Comparative Evaluation of the Efficacy of Herbal and Chlorhexidine Mouthwash on Gingival Health: A Randomized Clinical Trial
Keywords:
Chlorhexidine gluconate, Herbal mouthwash, Gingivitis, Plaque control, Green tea, Aloe vera, Triphala, Clinical trialAbstract
Background:Chlorhexidine (CHX) gluconate has long been considered the “gold standard” chemical plaque control agent due to its broad antimicrobial spectrum and high substantivity. However, its use is often limited by adverse effects such as tooth staining, mucosal irritation, and taste alteration. Herbal mouthwashes, containing plant-based bioactive agents with antimicrobial and anti-inflammatory properties, are gaining attention as safer and more biocompatible alternatives.
Objective:This randomized clinical trial aimed to compare the clinical efficacy of a standardized herbal mouthwash and 0.12% chlorhexidine gluconate in improving gingival health among patients with plaque-induced gingivitis.
Methods:Ninety participants aged 18–45 years with plaque-induced gingivitis were randomly allocated into three equal groups: Group I – 0.12% chlorhexidine gluconate, Group II – herbal mouthwash (green tea + aloe vera + triphala formulation), and Group III – placebo (distilled water). All participants were instructed to rinse twice daily for 30 days. Clinical parameters including Plaque Index (PI), Gingival Index (GI), and Bleeding on Probing (BOP) were recorded at baseline, Day 7, Day 14, and Day 30. Adverse effects and patient acceptability were also assessed. Data were analyzed using repeated-measures ANOVA with p < 0.05 considered significant.
Results:Both CHX and the herbal mouthwash demonstrated significant reductions in PI, GI, and BOP from baseline to Day 30 (p < 0.001). Mean reduction in GI for CHX was 0.95 ± 0.30, for the herbal rinse 0.88 ± 0.29, while placebo achieved 0.30 ± 0.25. No statistically significant difference was observed between CHX and the herbal rinse for either PI or GI (p > 0.05). However, the herbal group exhibited superior taste acceptability and minimal staining or mucosal irritation compared to CHX (p < 0.01).
Conclusions:The herbal mouthwash demonstrated comparable clinical efficacy to chlorhexidine in reducing plaque and gingival inflammation, with better tolerance and fewer side effects. Herbal formulations thus represent a promising adjunct
in gingivitis management and may serve as effective long-term alternatives to CHX
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