An online national survey conducted March 2015 on behalf of the American Academy of Periodontology (AAP) has uncovered that adult Americans require a great deal of improvement in their dental education regarding gingivitis. Gingivitis has been reported affecting one in every two adults 30 years and older. These findings are not surprising since additional survey results indicate 36% of adults prefer to perform unpleasant activities such as washing dishes or sitting in gridlock traffic versus daily flossing.1 Suboptimal plaque control is not only detrimental for our patients’ oral health, but prolonged oral inflammation may also affect their overall health status.3-5
Mechanical hygiene — specifically brushing and flossing has been updated to include therapeutic mouthrinses for bacterial control and are the first line of defense against plaque biofilm accumulation. However, a large proportion of patients continue to fall short of desired oral hygiene.2 Use of chemotherapeutic antiplaque/antigingivitis formulations in addition to mechanical hygiene can serve as an effective and successful adjunct to patients’ daily hygiene routine. Recently, there has been a dramatic increase in the number of rinses, including new flavors and formulations, offering patients more options to address prevention of biofilm accumulation and meet their unique needs and preferences. The expansion of rinses also increases the need for dental professionals to be familiar with their modes of administration, mechanisms of action, and clinical effectiveness to ensure successful outcomes.
Three common therapeutic agents have been clinically proven to produce significant gingival and plaque control benefits when formulated at specific therapeutic concentrations: chlorhexidine; cetylpyridinium chloride (CPC); and essential oils.6,7 The latter two active ingredients are the only two the US Food and Drug Administration (FDA) Dental Plaque Subcommittee of the Nonprescription Drugs Advisory Committee recommended to be classified as safe and effective for use in over-the-counter mouthrinses to treat plaque-induced gingivitis.7 This course reviews the clinical evidence behind each agent and discusses practical implications of incorporating rinses into patients’ daily routine.