Combined chlorhexidine-sodiumfluoride mouthrinse for orthodontic patients: Clinical and microbiological study

BACKGROUND Orthodontic appliances impede good dental plaque control by brushing. Antimicrobial mouth rinses were suggested to improve this performance. We therefore aimed to investigate the effects of combined mouthrinse containing chlorhexidine (CHX) and sodium fluoride (NaF) on clinical oral hygiene parameters,and plaque bacterial level. MATERIAL AND METHODS In this double-blind clinical study, 60 fixed orthodontic patients aged 14-25 years were randomly assigned to one of four mouthrinses groups: 1- combined CHX /NaF 2- CHX 0.06% 3- NaF0.05% 4-placebo. Following baseline examination patients were instructed to use the assigned mouthrinse twice daily for 21 days. Bleeding index (BI), modified gingival index (MGI) and plaque index (PI) were determined at the baselineand after three weeks of rinsing. Samples from supragingival plaque were obtained for the assessment of total bacterial, Streptococcus mutans and Lactobacilli colony counts. Data were analyzed by Wilcoxon, Kruskal-Wallis, and Mann-Whitney tests. RESULTS Clinical parameters; All three active mouth rinses induced significant improvements of BI, MGI, and PI (P<0.05). Results of CHX/NaF were slightly, but not significantly, better than CHX. CHX/NaF and CHX induced significantly more changes than NaF and placebo. Microbiological measurements; Except placebo, other mouthrinses reduced total bacterial, Streptococcus mutans, and Lactobacilli counts significantly (P<0.05). CHX/NaF acted against Lactobacilli significantly more than others. CONCLUSIONS Adding CHX0.06%/NaF0.05% combined mouth rinse to daily oral hygiene regimen of orthodontic patients significantly improved oral hygiene status. Effect of this combined mouth rinse on dental plaque Lactobacilli was remarkable. However, large controlled trials could provide more definitive evidence. KEY WORDS Mouthrinse, fluoride, chlorhexidine, plaque.