Anti-inflammatory potential of an essential oil-containing mouthwash in elderly subjects enrolled in supportive periodontal therapy: a 6-week randomised controlled clinical trial

Abstract

Objectives Essential oils and other plant extracts have evoked interest as sources of natural medicinal products. They have been proven to exert antibacterial, antifungal, antiviral and antioxidant properties, but the mechanism of action has not been fully elucidated. Aim This study aims to evaluate the potential of a sage-containing mouthwash to alleviate inflammatory signs of intra-oral mucosa and gingiva in comparison with a water/alcohol-based placebo. Material and methods This study was conducted as a randomised, placebo-controlled, double-blind, parallel design clinical study. Forty-eight dentate subjects were randomly assigned to a test (sage-containing mouthwash) or a placebo group (water/ alcohol-based solution). Subjects rinsed once daily for 30 s over a period of 6 weeks. Sulcus Bleeding Index (SBI), Plaque Index (PLI), tooth staining, xerostomia and degree of stomatitis were assessed at baseline and after 6 weeks. Results Subjects' mean age was 77.5 ± 7.3 years. SBI was reduced from 1.3 ± 0.9 to 0.8 ± 0.7 (test, p = 0.0029) and 1.4 ± 0.9 to 1.1 ± 0.7 (placebo, p = 0.0105). Similarly, PLI was reduced from 1.2 ± 0.5 to 1.0 ± 0.3 (test, p = 0.0080) and 1.3 ± 0.4 to 1.1 ± 0.6 (placebo, p = 0.0087); no between-group differences were found (p > 0.05). Stomatitis, xerostomia and tooth staining revealed no change after 6 weeks. Conclusion The irrigation with a sage-containing mouthwash did not result in a superior beneficial effect on inflammatory parameters and plaque indices compared with the placebo. The expected contribution of the plant extracts to their potential impact on oral health may need further investigation. Clinical relevance The proposed mouthwash might be suitable for patients with inflammatory signs of the gingiva who prefer natural remedies.

Can Plant Materials Be Valuable in the Treatment of Periodontal Diseases? Practical Review

“…Use of S. sclarea extracts significantly inhibits the inflammatory process by lowering IL-1β, IL-6 and TNF-α levels, reducing gingival tissue changes, and preserving alveolar bone resorption in lipopolysaccharide-induced periodontitis in rats [43]. A randomized, placebo-controlled, double-blind did not confirm the superior beneficial effect of the mouthwash with S. officinalis on inflammatory parameters and plaque indices compared with the placebo after 6 weeks [44]. On the other hand, S. officinalis gel has a potential anti-inflammatory role in the management of chronic periodontitis.…”

Comparison between 3 Different Types of Mouthwash on the Healing Process of Periodontal Diseases

“…The role of bacterial plaques was demonstrated by dental caries aetiology and by periodontal diseases. The mechanical methods of plaque inhibition are limited; this problem is proposed to chemical methods for plaque inhibition (6) . Therefore, the utilisation of mouth washing as disinfectants can help mechanically reduce plaques.…”

Comparison Between 3 Different Types of Mouthwash on the Healing Process of Periodontal Diseases

“…The mechanical methods of plaque inhibition are limited; this problem is proposed to chemical methods for plaque inhibition (6) . Therefore, the utilisation of mouth washing as disinfectants can help mechanically reduce plaques.…”

“…Various bacterial and fungal communities integrated into a highly specialised extracellular matrix are present in oral biofilms. The decrease in oral biofilm accumulation (dental plates) and the control/reduction of dental disease risks are essential for good oral care practices (6) . The primary effect of Mouth rinses on the supragingival and marginal plaque is limited due to tight gingival contact with the tooth in healthy persons (7) .…”