The Efficacy Of 0.05% Cetylpyridinium Chloride Mouthwash As An Adjunct To Toothbrushing On Reducing Dental Plaque And Gingivitis
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Date
2016-09
Authors
Oo, Phyoe Htut
Journal Title
Journal ISSN
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Publisher
Universiti Sains Malaysia
Abstract
Introduction: Mouthwashes containing various antimicrobial agents have been used since the 1960s to inhibit plaque and improve gingival health. Objectives: This study aimed to determine the efficacy of cetylpyridinium chloride (CPC) mouthwash as an adjunct to toothbrushing in comparison with chlorhexidine gluconate (CHX) mouthwash and placebo in reducing plaque accumulation and gingival inflammation. The effect of CPC mouthwash and CHX mouthwash on tooth staining and perceived loss of taste, burning sensation and numbness were also determined. Materials and Methods: A double-blinded, parallel, randomized control study was conducted on 219 students from Universiti Sains Malaysia (USM), Health Campus. The participants were divided into 3 trial groups using block randomization: CPC group (73), CHX group (73) and placebo group (73). Clinical oral examination to assess gingival health (Loe and Silness gingival index), tooth staining (Lobene stain index) and dental plaque accumulation (modified Quigley-Hein plaque index) was done at the beginning of study as baseline and 6 weeks after use of mouthwash. The participants were requested to refrain from all oral hygiene procedures for 24 hours, and from eating and drinking for 4 hours prior to clinical examinations. Both examiner and participants were blinded to the trial group. Loss of taste perception, experience of burning sensation and numbness were assessed using questionnaires. One-way ANOVA was used to assess the differences in plaque and gingivitis scores between the three groups at baseline and after trial. Paired t test was used to assess the difference in plaque and gingivitis scores
between baseline and after treatment in all groups. Independent t test was used to assess the differences in staining scores between CPC and CHX groups. Chi-square test was used for assessing the differences in loss of taste, burning sensation and numbness between CPC and CHX groups. Results: Two-hundred and nineteen participants complied with the protocol and completed the six-week study. The plaque score and gingivitis score were not significantly different between the three groups at baseline (P=0.143). After 6 weeks of trial there were significant differences in plaque score and gingivitis score between the CPC and placebo groups (P=0.001), and between CHX and placebo groups (P=0.001). However, there was no significant difference between CPC and CHX groups. The differences in plaque score at baseline and after 6 weeks of trial were significant for CPC and CHX groups but not the placebo group. The differences in gingivitis score at baseline and after 6 weeks of trial were significant for all groups. The mean staining score of CPC mouthwash group was 0.14 (SD 0.35) and for the CHX mouthwash group the mean score was 0.25 (SD 0.39). The difference in staining score between CPC and CHX mouthwashes groups was not statistically significant (P=0.07). Chi-square test showed that perceptions of loss of taste and numbness were significantly different between the CHX group and the CPC group (P=0.001). However, there was no significant difference in burning sensation was found between the two groups (P=0.47). Conclusion: CPC was as efficient as CHX in reducing dental plaque accumulation and ginvival inflammation. CPC mouthwash had lesser staining effect on teeth than CHX mouthwash. The loss of taste and numbness perceptions between the CPC and CHX mouthwash groups were significantly different. Being as effective as CHX mouthwash, with lesser staining effect, the use of 0.05% CPC mouthwash as an adjunct to toothbrushing in reducing dental plaque and gingival inflammation is recommended.
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Keywords
Efficacy of cetylpyridinium chloride mouthwash , adjunct to toothbrushing.