Novel natural product-based oral topical rinses and toothpastes to prevent periodontal diseases

There is increasing public interest in natural or herbal-based healthcare products. This trend is not only visible in supermarkets and dental practices, but also in the scientific world. An improving number of clinical trials are being conducted to validate the claims made about these products in regards to periodontal health. Among single component preparations, Aloe vera and green tea are the most studied natural ingredients. Concerning polyherbal mixtures, triphala has garnered great interest. The effects of these natural products on periodontal health is encouraging, with almost all studies showing an inhibitory effect on plaque accumulation and an improvement in gingival health. However, more studies are needed to be able to design clinical guidelines to guide the use of these natural products in periodontal practice. For most of these products, few studies are available and, moreover, the available studies are limited in duration, the number of participants, and the specific composition of the natural product is often not described in detail.     

Efficacy of Preprocedural Mouth Rinsing in Reducing Aerosol Contamination Produced by Ultrasonic Scaler: A Pilot Study

Background: The aerosol generated by an ultrasonic scaler contains microorganisms that can penetrate into the body through the respiratory system of dental surgeons and patients. The aim of this pilot study is to evaluate and compare the efficacy of commercially available preprocedural mouthrinses containing 0.2% chlorhexidine gluconate, an herbal mouthwash, and water in reducing the levels of viable bacteria in aerosols. Methods: This single‐center, double‐masked, placebo‐controlled, randomized, three‐group parallel design was conducted over a period of 45 days. Twenty‐four patients with chronic periodontitis were divided randomly into three groups (A, B, and C) of eight patients each to receive 0.2% chlorhexidine gluconate, herbal mouthwash, and water, respectively, as a preprocedural rinse. The aerosol produced by the ultrasonic unit was collected at patient's chest area, doctor's chest area, and assistant's chest area on blood agar plates in all three groups. The blood agar plates were incubated at 37°C for 48 hours, and the total number of colony‐forming units (CFUs) was counted and statistically analyzed. Results: The results showed that CFUs in groups A and B were significantly reduced compared with group C, P <0.001 (analysis of variance). Also, CFUs in group A were significantly reduced compared with group B, P <0.05 (independent t‐test). The numbers of CFUs were highest at the patient's chest area and lowest at the assistant's chest area. Conclusion: This study suggests that a routine preprocedural mouthrinse could eliminate the majority of bacterial aerosols generated by the use of an ultrasonic unit, and that 0.2% chlorhexidine gluconate is more effective than herbal mouthwash.     

浓替硝唑含漱液治疗牙周炎45例临床疗效评价

目的 观察浓替硝唑含漱液在口腔抗感染中的有效性和安全性。方法 将入选的45例患者随机分为治疗组23例应用复方替硝唑漱口液，对照组22例应用多贝尔液。结果治疗组浓替硝唑含漱液在预防口腔感染方面的疗效明显优于对照组多贝尔漱口液（P〈0．01），安全性两者相似。结论 应用浓替硝唑含漱液治疗牙周炎安全有效，不良反应发生率低于口服和注射给药。     

Influence of mouthwashes on extended exhaled nitric oxide (FENO) analysis

Abstract

Fractional exhaled nitric oxide (F_ENO) is used to assess eosinophilic inflammation of the airways. F_ENO values are influenced by the expiratory flow rate and orally produced NO. We measured F_ENO at four different expiratory flow levels after two different mouthwashes: tap water and carbonated water. Further, we compared the alveolar NO concentration (C_ANO), maximum airway NO flux (J′_awNO) and airway NO diffusion (D_awNO) after these two mouthwashes. F_ENO was measured in 30 volunteers (healthy or asthmatic) with a chemiluminescence NO-analyser at flow rates of 30, 50, 100 and 300?mL/s. A mouthwash was performed before the measurement at every flow rate. The carbonated water mouthwash significantly reduced F_ENO compared to the tap water mouthwash at all expiratory flows: 50?mL/s (p?<?.001), 30?mL/s (p?=?.001), 100?mL/s (p?<?.001) and 300?mL/s (p?=?.004). J′_awNO was also significantly reduced (p?=?.017), however, there were no significant differences in C_ANO and D_awNO. In conclusion, a carbonated water mouthwash can significantly reduce oropharyngeal NO compared to a tap water mouthwash at expiratory flows of 30–300?mL/s without affecting the C_ANO and D_awNO. Therefore, mouthwashes need to be taken into account when comparing F_ENO results.     

西吡氯铵含片治疗口腔念珠菌病临床疗效观察

目的探讨西吡氯铵含片单独或联用碳酸氢钠含漱液治疗口腔念珠菌病的临床疗效。 方法选取经临床及实验室检查确诊为红斑型或伪膜型口腔念珠菌病的患者,采用单中心、平行对照随机分为3组：（1）实验1组为西吡氯铵含片组;（2）实验2组为西吡氯铵含片+2.5%碳酸氢钠含漱组;（3）对照组为2.5%碳酸氢钠含漱组。分别于初诊与治疗2周后复诊时记录患者口干、疼痛、红斑或伪膜的程度以及念珠菌培养数量。采用SPSS 20.0统计软件对计量资料进行配对样本t检验、配对样本秩和检验,对计数资料进行卡方检验,检验水准α= 0.05。 结果本研究共纳入73例口腔念珠菌病患者,其中实验1组25例、实验2组24例、对照组24例。经治疗3组均能改善口腔念珠菌病的临床表现及减少念珠菌培养数量;3组对口干改善的总有效率分别为85%、80%、84.2%,各组间差异无统计学意义（P= 0.711）;3组对疼痛改善的总有效率分别为90.9%、95.2%、95.2%,各组间差异无统计学意义（P= 0.880）;3组对红斑或伪膜改善的总有效率分别为88%、95.8%、50%,2个实验组对红斑或伪膜的改善效果均优于对照组（χ²_1组= 10.091,P_1组= 0.001;χ²_2组= 13.819,P_2组<0.001）,且2个实验组对红斑或伪膜的改善效果差异无统计学意义（P= 0.546）;3组对念珠菌清除的总有效率分别为80%、91.7%、79.2%,实验2组对念珠菌的清除效果分别优于实验1组与对照组（χ²_1组= 6.026,P_1组= 0.014;χ²_对照组= 5.147,P_对照组= 0.023）,实验1组与对照组对念珠菌清除效果差异无统计学意义（P= 0.992）。 结论西吡氯铵含片能够有效治疗红斑或伪膜型口腔念珠菌病,西吡氯铵含片联合碳酸氢钠含漱液对口腔念珠菌病的抗念珠菌效果更优。     

Mouthwash in the etiology of oral cancer in Puerto Rico

Objectives: To determine if the risk of cancers of the mouth and pharynx is associated with mouthwash use in Puerto Rico, an area of relatively high risk. Methods: Interviews were conducted with 342 cases of oral and pharyngeal cancer registered in Puerto Rico and diagnosed between 1992 and 1995 and with 521 population-based controls regarding mouthwash use and other factors. Mouthwash-related risks were estimated using unconditional logistic regression controlling for potential confounders. Results: The adjusted odds ratio associated with using mouthwash with an alcohol content of 25% or greater was 1.0. Risks were not higher with greater frequency, years of use, or lifetime mouthwash exposure. Among tobacco and alcohol abstainers the odds ratio associated with mouthwash use was 2.8 (CI = 0.8–9.9), in contrast to 0.8 (CI = 0.4–1.7) and 0.9 (CI = 0.6–1.3) among those with light and heavy cigarette smoking/alcohol drinking behaviors, respectively. Conclusions: There was no overall increased risk of oral cancer associated with mouthwash use. An elevated, but not statistically significant, risk was observed among the small number of subjects who neither smoked cigarettes nor drank alcohol, among whom an effect of alcohol-containing mouthwash would be most likely evident. Our findings indicate the need to clarify the mechanisms of oral carcinogenesis, including the possible role of alcohol-containing mouthwash.     

The effectiveness of commonly used mouthwashes for the prevention of chemotherapy-induced oral mucositis: a systematic review

Daily chlorhexidine mouthwash is often recommended for preventing chemotherapy-induced oral mucositis. Povidone-iodine, NaCl 0.9%, water salt soda solution and chamomile mouthwash are also recommended. However, the effectiveness of these mouthwashes is unclear. Therefore, we performed a systematic review to assess the effectiveness of mouthwashes in preventing and ameliorating chemotherapy-induced oral mucositis. Based on study quality, three out of five randomized controlled trials were included in a meta-analysis. The results failed to detect any beneficial effects of chlorhexidine as compared with sterile water, or NaCl 0.9%. Patients complained about negative side-effects of chlorhexidine, including teeth discoloration and alteration of taste in two of the five studies on chlorhexidine. The severity of oral mucositis was shown to be reduced by 30% using a povidone-iodine mouthwash as compared with sterile water in a single randomized controlled trial. These results do not support the use of chlorhexidine mouthwash to prevent oral mucositis.