In this issue, we will discuss interventions to maintain gum health.
Issues related to periodontal disease, such as gingivitis, that may affect other aspects of dental health as they become compromised.
The evidence for adjunctive therapies for these will be presented.
Study details
We included 51 studies that analyzed a total of 5345 participants.
Gingivitis
After 4 to 6 weeks of use, chlorhexidine mouth rinse makes gingivitis 0.21 scale compared to placebo, control or no mouth rinse.
A similar effect size was found for reducing gingivitis at 6 months.
There was insufficient data to determine a reduction in gingivitis associated with the use of chlorhexidine mouth rinses in individuals with a mean GI score of 1.1 to 3 (moderate or severe gingivitis).
Plaque
Plaque was measured by a variety of indices, with a 4 to 6 week SMD that was 1.45 standard deviations lower in the chlorhexidine group.
A similar significant reduction in the use of chlorhexidine mouth rinses was seen at 6 months.
Exogenous tooth staining
There was a significant increase in exogenous tooth staining in participants who used chlorhexidine mouth rinses between 4 and 6 weeks.
Calculus
Results of the effect of chlorhexidine mouth rinses on stone formation were inconclusive.
Effect of concentration and frequency of rinsing
There were insufficient data to determine if there was a difference in the effect of either chlorhexidine concentration or frequency of rinsing.
Other adverse effects
The most commonly reported adverse effects in the included studies were taste disturbances/changes (reported in 11 studies), effects on the oral mucosa including pain, irritation, mild desquamation and mucosal ulcers/erosions (reported in 13 studies), and a general burning sensation of heat or burning tongue or both.
Conclusions
There is high quality evidence from studies that reported the Löeand Silness Gingival Index, which reported a mean reduction in gingivitis in patients with mild gingivitis (mean score 1 on the 0 to 3 GI scale) that was not considered clinically relevant. There is high quality evidence that chlorhexidine mouth rinses, when used for 4-6 weeks and 6 months as an adjunct to mechanical oral hygiene procedures, significantly reduce plaque. There is no evidence that one concentration of chlorhexidine rinse is more effective than another. There is insufficient evidence to determine a reduction in gingivitis associated with the use of chlorhexidine mouth rinses in individuals with a mean GI score of 1.1-3, which indicates a level of moderate or severe gingivitis. Rinsing with chlorhexidine mouthwash for more than 4 weeks can result in exogenous tooth staining. In addition, other adverse effects were reported in studies that included tartar buildup, transient taste disturbances, and effects on the oral mucosa.
James P, Worthington HV, Parnell C, Harding M, Lamont T, Chan A, Welton H, Riley P. Cochrane Database of Systematic Reviews 2017, Issue 3 as an Adjunctive Treatment for Gingival Health. art. No.: CD008676. doi: 10.1002 / 14651858.CD008676.pub2.
Summary.
While there are benefits in terms of dental health, such as reduced plaque, there have also been adverse reports.It's up to you to decide which one you want to take, but in terms of maintaining gum health, the goal is achieved. It seems to have achieved its purpose in maintaining healthy gums.
However, I am curious about the side effects reported, so I will write an article when I find different research results.
