Do adjunctive therapies help in the treatment of gingivitis?
PD Dr. Kristina Bertl, PhD MSc MBA
Another topic that was discussed as part of the Perio Workshop 2019 was the efficacy of chemical adjunctive therapies in the treatment of gingivitis. Of course, this is not a ‘new’ topic, and several reviews on this subject already exist; this time, however, two new issues were tackled:
- Mouth-rinse solution or toothpaste – does one method work better than the other as a way of deploying chemical adjunctive therapies?
- Does it make a difference whether we are treating gingivitis in a healthy, intact periodontium or in a reduced periodontium?
At the start of their systematic review, the research group determined that the review should include all randomized controlled studies with a follow-up of at least six months that had tested the effect of a chemical agent as an adjunct to mechanical cleaning compared with mechanical cleaning alone (Figuero et al. 2020). Based on these criteria, the authors identified 70 studies and came to the following conclusions:
- Compared with mechanical cleaning alone, chemical (primarily anti-septic) adjunctive therapies to mechanical cleaning lead to statistically significant reductions in gingival, bleeding and plaque indices.
- Chemical adjunctive therapies seem to be more effective when used in mouth-rinse solutions than when used in toothpaste – at least in terms of plaque reduction.
- Adjunctive chemical therapies to mechanical cleaning are effective at treating gingivitis in both periodontally healthy and periodontally reduced dentition.
- Discolouration of the teeth and mild irritation of the oral mucosa were the main undesirable side effects.
An earlier review (Figuero et al. 2019) also produced a ranking of chemical adjunctive therapies. In this review the following mouth-rinse solutions were found to be the most effective: essential oils, chlorhexidine, triclosan/copolymer and cetylpyridinium chloride.
However, when discussing the benefits of adjunctive chemical therapies for treating gingivitis, we should not forget that they are ALWAYS only used as an adjunct to mechanical cleaning – i.e. mechanical cleaning is absolutely essential!
You can find other articles on this topic in the Prophy Community:
- Figuero E, Herrera D, Tobías A, Serrano J, Roldán S, Escribano M, Martín C. Efficacy of adjunctive anti-plaque chemical agents in managing gingivitis: A systematic review and network meta-analyses. J Clin Periodontol. 2019 Jul;46(7):723-739. doi: 10.1111/jcpe.13127. Epub 2019 May 31.
Figuero E, Roldán S, Serrano J, Escribano M, Martín C, Preshaw PM. Efficacy of adjunctive therapies in patients with gingival inflammation. A systematic review and meta-analysis. J Clin Periodontol. 2020; doi: 10.1111/jcpe.13244