Effectiveness of chlorhexidine-based mouthwashes after dental surgery: a quadruple-blind randomized pilot trial

This quadruple-blind randomized pilot trial evaluated the short-term effectiveness, side effects, and patient acceptability of three commercial chlorhexidine (CHX) mouthwashes compared with a placebo following dental surgery. Twenty-one patients were randomly assigned to: (A) 0.2% alcohol-free CHX, (B) 0.12% CHX + 0.05% cetylpyridinium chloride (CPC), (C) 0.05% sodium fluoride (placebo), or (D) 0.2% CHX with an anti-discoloration system (ADS). After two weeks, only Group A demonstrated statistically significant reductions in plaque (FMPS: median 10.7% to 3.9%, p = 0.0002) and gingival bleeding (FMMBS: median 3.4% to 0.5%, p = 0.0005). Group D demonstrated the least plaque reduction and the highest final FMPS (median 15.8%). Tooth staining was observed in all CHX groups, most pronounced in Group A (median 0.4/12 teeth), though differences were not statistically significant. Taste alteration was most frequent in Group A (100%), while Groups B and D were better tolerated. No adverse events occurred. These findings indicate that 0.2% alcohol-free CHX is the most effective short-term rinse after dental surgery, but its acceptability may be limited by taste disturbance and staining. Larger multicenter trials with extended follow-up are needed to confirm these preliminary results.