Effectiveness of 0.50 and 0.75% chlorhexidine dentifrice in orthodontic patients

Objectives: This double-blind and randomized-controlled trial analyzed whether a lower concentration of chlorhexidine in dentifrices could reduce the risk of toothstaining without compromising its effectiveness in controlling gingivitis, bleeding and dental plaque. Methods: Volunteers with fixed orthodontic therapy were randomly divided into 3 groups: control, 1,100 ppm F, NaF (group A, n = 27); experimental, chlorhexidine 0.50% (group B, n = 27); and experimental, chlorhexidine 0.75% (group C, n = 27). At baseline, after 6 and 12 weeks, clinical examinations were carried out. Staining, calculus, gingivitis, bleeding and dental plaque data were analyzed by Friedman tests, to evaluate intra-group changes over time. To detect inter-group differences after 12 months (12-b) the data were evaluated by Kruskal-Wallis tests. Dunn's tests were used in both situations for necessary post-hoc analyses. Results: The groups were statistically similar in relation to stain, calculus and plaque indexes, but there were statistically significant differences regarding gingival and bleeding indexes. Considering each group, during the experimental periods, gingivitis and bleeding scores improved in all three groups. Only the 0.75% chlorhexidine dentifrice significantly increased the stain index, although most of the patients did not notice the stains. The intergroup comparison results demonstrated a statistically significant better performance of the experimental groups regarding the gingival and bleeding indexes. Conclusion: This study suggests that the use of dentifrices with lower concentration of chlorhexidine may reduce the risk of toothstaining without compromising its effectiveness in controlling gingivitis and bleeding in orthodontic patients.