Effect of different chlorhexidine formulations in mouthrinses on de novo plaque formation

Background: Chlorhexidine (CHX) 0.2% solution, still the golden standard as mouthrinse for the prevention of plaque formation and development of gingivitis, has some limited side-effects such as extrinsic tooth staining, poor taste, taste disturbance, sensitivity changes in tongue, pain, and the content of alcohol. These side effects led to the search of new formulations. Methods: In this double-blind, randomised, cross-over study, 16 young dental students with a healthy periodontium, abolished all means of mechanical plaque control during 4 experimental periods of 11 days (separated from each other by a washout period of 3 weeks). During each experimental period, they rinsed 2X daily with one of the following mouthrinses in a randomised order: CHX 0.2% + alcohol (Corsodyl((R))), CHX 0.12% + alcohol (Perio.Aid((R))), CHX 0.12% + sodium fluoride 0.05% (Cariax Gingival((R))) and CHX 0.12% + CPC 0.05% (Perio.Aid((R)), new formulation). After 7 and 11 days of undisturbed plaque formation, clinical parameters were recorded, questionnaires completed and plaque samples (supragingivally and saliva) collected. Results: The CHX 0.12% + alcohol and the CHX 0.12% + CPC 0.05% formulations were as efficient as the CHX 0.2% mouthrinse in retarding de novo plaque formation (proven by clinical observations as well as by anaerobic and aerobic culture data), and always superior (p <0.001) to the CHX 0.12% + sodium fluoride 0.05% solution. The subjective ratings were in favour of the new CHX formulation when compared with the other CHX formulations, especially for taste (p <0.05). Conclusions: The results of this study demonstrated the potential of a new CHX 0.12% + CPC 0.05% non-alcoholic formulation as an effective anti-plaque and anti-inflammatory agent with reduced unpleasant subjective side-effects.