Effect of a sodium hypochlorite mouthwash on plaque and clinical parameters of periodontal disease-a systematic review

Int J Dent Hyg. 2022 Feb;20(1):40-52. doi: 10.1111/idh.12510. Epub 2021 Jul 19.

Abstract

Objective: The present study aimed to establish the efficacy of sodium hypochlorite mouthwash (NaOCl-MW) compared with a control mouthwash on plaque and clinical parameters of periodontal disease.

Methods: MEDLINE-PubMed, Embase and Cochrane-CENTRAL databases were searched for clinical trials on patients with gingivitis or periodontitis that assessed the effect of NaOCl-MW in comparison with a negative or positive control on plaque index (PI), gingival index (GI), and bleeding index (BI) scores and probing pocket depth (PPD). Data were extracted from the eligible studies.

Results: Seven eligible papers were retrieved, which together represented six clinical trials. The studies showed considerable heterogeneity regarding methodological and clinical aspects that did not permit a meta-analysis. Two of the three studies in which NaOCl-MW was compared with a negative control showed that NaOCl-MW significantly reduced PI, GI and BI, and no effect was found on PPD. In three studies, NaOCl-MW was assessed using chlorhexidine mouthwash (CHX-MW) as a positive control; no difference was found for GI and BI. One of the three comparisons showed a statistically significant PI score favouring NaOCl-MW. One study measured PPD and found it to be significant in favour of NaOCl-MW.

Conclusions: Studies with a negative control group provided very weak quality evidence for a very small beneficial effect of NaOCl-MW on PI, GI and BI scores. Studies with a positive control group provided very weak quality evidence that NaOCl-MW had a similar effect as CHX-MW on PI, GI and BI scores. The outcome for PPD was inconclusive.

Keywords: dental plaque; mouthwashes; periodontal health; sodium hypochlorite; systematic review.

Publication types

  • Review
  • Systematic Review

MeSH terms

  • Chlorhexidine / therapeutic use
  • Dental Plaque* / drug therapy
  • Dental Plaque* / prevention & control
  • Gingivitis* / drug therapy
  • Gingivitis* / prevention & control
  • Humans
  • Mouthwashes
  • Periodontal Diseases* / drug therapy
  • Periodontal Diseases* / prevention & control
  • Sodium Hypochlorite

Substances

  • Mouthwashes
  • Sodium Hypochlorite
  • Chlorhexidine