Comfort and Adverse Reactions in Immediate Mouthwash Use: A Comparative Study

To evaluate the immediate effects and user acceptance of mouthwashes containing different active ingredients - chlorhexidine, essential oils, and green tea/hyaluronic acid - by assessing their impact on salivary pH, sensory experiences, and potential side effects.

This is a randomised clinical trial, including 96 students who were randomised into three groups, each using one of three mouthwashes: essential oils, chlorhexidine, and green tea/hyaluronic acid. Participants conducted a 60-s rinse and subsequently filled out questionnaires on sensory experiences, such as taste and irritation, and the potential for daily use. Salivary pH was measured immediately before and after rinsing to assess any changes.

All mouthwashes effectively increased salivary pH from an average of 7.0 to 8.6, indicating a shift towards a less acidic oral environment. There were no significant differences in the sensation of clean teeth across different mouthwashes. However, the green tea/hyaluronic acid mouthwash was more favourably received, causing less discomfort in the lips, tongue, and throat and showing no reports of tongue irritation. Participants expressed a significantly higher preference for this mouthwash (p = 0.04) for potential daily use, as opposed to those using essential oil or chlorhexidine mouthwashes, which commonly reported burning sensations.

Although all tested mouthwashes were effective in increasing salivary pH, the green tea/hyaluronic acid formulation stood out due to higher user comfort and acceptance, potentially due to its natural component base. These findings suggest a promising direction for future mouthwash formulations that prioritise natural ingredients and user comfort. In conclusion, green tea and hyaluronic acid mouthwash increases salivary pH with better user comfort and acceptance than chlorhexidine or essential oils.