Critical Appraisal

Is chlorhexidine mouth rinse, used as a mono-therapy or adjunct with oral hygiene, effective at reducing plaque growth and gingival inflammation?

Andre W. van Zy, Johan Hartshorne, Alonso Carrasco-Labra
Open Journal of Implant Dentistry | Vol 1, No 1 | a5 | DOI: | © 2013 Andre W. van Zy, Johan Hartshorne, Alonso Carrasco-Labra | This work is licensed under CC Attribution 4.0
Submitted: 30 January 2013 | Published: 25 March 2013

About the author(s)

Andre W. van Zy, Department of Periodontics and Oral Medicine, University of Pretoria,
Johan Hartshorne, Visiting Professor, Department of Periodontics and Oral Medicine, School of Dentistry, University of Pretoria. South Africa, South Africa
Alonso Carrasco-Labra, Department of Oral and Maxillofacial Surgery and Evidence-Based Dentistry Unit, Faculty of Dentistry, Universidad de Chile, Chile


This study describes a systematic review of the best available evidence on the effectiveness of a chlorhexidine mouth rinse as a mono-therapy or as an adjunct to mechanical oral hygiene against plaque growth and gingival inflammation. Medline, EMBASE and the Cochrane Central register of Controlled Trials were searched up to April 2011. Randomised controlled clinical trials that compared chlorhexidine to placebo or controlled mouth rinses or regular oral hygiene for a minimum duration of at least four weeks amongst gingivitis patients (≥ 18 years of age) were included. A total of 30 publications fulfilled the selection criteria. Clinical parameters measured at baseline and end of trial were plaque, gingival inflammation, bleeding and staining. Chlorhexidine reduced plaque by 33% and gingivitis by 26% compared to a placebo or a control mouth rinse. The investigators concluded that when used together with oral hygiene, chlorhexidine mouth rinses provide significant reductions in plaque and gingivitis scores in gingivitis patients, but a significant increase in staining compared to placebo or control mouth rinses.


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