Postoperative anti‐inflammatory efficacy of 2% saline rinses and a herbal‐ mouthwash after non‐surgical periodontal therapy for the management of periodontal inflammation in young adults with chlorhexidine allergy: A randomized controlled trial

Abstract

Aim The present randomized controlled trial assessed the postoperative anti‐inflammatory efficacy of 2% saline rinses (SR) and a herbal‐ mouthwash (HMW) after non‐surgical periodontal therapy (NSPT) for the management of periodontal inflammation in patients with chlorhexidine (CHX) allergy. Materials and Methods Patients with periodontal inflammation with and without self‐reported CHX allergy were included. All patients underwent non‐surgical periodontal therapy (NSPT). Patients were randomly divided into three groups. In the SR and HMW groups, 2% SR and a HMW, respectively, were prescribed. In Group 3 (CHX‐group), patients without CHX allergy were included and were prescribed 0.12% CHX. In all groups, plaque index (PI), gingival index (GI), probing depth (PD), clinical attachment loss (AL), and marginal bone loss were measured at baseline. Clinical periodontal parameters were re‐assessed at 6‐weeks’ follow‐up. p < 0.01 were considered statistically significant. Results Thirteen, 12, and 12 patients were included in the SR, HMW, and CHX groups, respectively. At baseline, clinical and radiographic periodontal parameters were comparable in all groups. In all groups, PI (p < 0.01), GI (p < 0.01), and PD (p < 0.01) were significantly higher at baseline than their respective values at 6 weeks of follow‐up. There was no significant difference in clinical AL at all time intervals in all groups. There was no significant correlation between periodontal parameters and age, gender, and daily toothbrushing/flossing in all groups. Conclusion In young adults with self‐reported CHX allergy, herbal mouthwashes and/or 2% SR are suitable post‐operative prescriptions after NSPT.

Comparison of the Anti-bacterial Efficacy of Saussurea costus and Melaleuca alternifolia Against Porphyromonas gingivalis, Streptococcus mutans, and Enterococcus faecalis: An in-vitro Study

“…Although CA is a rare condition, it may be a source of distress to patients as it induces type-IV hypersensitivity reactions such as erythema in gingival tissues, burning sensation in the mouth and stomatitis [ 28 , 29 ]. In a recent randomized controlled trial (RCT), Al-Zawawi et al [ 30 ] investigated the postoperative anti-inflammatory efficacy of herbal-based oral rinses after non-surgical instrumentation for the management of periodontal inflammation in patients with chlorhexidine allergy. The results showed that herbal-based oral rinses are suitable substitutes to 0.12% CG as post-operative prescriptions following periodontal treatment [ 30 ].…”

“…In a recent randomized controlled trial (RCT), Al-Zawawi et al [ 30 ] investigated the postoperative anti-inflammatory efficacy of herbal-based oral rinses after non-surgical instrumentation for the management of periodontal inflammation in patients with chlorhexidine allergy. The results showed that herbal-based oral rinses are suitable substitutes to 0.12% CG as post-operative prescriptions following periodontal treatment [ 30 ]. The present in-vitro results applaud the results reported by Al-Zawawi et al [ 30 ]; and suggest that S. costus based mouthwashes can be used for the management of periodontal inflammatory conditions as a substitute to 0.12% CHX.…”

“…The results showed that herbal-based oral rinses are suitable substitutes to 0.12% CG as post-operative prescriptions following periodontal treatment [ 30 ]. The present in-vitro results applaud the results reported by Al-Zawawi et al [ 30 ]; and suggest that S. costus based mouthwashes can be used for the management of periodontal inflammatory conditions as a substitute to 0.12% CHX. However, this needs additional well-designed and power adjusted RCTs.…”

Clinical Effectiveness of Herbal Oral Care Products in Periodontitis Patients: A Systematic Review

“…All included studies were published between 2003 and 2022 [ 43 , 44 , 45 , 46 , 47 , 48 , 49 , 50 , 51 , 52 , 53 , 54 , 55 , 56 , 57 , 58 , 59 , 60 , 61 , 62 , 63 , 64 ] and the majority of them were randomized clinical trials [ 43 , 44 , 45 , 46 , 47 , 48 , 49 , 50 , 51 , 52 , 54 , 55 , 56 , 58 , 59 , 60 , 61 , 62 , 63 , 64 ] and conducted in India [ 43 , 45 , 46 , 47 , 48 , 51 , 52 , 53 , 55 , 63 , 64 ], while the rest of them were from Iran [ 44 , 49 , 59 ], Iraq […”

“…None of the included eligible investigations tested herbal gels. Various herbal products were tested in the included investigations including 1% Matricaria chamomilla [ 43 ], triphala ( Emblica officinalis , Terminalia chebula , and Terminalia belerica ) [ 45 , 52 , 53 ], Saussurea lappa extracts [ 46 ], 4% Ocimums anctrum [ 47 ], green tea [ 48 , 49 , 50 ], Nigella sativa [ 54 ], liquorice [ 57 ], Stuckenia striata [ 59 ], lemongrass oil [ 63 ], red ginseng [ 64 ], or combinations of different herbs [ 44 , 51 , 55 , 56 , 58 , 60 , 61 , 62 ].…”