The other active system recommended by the FDA Dental Plaque Subcommittee as safe and effective for an over-the-counter antiplaque/antigingivitis rinse is essential oils (Listerine®, Johnson & Johnson).7 The specific formulation that has been approved combines 0.092% eucalyptol, 0.042% menthol, 0.06% methyl salicylate, and 0.064% thymol in a hydroalcoholic vehicle containing 21.6% to 26.9% alcohol.26 Essential oils rinses work by disrupting the bacterial cell wall and inhibiting the cell’s enzymatic activity.
The efficacy of essential oils for antiplaque and antigingivitis activity has been well-documented in the literature.27-31 Long-term trials, including those involving flossing and rinsing, have shown reductions in gingivitis from 12% to 30% and plaque reductions from 21% to 56% when compared to a placebo. The safety of rinses containing essential oils is also well-established.27-31 The burning associated with the alcohol in the formula may be difficult for some patients to tolerate32 which could affect compliance. Light extrinsic staining, a potential occurrence with use of antimicrobial rinses, has also been reported in clinical research.27
