Evidence on the Use of Mouthwash for the Control of Supragingival Biofilm and Its Potential Adverse Effects
Abstract
:1. Introduction
2. The Process of Biofilm Formation and Anti-Biofilm Strategy
3. Intended Effects of Mouthwash on Biofilm Control
3.1. Study Selection and Data Collection
3.2. Current Evidence on the Effects of Mouthwash
3.2.1. CHG
3.2.2. EO
3.2.3. CPC
3.2.4. Other Chemical Compounds
3.2.5. Natural Products
3.2.6. Sodium Hypochlorite (NaOCl)
3.2.7. Chlorine Dioxide (ClO2)
3.2.8. Cariostatic Property: Children and Adolescents
3.2.9. Cariostatic Property: Root Caries
4. Side Effects and Potential Adverse Reactions to Mouthwashes
4.1. Side Effects (Patients’ Complaints)
4.2. Cytotoxic Effects on Human Cells
4.3. Antimicrobial Resistance
4.4. Residual Structure
4.5. Retarded Penetration into Biofilm and Promotion of Biofilm Development
4.6. Ecological Changes in the Oral Biofilm Microbiota
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
References
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Sequence No. | Terms and Strategy (Publication Dates from 2012 to 2022) | Hits |
---|---|---|
#1 | (“mouthwashes” [Pharmacological Action] OR “mouthwashes” [MeSH Terms] OR “mouthwashes” [All Fields] OR “mouthwash” [All Fields] OR “mouthwashing” [All Fields] OR “mouthwashings” [All Fields]) AND (“systematic review” [Publication Type] OR “systematic reviews as topic” [MeSH Terms] OR “systematic review” [All Fields]) | 300 |
#2 | (“mouthwashes” [Pharmacological Action] OR “mouthwashes” [MeSH Terms] OR “mouthwashes” [All Fields] OR “mouthwash” [All Fields] OR “mouthwashing” [All Fields] OR “mouthwashings” [All Fields]) AND (“meta analysis” [Publication Type] OR “meta analysis as topic” [MeSH Terms] OR “meta analysis” [All Fields]) | 246 |
#3 | (“mouthrinse” [All Fields] OR “mouthrinsed” [All Fields] OR “mouthrinses” [All Fields] OR “mouthrinsing” [All Fields] OR “mouthrinsings” [All Fields]) AND (“systematic review” [Publication Type] OR “systematic reviews as topic” [MeSH Terms] OR “systematic review” [All Fields]) | 57 |
#4 | (“mouthrinse” [All Fields] OR “mouthrinsed” [All Fields] OR “mouthrinses” [All Fields] OR “mouthrinsing” [All Fields] OR “mouthrinsings” [All Fields]) AND (“meta analysis” [Publication Type] OR “meta analysis as topic” [MeSH Terms] OR “meta analysis” [All Fields]) | 40 |
Solutions | n | Weighted Mean Difference (95% Cl) | Index | Compared Control | Follow-up Periods | Reference |
---|---|---|---|---|---|---|
CHG | 12 | −1.45 (−1.00 to −1.90) | QHI | Baseline | 4 to 6 weeks | [46] |
4 | −0.78 (−1.07 to −0.49) | TQHI | Placebo | 6 months | [47] | |
3 | −0.640 (−0.756 to −0.524) | TQHI | Placebo | 6 months | [16] | |
2 | −0.208 (−0.351 to −0.065) | PI | Placebo | 6 months | [16] | |
17 | −0.362 (−0.571 to −0.153) † | QHI or TQHI | Baseline | ≥ 4 weeks | [48] | |
5 | −0.39 (−0.70 to −0.08) | PI | Baseline | 6w or 6m | [49] | |
10 | −0.67 (−0.82 to −0.52) | QHI | Baseline | 4w to 6m | [49] | |
EO | 9 | −0.86 (−1.05 to −0.68) | TQHI | Placebo | 6 months | [47] |
9 | −0.827 (−1.053 to −0.600) | TQHI | Placebo | 6 months | [16] | |
16 | −0.265 (−0.405 to −0.124) † | QHI or TQHI | Baseline | ≥ 4 weeks | [48] | |
14 | −0.86 (−1.05 to −0.66) | QHI | Placebo | 6 months | [51] | |
4 | −0.39 (−0.3 to −0.47) | QHI | 21.6 or 26.9% hydro-alcohol | 6 months | [52] | |
CPC (>0.05%) | 6 | −0.41 (−0.65 to −0.17) | TQHI | Placebo | 6 months | [47] |
3 | −0.465 (−0.631 to −0.299) | TQHI | Placebo | 6 months | [16] | |
8 | −0.112 (−0.273 to 0.029) *,† | TQHI | Baseline | ≥ 4 weeks | [48] | |
9 | −0.70 (−0.83 to −0.57) | PI, TQHI, MPI | Placebo | ≥ 6 weeks | [54] | |
CPC (<0.05%) | 3 | −0.26 (0.07 to −0.55) * | TQHI | Placebo | 6 months | [47] |
Del | 2 | −0.24 (−0.67 to 0.19) * | TQHI | Placebo | 6 months | [47] |
3 | −0.144 (−0.231 to −0.058) | TQHI | Placebo | 6 months | [16] | |
4 | −0.173 (−0.853 to 0.507) *,† | TQHI | Baseline | 4 weeks | [48] | |
AmF/SnF | 2 | −0.079 (−0.260 to 0.101) * | TQHI | Placebo | 6 months | [31] |
2 | −0.195 (−0.335 to −0.054) | PI | Placebo | 6 months | [31] | |
Alexi | 2 | −0.18 (−0.60 to 0.24) * | TQHI | Placebo | 6 months | [47] |
Tric | 3 | −0.67 (−1.05 to −0.30) | TQHI | Placebo | 6 months | [47] |
Herb | 6 | −2.93 (−6.43 to 0.58) * | PI or TQHI | CHG | 4 weeks | [57] |
6 | 2.61 (4.42 to 0.9) | PI or TQHI | CHG or Placebo | 12 weeks | [57] | |
11 | 0.22 (0.20 to 0.24) | PI or QHI or TQHI | CHG | [58] | ||
5 | −0.61 (−0.80 to −0.42) | QHI | Placebo | 2w to 3 M | [59] | |
5 | 0.08 (−0.19 to 0.34) * | PI | CHG | 10d to 3w | [59] | |
5 | 0.00 (−0.04 to 0.04) * | TQHI | CHG | 2 or 4w | [59] | |
Curcumin | 6 | 0.27 (−0.53 to 1.07) * | PI or TQHI | CHG | 21 or 28 days | [60] |
Propolis | 3 | −1.24 (−2.51 to 0.04) * | PI | Placebo | 3 or 5 days | [61] |
Salvadora persica | 12 | −0.46 (−0.29 to −0.63) | PI or TQHI | Placebo | 4d to 2m | [62] |
Salvadora persica | 18 | 0.19 (0.01 to 0.37) * | PI or TQHI | CHG | 4d to 2m | [62] |
Green Tea | 5 | −0.14(−1.80 to 1.43) * | PI | CHG | 2 to 4w | [63] |
ClO2 | 5 | −0.720 (−0.487 to −0.952) | PI | Placebo | 7 days to 5w | [33] |
Solutions | n | Weighted Mean Difference (95% Cl) | Index | Compared Control | Follow-up Periods | Reference |
---|---|---|---|---|---|---|
CHG | 3 | −1.20 (−0.23 to −2.16) | GI or MGI | Placebo | 6 months | [50] |
10 | −0.21 (−0.11 to −0.31) | GI | Baseline | 4 to 6 weeks | [46] | |
4 | −0.185 (−0.285 to −0.086) | GI | Placebo | 6 months | [16] | |
19 | −0.223 (−0.412 to −0.034) † | GI or MGI | Baseline | ≥ 4 weeks | [48] | |
8 | −0.32 (−0.42 to −0.23) | GI | Baseline | 6w, 3m, 6m | [49] | |
EO | 9 | −1.44 (−0.82 to −2.06) | GI or MGI | Placebo | 6 months | [50] |
2 | −0.133 (−0.194 to −0.072) | GI | Placebo | 6 months | [16] | |
8 | −0.537 (−0.764 to −0.311) | MGI | Placebo | 6 months | [16] | |
16 | −0.203 (−0.312 to −0.093) † | GI or MGI | Baseline | ≥ 4 weeks | [48] | |
2 | −0.36 (−0.26 to −0.62) | GI | 21.6 or 26.9% hydro-alcohol | 6 months | [52] | |
11 | −0.52 (−0.67 to −0.37) | MGI | Placebo | 6 months | [51] | |
3 | −0.24 (−0.46 to −0.01) | GI | Placebo | 6 months | [51] | |
CPC (>0.05%) | 2 | −1.04 (0.06 to −2.14) * | GI or MGI | Placebo | 6 months | [50] |
5 | −0.70 (−0.83 to −0.57) | GI | Placebo | ≥ 6 weeks | [54] | |
3 | −0.344 (−0.627 to −0.062) | GI | Placebo | 6 months | [16] | |
2 | −0.357 (−0.483 to −0.231) | MGI | Placebo | 6 months | [16] | |
8 | −0.126 (−0.312 to 0.059) *,† | GI or MGI | Baseline | ≥ 4 weeks | [48] | |
CPC (≤0.05%) | 3 | −0.31 (0.76 to −1.38) * | GI or MGI | Placebo | 6 months | [50] |
Del | 1 | −0.06 (1.86 to −1.98) * | GI or MGI | Placebo | 6 months | [50] |
2 | −0.038 (−0.145 to −0.069) * | MGI | Placebo | 6 months | [16] | |
3 | −0.014 (−2.337 to 2.308) †,* | GI or MGI | Baseline | ≥ 4 weeks | [48] | |
AmF/SnF AmF/SnF | 1 | −0.76 (0.72 to −2.25) * | GI or MGI | Placebo | 6 months | [50] |
2 | −0.248 (−0.427 to −0.069) | GI | Placebo | 6 months | [16] | |
Alexi | 1 | −0.16 (1.77 to −2.09) * | GI or MGI | Placebo | 6 months | [50] |
Tric | 3 | −1.50 (−0.36 to −2.62) | GI or MGI | Placebo | 6 months | [50] |
Herb | 6 | −0.15 (−0.32 to 0.01) * | GI | CHG | 4 weeks | [57] |
5 | −0.09 (−0.25 to 0.08) * | GI | CHG | 12 weeks | [57] | |
3 | −0.28 (−0.51 to −0.06) | GI | Placebo | 3 w or 3 m | [59] | |
3 | −0.59 (−1.08 to −0.11) | MGI | Placebo | 2 to 4 weeks | [59] | |
5 | −0.07 (−0.22 to 0.07) * | GI | CHG | 2 to 4 w | [59] | |
Curcumin | 6 | −0.13 (−0.35 to 0.09) * | GI | CHG | 21 or 28 days | [60] |
Green Tea | 5 | 0.43(−0.63 to 1.49) * | GI | CHG | 2 to 4 w | [63] |
ClO2 | 4 | −0.712 (−0.457 to −0.967) | GI | Placebo | 7 to 21 days | [33] |
Biocide | Concentration | Species | Condition of Bacteria | Incubation Time | Upregulated Genes | Reference |
---|---|---|---|---|---|---|
NaF, CHG, Tea polyphenol | 1/2 MIC | S. mutans | Planktonic | 24 h | gtfB, gtfC, luxS, comD, comE | [108] |
NaF, CHG, Tea polyphenol | 1/2 MIC | S. mutans | Biofilm | 24 h | gtfB, gtfC, luxS, comD, comE | [108] |
Triclosan | 1/2 and 1/4 MIC | S. mutans | Planktonic | 2 h | atlA, gtfB, gtfC, comD, luxS | [109] |
MTAD, MTADN, MTAN | 1/4 MIC | Porphyromonas gingivalis | Planktonic | 1 h | clpC, clpP (MTAD, MTADN, MTAN), sprE (MTAD, MTADN), ace, clpX, cylB, efaA, gelE (MTAN) | [110] |
CHG | 1/10 MIC | S. mutans, Streptococcus oralis, Actinomyces naeslundii | Biofilm | 48 h | gtfB, gtfC, gtfD, comD, luxS | [107] |
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Takenaka, S.; Sotozono, M.; Ohkura, N.; Noiri, Y. Evidence on the Use of Mouthwash for the Control of Supragingival Biofilm and Its Potential Adverse Effects. Antibiotics 2022, 11, 727. https://doi.org/10.3390/antibiotics11060727
Takenaka S, Sotozono M, Ohkura N, Noiri Y. Evidence on the Use of Mouthwash for the Control of Supragingival Biofilm and Its Potential Adverse Effects. Antibiotics. 2022; 11(6):727. https://doi.org/10.3390/antibiotics11060727
Chicago/Turabian StyleTakenaka, Shoji, Maki Sotozono, Naoto Ohkura, and Yuichiro Noiri. 2022. "Evidence on the Use of Mouthwash for the Control of Supragingival Biofilm and Its Potential Adverse Effects" Antibiotics 11, no. 6: 727. https://doi.org/10.3390/antibiotics11060727