Stain, plaque and gingivitis reduction by combining chlorhexidine and peroxyborate

Background: Previous studies have shown that using an oxidising agent in addition to chlorhexidine reduces staining. Aim:The purpose of the present study was to investigate whether, compared to chlorhexidine alone, the use of an oxidising mouthrinse as an adjunct to chlorhexidine is efficacious in reducing stain, plaque and gingivitis. Method: This study had a single-blind, 2-group parallel design, including a 14-day experimental non-brushing period during which 1 group (n=14) used chlorhexidine alone (CHX) (chlorhexidine mouthrinse, 0.12% Oral-B(R) laboratories, Ireland), and the other (n=14) used chlorhexidine in combination with an oxidising agent (sodiumperborate-monohydrate-Bocasan(R), Oral-B laboratories, Ireland). Patients were randomly assigned to either group. All participants received a scaling and polishing before the start of the trial. No oral hygiene instructions were given. Since, at the start of the experiment, all stain and plaque were removed, only the gingival condition was evaluated at baseline by means of bleeding on marginal probing. The examination after 14 days of rinsing included the evaluation of plaque, bleeding on marginal probing and stain (GMSI: gingival modification of the stain index). Results: The results showed at day 14, a significant difference between the 2 groups for plaque (CHX: 0.18, CHX+PER: 0.08, p=0.03) and gingival bleeding (CHX: 0.38, CHX+PER: 0.21, p<0.001). The proportion of stained surfaces was less in the CHX+PER group (28%), than in the chlorhexidine group (48%) (p=0.04). Conclusions: In conclusion, the adjunctive use of an oxidising agent peroxyborate to chlorhexidine, proved to be superior to chlorhexidine alone with regard to the inhibition of plaque and development of gingivitis, In addition, the proportion of stained surfaces was significantly less when adding the oxidising mouthrinse to chlorhexidine.