Impact of Mouthwashes on Antibacterial Activity of Subjects with Fixed Orthodontic Appliances: A Randomized Clinical Trial. 2017

A Nishad, and N S Sreesan, and Joseph Joy, and Lakshmi Lakshmanan, and Joyce Thomas, and V A Anjali
Department of Orthodontics and Dentofacial Orthopedics Noorul Islam College of Dental Science, Thiruvananthapuram Kerala, India, e-mail: drnishath@hotmail.com.

OBJECTIVE The study aimed to assess the impact of mouthwashes on antibacterial activity of individuals with fixed orthodontic appliances. METHODS A total of 60 individuals were considered in the study. Sixty (20 each group) nonextraction class I individuals were randomly divided into experimental and control groups. Group I: Experimental group [chlorhexidine (CHX) mouthwash], group II: Experimental group (neem mouthwash), group III: Control group (distilled water). All the clinical examinations were done at baseline and 30th day respectively, after the start of orthodontic treatment. The mean differences between the different experimental groups were calculated using one-way analysis of variance (ANOVA) test. RESULTS There was no statistical significance at baseline mean plaque index (PI), gingival index (GI) scores, and Streptococcus mutans (SM) colony count between groups. The PI and GI scores among CHX and neem mouthwash groups (p = 0.002, p = 0.032 respectively) were significantly reduced after intervention and also the SM colonies count was reduced in CHX and neem mouthwash groups and there was significant difference between the groups. CONCLUSIONS As both mouthwashes showed significant effectiveness on antibacterial activity in individuals with fixed orthodontic appliances, neem mouthwash can be used as an alternative to CHX. CONCLUSIONS It is better to have a sound knowledge regarding the use of mouthwash in long term as fixed orthodontics are associated with accumulation of SM, enamel demineralization, and an increased number of carious lesions, predominantly in sites adjacent to bracket.

UI MeSH Term Description Entries
D009067 Mouthwashes Solutions for rinsing the mouth, possessing cleansing, germicidal, or palliative properties. (From Boucher's Clinical Dental Terminology, 4th ed) Mouth Bath,Mouth Rinse,Mouth Wash,Bath, Mouth,Baths, Mouth,Mouth Baths,Mouth Rinses,Rinse, Mouth,Rinses, Mouth,Wash, Mouth
D009967 Orthodontic Appliances Devices used for influencing tooth position. Orthodontic appliances may be classified as fixed or removable, active or retaining, and intraoral or extraoral. (Boucher's Clinical Dental Terminology, 4th ed, p19) Appliance, Orthodontic,Appliances, Orthodontic,Orthodontic Appliance
D010512 Periodontal Index A numerical rating scale for classifying the periodontal status of a person or population with a single figure which takes into consideration prevalence as well as severity of the condition. It is based upon probe measurement of periodontal pockets and on gingival tissue status. Bleeding on Probing, Gingival,CPITN,Community Periodontal Index of Treatment Needs,Gingival Bleeding on Probing,Gingival Index,Gingival Indexes,Periodontal Indexes,Gingival Indices,Index, Gingival,Index, Periodontal,Indexes, Gingival,Indexes, Periodontal,Indices, Gingival,Indices, Periodontal,Periodontal Indices
D002710 Chlorhexidine A disinfectant and topical anti-infective agent used also as mouthwash to prevent oral plaque. Chlorhexidine Acetate,Chlorhexidine Hydrochloride,MK-412A,Novalsan,Sebidin A,Tubulicid,Acetate, Chlorhexidine,Hydrochloride, Chlorhexidine,MK 412A,MK412A
D003731 Dental Caries Localized destruction of the tooth surface initiated by decalcification of the enamel followed by enzymatic lysis of organic structures and leading to cavity formation. If left unchecked, the cavity may penetrate the enamel and dentin and reach the pulp. Caries, Dental,Carious Lesions,Dental Cavities,Dental Cavity,Dental Decay,Dental White Spots,Carious Dentin,Decay, Dental,Dental White Spot,White Spot, Dental,White Spots, Dental,Carious Dentins,Carious Lesion,Cavities, Dental,Cavity, Dental,Dentin, Carious,Dentins, Carious,Lesion, Carious,Lesions, Carious,Spot, Dental White,Spots, Dental White
D003774 Dental Plaque Index An index which scores the degree of dental plaque accumulation. Dental Plaque Indexes,Dental Plaque Indices,Index, Dental Plaque,Indexes, Dental Plaque,Indices, Dental Plaque
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000293 Adolescent A person 13 to 18 years of age. Adolescence,Youth,Adolescents,Adolescents, Female,Adolescents, Male,Teenagers,Teens,Adolescent, Female,Adolescent, Male,Female Adolescent,Female Adolescents,Male Adolescent,Male Adolescents,Teen,Teenager,Youths
D000328 Adult A person having attained full growth or maturity. Adults are of 19 through 44 years of age. For a person between 19 and 24 years of age, YOUNG ADULT is available. Adults
D013295 Streptococcus mutans A polysaccharide-producing species of STREPTOCOCCUS isolated from human dental plaque.

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