Prophylaxis with GM-CSF mouthwashes does not reduce frequency and duration of severe oral mucositis in patients with solid tumors undergoing high-dose chemotherapy with autologous peripheral blood stem cell transplantation rescue: a double blind, randomized, placebo-controlled study.

BACKGROUND: The aim of this study was to evaluate the effectiveness of granulocyte-macrophage colony-stimulating factor (GM-CSF) mouthwashes in the prevention of severe mucositis induced by high doses of chemotherapy. PATIENTS AND METHODS: Ninety consecutive patients affected by solid tumors and undergoing high-dose chemotherapy with autologous peripheral blood stem cell transplantation rescue were randomized to receive placebo versus GM-CSF mouthwash 150 micro g/day. Patients were stratified on the basis of the conditioning treatment and the consequent different risk of severe oral mucositis. Treatment was administered from the day after the end of chemotherapy until the resolution of stomatitis and/or neutrophil recovery. RESULTS: The statistical analyses were intention-to-treat and involved all patients who entered the study. The severity of stomatitis was evaluated daily by the physicians according to National Cancer Institute Common Toxicity Criteria. Both study and control groups were compared with respect to the frequency [30% versus 36%, chi(2) exact test, not significant (NS)] and mean duration (4.8 +/- 4.7 versus 4.4 +/- 2.7 days, t-test, NS) of severe stomatitis (grade > or =3). Oral pain was evaluated daily by patients themselves by means of a 10 cm analog visual scale: the mean (+/- standard error of the mean) maximum mucositis scores were 4.8 +/- 3.5 versus 4.2 +/- 3.5 cm (t-test, NS). Furthermore, 15/46 patients in the study group (33%) and 19/44 patients in the control group experienced pain requiring opioids (chi(2) exact test, NS). CONCLUSION: We did not find any evidence to indicate that prophylaxis with GM-CSF mouthwash can help to reduce the severity of mucositis in the setting of the patients we studied.     

Effect of 0.1% pilocarpine mouthwash on xerostomia: double‐blind,randomised controlled trial

The objective of this study was to evaluate the effect of 0.1% pilocarpine mouthwash in xerostomic patients. Sixty volunteers were randomly allocated to two groups. The experimental group used 0.1% pilocarpine solution, and the control group used 0.9% saline. The short‐ and long‐term effects of pilocarpine were investigated by measuring the severity of oral dryness, minor salivary flow rates and unstimulated whole salivary flow rate at predetermined times. The severity of oral dryness was decreased in both groups at 0, 30 and 60 min after mouthwashing, with no significant difference between the groups. Buccal and labial secretions were increased in both groups, but only the experimental group exhibited increased palatal secretion. Labial and palatal secretions, but not buccal secretion, differed between the groups. The unstimulated whole salivary flow rate was increased in the experimental group and differed from that in the control group. After 4 weeks, the severity of oral dryness was decreased in both groups and did not differ between them. The oral dryness at night or on awakening significantly decreased in both groups, with no significant difference between them, but the oral dryness at other times of the day and the difficulty in swallowing foods were not significantly changed in both groups. Minor salivary and unstimulated whole salivary flow rates did not increase in both groups. Until 1 h after mouthwashing, 0.1% pilocarpine mouthwash increased minor salivary and unstimulated whole salivary secretions, but was not superior compared with 0.9% saline at relieving subjective oral dryness.     

Effect of aloe vera mouthwash on dental plaque and gingivitis indices in children: A randomized controlled clinical trial

BackgroundThere is a tendency nowadays to encourage the use of natural substances in dentistry. Aloe vera is one of these substances, which has recently gained great importance in clinical research.ObjectivesTo evaluate the effectiveness of Aloe vera mouthwash in improving plaque, gingival and gingival bleeding indices in children.Materials and methodsThe study sample consisted of (17) children [age: (8) to (12) years]. The crossover design was applied, which means that the three types of mouthwashes (experimental “Aloe vera”, positive control “chlorhexidine”, and negative control “placebo”) would be used for all participants, with a washout period of (12) days. A special plaque guard was fabricated to facilitate localized plaque accumulation for (3) days. After that period, the mouthwashes were applied for (5) days. Plaque, gingival and gingival bleeding indices were studied before plaque accumulation (T0), after plaque accumulation (T1), and after applying the mouthwashes (T2). The values of plaque index (PI), gingival index (GI) and gingival bleeding index (GBI) were measured at each studied time point (T0, T1, and T2). Then, the differences between the values at the beginning of the use of each type of the mouthwashes and at the end of the period of there use were compared.ResultsThe results showed the efficacy of Aloe vera mouthwash in improving plaque, gingival and gingival bleeding indices, which was similar to chlorhexidine mouthwash effectiveness when both compared to the placebo mouthwash.ConclusionsThe use of Aloe vera mouthwash is effective in improving oral health and preventing gingivitis.     

自制漱口液防治口腔炎的效果观察

目的:观察自制漱口液防治口腔炎的临床效果。方法:选择我科2013年4~12月各种原因引起的口腔炎患者70例,随机等分为观察组和对照组,观察组采用自制漱口液口腔护理,对照组采用常规漱口液口腔护理。结果:两组治疗效果比较观察组治疗效果明显好于对照组,差异有统计学意义(P0.05)。结论:自制漱口液有效地防治了口腔炎的发生、发展,临床效果明显。     

Evaluation of the clinical efficacy of a betaine-containing mouthwash and an intraoral device for the treatment of dry mouth

J Oral Pathol Med (2012) 41 : 201–206 Objective: An evaluation is made of the efficacy and safety of an intraoral device with a betaine (BET)‐containing mouthwash in treating xerostomia. Methods: A total of 105 patients with dry mouth (xerostomia) were included in a randomized, non‐blinded, parallel‐group, controlled clinical trial. The patients were assigned to one of the three groups: A (night guard), B (mouthwash), or C (night guard and mouthwash). A xerostomia questionnaire was administered, and unstimulated salivary flow was measured. The Oral Health Impact Profile (OHIP) – 14 was assessed. All measurements were taken before and after treatment, which had a duration of 4 weeks. The patients in turn completed a treatment satisfaction questionnaire. Results: Ninety patients (eight men and 82 women) completed the study. All three treatments alleviated the symptoms of xerostomia, with improvement in the OHIP‐14 scores and sialometry findings. There were no adverse effects. Patient satisfaction with the treatment received showed no statistically significant differences among the three groups; though, the patients in group A considered treatment to have been extremely beneficial in 10% of the cases, while 43% considered it to have been beneficial. Conclusions: The daily use of a night guard and BET‐containing mouthwash was seen to improve dry mouth during the 4‐week duration of the study.     

Preventive effect and safety of Chinese herbal medicine mouthwash in chemotherapy-induced oral mucositis: A protocol for systematic review and meta analysis

Background:Oral mucositis (OM), one of the most common side effects for cancer patients who have undergone chemotherapy, can cause severe impairment to patients’ functional ability and impact their quality of life, resulting in delayed and/or incomplete treatment. Traditional Chinese medicine offers empirical herbal decoctions to gargle for the prevention of chemotherapy-induced OM; however, evidence for its clinical efficacy and safety is lacking. Therefore, we provide a protocol to evaluate the preventive effect and safety of Chinese herbal medicine mouthwash in chemotherapy-induced OM.Methods:We will comprehensively retrieve relevant articles published till August 15, 2020, in the following electronic databases: the Cochrane Library, PubMed, EMBASE, Chinese National Knowledge Infrastructure Database, Chinese Biomedical Literature Database, Chinese Science and Technique Journals Database, and the Wan-fang Database. Only randomized controlled trials will be included. We will use the criteria provided by the Cochrane Handbook for quality assessment and risk assessment of the included studies and use the RevMan 5.3 software for meta-analysis of the preventive effect and safety.Results:This study will assess the preventive effect and safety of Chinese herbal medicine mouthwash in chemotherapy-induced OM.Conclusion:This systematic review will provide evidence-based medical corroboration for the clinical application of the Chinese herbal medicine mouthwash in chemotherapy-induced OM.PROSPERO registration number:CRD42020206614.     

Chlorhexidine with an Anti Discoloration System. A comparative study

Abstract  Correct oral hygiene is believed to be the basis of primary and secondary prevention. Sometimes, using a toothbrush or other mechanical instruments for oral hygiene may be difficult and it may become necessary to use an antiseptic. Chlorhexidine is an essential component in many available preparations on sale, because of its marked antiseptic qualities. One of the most frequent side-effects is the appearance of stains on the teeth and mucous membranes, which particularly disturbs the patient. A new mouthwash containing chlorhexidine has recently become available, besides maintaining its antiseptic qualities, also avoids the side-effect of staining. Objectives: The aim of this study was to check the capacity of the new mouthwash, which contains chlorhexidine and Anti Discoloration System (ADS), not only to prevent plaque formation like the other mouthwashes containing chlorhexidine but also to avoid staining that is one of the most frequent side-effects. Study design: The comparative study was carried out on a sample of 15 patients treated with two mouthwashes both containing 0.2% chlorhexidine, but different in that the first does not contain ADS, which is instead present in the second, a new product. The results obtained show that in the 15 patients treated, there is no statistically significant difference in the ability of the mouthwash to prevent bacterial plaque, however evidence of the stain was much less with the new mouthwash.     

Use of toothpicks for chlorhexidine staining.

The purpose of this study was to determine if the extrinsic dental staining associated with the use of chlorhexidine gluconate (CHX) mouthrinse could be prevented or controlled by the patient with the use of toothpicks. 25 subjects received a prophylaxis to establish a stain-free baseline and were then randomly assigned a control and experimental side of the mouth. The rinsing regimen was 1/2 oz of 0.12% CHX mouthrinse 2x a day for 3 months. Subjects self-examined daily for the appearance of stain. Where stain was visible, a toothpick was used to 'rub it away' on the distolabial, labial and mesiolabial surfaces of the experimental side only. The rubbing action was similar to the use of an eraser to remove a pencil mark from paper. The amount and intensity of stain was photographed and graded by a blinded examiner after 2 weeks, 1, 2 and 3 months. Subjects kept calendars to encourage and document compliance. When analyzed across time, teeth and surfaces, there was a statistically significant difference in stain between the control and experimental sides for stain amount, intensity, and for a composite of amount/intensity. Clinical differences were slight. The study indicates that the use of a simple toothpicking technique can affect chlorhexidine stain.