Comparative antiplaque and antigingivitis effectiveness of tea tree oil mouthwash and a cetylpyridinium chloride mouthwash: A randomized controlled crossover study

Betul Rahman, Sausan Alkawas, Elaf A Al Zubaidi, Omar I Adel, Nuha Hawas, Betul Rahman, Sausan Alkawas, Elaf A Al Zubaidi, Omar I Adel, Nuha Hawas

Abstract

Objective: The aim of this study was to compare the antiplaque and antigingivitis effects of a mouthwash containing tea tree oil (TTO) with a cetylpyridinium chloride (CPC) mouthwash.

Materials and methods: This was a randomized 4 × 4, controlled, cross-over, involving 20 healthy volunteers in a 5-day plaque re-growth model. Test mouthwashes were TTO (Tebodont(®)) and a mouthwash containing CPC 0.05% (Aquafresh(®)). A 0.12% chlorhexidine (CHX) mouthwash (Oro-Clense(®)) was used as positive and colored water (placebo [PLB]) as negative controls. Gingival bleeding index (GBI) and plaque index (PI) scores were recorded before and after each test period. Test periods were separated with 2 weeks washout period.

Results: All four mouthwashes significantly (P < 0.001) reduced the GBI scores when compared to the baseline GBI scores. There was no significant difference between PLB and active mouthwashes in the GBI scores. CHX and CPC mouthwashes were found more effective in reducing the PI scores than TTO and PLB mouthwashes. There was no significant difference in PI scores of CHX and CPC mouthwashes.

Conclusion: 0.05% CPC mouthwash can be an alternative to CHX mouthwash since it is alcohol free and found as efficient as CHX in dental plaque reduction with lesser side effects. More studies are needed to test antigingivitis effects of the mouthwashes used in this study, preferably without initial scaling and polishing.

Keywords: Antigingivitis; antiplaque; cetylepyridinium chloride; mouthwash; tea tree oil.

Conflict of interest statement

Conflict of Interest: None declared.

Figures

Figure 1
Figure 1
Outline of the clinical trial
Figure 2
Figure 2
Gingival bleeding index results for different mouth-rinses in box whisker plots
Figure 3
Figure 3
Plaque index results from analysis of variance for the different mouthwashes in box whisker plots

References

    1. Listgarten MA. The role of dental plaque in gingivitis and periodontitis. J Clin Periodontol. 1988;15:485–7.
    1. Tatakis DN, Trombelli L. Modulation of clinical expression of plaque-induced gingivitis. I. Background review and rationale. J Clin Periodontol. 2004;31:229–38.
    1. Paraskevas S. Randomized controlled clinical trials on agents used for chemical plaque control. Int J Dent Hyg. 2005;3:162–78.
    1. Mandel ID. Chemotherapeutic agents for controlling plaque and gingivitis. J Clin Periodontol. 1988;15:488–98.
    1. Baehni PC, Takeuchi Y. Anti-plaque agents in the prevention of biofilm-associated oral diseases. Oral Dis. 2003;9(Suppl 1):23–9.
    1. Keijser JA, Verkade H, Timmerman MF, Van der Weijden FA. Comparison of 2 commercially available chlorhexidine mouthrinses. J Periodontol. 2003;74:214–8.
    1. Jones CG. Chlorhexidine: is it still the gold standard? Periodontol 2000. 1997;15:55–62.
    1. Van Strydonck DA, Slot DE, Van der Velden U, Van der Weijden F. Effect of a chlorhexidine mouthrinse on plaque, gingival inflammation and staining in gingivitis patients: a systematic review. J Clin Periodontol. 2012;39:1042–55.
    1. Sanz M, Vallcorba N, Fabregues S, Müller I, Herkströter F. The effect of a dentifrice containing chlorhexidine and zinc on plaque, gingivitis, calculus and tooth staining. J Clin Periodontol. 1994;21:431–7.
    1. Rosin M, Welk A, Kocher T, Majic-Todt A, Kramer A, Pitten FA. The effect of a polyhexamethylene biguanide mouthrinse compared to an essential oil rinse and a chlorhexidine rinse on bacterial counts and 4-day plaque regrowth. J Clin Periodontol. 2002;29:392–9.
    1. Carson CF, Riley TV. Antimicrobial activity of the major components of the essential oil of Melaleuca alternifolia. J Appl Bacteriol. 1995;78:264–9.
    1. May J, Chan CH, King A, Williams L, French GL. Time-kill studies of tea tree oils on clinical isolates. J Antimicrob Chemother. 2000;45:639–43.
    1. Soukoulis S, Hirsch R. The effects of a tea tree oil-containing gel on plaque and chronic gingivitis. Aust Dent J. 2004;49:78–83.
    1. Mankodi S, Bauroth K, Witt JJ, Bsoul S, He T, Gibb R, et al. A 6-month clinical trial to study the effects of a cetylpyridinium chloride mouthrinse on gingivitis and plaque. Am J Dent. 2005;18 Spec No:9A–14.
    1. Rawlinson A, Pollington S, Walsh TF, Lamb DJ, Marlow I, Haywood J, et al. Efficacy of two alcohol-free cetylpyridinium chloride mouthwashes: A randomized double-blind crossover study. J Clin Periodontol. 2008;35:230–5.
    1. Ainamo J, Bay I. Problems and proposals for recording gingivitis and plaque. Int Dent J. 1975;25:229–35.
    1. Turesky S, Gilmore ND, Glickman I. Reduced plaque formation by the chloromethyl analogue of victamine C. J Periodontol. 1970;41:41–3.
    1. Arweiler NB, Donos N, Netuschil L, Reich E, Sculean A. Clinical and antibacterial effect of tea tree oil: A pilot study. Clin Oral Investig. 2000;4:70–3.
    1. Witt JJ, Walters P, Bsoul S, Gibb R, Dunavent J, Putt M. Comparative clinical trial of two antigingivitis mouthrinses. Am J Dent. 2005;18 Spec No:15A–7.
    1. Albert-Kiszely A, Pjetursson BE, Salvi GE, Witt J, Hamilton A, Persson GR, et al. Comparison of the effects of cetylpyridinium chloride with an essential oil mouth rinse on dental plaque and gingivitis: A six-month randomized controlled clinical trial. J Clin Periodontol. 2007;34:658–67.
    1. Stookey GK, Beiswanger B, Mau M, Isaacs RL, Witt JJ, Gibb R. A 6-month clinical study assessing the safety and efficacy of two cetylpyridinium chloride mouthrinses. Am J Dent. 2005;18 Spec No:24A–8.
    1. Hammer KA, Carson CF, Riley TV, Nielsen JB. A review of the toxicity of Melaleuca alternifolia (tea tree) oil. Food Chem Toxicol. 2006;44:616–25.
    1. Groppo FC, Ramacciato JC, Simões RP, Flório FM, Sartoratto A. Antimicrobial activity of garlic, tea tree oil, and chlorhexidine against oral microorganisms. Int Dent J. 2002;52:433–7.
    1. Blenman TV, Morrison KL, Tsau GJ, Medina AL, Gerlach RW. Practice implications with an alcohol-free, 0.07% cetylpyridinium chloride mouthrinse. Am J Dent. 2005;18 Spec No:29A–34.

Source: PubMed

Sponsors en medewerkers

Medische omstandigheden

Geneesmiddelinterventies

3
Abonneren