Alcohol-free Essential Oils Containing Mouthrinse Efficacy on 3-day Supragingival Plaque Regrowth
Condition: Gingivitis; Periodontitis
MeSH terms: Gingivitis; Periodontitis
Study type: Interventional

Summary: 
      The purpose of this study is to evaluate the antiplaque effects of an alcohol-free
      essential-oil containing mouthrinse - Listerine Zero (LZ) and an alcohol-based essential oils
      (EO+) mouthwash compared to a positive control of 0.20% chlorhexidine (CHX) mouthwash, and a
      negative control of a placebo solution (saline), using an in vivo plaque regrowth model of 3
      days.
    

Detailed description: 
      Plaque is a biofilm of microorganisms responsible for the development of caries and
      periodontal disease. The daily removal of supragingival dental plaque represents a major
      factor in the prevention of caries, gingivitis and periodontitis. Plaque control is largely
      obtained by daily effective tooth brushing and inter-dental cleaning, but in some cases
      plaque removal can be improved by adding the use of a mouthwash.

      An effective action of chemical formulation (especially antiseptics) to control plaque and
      gingivitis levels has been proved.

      Most mouthwashes contain an alcohol (especially ethanol) in order to act as a carrier agent
      for active essential oils to penetrate the plaque, and to give the subject a "clean mouth
      sensation".

      The alcohol content of mouthwashes, besides having antiseptic properties, serves the purpose
      of breaking down or dissolving active principles, in addition to that of preserving the
      formula components, although such content does not directly contribute to effective biofilm
      and gingivitis control.

      However, there are some contraindications in the use of alcohol-based mouthwashes, like the
      use by infants, pregnant women, alcohol addicts and patients with mucosal injuries. There are
      also some undesirable effects, like burning or sore sensation, or a painful sensation for
      patients with existing soft tissue injuries, or a perception of dryness in the mouth.

      In order to avoid the use of alcohol-based mouthwashes in particular conditions, scientific
      interest is becoming more widespread in introducing a mouthrinse with strong anti-plaque
      qualities and no alcoholic ingredients.

      One of these product is the alcohol-free essential oil mouthwash Listerine Zero (LZ), that
      has little documentation with regard to its anti-plaque effects.

      The aim of this study was to evaluate the antiplaque effects of an alcohol-free essential oil
      mouthwash (Listerine Zero, LZ) and a alcohol-based essential oil mouthwash (EO+), compared to
      a positive control of a 0.2% chlorhexidine mouthwash (CHX), and a negative control of a
      placebo solution (saline), using an in vivo plaque regrowth model of 3 days.

      The study was designed as a double-masked, randomized, crossover clinical trial, involving 21
      volunteers to compare four different mouthwashes, using a 3-day plaque regrowth model. After
      receiving thorough professional prophylaxis at baseline, over the next 3 days, each volunteer
      refrained from all oral hygiene measures and performed two daily rinses with 15 ml of the
      test mouthwashes. EO+ was compared to LZ. CHX rinse served as a positive control, and a
      placebo solution as a negative control. At the end of each experimental period, plaque index
      (PI) was assessed, and a panelists completed through a visual analogue scale (VAS)
      questionnaire evaluating the organoleptic properties of each product. Each subject underwent
      a 14-day washout period, and then there was another allocation.
    

Intervention name(s): alcohol free essential oils mouthwash; alcohol essential oils mouthwash; 0.20% chlorhexidine mouthwash; Placebo
Intervention type(s): Other; Other; Other; Other
Intervention description(s): All subjects were instructed to rinse twice a day, in the morning and in the evening, with 15 ml solution for 60 seconds, after which they expectorated. Subsequent rinsing with water was not allowed.; All subjects were instructed to rinse twice a day, in the morning and in the evening, with 15 ml solution for 60 seconds, after which they expectorated. Subsequent rinsing with water was not allowed.; All subjects were instructed to rinse twice a day, in the morning and in the evening, with 15 ml solution for 60 seconds, after which they expectorated. Subsequent rinsing with water was not allowed.; All subjects were instructed to rinse twice a day, in the morning and in the evening, with 15 ml solution for 60 seconds, after which they expectorated. Subsequent rinsing with water was not allowed.
Other intervention name(s): Listerine Zero, Johnson & Johnson Consumer Inc.; Listerine, Johnson & Johnson Consumer Inc.; Meridol Chlorhexidine 0.20, GABA International AG
Intervention MeSH terms: Ethanol; Chlorhexidine; Chlorhexidine gluconate; Listerine; Sodium Fluoride
Allocation: Randomized
Intervention model: Crossover Assignment
Masking: Double (Participant, Care Provider)
Primary purpose: Prevention
Keywords: Antiplaque agents; chemical plaque control; oral hygiene; essential oils; alcohol; mouthwash