Effects of Rinsing with a Chlorhexidine Mouthwash on Oral PMN

Objectives: Chlorhexidine [CHX] represents a widely evaluated agent with application in the dental clinic. This two-week clinical study examined the effects of rinsing with mouthwashes formulated with chlorhexidine [CHX] or another with fluoride on oral polymorphonuclear leukocytes [PMN] representing a novel measure of inflammation. Additionally, the study determined clinical indices for dental plaque and gingivitis.
Methods: Adults who provided informed consent, met study criteria and registered gingival index scores of 1.0 or more at the screening visit were enrolled. Subjects [n=90; age range 19-58 years] completed a washout phase with a commercially available fluoride toothpaste prior to baseline evaluations for PMN and clinical assessments for dental plaque and gingivitis. Treatments [CHX or fluoride mouthwash] were randomly assigned to subjects for twice-daily use for the next two weeks. Post-treatment assessments similar to baseline were conducted after one and two week use of assigned treatment.
Results: At baseline, statistical analyses demonstrated no statistically significant differences treatment groups for PMN nor clinical indices for dental plaque or gingivitis. At all post-treatment evaluations, rinsing with CHX demonstrated statistically significant reductions for PMN and dental plaque, gingivitis in comparison to the fluoride group. After one and two week use of CHX, results demonstrated a 35.9% and 54.9% reduction respectively for PMN in comparison to the fluoride group representing statistically significant differences [p<0.05]. At the one and two week post-treatment evaluations, rinsing with CHX demonstrated 15% and 25% reductions in gingivitis respectively and were significantly different from the control group [p<0.05]. Rinsing with CHX also demonstrated significant reductions in dental plaque of 14% and 17.8% at the one and two-week post-treatment evaluations respectively in comparison to the fluoride group [p<0.05].
Conclusions: These results demonstrate the large and sustained reductions in oral PMN after use of CHX with these outcomes greater than conventional clinical indices for gingivitis.