Prevention and Therapy of Gingivitis: Toothbrush and Mouthwash

This thesis evaluated the efficacy of manual toothbrushes to remove plaque and several mouthwashes to reduce gingivitis. The results of a 12-months study show that after 3 weeks, twice daily use of a chlorhexidine mouthwash, used in conjunction with an oxygenating mouthwash, significantly decreased the level of gingival inflammation. However, this effect was transient and lost within 4 months. Evaluation of the toothbrushes used during this study showed for participants who returned a set of three, 3-months-used toothbrushes of the same brand, that toothbrush wear per individual was fairly consistent. Toothbrushes with a high level of wear were associated with significantly higher plaque scores as compared to those with no to light wear. A 0.07% cetylpyridinium chloride mouthwash was evaluated in a 6-months study. This product was found to be significantly more effective in reducing plaque scores than the vehicle control, however, gingivitis scores were not concomitantly affected. Systematic analyses of the available published scientific literature showed that a standardized formula of an essential oils mouthwash provides additional benefits with regard to the reduction of plaque and gingivitis, as compared to a placebo or control. Evaluation of the data related to the vehicle solution of this mouthwash showed that the efficacy in reducing plaque scores could be attributed to the essential oils themselves and not to the alcohol within the solution. The main message emerging from this thesis with respect to control of gingival inflammation is that in the long-term, essential oils mouthwash (Listerine®) is a suitable alternative for chlorhexidine.