Clinical Gingivitis Assessment: Evaluation of a Short-term, Partial Grading Model

Objective: This clinical study was conducted to evaluate the feasibility of a short-term gingivitis model involving partial mouth clinical grading of established gingivitis. Methods: A randomized controlled trial was conducted to evaluate gingivitis treatment over a 5-week period when measured clinically using partial mouth scoring. Adults with mild-to-moderate gingivitis were randomly assigned to one of two antimicrobial rinse dose/frequency/duration groups with 0.12% chlorhexidine gluconate (Peridex®) used conventionally (15 mL BID 30 s) or at reduced dose, frequency & duration of use (10 mL QD 10 s), or a water rinsing group which served as the negative control. Partial-mouth gingivitis was graded using the GI index (0-3) on up to 6 surfaces of 3 maxillary and 3 mandibular posterior teeth. Treatments were compared using ANCOVA with baseline as a covariate. Results: The predominantly female (73%) population ranged from 18-72 years of age, with 21% reporting daily tobacco usage. Groups were balanced (p>0.90) on baseline mean GI (1.29) and proportion of bleeding sites (0.32). Relative to baseline, both chlorhexidine groups exhibited significant (p<0.02) reductions in gingivitis and bleeding at Week 5, with the greatest improvement (30.1% reduction in gingivitis and 49.5% reduction in bleeding) seen at the highest chlorhexidine dose and frequency (15 mL BID 30 s). Between-group comparisons significantly (p<0.01) favored the 0.12% chlorhexidine 15 mL BID 30 s group, which had a 26.2% reduction in gingivitis versus the negative control. Conclusion: A simplified, 5-week randomized controlled study of established gingivitis measured with partial mouth scoring showed significant (p<0.001) treatment effects of 25%+ for positive versus negative controls.