EFFECTIVENESS OF DIFFERENT ANTIMICROBIAL MOUTHWASHES ON THE MANAGEMENT OF HALITOSIS IN PATIENTS WITH PERIODONTAL DISEASE
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Keywords
Antimicrobial mouthwashes, cetylpyridinium chloride, chlorhexidine, essential oils, halitosis, periodontal disease, volatile sulfur compounds
Abstract
Background: Halitosis is a common condition that often coexists with periodontal disease and significantly impacts patients’ quality of life. Antimicrobial mouthwashes are commonly recommended to manage oral malodor, yet their comparative effectiveness in reducing volatile sulfur compounds (VSCs) and improving periodontal health is not fully established.
Objective: This study aimed to evaluate the effectiveness of different antimicrobial mouthwashes—chlorhexidine, cetylpyridinium chloride (CPC), and essential oils—compared to a placebo in reducing halitosis and improving periodontal health in patients with periodontal disease.
Methodology: This randomized controlled trial was conducted at Islam Medical and Dental College Sialkot from April 2021 to September 2021. Total 125 patients diagnosed with moderate to severe periodontitis and halitosis. Participants were randomly assigned to one of four groups: 0.12% chlorhexidine, 0.07% CPC, essential oils-based mouthwash, or placebo (saline solution). Participants used the mouthwash twice daily after brushing. Primary outcomes were reductions in VSC levels, measured with a halimeter, and organoleptic scores assessed by calibrated examiners. Secondary outcomes included improvements in probing depth, clinical attachment level, and bleeding on probing. Data were analyzed using repeated measures ANOVA, and a p-value of <0.05 was considered statistically significant.
Results: At six months, significant reductions in VSC levels were observed in the CPC (57.1%) and essential oils (54.3%) groups compared to the chlorhexidine (48.6%) and placebo (14.3%) groups (p < 0.001). Organoleptic scores improved significantly in the CPC (1.3 ± 0.5) and essential oils (1.4 ± 0.7) groups (p < 0.01). The CPC group showed the greatest improvement in probing depth and clinical attachment level, with minimal adverse effects.
Conclusion: CPC and essential oils mouthwashes demonstrated superior efficacy in reducing halitosis and improving periodontal health compared to chlorhexidine and placebo, with minimal adverse effects.
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Yousaf Athar
BDS, MSC, PhD, Associate professor Department of periodontics, IOD, CMHLMC
Aamina Sagheer
BDS , MSc, Associate professor Department of periodontics Islam medical and dental college,
Atiq Ur Rehman
Assistant Professor Department of Prosthodontics Institute of Dentistry, CMH Lahore Medical College, Lahore, Pakistan National University of Medical Sciences, Rawalpindi, Pakistan
Muhammad Anwaar Alam
Associate Professor Department of Oral Biology Azra Naheed Dental College, The Superior university Raiwind Road Lahore
Ali Anwaar
Associate Professor Department of Community & Preventive Dentistry Institute of Dentistry, CMH Lahore Medical College, Lahore, Pakistan National University of Medical Sciences, Rawalpindi, Pakistan
Fareed Ahmad
Associate Professor Department of Oral Medicine Institute of Dentistry, CMH Lahore Medical College, Lahore, Pakistan National University of Medical Sciences, Rawalpindi, Pakistan