Are adjunctive therapies effective in reducing gingivitis and plaque?

Area of Science:

• Periodontology
• Oral Hygiene
• Pharmacology

Background:

• Gingivitis and plaque are common oral conditions.
• Mechanical plaque control is standard, but adjuncts may improve outcomes.
• Antiseptics are used in oral hygiene products.

Purpose of the Study:

• To systematically review and meta-analyze the efficacy of adjunctive antiseptics for gingivitis and plaque control.
• To compare the effectiveness of antiseptic mouth rinses versus dentifrices.
• To assess antiseptic efficacy in systemically healthy patients and those with treated periodontitis.

Main Methods:

• Systematic review of randomized controlled trials from PubMed, CENTRAL, Scopus, and Cochrane databases up to February 2019.
• Inclusion criteria: patients aged 18+ with gingivitis, adjuncts to mechanical plaque control, primary outcome gingival/bleeding indices up to six months.
• Meta-analysis of six-month data using random-effects models; assessed heterogeneity and publication bias.

Main Results:

• Seventy randomized controlled trials (RCTs) were included in the quantitative synthesis.
• Adjunctive antiseptics significantly reduced gingival index, plaque index, and plaque levels.
• Antiseptic mouth rinses demonstrated greater plaque reduction compared to dentifrices.

Conclusions:

• Adjunctive antiseptics in mouth rinses and dentifrices are effective in reducing gingival, bleeding, and plaque indices alongside mechanical plaque control.
• Antiseptic mouth rinses may offer superior plaque reduction compared to dentifrices.
• Clinical significance should be interpreted cautiously due to study heterogeneity and publication bias.