Comparison of antiplaque and anti‐gingivitis effects of aloe vera mouthwash with chlorhexidine in fixed orthodontic patients—A randomized controlled trial

Abstract

Background In daily dental practice, plaque‐induced gingivitis is one of the most common periodontal diseases that is frequently encountered. Accumulation of microbial biofilms on surfaces of teeth and poor or inadequate oral hygiene is the chief predisposing factor for this condition. In such a state, antimicrobial mouthwash as an adjunct to mechanical plaque control helps in maintaining good oral hygiene. Among the many conditions, fixed orthodontic treatment is one of the conditions where plaque control becomes challenging to the patient as well as the dentist. In such a situation, antimicrobial mouthwash as an adjunct to mechanical plaque control is highly recommended. Dentistry has recently evidenced a shift of approach for treating many inflammatory oral diseases by using herbal treatment modalities. Aloe vera is one such product exhibiting multiple benefits and has gained considerable importance in clinical research recently. The present study aimed to evaluate efficacy of aloe vera mouth rinse on the dental plaque and gingivitis in patients who were undergoing fixed orthodontic treatment in comparison with 0.2% chlorhexidine mouthwash. Material and Method This randomized controlled trial was conducted on 30 subjects with fixed orthodontic treatment. The subjects were grouped in the test group (15 subjects with 10 ml aloe vera mouthwash (99.6% [w/v])) and the control group (15 subjects with 0.2% 10 ml chlorhexidine mouthwash). Plaque index, gingival index and bleeding on probing were recorded for each participant at baseline, 21 days from baseline and 35 days from baseline. The findings were then statistically analysed using student paired and unpaired t‐test. Results Gingival index showed a statistically significant difference from baseline to 21 days and 35 days visit in both the groups. Plaque index and bleeding on probing were statistically significant among both groups when compared baseline to 21 days and 35 days visit, but the difference was not significant between visit 2 and visit 3. Conclusions Although chlorhexidine is still the gold standard mouthwash, aloe vera exhibits promising results in reducing plaque and gingivitis scores, without any reported adverse effects. Larger multi‐centric trials are needed to prove its effectiveness on dental plaque‐induced gingivitis.

Evaluating the Therapeutic Properties of Natural Products in Orthodontic and Surgical Treatment of Dentofacial Deformities: A Systematic Review of Clinical Trials

“…The systematic review included a total of nine studies [ 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 ], as summarized in Table 1 . These studies were conducted in various countries, including Spain [ 21 , 23 ], the United States [ 22 ], India [ 24 , 27 ], Brazil [ 25 , 26 ], Egypt [ 28 ], and Iran [ 29 ], over a period spanning from 2014 to 2022. Each study employed a randomized clinical trial design, focusing on evaluating the therapeutic properties of natural products in orthodontic treatment.…”

“…The quality assessment of these studies revealed a mix of medium and high ratings. Specifically, five studies [ 21 , 24 , 25 , 26 , 28 ] were rated as medium quality, indicating satisfactory adherence to standard research methodologies but potentially possessing some limitations in study design or execution. In contrast, four studies [ 22 , 23 , 27 , 29 ] received high-quality ratings, suggesting a robust study design, comprehensive methodology, and reliable results that adhere closely to the highest standards of clinical research.…”

“…The age of participants varied widely across the studies. López-Mateos et al [ 21 ] and Kamath et al [ 24 ] reported older intervention groups with mean ages of 32.2 years and 22.5 years, respectively, contrasting sharply with the predominantly adolescent cohorts in studies by Furtado Júnior et al [ 25 ] and Atwa et al [ 28 ], who reported age ranges of 12–16 years and 12–18 years, respectively. The broadest age range was observed in the study by Goes et al [ 26 ], where participants ranged from 10 to 40 years, with a mean age of 28.8 years, illustrating the inclusion of both adolescent and adult orthodontic patients.…”

“…The gender distribution also showed considerable variability. The studies by López-Mateos et al [ 21 ] and Kamath et al [ 24 ] demonstrated a higher female participation in the intervention groups, with 85.4% and 60.0%, respectively, reflecting a common trend in orthodontic studies where females often represent a larger proportion of the sample. In contrast, studies by Martin et al [ 22 ] and Yeturu et al [ 27 ] maintained a balanced gender ratio, each with an even 50% distribution, indicating a deliberate design to eliminate gender as a confounding factor.…”

Exploring the efficacy of in-vitro low-temperature plasma treatment on single and multispecies dental cariogenic biofilms

“…Using 0.12% chlorhexidine as a positive control was based on knowing that chlorhexidine is a goldstandard chemical substance with an antibacterial action against gram-positive and gram-negative bacteria [45]. In this study, treatment with 0.12% chlorhexidine reduced C. albicans, L. casei, and S. mutans log 10 CFU/mL amount according to the exposure.…”