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; Junyu Chen; Nirmala K Panagodage Perera; Xing Liang

doi:10.1155/2020/2829854

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

Evid Based Complement Alternat Med. 2020 Jan 20:2020:2829854. doi: 10.1155/2020/2829854. eCollection 2020.

Authors

He Cai^{1

2

3}, Junyu Chen^{1

2

4}, Nirmala K Panagodage Perera^{3

5}, Xing Liang^{1

2}

Affiliations

¹ State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, No. 14, Section 3, South Renmin Road, Chengdu 610041, China.
² Department of Prosthodontics, West China Hospital of Stomatology, Sichuan University, No. 14, Section 3, South Renmin Road, Chengdu 610041, China.
³ Department of Orthopaedics, Rheumatology, and Musculoskeletal Sciences, Centre for Sport, Exercise and Osteoarthritis Research Versus Arthritis, University of Oxford, Windmill Road, Oxford OX3 7LD, UK.
⁴ Kennedy Institute of Rheumatology, University of Oxford, Roosevelt Drive, Oxford OX3 7FY, UK.
⁵ La Trobe Sports and Exercise Medicine Research Centre, College of Science, Health and Engineering, La Trobe University, Bundoora, VIC 3086, Australia.

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).

Publication types

Review