Effects of Peroxide-Based Mouth Rinses on Oral Cells

Objectives: In the wake of the COVID-19 pandemic, the use of peroxide-based mouth rinses increased. This was primarily due to the belief that these mouth rinses provided greater anti-viral capabilities compared to essential oil or chlorhexidine-based mouth rinses. Despite this, little is known of the effects of these peroxide-based mouth rinses on the cells of the oral mucosa. The purpose of this study was to examine the effects of these peroxide-based mouth rinses on periodontal cells.
Methods: The mouth rinses examined were: Peroxyl®, Prevention™, Essential Oxygen™, Rincinol®, hydrogen peroxide (3% H₂O₂) and Peridex™ (chlorohexidine-based). Gingival fibroblasts were treated for 3 minutes with dilutions of various peroxide containing mouth rinses. Cell survival was assessed fluorometrically using Calcein-AM, and cell proliferation using Cyquant. Cell motility was assessed using a scrape assay.
Results: Dilutions as low as 1% of Peroxyl®, Essential Oxygen™ and hydrogen peroxide (0.03% final concentration) were significantly more cytotoxic than Peridex™, Rincinol®, and Prevention™ (at dilutions of 15%). Sub-lethal doses of hydrogen peroxide and Peroxyl® also inhibited cell proliferation and cell motility more than other mouth rinses.
Conclusions: Based on these results, Hydrogen peroxide alone inhibited cell proliferation and motility. This study provides evidence that peroxide-based mouth rinses may impede periodontal and gingival healing more than the traditionally prescribed mouth rinses. Thus, peroxide-based mouth rinses should be recommended with caution for patients in which oral mucosal healing is desired.