Abstract
Question:
What are the benefits and harms of chlorhexidine mouthrinse as adjunctive treatment for promoting gingival health?
Clinical Answer:
Chlorhexidine mouthrinse, used as adjunctive treatment to oral hygiene instructions, is effective in reducing symptoms of mild gingivitis and dental plaque, but can cause tooth staining and other adverse effects such as calculi, transient taste disturbance, and effects on oral mucosa including irritation, soreness, and ulceration.
Randomized controlled trials (RCTs) show that chlorhexidine (at a concentration of 0.1% to 0.2%) reduced the severity of mild gingivitis (defined as Gingival Index score 0.8 to 1) at four to six weeks (high-quality evidence) and at six months (13 RCTs with 2616 participants) by 0.02 points on the Gingival Index (not clinically relevant). There were no data to assess effects of chlorhexidine in moderate and severe gingivitis (defined as Gingival Index score 1.1 to 3.0).
People had far less gingival bleeding with chlorhexidine than with placebo/control at four to six weeks (eight RCTs with 649 participants) and at six months (eight RCTs with 1132 participants) and far less plaque at four to six weeks (high-quality evidence) and at six months (11 RCTs with 2075 participants).
However, data show that chlorhexidine caused staining when used over a period of four to six weeks (moderate-quality evidence) and for six months (four RCTs with 323 participants). RCTs reported that other adverse effects such as calculus, transient taste disturbance, and effects on the oral mucosa including irritation, soreness, and ulceration were far more common with chlorhexidine than with placebo/control.
What are the benefits and harms of chlorhexidine mouthrinse as adjunctive treatment for promoting gingival health?
Clinical Answer:
Chlorhexidine mouthrinse, used as adjunctive treatment to oral hygiene instructions, is effective in reducing symptoms of mild gingivitis and dental plaque, but can cause tooth staining and other adverse effects such as calculi, transient taste disturbance, and effects on oral mucosa including irritation, soreness, and ulceration.
Randomized controlled trials (RCTs) show that chlorhexidine (at a concentration of 0.1% to 0.2%) reduced the severity of mild gingivitis (defined as Gingival Index score 0.8 to 1) at four to six weeks (high-quality evidence) and at six months (13 RCTs with 2616 participants) by 0.02 points on the Gingival Index (not clinically relevant). There were no data to assess effects of chlorhexidine in moderate and severe gingivitis (defined as Gingival Index score 1.1 to 3.0).
People had far less gingival bleeding with chlorhexidine than with placebo/control at four to six weeks (eight RCTs with 649 participants) and at six months (eight RCTs with 1132 participants) and far less plaque at four to six weeks (high-quality evidence) and at six months (11 RCTs with 2075 participants).
However, data show that chlorhexidine caused staining when used over a period of four to six weeks (moderate-quality evidence) and for six months (four RCTs with 323 participants). RCTs reported that other adverse effects such as calculus, transient taste disturbance, and effects on the oral mucosa including irritation, soreness, and ulceration were far more common with chlorhexidine than with placebo/control.
| Original language | English |
|---|---|
| Type | Cochrane Clinical Answers |
| Publisher | Cochrane Collaboration |
| DOIs | |
| Publication status | Published - 2017 |