Role of Chlorhexidine and Herbal Oral Rinses in Managing Periodontitis

Marwa Y Shaheen; Abeer S Al-Zawawi; Darshan Devang Divakar; Hajer A Aldulaijan; Amani M Basudan

doi:10.1016/j.identj.2022.06.027

Role of Chlorhexidine and Herbal Oral Rinses in Managing Periodontitis

Int Dent J. 2023 Apr;73(2):235-242. doi: 10.1016/j.identj.2022.06.027. Epub 2022 Jul 28.

Authors

Marwa Y Shaheen¹, Abeer S Al-Zawawi², Darshan Devang Divakar³, Hajer A Aldulaijan², Amani M Basudan²

Affiliations

¹ Department of Periodontics and Community Dentistry, College of Dentistry, King Saud University, Riyadh, Saudi Arabia. Electronic address: mashaheen@ksu.edu.sa.
² Department of Periodontics and Community Dentistry, College of Dentistry, King Saud University, Riyadh, Saudi Arabia.
³ Department of Oral Medicine and Radiology, Sharavathi Dental College and Hospital, Shivamogga, Karnataka, India; Department of Oral Medicine and Radiology, Faculty of Dentistry, Levy Mwanawasa Medical University, Ministry of Health, Lusaka, Zambia.

Abstract

Objective: The aim of this research was to assess the effect of 0.12% chlorhexidine (CHX) and a Salvadora persica-based mouthwash on whole salivary tumour necrosis factor-alpha (TNF-α) levels and periodontal inflammation in patients with type 2 diabetes mellitus (T2DM).

Methods: Patients with and without medically diagnosed T2DM were included. Patients' medical records were evaluated to confirm the diagnosis of T2DM. All patients underwent nonsurgical periodontal therapy (NSPT). Patients were divided into 2 subgroups. In the test and control group, patients were advised to rinse with an S persica-based mouthwash and a non-alcoholic 0.12% CHX after NSPT twice daily for 2 weeks, respectively. Demographic data were collected. Full-mouth plaque index (PI), gingival index (GI), probing depth (PD), and clinical attachment loss (AL) were measured, and whole salivary TNF-α levels were gauged at baseline and at 3-month follow-up. Haemoglobin A1c (HbA1c) levels were measured in all patients at baseline and at 3-month follow-up. Sample size estimation was done, and group comparison was performed. Level of significance was set at P < .01.

Results: Twenty-one nondiabetic individuals and 21 patients with T2DM were included. At baseline, there was no significant difference in clinical and radiographic periodontal parameters amongst in patients with and without T2DM. At 3-month follow-up, HbA1c, TNF-α, PI, PD, and clinical AL were comparable with their respective baseline values in the test and control groups amongst patients with T2DM. In nondiabetic individuals, there was a significant reduction in PI (P < .01), GI (P < .01), and PD (P < .01), and TNF-α (P < .01) at 3-month follow-up in the test and control groups compared with their respective baseline scores.

Conclusions: In the short term, NSPT with 0.12% CHX or S persica-based mouthwashes is more effective in reducing periodontal inflammation and whole salivary TNF-α levels in nondiabetic individuals than in patients with T2DM with periodontal inflammation.

Keywords: Chlorhexidine; Diabetes mellitus; Nonsurgical periodontal therapy; Periodontal inflammation; Salvadora persica.

MeSH terms

Chlorhexidine / therapeutic use
Diabetes Mellitus, Type 2*
Glycated Hemoglobin
Humans
Inflammation / drug therapy
Mouthwashes / therapeutic use
Periodontitis*
Tumor Necrosis Factor-alpha

Substances

Chlorhexidine
Mouthwashes
Glycated Hemoglobin
Tumor Necrosis Factor-alpha