Microbiological and clinical comparison of two oral hygiene regimens

Objective: This examiner-blinded, randomized clinical study compared two oral hygiene regimens - brushing with a commercially-available fluoride toothpaste plus rinsing with a 0.075% cetylpyridinium chloride and fluoride mouthwash versus brushing alone. 

Materials and Methods: Sixty-eight subjects (20-64 years old) with a mean Loe-Silness Gingival Index (GI) >1 and a modified Quigley Hein Plaque Index (PI)> 1.5, completed a one-week washout using a fluoride toothpaste.  For 12-hours prior to baseline examinations, subjects abstained from eating, drinking and oral hygiene. Supragingival plaque was collected for anaerobic culture. Whole mouth assessments were made for GI, PI, gingival bleeding, and probing depths.  Subjects were randomly assigned to either; (1) a test group that brushed with the fluoride toothpaste and rinsed with the 0.075% CPC-fluoride mouthwash twice daily, or (2) a control group that brushed with the fluoride toothpaste twice daily. Microbiological and clinical evaluations were made at 2-weeks and 4-weeks as at baseline. Results:  Compared to baseline, the test group demonstrated significant reductions in anaerobic bacteria at the 2-week and 4-week evaluations of 70.5% and 94.6%, respectively, (p<0.05).  Compared to baseline, the control group also demonstrated significant reductions in anaerobic bacteria at the 2-week and 4–week evaluations of 2.28% and 2.3%, respectively, (p<0.05). Compared to the control group, the test group demonstrated significant reductions in anaerobic bacteria of 55.3% and 91.9% at the 2-week and 4-week evaluations, respectively (p<0.05).  Compared to the control group, the test group exhibited significant reductions at the 4-week evaluation of 19.6%, 11.2%, 42.5%, and 13.2% in gingival inflammation, dental plaque, gingival bleeding, and probing depths, respectively (p<0.05).   

Conclusions:  Twice daily toothbrushing with a fluoride toothpaste and rinsing with a 0.075% cetylpyridinium chloride and fluoride mouthwash was significantly more effective in improving gingival health and reducing numbers of anaerobic plaque bacteria than twice daily toothbrushing alone.