The effects of hydrogen peroxide mouthwashes on the prevention of plaque and gingival inflammation: a systematic review

Objectives: The purpose of this review was to describe systematically the effects of hydrogen peroxide mouthwashes as an adjunct to daily oral hygiene or as a mono-therapy in the prevention of plaque accumulation and gingival inflammation. Materials and methods: PubMed-MEDLINE and the Cochrane-CENTRAL were searched up to December 2009 to identify appropriate papers. The primary outcome measures included plaque accumulation and parameters of gingivitis. Results: Independent screening of titles and abstracts of 229 articles resulted in 10 publications that met the criteria for eligibility. Descriptive comparisons are presented for hydrogen peroxide mouthwash as compared with control mouthwashes or no oral hygiene. Mean values and standard deviations were obtained by data extraction. Based on a quality assessment, three studies, of which one evaluated H2O2 over a period of 6 months, were considered to represent a low risk of bias. This 6-month study showed a positive effect of the use of H2O2 on the modified gingival index. Conclusions: The results of the studies included in this review showed that H2O2 mouthwashes do not consistently prevent plaque accumulation when used as a short-term mono-therapy. When used as a long-term adjunct to daily oral hygiene, the results of one study indicate that oxygenating mouthwashes reduce gingival redness.