Mouthrinses

Mouthrinses containing essential oils, cetylpyridinium chloride, stannous fluoride, and 0.12% chlorhexidine have demonstrated efficacy in reducing biofilm, signs of gingival inflammation and gingival bleeding when used as an adjunct to toothbrushing.105,106 Cetylpyridinium chloride mouthrinses demonstrated wider variability in their efficacy, depending upon the formulation of the mouthrinse.88,106 Furthermore, the use of fluoride mouthrinses as an adjunct to brushing and flossing for reduction of caries in children is well established.107

Despite these benefits, we cannot conclude that mouthrinses are a replacement for proper interdental cleaning. While some studies demonstrate no statistically significant difference in gingivitis and plaque reduction when compared to floss,108 it is important to note these studies were limited to patients without active caries and/or periodontal attachment loss. For patients who have experienced periodontal bone loss and/or who have significant interproximal restorations, these findings may not apply. Nevertheless, patient acceptance of mouthrinses is significantly higher than floss and thus may provide a reasonable adjunct to toothbrushing and interdental aids in the control of plaque and gingivitis in healthy patients.