Effect of chlorhexidine on plaque and gingival scores: six-month study

The most common method to prevent caries and periodontal disease is mechanical supragingival plaque control by toothbrush. Maintaining an adequate low level of plaque through daily tooth brushing is often not feasible. The application of chlorhexidine can be an effective plaque inhibitor when used as an adjunct to mechanical cleaning procedures as well as when used alone. Objectives: The purpose of the present study was to assess the effect of three different formulations of chlorhexidine gel in the concentrations of 0.2%, 1% and 2% for the control of plaque accumulation and gingivitis. Methods: This was a double-blind, longitudinal, non-crossover study in 48 children between 7 to 11 years of age. Subjects were randomly assigned to 4 different groups: G 1 (placebo), G 2 (0.2% chlorhexidine gel), G 3 (1% chlorhexidine gel) and G 4 (2% chlorhexidine gel). The chlorhexidine gel was administered once a week during 4 weeks. The surfaces of each tooth were evaluated in according with the criteria of the Turesky modification of the Quigley and Hein plaque index and the Löe and Silness gingival index. The clinical evaluations were made after 1 week, 1, 3 and 6 months of the last application of the chlorhexidine gel. Subsequently, all children and their parents received questionnaires in order to evaluate possible adverse reactions. Results: Mean plaque and gingival scores were reduced over the four-week trial period for experimental and control groups. There was no significant difference (p<0.05) between the groups treated with chlorhexidine gel when compared with the placebo group in the reduction of plaque and gingival scores. No adverse reactions to any of the gels were reported. Conclusions: The results indicated that different formulations of chlorhexidine gel did not produce an effective inhibitor of plaque growth. Within the limitations of the present study design, further studies are required to clarify the role of chlorhexidine to prevent caries and periodontal disease. (Grant number - FAPESP#2007/00962-6).