A comparison of two chlorhexidine gel brushing regimens and a conventional toothpaste brushing regimen for the development of tooth staining over a 6-week period

Abstract:  Aims:  A single-centre, randomized single-blind parallel study was undertaken to compare staining seen with three brushing regimens and to determine subject perception of side effects such as staining and effects on taste. Methods:  This 6-week parallel study used 157 volunteers who were randomized into one of three treatment groups: (i) brushing in the morning and evening with a normal dose of a 1% chlorhexidine gel, (ii) brushing with a low dose of chlorhexidine gel in the evening and a whitening dentifrice in the morning, and (iii) brushing with a standard fluoride paste in the morning and evening. Following home usage of their allocated products, the study volunteers returned after 3 and 6 weeks to record the amount of stain present. After the 6-week period, subject perception of taste and stain acceptability was determined using a questionnaire. Results:  After 6 weeks of use of the low-dose chlorhexidine gel and whitening dentifrice, significantly more stain was seen compared with the use of a standard dentifrice ( P  < 0.0001). Similarly, significantly more stain was seen with use of the normal-dose chlorhexidine gel compared with the low-dose gel and whitening dentifrice ( P  = 0.0007). Approximately 30% of individuals on the low-dose chlorhexidine gel regimen found the amount of stain unacceptable and 10% noted an effect on their taste perception. Conclusions:  The use of low dose of chlorhexidine gel at night and a whitening paste in the morning produced a significant amount of stain that 30% of subjects considered unacceptable.