Effects of Chlorine Dioxide on Oral Hygiene - A Systematic Review and Meta-analysis

Abstract

Background: Effective and selective oral rinses are required in the daily medical and dental practice. Currently used mouthwashes have substantial side effects. Objectives: Our aim was to evaluate the efficacy of chlorine dioxide-containing mouthwashes in comparison with other previously established mouth rinses in healthy adults using oral hygiene indices. Methods: This work was registered in PROSPERO (CRD42018099059) and carried out using multiple databases and reported according to the PRISMA statement. The following search terms were used “chlorine dioxide” AND “oral”, only randomised controlled trials (RCTs) were included. The primary outcome was the alteration of the plaque index (PI), while the secondary outcomes were the gingival index (GI) and bacterial counts. For the risk of bias assessment, the Cochrane Risk of Bias Tool was used. Statistical analysis for data heterogeneity was performed by Q-value and I2 -tests. Results: 364 articles were found in the databases. After the selection process, only five RCTs were eligible for meta-analysis. Data heterogeneity was low. There were no statistical differences in effectiveness between chlorine dioxide and the other effective mouth rinses in PI (0.720±0.119 vs 0.745±0.131; 95%; confidence intervals (CIs): 0.487–0.952 vs 0.489– 1.001, respectively) and GI (0.712±0.130 vs 0.745±0.131; 95% CIs: 0.457–0.967 vs 0.489– 1.001, respectively) and also in bacterial counts. Conclusion: Chlorine dioxide reduces both plaque and gingival indices and bacterial counts in the oral cavity similar to other routinely used oral rinses, however, the evidence supporting this is very limited. Therefore, further large scale RCTs are needed to decrease the risk of bias.

Orally Administered Probiotics Decrease Aggregatibacter actinomycetemcomitans but Not Other Periodontal Pathogenic Bacteria Counts in the Oral Cavity: A Systematic Review and Meta-Analysis

“…This meta-analysis was reported according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement ( Liberati et al, 2009 ) using the same strategy as in our other recent oral cavity/upper GI-related studies ( Czumbel et al, 2019 ; Keremi et al, 2020 ; Ruksakiet et al, 2020 ). The content of this meta-analysis is summarized using the PRISMA checklist ( Supplementary Table 1 ).…”

Dióxido de cloro:

“…No existe ninguna aprobación actual en el ámbito médico del dióxido de cloro como medicamento, aunque existen patentes actuales que solo hacen referencia al uso del dióxido de cloro como desinfectante de las superficies o como componente en los enjuagues bucales, ya que se ha demostrado que puede ser viricida y disminuir las bacterias orales, así como neutralizar los compuestos volátiles producidos por las mismas (40)(41)(42).…”

Ingesta de dióxido de cloro para la COVID-19

“…33 Todos los enjuagues bucales tienen efectos colaterales sustanciales. 34 A la fecha no hay estudios publicados sobre el uso de dióxido de cloro para enjuague bucal y/o spray nasal en los pacientes con COVID-19. 35…”