Maintenance of oral hygiene with beetroot rinse in gingivitis patients with oral lichen planus: A pilot randomized...

Oral lichen planus (OLP) is a chronic inflammatory mucocutaneous disorder frequently associated with painful gingival involvement, which can compromise effective plaque control. Chlorhexidine (CHX) is the gold standard chemical plaque control agent but may be poorly tolerated in OLP patients due to mucosal irritation. Natural alternatives such as beetroot juice, rich in bioactive compounds, may offer supportive benefits.

The study aimed to compare the short-term antiplaque, antimicrobial, and salivary nitric oxide (NO) effects of a beetroot juice mouthrinse with chlorhexidine in gingivitis patients with and without OLP.

This pilot randomized controlled study included 44 gingivitis patients, with OLP (Group 1) and without OLP (Group 2). Participants were randomly allocated to receive either beetroot juice rinse (Groups 1A and 2A) or once-daily 0.2% chlorhexidine mouthrinse (Groups 1B and 2B). All patients underwent scaling and root planing before intervention. The clinical and biochemical parameters were recorded at baseline, immediately after intervention, and at 1-week follow-up. Plaque index (PI), gingival index (GI), Streptococcus spp. colony-forming units (CFU), and salivary NO levels were evaluated.

At 1 week, significant reductions in PI and GI scores were observed within all treatment groups (P < 0.05). Streptococcus spp. CFU counts decreased following intervention in all groups; however, sustained reduction from day 1 to day 7 was more consistently observed in the chlorhexidine groups. Salivary NO levels showed a significant increase in the OLP + beetroot group, while reductions were observed in the chlorhexidine groups.

Within the limitations of this short-term pilot study, beetroot juice rinse demonstrated preliminary antiplaque effects and was associated with changes in salivary NO levels. Chlorhexidine remains the gold standard for antimicrobial persistence. Beetroot rinse may be considered an exploratory, well-tolerated adjunct for oral hygiene maintenance in OLP patients, pending confirmation from larger, long-term studies.