Effectiveness of Antimicrobial Sprays for Institutionalized Elders’ Oral Health

Objectives: To compare the effectiveness of daily use of antimicrobial sprays versus a placebo spray in reducing dental plaque and gingival bleeding among institutionalized elders.
Methods: A total of 217 elders were block randomized to receive 1) chlorhexidine spray (0.2%, daily), 2) chlorine dioxide spray (0.1%, daily), or 3) sterile water spray (placebo, daily) as part of an oral health promotion intervention. Dental plaque was assessed by the Silness and Löe Plaque Index - PI (1964) and gingival bleeding was assessed by the Ainamo and Bay Gingival Bleeding Index - GBI (1975) at baseline and 3-months.
Results: The response rate among those with mild/moderate cognitive impairment was 79% (n=132). There were significant changes in the dental plaque index scores among those who received the chlorhexidine spray daily (p<0.001) and among those who received the chlorine dioxide spray daily (<0.05); but not among those who received the placebo spray (p>0.05). Changes in dental plaque index scores were significantly greater among those who received the chlorhexidine spray daily compared to those who received the chlorine dioxide spray or placebo spray daily (p<0.05). There were significant changes in the gingival bleeding scores among those who received the chlorhexidine spray daily (p<0.001), chlorine dioxide spray daily (p<0.01), and the placebo spray daily (p<0.01). Changes in gingival bleeding scores were significantly greater among those who received the chlorhexidine spray daily compared to those who received chlorine dioxide spray or placebo spray daily (p<0.05).
Conclusions: Daily use of antimicrobial sprays among institutionalised elders are effective in reducing dental plaque and gingival bleeding in a 3-month clinical trial. Chlorhexidine spray (0.2%, daily) is more effective than a chlorine dioxide spray (0.1%, daily).