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The effect of chlorhexidine dentifrice or gel versus chlorhexidine mouthwash on plaque, gingivitis, bleeding and tooth discoloration: a systematic review.
Int J Dent Hyg 2015; 13(2):83-92IJ

Abstract

OBJECTIVE

To systematically review and evaluate the available scientific evidence on the effectiveness of chlorhexidine dentifrice or gel (CHX DF/gel) compared to chlorhexidine mouthwash (CHX MW) on plaque, bleeding, gingival inflammation and tooth discoloration scores.

MATERIAL AND METHODS

PubMed-MEDLINE, Cochrane-CENTRAL and EMBASE databases were searched to identify appropriate studies.

RESULTS

Independent screening of the 2256 unique titles and abstracts resulted in five publications that met the eligibility criteria. Considerable heterogeneity was found between the studies. Three of the five studies showed a positive effect on plaque scores in favour of the CHX MW. With respect to gingival index and bleeding scores, no significant differences were found. Chlorhexidine mouthwash, however, showed a significantly more tooth discoloration than the CHX DF/gel. A meta-analysis of the effect on 'de novo' plaque formation of CHX DF/gel versus CHX MW resulted in a difference in means of 0.27 [95% CI: 0.14; 0.39] (P < 0.0001).

CONCLUSION

Chlorhexidine gel can be successfully formulated and will inhibit plaque growth to some degree, but not to the same extent, as a CHX MW. When CHX DF/gel is used in a non-brushing model, it is significantly less effective in plaque inhibition compared to CHX MW. Based on one study when CHX gel was applied with a finger after brushing, it is significantly more effective on plaque scores and the gingival index. The only brushing study also with a long follow-up showed that there is no significant difference between CHX DF and CHX MW. However, as a corollary, significantly more tooth discoloration was observed with the CHX MW. Altogether, the data show that when daily oral hygiene cannot be performed, CHX MW is the first product of choice.

Authors+Show Affiliations

Department of Periodontology, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam, VU University Amsterdam, Amsterdam, The Netherlands.No affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Comparative Study
Journal Article
Research Support, Non-U.S. Gov't
Review
Systematic Review

Language

eng

PubMed ID

25059640

Citation

Supranoto, S C., et al. "The Effect of Chlorhexidine Dentifrice or Gel Versus Chlorhexidine Mouthwash On Plaque, Gingivitis, Bleeding and Tooth Discoloration: a Systematic Review." International Journal of Dental Hygiene, vol. 13, no. 2, 2015, pp. 83-92.
Supranoto SC, Slot DE, Addy M, et al. The effect of chlorhexidine dentifrice or gel versus chlorhexidine mouthwash on plaque, gingivitis, bleeding and tooth discoloration: a systematic review. Int J Dent Hyg. 2015;13(2):83-92.
Supranoto, S. C., Slot, D. E., Addy, M., & Van der Weijden, G. A. (2015). The effect of chlorhexidine dentifrice or gel versus chlorhexidine mouthwash on plaque, gingivitis, bleeding and tooth discoloration: a systematic review. International Journal of Dental Hygiene, 13(2), pp. 83-92. doi:10.1111/idh.12078.
Supranoto SC, et al. The Effect of Chlorhexidine Dentifrice or Gel Versus Chlorhexidine Mouthwash On Plaque, Gingivitis, Bleeding and Tooth Discoloration: a Systematic Review. Int J Dent Hyg. 2015;13(2):83-92. PubMed PMID: 25059640.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - The effect of chlorhexidine dentifrice or gel versus chlorhexidine mouthwash on plaque, gingivitis, bleeding and tooth discoloration: a systematic review. AU - Supranoto,S C, AU - Slot,D E, AU - Addy,M, AU - Van der Weijden,G A, Y1 - 2014/07/24/ PY - 2014/02/28/accepted PY - 2014/7/26/entrez PY - 2014/7/26/pubmed PY - 2016/7/13/medline KW - bleeding KW - chlorhexidine KW - dentifrice KW - gel KW - gingivitis KW - mouthwash KW - oral hygiene KW - plaque KW - systematic review KW - tooth discoloration SP - 83 EP - 92 JF - International journal of dental hygiene JO - Int J Dent Hyg VL - 13 IS - 2 N2 - OBJECTIVE: To systematically review and evaluate the available scientific evidence on the effectiveness of chlorhexidine dentifrice or gel (CHX DF/gel) compared to chlorhexidine mouthwash (CHX MW) on plaque, bleeding, gingival inflammation and tooth discoloration scores. MATERIAL AND METHODS: PubMed-MEDLINE, Cochrane-CENTRAL and EMBASE databases were searched to identify appropriate studies. RESULTS: Independent screening of the 2256 unique titles and abstracts resulted in five publications that met the eligibility criteria. Considerable heterogeneity was found between the studies. Three of the five studies showed a positive effect on plaque scores in favour of the CHX MW. With respect to gingival index and bleeding scores, no significant differences were found. Chlorhexidine mouthwash, however, showed a significantly more tooth discoloration than the CHX DF/gel. A meta-analysis of the effect on 'de novo' plaque formation of CHX DF/gel versus CHX MW resulted in a difference in means of 0.27 [95% CI: 0.14; 0.39] (P < 0.0001). CONCLUSION: Chlorhexidine gel can be successfully formulated and will inhibit plaque growth to some degree, but not to the same extent, as a CHX MW. When CHX DF/gel is used in a non-brushing model, it is significantly less effective in plaque inhibition compared to CHX MW. Based on one study when CHX gel was applied with a finger after brushing, it is significantly more effective on plaque scores and the gingival index. The only brushing study also with a long follow-up showed that there is no significant difference between CHX DF and CHX MW. However, as a corollary, significantly more tooth discoloration was observed with the CHX MW. Altogether, the data show that when daily oral hygiene cannot be performed, CHX MW is the first product of choice. SN - 1601-5037 UR - https://www.unboundmedicine.com/medline/citation/25059640/The_effect_of_chlorhexidine_dentifrice_or_gel_versus_chlorhexidine_mouthwash_on_plaque_gingivitis_bleeding_and_tooth_discoloration:_a_systematic_review_ L2 - https://doi.org/10.1111/idh.12078 DB - PRIME DP - Unbound Medicine ER -