind with mechanical oral health routines, and chemotherapeutic agents may have a key role as adjuncts to daily home-care. To date, two antiseptic mouthwashes have received the ADA Seal of Acceptance: Peridex (Zila Pharmaceuticals, Phoenix, AZ, USA; CHX, chlorhexidine) and Listerine (Pfizer Consumer Healthcare, Morris Plains, NJ, USA; essential oil (EO) mouthwash). CHX has a strong affinity for tooth and tissue surfaces, but can cause brown staining on the teeth and tongue. Patients must also wait until all traces of toothpaste are removed before rinsing with CHX. Long-term use of an EO mouthwash is microbiologically safe, with no changes observed in the bacterial composition of supragingival plaque, and no evidence of antimicrobial resistance. A number of trials have demonstrated the long-term plaque- and gingivitis-reducing properties of both CHX and EO mouthwashes. These studies clearly demonstrate that these agents have lasting efficacy, and can access hard-to-reach areas.

Topics: Adult; Anti-Infective Agents, Local; Bacteria; Chlorhexidine; Dental Devices, Home Care; Dental Plaque; Drug Combinations; Gingivitis; Humans; Mouthwashes; Oils, Volatile; Salicylates; Terpenes; Toothbrushing

Topics: Adult; Anti-Infective Agents, Local; Dental Caries; Dental Plaque; Drug Combinations; Gingival Diseases; Humans; Mouthwashes; Salicylates; Terpenes

Bacteria contained in biofilms have been shown to have a decreased susceptibility to antimicrobial agents compared to those in planktonic form. Thus, in vitro biofilm models have been developed for screening oral antimicrobial formulations in an effort to produce findings more predictive of clinical activity. This study compared the antimicrobial activity of three mouthrinse formulations when tested against isogenic strains of Actinobacillus actinomycetemcomitans (Aa), one of which was a clinical isolate which forms tenacious biofilms in vitro and the other of which was a spontaneous variant which always grows planktonically.. Biofilm-forming Aa strains CU1000 and NJ4300, obtained as clinical isolates, and their respective spontaneous planktonic variants, CU1060 and NJ4350, were grown under standard laboratory conditions and exposed for 15 s to either a negative control (phosphate buffered saline [PBS]), an essential-oil containing mouthrinse (Listerine Antiseptic [LA]), an amine fluoride/stannous fluoride-containing mouthrinse (Meridol [M]), or a triclosan and PVM/MA copolymer-containing mouthrinse (Plax [P]). The cells were then washed, serially diluted, plated, and incubated for enumeration of viable bacteria. Colony-forming units (CFU)/ml were log10 transformed and the mouthrinse groups were compared to the PBS group using analysis of variance.. All 3 mouthrinses produced statisically significant 99.99% reductions (p< or =0.0001) in both planktonic strains compared to the PBS control. Effects on the biofilm forms of the organisms were more variable. Exposure to LA produced statistically significant (p< or =0.0001) reductions in strains CU1000 and NJ4300 of 98.20% and 96.47%, respectively, compared to PBS. M and P produced much smaller reductions which were not statistically significant.. The results of this study, in which antimicrobial mouthrinses were tested against biofilm-forming and planktonic strains of the same organism, provide a clear demonstration of the resistance to antimicrobial agents conferred by biofilm formation and provide additional support for employing tests using biofilms to more accurately assess the relative activities of antiplaque agents in vitro.

Topics: Aggregatibacter actinomycetemcomitans; Amines; Analysis of Variance; Anti-Infective Agents, Local; Benzoates; Biofilms; Cariostatic Agents; Colony Count, Microbial; Dental Plaque; Drug Combinations; Drug Resistance, Microbial; Humans; Linear Models; Maleates; Mouthwashes; Oils, Volatile; Pharmaceutical Vehicles; Polyethylenes; Salicylates; Sodium Chloride; Sodium Dodecyl Sulfate; Terpenes; Time Factors; Tin Fluorides; Triclosan

To evaluate the efficacy of a fluoride dentifrice containing a fixed combination of essential oils (Thymol, Menthol, Eucalyptol, and Methyl Salicylate) in preventing caries in Sprague Dawley rats.. The dentifrice contains 0.76% sodium monofluorophosphate (SMFP) as the fluoride source and a silica abrasive system. A fluoride-free placebo and a clinically proven USP dentifrice reference standard for SMFP/silica were included as controls. Three groups of 45 SDV-free Sprague Dawley weanlings were infected by a cariogenic strain of Streptococcus sobrinus and fed cariogenic diet NIH 2000 ad libitum. Animals were treated twice daily (once on weekends) with the assigned dentifrice using a cotton-tipped applicator, for 5 wks, after which they were terminated and caries scored using Larson's modification of the Keyes method.. Analyses of variance were used to compare inter-group means, the total E lesion score was the primary efficacy variable. Compared with the fluoride-free vehicle control, the experimental dentifrice and USP reference standard dentifrice produced a statistically significant reductions of 18.3% and 12.2% respectively for total caries score (P<0.001). Compared with the clinically tested USP positive control dentifrice, the experimental dentifrice produced a statistically significant reduction in the total caries score of 6.9% (P=0.028). The results of this study show that 1) both the new dentifrice containing essential oils and USP dentifrice are statistically significantly effective in reducing caries in the rat model, 2) the anticaries activity of the SMFP dentifrice is not adversely affected with the addition of essential oils.

Topics: Analysis of Variance; Animals; Anti-Infective Agents, Local; Cariostatic Agents; Cyclohexanols; Dental Caries; Dental Plaque; Dentifrices; Diet, Cariogenic; Disease Models, Animal; Eucalyptol; Eucalyptus; Fluorides; Gingivitis; Menthol; Monoterpenes; Oils, Volatile; Pharmaceutical Vehicles; Phosphates; Placebos; Random Allocation; Rats; Rats, Sprague-Dawley; Salicylates; Silicon Dioxide; Single-Blind Method; Streptococcus sobrinus; Terpenes; Thymol

Although laboratory studies are not necessarily predictive of clinical activity; they can help to elucidate mechanisms underlying clinical activity when the latter has been established. In a recent clinical study, an essential oil mouthrinse (Listerine Antiseptic) was shown to be significantly more effective than an amine fluoride/stannous fluoride mouthrinse (Meridol) in inhibiting supragingival plaque formation. This paper reports the results of laboratory studies comparing the antimicrobial effectiveness of these 2 mouthrinses using a kill kinetics assay and a plaque biofilm kill assay. In both assays, the essential oil mouthrinse was considerably more effective than the amine fluoride/stannous fluoride mouthrinse. These findings are consistent with the results of the clinical trial and may help to explain the observed differences in clinical activity.

Topics: Amines; Anti-Infective Agents, Local; Bacteria; Biofilms; Candida albicans; Coloring Agents; Dental Plaque; Drug Combinations; Fusobacterium nucleatum; Humans; Lacticaseibacillus casei; Mouthwashes; Oils, Volatile; Prevotella intermedia; Salicylates; Saliva; Streptococcus mutans; Terpenes; Tin Fluorides; Tongue

Topics: Anti-Infective Agents, Local; Dental Devices, Home Care; Dental Plaque; Drug Combinations; Humans; Hydrogen Peroxide; Mouthwashes; Oral Hygiene; Salicylates; Soaps; Terpenes; Therapeutic Irrigation

The mutans group of streptococci is considered to play a key role in the etiology of dental caries. We have evaluated the ability of different substances to prevent dental plaque formation without affecting Streptococcus sobrinus viability. Viable organisms were detected as CFU/mL in agar plates and bacterial adherence was assessed by dry weight. We studied 23 compounds and we demonstrated that phenyl salicylate, phenylmercuric nitrate and potassium iodate are more effective to inhibit adhesion without showing antibacterial activity.

Topics: Anti-Infective Agents, Local; Bacterial Adhesion; Colony Count, Microbial; Dental Plaque; Iodates; Phenylmercury Compounds; Potassium Compounds; Salicylates; Streptococcus sobrinus

Although the mechanism responsible for the clinical antiplaque efficacy of oral antiseptics is generally considered to be primarily one of bactericidal activity, it has been suggested that oral antiseptics may have additional effects on bacteria exposed to sublethal levels. Studies reported herein, investigated the effects of sublethal levels of an essential oil-containing antiseptic mouthrinse (Listerine Antiseptic, Warner-Lambert Co., Morris Plains, NJ) on selected activities of representative plaque microorganisms using in vitro models. These studies demonstrated that sublethal exposure to the tested oral antiseptic can have significant effects in reducing intergeneric coaggregation, increasing bacterial generation time, and extracting endotoxin from Gram-negative bacteria. These in vitro activities can be correlated with features of plaque formation and pathogenicity seen in vivo; however, additional studies will be necessary to confirm that these mechanisms are, in fact, operative clinically.

Topics: Aggregatibacter actinomycetemcomitans; Anti-Infective Agents, Local; Bacteria; Bacterial Adhesion; Bacteriolysis; Candida albicans; Capnocytophaga; Cell Division; Dental Plaque; Dose-Response Relationship, Drug; Drug Combinations; Endotoxins; Fusobacterium nucleatum; Gram-Negative Bacteria; Humans; Mouthwashes; Oils, Volatile; Salicylates; Streptococcus mutans; Streptococcus sanguis; Terpenes; Veillonella

Inflammatory periodontal diseases are related to dental plaque formation. Increase in the perfusion of the inflamed tissue results in increased oxygen supply. Although oxygen has healing effects, it is bound to be a mediator of peroxidation in biological membranes. Chemotherapeutic agents such as chlorhexidine, listerine, sanguinarine, and cetylpridinium chloride and oral antibiotics such as tetracycline HCl and doxycyline were tested for their antioxidative activities. While doxycycline has the highest antioxidant activity in lower volumes (0.1 ml), sanguinarine, listerine and a pace after them, tetracycline HCl, had similar effects in higher volumes (0.3 and 0.4 ml). The results showed that in addition to their antiseptic or antimicrobial effects, these preparations have an antioxidative activity against spontaneous oxidation.

Topics: Alkaloids; Animals; Anti-Infective Agents, Local; Antioxidants; Benzophenanthridines; Brain; Cattle; Cetylpyridinium; Chlorhexidine; Dental Plaque; Doxycycline; Drug Combinations; Gingivitis; Isoquinolines; Malondialdehyde; Membranes; Mouthwashes; Oxidation-Reduction; Peroxides; Salicylates; Terpenes; Tetracycline

Today's dental professional must advise patients as to the antimicrobial mouthrinse appropriate for their periodontal condition. Considerations such as chemical nature, mechanism of action, efficacy, and safety of mouthrinses are important to the clinician. Taste and cost are equally important considerations to the patient. No ideal antimicrobial mouthrinse exists; yet, chlorhexidine gluconate (Peridex), Listerine, and two of its generic equivalents have the American Dental Association's Seal of Acceptance. An expanded role of antimicrobial mouthrinses that holds promise is that of preprocedural rinsing. This protocol can decrease the number of microorganisms aerosolized during numerous dental procedures.

Topics: Aerosols; Anti-Infective Agents; Chlorhexidine; Dental Plaque; Dentists; Drug Combinations; Gingivitis; Humans; Mouthwashes; Occupational Exposure; Premedication; Salicylates; Terpenes

The aim of the present study was to describe a 4-day no oral hygiene model to assess the pattern of de novo plaque formation and to use this model to appraise the potential of some mouthwash preparations to retard or inhibit plaque formation in the human dentition. 10 subjects were recruited for the trial. During a preparatory period, the participants were exposed to repeated professional plaque control and given oral hygiene instruction to eliminate signs of gingivitis. At the end of the preparatory period, each participant received a final professional tooth cleaning and was subsequently told to abstain from mechanical plaque control efforts for the next 4 days. They were asked to rinse twice daily for 60 s with 10 ml varying test solutions. On Day 4, the volunteers were exposed to a new clinical examination and the presence and amount of plaque were examined by the use of the plaque index system (P1I). The participants were subsequently given a professional tooth cleaning and asked to exercise proper self performed plaque control during the next 10 days. A new test period was then initiated. 6 different mouthwash preparations were tested in each subject namely, (1) placebo (a negative control rinse), (2) Veadent mouthrinse, (3) Listerine mouthrinse, (4) 0.06% triclosan + polyvinyl phosphonic acid (PVPA), (5) 0.06% triclosan + phenolic flavor and (6) 0.12% chlorhexidine digluconate (a positive control rinse). The results from the study revealed that the mean P1I values for individuals, groups of teeth and tooth surfaces provide an adequate but gross overall estimation of the potential of a given mouthrinse to retard/inhibit plaque build up. More detailed information on the effects of the test rinses could be obtained by data describing the % distribution of different P1I score categories; a high frequency of score 0 describes the potential of a mouthrinse to maintain tooth surfaces free from plaque while a low frequency of score 2/3 describes the ability of a treatment to retard/prevent gross plaque formation. The plaque pattern displays finally allowed assessment of the magnitude of plaque prevention, in comparison to the positive and negative controls, that could be achieved by a given compound in various parts and surfaces of the dentition. In this model, all test rinses (i) were significantly more effective than the placebo rinse in retarding de novo plaque build up and (ii) had a minor effects on plaque build up in the maxillary molars and at the a

Topics: Adult; Alkaloids; Anti-Infective Agents; Benzophenanthridines; Bicuspid; Chlorhexidine; Dental Plaque; Dental Plaque Index; Drug Combinations; Erythrosine; Flavoring Agents; Humans; Isoquinolines; Mandible; Maxilla; Models, Biological; Molar; Mouthwashes; Organophosphorus Compounds; Placebos; Polyvinyls; Salicylates; Terpenes; Triclosan

The purpose of this study was to compare the efficacy of a 0.12% chlorhexidine mouthrinse and an essential oil mouthrinse on plaque accumulation and gingivitis in mentally handicapped adults over a one-year period. Twenty-seven institutionalized mentally handicapped adults participated. Gingival index (GI), plaque index (PI), and probing depths (PD) were recorded and an ultrasonic scaling was performed (Baseline 1). GI, PI, and PD were again recorded after 2 weeks (Baseline 2). Patients were then assigned to either the chlorhexidine or essential oil mouthrinse group. The patients rinsed twice daily under supervision with their assigned mouthrinse while maintaining their attempts at daily brushing. GI and PI were recorded at monthly intervals for 12 months, while the PD was recorded only at Baseline 1 and 2 and at 12 months. A paired t-test was used to compare differences between the parameters at Baseline 1 and Baseline 2. A 2-factor repeated measure ANOVA was performed on each parameter after the Baseline 2 evaluation. A statistically significant decrease in the probing depth occurred as a result of ultrasonic scaling; however, no significant changes in the PI or GI occurred. Both mouthrinses produced a significant improvement in the GI after one month. Despite the improvement, the GI was still indicative of disease. Over the 12 months no further significant improvement in the GI occurred. A statistically significant improvement in the PI occurred in the chlorhexidine group at month 1, but returned to Baseline 2 levels over the 12 months. No improvement in the PI occurred in the essential oil group. The probing depths remained the same over the 12 months.(ABSTRACT TRUNCATED AT 250 WORDS)

Topics: Adult; Chlorhexidine; Dental Care for Disabled; Dental Plaque; Dental Plaque Index; Dental Scaling; Drug Combinations; Female; Gingival Pocket; Gingivitis; Humans; Institutionalization; Intellectual Disability; Male; Middle Aged; Mouthwashes; Oils, Volatile; Periodontal Index; Salicylates; Terpenes; Ultrasonic Therapy

To evaluate the efficacy of Listerine, a solution for washing the oral cavity consisting of essential oils (thymol, methanol, eukalyptol) and methyl salicylate, minimum concentrations inhibiting the growth of various microorganisms in the oral cavity and the bactericidal effects on bacteria in the saliva and dental plaque were evaluated in vitro. Listerine inhibited the growth of microorganisms over a very broad range. The minimum concentration inhibiting growth of Listerine was a 4 to 32 fold dilution, 2-4 times as potent as the solution after elimination of active ingredient components, in 38 of 54 bacterial strains, indicating the efficacy of the active ingredient in the inhibition of the growth of microorganisms. Bactericidal action of Listerine against from bacteria isolated from saliva and dental plaque from 5 healthy normal subjects was tested. Listerine exhibited a potent bactericidal effect on bacteria in saliva and dental plaque. Most of the bacteria died after a 30 second exposure to Listerine. According to these results, Listerine appears to be effective as a solution used for cleansing the oral cavity and dentures.

Topics: Bacteria; Dental Plaque; Drug Combinations; Halitosis; Humans; Mouthwashes; Salicylates; Saliva; Terpenes

Topics: Anti-Infective Agents; Chlorhexidine; Dental Plaque; Drug Combinations; Gingivitis; Humans; Mouthwashes; Salicylates; Terpenes

Topics: Candidiasis, Oral; Chlorhexidine; Dental Plaque; Drug Combinations; Humans; Mouthwashes; Postoperative Care; Salicylates; Terpenes; Therapeutic Irrigation

Topics: American Dental Association; Dental Plaque; Drug Combinations; Gingivitis; Humans; Mouthwashes; Salicylates; Terpenes; United States

Topics: Alkaloids; Benzophenanthridines; Chlorhexidine; Dental Plaque; Drug Combinations; Humans; Isoquinolines; Microscopy, Electron, Scanning; Mouthwashes; Salicylates; Terpenes; Tin Fluorides

Topics: Chlorhexidine; Dental Plaque; Drug Combinations; Gingivitis; Humans; Mouthwashes; Salicylates; Terpenes

Topics: Carbonyl Cyanide m-Chlorophenyl Hydrazone; Cell Membrane; Dental Plaque; Dinitrophenols; Fluorides; Gramicidin; Humans; Hydrogen-Ion Concentration; Salicylates; Streptococcus mutans; Valinomycin

Several phenols known to be antiseptics were tested in vitro for their ability to adsorb to saliva-coated enamel and subsequently inhibit plaque formation. 3,5,4'-tribromosalicylanilide was found to be effective against growth and plaque formation of A viscosus, A naeslundii, S mutans and S sanguis. Dibromsalicil was effective against A viscosus. The other phenols (hexylresorcinol, thymol, phenylphenol and zinc phenolsulfonate) did not inhibit in vitro growth or plaque formation.

Topics: Animals; Anti-Bacterial Agents; Bacteria; Bromobenzoates; Cattle; Dental Plaque; Hexylresorcinol; Phenols; Salicylanilides; Salicylates; Solubility; Thymol; Water; Zinc