Breath and Plaque Prevention with Cetylpyridinium Chloride Rinses: Clinical Meta-Analysis

Method: Subjects from two 4-day crossover clinical trials were included in the pooled analysis.  In each study, general subjects with evidence of plaque accumulation received a dental prophylaxis and then were assigned two cetylpyridinium chloride (CPC) rinses for use over a 4-day period.  Subjects received either a 0.07% CPC rinse (Crest® ProHealth™) or 0.10% CPC rinse with 1.5% hydrogen peroxide (Crest ProHealth Clinical) in blinded rinse bottles, along with a regular anticavity paste and brush.  Efficacy was measured at the end of each period as volatile sulfur compounds (VSC) in exhaled overnight breath measured via Halimeter, and disclosed plaque scored clinically using the Modified Quigley Hein Index (MQH).   Treatment comparisons were made using analysis of covariance models with baseline as the covariate. 

Result: The inclusive meta-analysis had 56 subjects, with mean (SD) age of 40.8 (8.0) years.  Baseline means (SD) were 150.8 (89.1) for VSC and 1.93 (0.43) for MQH.  For breath, Day 4 VSC means were 111.1 in the 0.07% CPC group and 60.5 in the 0.10% CPC + 1.5% H2O2 group, with treatments differing significantly (p<0.0001).  For plaque, Day 4 MQH means were 1.01 in the 0.07% CPC group and 0.69 in the 0.10% CPC + 1.5% H2O2 group, with treatments differing significantly (p<0.0001).

Conclusion: An inclusive meta-analysis of breath and plaque responses showed significant 30%+ concurrent reductions in breath and plaque with a higher cetylpyridinium chloride plus hydrogen peroxide rinse when used after dental prophylaxis versus control.