The effect of 0.12% chlorhexidine dentifrice gel on plaque accumulation: a 3-day non-brushing model

Maintaining an adequate low level of plaque through daily tooth brushing is often not feasible. Effective chemotherapeutic agents as an adjunct to mechanical plaque control would therefore be valuable. Chlorhexidine (CHX) mouthwash has proved to be an effective inhibitor of plaque accumulation. The purpose of the present study was to assess the effect of application of 0.12% CHX dentifrice gel on de novo plaque accumulation. The study was designed as a single blind, randomized three-arm parallel clinical trial. At the beginning of the test period all volunteers received a thorough professional oral prophylaxis. Subjects were randomly assigned to one of three regimens. During a 3-day non-brushing period, subjects abstained from all forms of mechanical oral hygiene. One regimen (test group) used 0.12% chlorhexidine dentifrice gel (CHX-DGel, Perio.Aid) applied in a fluoride gel tray, the benchmark control group used a regular dentifrice applied in a fluoride gel tray (RegD, Everclean HEMA). The positive control group rinsed with a 0.12% chlorhexidine mouthwash (CHX-MW, Perio.Aid). The Quigley and Hein plaque index (PI) from all subjects was assessed after 3 days of de novo plaque accumulation. Subsequently, all subjects received a questionnaire to evaluate their attitude, appreciation and perception towards the products used employing a Visual Analogue Scale scores. After the experimental period, habitual oral hygiene procedures were resumed. Ninety-six systemically healthy subjects completed the study. After 3 days, the full-mouth PI for the CHX-DGel regimen was 1.87 compared with 1.93 for the RegD regimen and 1.55 for the CHX-MW regimen. The two dentifrices (CHX-DGel and RegD) were significantly less effective as the CHX-MW (P=0.0006). No significant difference between scores of the dentifrices was found. Within the limitations of the present 3-day non-brushing study design, it can be concluded that application of 0.12% CHX dentifrice gel is not significantly different from application of regular dentifrice on plaque accumulation. Use of a 0.12% CHX mouthwash is significantly more effective. CHX-DGel appears a poor alternative for a dentifrice. It is not an effective inhibitor of plaque growth and does not possess fluoride