# Evaluation of Blue(r)m Mouthwash vs. Chlorhexidine
## 4 Discussion  
The present study was conducted to evaluate the efficacy of Blue(r)m mouthwash with chlorhexidine in plaque-induced gingivitis. Both the groups were matched for the clinical parameters (plaque index, gingival index, and bleeding on probing percentage) so that any kind of bias could be avoided in the outcome. Chlorheidine has been used as an antiplaque agent with considerable side effects, such as the brownish staining of teeth, altered taste perceptions, and hypersensitivity, to name a few [2; 3; 4; 8]. Hence, searches for mouthwashes which do not contain alcohol and are naturally derived have been ongoing for years. Blue(r)m has been developed with this element in mind, and it is composed of natural ingredients and completely free of alcohol. However, chlorheidine is much cheaper compared to Blue(r)m mouthwash; therefore, studies are required to validate the use of the latter as a worthy alternative to chlorheidine. As mentioned before, ROS have an important role in the pathogenesis of gingival and periodontal disease. Blue(r)m mouthwash has a positive impact on healing, as it promotes re-epithelial, improved collagen production, and neovascularization, hence the decrease in the parameters seen at the one-month follow up. It has a protective role in controlling gingival inflammation through the controlled release of reactive oxygen species, hence preventing tissue damage due to an increased concentration of the same element [17]. Although scarce, a few studies evaluating the efficacy of topical oxygen therapy in periodontal diseases, including the use of Blue(r)m mouthwash, could be found in the literature. [PERSON] et al. [25] in 2020 investigated the use of an oxygen-releasing gel against an antibiotic or antiseptic gel and found that its bactericidal efficacy was almost similar to both of them in terms of eliminating periodontal pathogens. [PERSON] et al. [26], in their pilot study comparing the in vitro application of Blue(r)m gel vs. chlorheidine gel in order to reduce Porphomonas gingivalis, discovered that the inhibitory effect of Blue(r)m gel on Porphomonas gingivalis at a concentration of 100% and 50% was similar to that of chlorhexiidine. Also, a study by [PERSON] et al. [27] used local oxygen-based therapy (Blue(r)m oral gel) as an adjunct to non-surgical therapy to manage peri-implant mucositis and peri-implantitis, concluding that it had a similar efficacy to conventionally used local supplements (antibacterial agents, probiotics, antibiotics) in reducing bleeding on probing and probing pocket depth and increasing radiographic bone levels. [PERSON] et al. [28] conducted a study to evaluate the effect of Blue(r)m mouthwash on intra oral wounds. In this study, 14 patients were recruited who underwent pre prosthetic surgery to remove hyperplasia of the posterior and anterior maxillary ridge prior to a final prosthesis. They were asked to use Blue(r)m mouthwash on the right-side ridge of their mouths as an adjunct therapy, leaving the left-side ridge as control. The subjects applied the product for 7 days thrice daily, after which the pain, taste alteration, and patients' acceptance were assessed. The results revealed that Blue(r)m mouthwash was well accepted by the patients and subsided the pain to a certain extent. Less inflammation on the test side was noted, depicting enhanced healing. The above study concluded that Blue(r)m mouthwash was quite helpful in pain management, reducing inflammation, and wound healing after surgery. Also, the efficacy of Blue(r)m mouthwash was tested in the study of [PERSON] et al. [29], where it was used by patients undergoing dental implant surgery. The results showed that Blue(r)m mouthwash was equally as effective as chlorhexiidine in reducing microbial load post-implant placement. Similar results were achieved by [PERSON] et al. [30], who proved that this oxygen-releasing mouthwash aids in controlling biofilm and reducing gingival inflammation following implant surgery. Also, [PERSON] et al.