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- Aloe Vera (Aloe vera, Xanthorrhoeaceae)
- Chlorine Dioxide
- Gingivitis
- Plaque Formation
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Date:
05-13-2016 | HC# 041621-544
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Re: Aloe Vera and Chlorine Dioxide Mouth Rinses Reduce Plaque and Gingivitis in Patients with Fixed Orthodontics
Yeturu
SK, Acharya S, Urala AS, Pentapati KC. Effect
of aloe vera, chlorine dioxide, and chlorhexidine mouth rinses on plaque and
gingivitis: a randomized controlled trial. J Oral Biol Craniofac Res. January-April 2016;6(1):54-58.
Dental
plaque formation is caused by the presence of bacterial colonies on the teeth
and can lead to gingivitis, periodontal disease, and dental caries. Bacteria
and plaque can be removed with both mechanical (brushing, flossing, and dental
instruments) and chemical (mouthwash) means. However, mechanical cleaning can
be particularly difficult in patients with fixed orthodontic hardware and some
mouth rinses, while effective, have unwanted side effects, including allergic
reactions, mouth lesions, and a disturbance in the sensation of taste. Aloe
vera (Aloe vera, Xanthorrhoeaceae)
and chlorine dioxide mouth rinses may provide better alternatives to
conventional mouth rinses. The mucilaginous gel within the aloe vera leaf has been
shown to have antibacterial, antioxidant, and anti-inflammatory properties. Chlorine
dioxide is an antibacterial agent and is often used to disinfect the mouth
during dental procedures and to treat halitosis and gingivitis. The goal of
this randomized, controlled, single-blind study was to measure the efficacy of
aloe vera and chlorine dioxide mouth rinses in reducing plaque and gingivitis
in dental patients with fixed orthodontic hardware.
The
study was conducted at the Department of Orthodontics, Manipal College of
Dental Sciences, Manipal University in Manipal, Karnataka, India. Patients were
included if they were > 18 years old, had visible plaque and gingivitis
associated with > 30% of the teeth examined, and had fixed orthodontics for
more than 3 months. Patients were excluded from the study if they had multiple
dental restorations or gross dental caries, had used antibiotics during the
last 2 weeks, were tobacco (Nicotiana
spp., Solanaceae) users, regularly used mouth rinses or antimicrobials, or had
removable dental appliances. The extent of plaque and gingivitis was measured
with the Silness and Löe Plaque Index and Gingival Index before and after the
treatment. Ninety patients were randomly divided into 3 treatment groups—an
aloe vera group, a chlorine dioxide group, and a chlorhexidine group.
Chlorhexidine was used as the positive control. The sources of the mouth rinses
were not provided. Patients were instructed to rinse with 10 ml of mouthwash
for 1 minute 2 times per day for a total of 15 days. Data were analyzed with
paired t-tests and analysis of variance with post hoc Dunnett's tests.
Five
patients were lost from the chlorhexidine group due to non-compliance with the protocol.
Plaque and gingivitis were significantly reduced in all of the treatment groups
(P < 0.001 for all). There was a significant treatment effect on plaque and
gingivitis reduction (P = 0.03 and 0.04, respectively). The percent mean
reduction of plaque for aloe vera, chlorine dioxide, and chlorhexidine was
20.38, 30.29, and 31.59, respectively; a similar trend was seen in percent mean
reduction of gingivitis of 9.88, 12.22, and 16.30, respectively.
Aloe
vera and chlorine dioxide mouth rinses both significantly reduced plaque and
gingivitis in dental patients with fixed orthodontics. Chlorine dioxide was
nearly as effective as chlorhexidine in reducing plaque and gingivitis. Aloe
vera was not as effective as chlorhexidine or chlorine dioxide in reducing
plaque and gingivitis, but still resulted in a significant decrease in these
measures. The study may have been limited by the small sample size. In
addition, the concentrations and sources of the mouth rinses were not given,
making it difficult to understand the phytochemical composition of the aloe
vera used and to compare these results with results from similar studies.
—Cheryl
McCutchan, PhD
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