Advances in Dental Research, Vol 8, 291-301, Copyright © 1994 by International & American Associations for Dental Research
Mouthrinses
D. Adams and M. Addy
Department of Basic Dental Science, Dental School, Cardiff, Wales.
Mouthrinses have been used for centuries for medicinal and cosmetic
purposes, but it is only in recent years that the rationale behind the use
of the ingredients has been subject to scientific research and clinical
trials. Although Listerine held its position for many years in the vanguard
of the anti-plaque agents, the advent of mouthrinses containing
chlorhexidine was a major breakthrough in the research for a chemical means
to prevent disease. Since that time, and especially in the past ten years,
the number of formulations that claim to have anti-plaque, anti-calculus,
and anti-caries activity has increased, and much emphasis has been placed
on such substances as an adjunct to, or indeed to replace, conventional
toothbrushing techniques. This review covers the literature on mouthrinses
over the past five years, concentrating more on the anti-plaque,
anti-gingivitis, and anti-calculus formulations. In the first section, the
methods of conducting clinical trials of mouthrinses are discussed, and a
plea is made for a greater degree of standardization of methodology with
agreed acceptable levels of clinical benefit. Trials of established
mouthrinses are considered, and the advantages and disadvantages of several
newer formulations discussed. From the review, it appears that
chlorhexidine has no equal in its effects on reduction of plaque and
gingivitis, but major drawbacks lie in the taste and stain-producing
problems. The pre-brushing rinse, Plax, does not have unqualified success
in all trials, though the more recent European formulation may have
promise. Newer rinses which inhibit bacterial adhesion to tooth surfaces
also appear promising, and it is suggested that more work on combinations
of active ingredients is necessary.
