Effects of 0.05% sodium hypochlorite oral rinse on supragingival biofilm and gingival inflammation

Objectives: This study aimed to evaluate the clinical effects of 0.05% sodium hypochlorite mouth rinse on supragingival biofilm and gingival inflammation. Methods: The study was performed as a controlled, randomised, investigator-blinded, parallel group trial in 40 prison inmates. Following a preparatory period to obtain a plaque- and gingivitis-free dentition, tooth-brushing was substituted for 21 days by supervised twice daily rinsing with either 15 ml of fresh solution 0.05% sodium hypochlorite or 15 ml of distilled water. Clinical outcomes were assessed using the QuigleyHein Plaque Index (QHPI), the Loe and Silness Gingival Index (L&SGI) and bleeding on probing. Adverse events were evaluated by questionnaire, visual examination and clinical photographs. Results: At day 21, the average QHPI score had increased to 3.82 in the water rinse group and 1.98 in the sodium hypochlorite rinse group. The average L&SGI score had increased to 2.1 in the water rinse group and 1.0 in the sodium hypochlorite rinse group, and the average percentage of sites that bled on probing had increased to 93.1% in the water rinse group and 56.7% in the sodium hypochlorite rinse group. Differences were statistically significant (P = 0.001). A brown extrinsic tooth stain along the gingival margin appeared in 100% of participants in the sodium hypochlorite rinse group and in 35.0% of participants in the water rinse group (P < 0.05). Conclusions: An oral rinse with 0.05% sodium hypochlorite resulted in significant reductions in supragingival biofilm accumulation and gingival inflammation. Dilute sodium hypochlorite may represent an efficacious, safe and affordable antimicrobial agent in the prevention and treatment of periodontal disease.