Superiority of an essential oil mouthrinse when compared with a 0.05% cetylpyridinium chloride containing mouthrinse: a six-month study.

OBJECTIVE: To evaluate the antiplaque/antigingivitis effectiveness of an essential oils containing mouthrinse as compared to a 0.05% cetylpyridinium chloride mouthrinse. METHOD: Generally healthy subjects with mild to moderate levels of plaque and gingivitis participated in a 6-month, examiner-blind, single centre, randomised, parallel-group controlled clinical trial. They were randomised into three mouthrinse groups--control (C), 0.05% cetylpyridinium chloride (CPC), or a fixed combination of essential oils (EO). Subjects received a dental prophylaxis at baseline and rinsed twice daily in addition to their usual oral hygiene for six months. Plaque Index and Modified Gingival Index were determined at 3 and 6 months. RESULTS: At 6 months, the EO group exhibited statistically significantly lower mean scores for MGI and PI than CPC (32.4% and 56.2% reductions, respectively). Compared to control, EO provided statistically significantly lower mean MGI and PI scores (36.3% and 69.7 %, respectively). The CPC group showed statistically significantly lower mean MGI and PI scores than the C group (5.8% and 30.7%, respectively). CONCLUSION: This study demonstrated the superiority of an EO rinse compared to a 0.05% CPC rinse in reducing plaque and gingivitis and confirmed that the daily use of an EO containing mouthrinse can provide a clinically significant benefit in reducing plaque and gingivitis.

Effect of rinsing with an essential oil-containing mouthrinse on subgingival periodontopathogens.

BACKGROUND: Studies have shown that the nature and amount of supragingival plaque can influence the composition of the contiguous subgingival flora. The purpose of this study was to investigate the effect of rinsing with an essential oil antimicrobial mouthrinse on levels of representative subgingival bacteria in subjects with mild to moderate periodontitis. METHODS: This controlled study used a randomized, double-masked, 2 x 2 crossover design. After baseline subgingival sampling, 37 qualifying subjects rinsed with the essential oil mouthrinse or a negative control twice daily for 14 days, with a post-treatment sample obtained on day 15. Following a washout period, the procedure was repeated with the alternative rinse. Target organisms enumerated were Porphyromonas gingivalis, Fusobacterium nucleatum, Veillonella sp., and total anaerobes. Intergroup comparisons of post-treatment log-transformed colony forming unit counts were made using analysis of covariance. RESULTS: After 14 days of twice-daily rinsing, the level of each of the target subgingival organisms was significantly lower in the essential oil group than in the control group (P < 0.001), with percent reductions ranging from 66.3% to 79.2%. CONCLUSIONS: Rinsing with the essential oil antiplaque/antigingivitis mouthrinse can have significant antimicrobial activity against subgingival periodontopathogens. Most likely, the antimicrobial effect was mediated primarily by disruption of the contiguous supragingival plaque by the mouthrinse. Because studies have shown that control of supragingival plaque can influence the onset and/or progression of periodontitis, additional studies on non-prescription antimicrobial oral care products may lead to new regimens for decreasing the burden of periodontal diseases in the population.

Use of essential oil-containing mouthrinses by xerostomic individuals: determination of potential for oral mucosal irritation.

PURPOSE: To assess the irritation potential of an essential oil-containing mouthrinse (Listerine Antiseptic) in a population with objectively documented xerostomia (hyposalivation) using an exaggerated-exposure clinical model. METHODS: Following a baseline oral soft tissue examination, 19 qualifying female subjects with a mean age of 61 years and a mean unstimulated baseline salivary flow of 0.06 mL/min were randomly assigned either the essential oil mouthrinse or a negative control rinse. They rinsed under supervision with 20 ml of their assigned rinse for 30 seconds and 5 minutes later a second salivary flow rate was determined. They then rinsed unsupervised with 20 ml for 30 seconds three times daily for the next 14 days, and received soft tissue examinations on days 7 and 14. After a 1-week interim period, subjects switched to the alternate rinse and the examination and rinsing regimens were repeated during the subsequent 2 weeks. RESULTS: The oral irritation potential of the essential oil mouthrinse was minimal. Oral mucosal abnormalities attributable to the test rinses were seen in only 2 subjects, both at the 7-day examination. These subjects were both using the essential oil mouthrinse. The abnormalities consisted of an asymptomatic "whitish slough" which was readily wiped off leaving a normal appearing, non-erythematous mucosa. In both subjects, the oral mucosa appeared normal at the 14-day examination.

Comparative effectiveness of an essential oil mouthrinse and dental floss in controlling interproximal gingivitis and plaque.

PURPOSE: To compare the effectiveness of rinsing with an essential oil-containing antimicrobial mouthrinse with that of dental floss in reducing interproximal gingivitis and plaque in an unsupervised 6-month clinical trial designed in accordance with ADA Acceptance Program Guidelines. MATERIALS AND METHODS: 319 qualifying subjects, aged 18-63, were randomized into one of three groups: essential oil mouthrinse (Listerine Antiseptic); dental floss (Reach Dental Floss); or a negative control rinse. At baseline, subjects received a complete oral soft tissue examination and scoring of the Modified Gingival Index (MGI), modified Quigley-Hein Plaque Index (PI), and bleeding index (BI). Following a complete dental prophylaxis and receiving flossing or rinsing instructions, subjects started on their respective regimen. They continued on their assigned regimen unsupervised at home, in addition to toothbrushing, and were reexamined at 3 and 6 months. The treatment groups were compared with respect to baseline demographic and clinical variables. The primary efficacy variables were mean interproximal MGI and PI at 6 months. Intergroup differences at 3 and 6 months were tested using a one-way analysis of covariance model with treatment as a factor and the respective baseline value as the covariate. In addition, the essential oil mouthrinse was compared to floss for interproximal gingivitis reduction using "at least as good as" statistical criteria. RESULTS: 301 subjects were considered evaluable. There were no statistically significant differences among the 3 groups at baseline, with the exception of the essential oil mouthrinse group having significantly fewer AfroAmerican subjects than the other two groups. For the interproximal MGI, the essential oil mouthrinse and flossing were both significantly more effective than the negative control (P < 0.001) at 3 and 6 months. The essential oil mouthrinse was shown to be "at least as good as" dental floss for the control of interproximal gingivitis. For the interproximal PI, the essential oil mouthrinse was significantly more effective than the negative control at 3 and 6 months (P < 0.001) while flossing was significantly more effective than the negative control at 3 months (P < 0.05) but not at 6 months. The essential oil mouthrinse was significantly more effective than floss (P < 0.001) at both these time periods.

Dental calculus composition following use of essential-oil/ZnCl2 mouthrinse.

PURPOSE: To test the hypothesis that anticalculus agents cannot completely inhibit calculus formation but can influence the types of calcium phosphate which form, i.e., they can influence the composition of the inorganic component of human dental calculus (HDC). MATERIALS AND METHODS: The composition of HDC specimens obtained from a 16-week multi-center clinical study using three regimens were analyzed, investigators blinded. The treatment regimens were: (a) standard dentifrice (SD), (b) pyrophosphate antitartar dentifrice, and (c) SD with Tartar Control Listerine Antiseptic mouthrinse (containing essential oils and 0.09% zinc chloride). 25 individual samples and eight pooled samples from each group were analyzed using X-ray diffraction, infrared spectroscopy, and scanning electron microscopy. RESULTS: (1) relative frequency of occurrence for: (a) bacteria: Group A = 100%, Group B = 60%, and Group C = 25%; (b) Carbonate hydroxyapatite (CHA): Groups A, B, and C = 100%; (c) dicalcium phosphate dihydrate (DCPD): Group A = 55%; Group B = 45%; Group C = 80%; (2) The relative amount of DCPD is inversely proportional to that of CHA in HDC: the higher the amount of DCPD, the lower the amount of CHA. Group C regimen with essential oil/ZnCl2 mouthrinse and standard dentifrice showed a significant anti-microbial effect and favored the formation of DCPD, the most soluble Ca-P.

Effect of an essential oil-containing antimicrobial mouthrinse on specific plaque bacteria in vivo.

AIM: This study was conducted to investigate the effect of rinsing with an essential oil-containing mouthrinse on levels of specific supra and subgingival bacteria in subjects with gingivitis. MATERIAL AND METHODS: Fifteen subjects meeting entry criteria completed this randomized, controlled, double-blind, crossover study. Subjects were required to have >or=1000 target organisms per millilitre in pooled samples from two subgingival sites. Following sampling of supra and subgingival plaque, subjects began twice-daily rinsing for 14 days with either an essential oil-containing mouthrinse (Cool Mint Listerine Antiseptic) or a negative control. Supra and subgingival plaque was again sampled on day 15, and the procedure repeated after a 1-week washout period with subjects using the alternate rinse. RESULTS: Compared with the negative control, the essential oil mouthrinse produced significant reductions in supragingival plaque levels of Veillonella sp., Capnocytophaga sp., Fusobacterium nucleatum, and total anaerobes ranging from 52.3 to 88.5% (p<0.001 except for Veillonella, p=0.002); respective reductions in subgingival plaque ranged from 54.1 to 69.1% (p<0.001). CONCLUSIONS: Rinsing with the essential oil mouthrinse can have an impact on the subgingival plaque flora. This study provides additional evidence indicating that reduction in supragingival plaque can reduce levels of subgingival plaque.