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Review
. 2020 Jan 20:2020:2829854.
doi: 10.1155/2020/2829854. eCollection 2020.

Effects of Herbal Mouthwashes on Plaque and Inflammation Control for Patients with Gingivitis: A Systematic Review and Meta-Analysis of Randomised Controlled Trials

He Cai  1   2   3 , Junyu Chen  1   2   4 , Nirmala K Panagodage Perera  3   5 , Xing Liang  1   2
Affiliations
Review

Effects of Herbal Mouthwashes on Plaque and Inflammation Control for Patients with Gingivitis: A Systematic Review and Meta-Analysis of Randomised Controlled Trials

He Cai et al. Evid Based Complement Alternat Med. .

Abstract

Objective: The aim of this study was to evaluate the overall effects of herbal mouthwashes as supplements to daily oral hygiene on plaque and inflammation control compared with placebos and chlorhexidine (CHX) mouthwashes in the treatment of gingivitis.

Methods: PubMed, EMBASE, Cochrane Database of Systematic Reviews, Cochrane Central Register of Controlled Trials, and grey literature databases were searched. Only randomised controlled trials (RCTs) comparing herbal mouthwashes with placebos or CHX in the daily oral hygiene of patient with gingivitis were included to compare the effect of different mouthwashes on plaque and inflammation control.

Results: A total of 13 studies satisfied the eligibility criteria, and 11 studies were included in meta-analyses. Significant differences were observed in favour of herbal mouthwashes compared with placebos in both plaque- and inflammation-related indices (Quigley-Hein Plaque Index, QHPI: WMD = -0.61, 95% CI (-0.80, -0.42), P < 0.001; Gingival Index, GI: -0.28 (-0.51, -0.06), P=0.01; Modified Gingival Index, MGI: -0.59 (-1.08, -0.11), P=0.02; Gingival Bleeding Index, GBI: -0.06 (-0.09, -0.04), P < 0.001). No significant difference was found between herbal and CHX mouthwashes.

Conclusions: Herbal mouthwashes have potential benefits in plaque and inflammation control as supplements to the daily oral hygiene of patients with gingivitis. Although no difference was observed between herbal and CHX mouthwashes in the selected studies, further high-quality RCTs are needed for more firm support before advising patients with gingivitis about whether they can use herbal mouthwashes to substitute for CHX mouthwashes or not (PROSPERO registration number: CRD42019122841).

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Conflict of interest statement

The authors declare that there are no conflicts of interest in this study.

Figures

Figure 1
Figure 1
Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) flow diagram for study selection (CDSR, Cochrane Database of Systematic Reviews; CENTRAL, Cochrane Central Register of Controlled Trials; RCT, randomised controlled trial).
Figure 2
Figure 2
Risk of bias summary for reviewing authors' judgements about each risk of bias item for each included study. Green stands for low risk of bias, yellow represents unclear risk of bias, and red indicates high risk of bias.
Figure 3
Figure 3
Forest plots comparing the clinical effects by specific indices between herbal mouthwashes and placebos. Comparison for (a) Turesky modification of Quigley-Hein Plaque Index (QHPI), (b) Gingival Index (GI), (c) Modified Gingival Index (MGI), and (d) Gingival Bleeding Index (GBI).
Figure 4
Figure 4
Forest plots comparing the clinical effects by specific indices between herbal and chlorhexidine (CHX) mouthwashes. Comparison for (a) Plaque Index (PI), (b) Turesky modification of Quigley-Hein Plaque Index (QHPI), (c) Gingival Index (GI), and (d) Modified Gingival Index (MGI).
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References

    1. Shibly O., Rifai S., Zambon J. J. Supragingival dental plaque in the etiology of oral diseases. Periodontology 2000. 1995;8(1):42–59. doi: 10.1111/j.1600-0757.1995.tb00044.x. - DOI - PubMed
    1. Fine D. H. Chemical agents to prevent and regulate plaque development. Periodontology 2000. 1995;8(1):87–107. doi: 10.1111/j.1600-0757.1995.tb00047.x. - DOI - PubMed
    1. Rodan R., Khlaifat F., Smadi L., Azab R., Abdalmohdi A. Prevalence and severity of gingivitis in school students aged 6–11 years in Tafelah Governorate, South Jordan: results of the survey executed by National Woman’s Health Care Center. BMC Research Notes. 2015;8(1):p. 662. doi: 10.1186/s13104-015-1532-y. - DOI - PMC - PubMed
    1. Carvajal P., Gomez M., Gomes S., et al. Prevalence, severity, and risk indicators of gingival inflammation in a multi-center study on South American adults: a cross sectional study. Journal of Applied Oral Science. 2016;24(5):524–534. doi: 10.1590/1678-775720160178. - DOI - PMC - PubMed
    1. Idrees M. M., Azzeghaiby S. N., Hammad M. M., Kujan O. B. Prevalence and severity of plaque-induced gingivitis in a Saudi adult population. Saudi Medical Journal. 2014;35(11):1373–1377. - PMC - PubMed

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