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Duane B, Yap T, Neelakantan P, Anthonappa R, Bescos R, McGrath C, McCullough M, Brookes Z. Mouthwashes: Alternatives and Future Directions. Int Dent J 2023; 73 Suppl 2:S89-S97. [PMID: 37867066 PMCID: PMC10690551 DOI: 10.1016/j.identj.2023.08.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2023] [Accepted: 08/21/2023] [Indexed: 10/24/2023] Open
Abstract
This narrative review summarises "alternative" or "natural" over-the-counter (OTC) mouthwashes not covered elsewhere in this supplement and newly emerging products, as potential mouthwashes of the future. The "natural" mouthwashes reviewed include saltwater, baking soda, coconut oil, charcoal, propolis, seaweeds, and probiotics. Other than essential oils, it is apparent that their clinical effectiveness is still under debate, but there is some evidence to suggest that propolis reduces plaque and gingivitis. This review also covers the host immune response, via novel anti-inmmunomodulant mouthwashes, such as erythropoietin to reduce inflammation with oral mucositis (OM) after radiotherapy. The emerging concept of nanoparticle-containing mouthwashes, such as iron oxide, is further discussed for OM, this agent having the potential for more targeted delivery of chemical antimicrobials. Unfortunately, there are impacts on the environment of widening mouthwash use with more new products, including increased use of packaging, antimicrobial resistance, and possible detrimental effects on marine life. Further, there are roadblocks, relating to regularly approvals and side effects, that still need to be overcome for any OTC deivered immunomodulant or nanoformulation mouthwashes. Despite these caveats, there are many new mouthwashes under development, which could help manage major oral diseases such as caries, gingivitis, and periodontal disease.
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Affiliation(s)
- Brett Duane
- Dublin Dental School and Hospital, Trinity College Dublin, Dublin, Ireland
| | - Tami Yap
- Faculty of Medicine, Dentistry & Health Sciences, Melbourne Dental School, University of Melbourne, Carlton, Australia
| | - Prasanna Neelakantan
- Department of Endodontics, University of the Pacific, Arthur A. Dugoni School of Dentistry, San Francisco, California, USA
| | | | - Raul Bescos
- School of Health Professions, Faculty of Health, University of Plymouth, Plymouth, UK
| | - Colman McGrath
- Applied Oral Sciences & Community Dental Care, Hong Kong
| | - Michael McCullough
- Faculty of Medicine, Dentistry & Health Sciences, Melbourne Dental School, University of Melbourne, Carlton, Australia
| | - Zoë Brookes
- Peninsula Dental School, Plymouth University, Plymouth, UK.
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Agyekum BA, Tuglo LS. Effect of COVID-19 on dental care for children during the post-pandemic era in Ghana: A concern for policymaking. FRONTIERS IN DENTAL MEDICINE 2023. [DOI: 10.3389/fdmed.2023.1120685] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/09/2023] Open
Abstract
The impacts of COVID-19 have been felt globally, especially in the delivery of healthcare services such as dental care, although the incidence in Africa is comparatively low. This review article aims to explore the COVID-19 pandemic lockdown and its impact on dental care for children in Ghana. Some dental facilities in Ghana have been experiencing multiple challenges in service delivery, and the ongoing COVID-19 pandemic has aggravated the situation. The COVID-19 pandemic has interrupted all dental care in many parts of Ghana due to its impact on food insecurity, economic breakdown, depression, shortage of essential instrument supplies, inadequate health workers, and poor infection control practices, which present the main risks to dental care. Furthermore, the shutting of dental departments due to the COVID-19 lockdown has restricted the accessibility and utilization of dental services, especially for children. Hence, to avoid further and future pandemics and their impacts on dental care, there is a need to address the implications identified and prepare for the delivery of suitable dental healthcare in Ghana.
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Adekunle AA, James O, Onuoha EO, Adeyemo WL. Wound Healing Following Palatoplasty Using Either Honey or Warm Saline Mouth Bath for Postoperative Wound Care: A Randomized-Controlled Study. Cleft Palate Craniofac J 2022:10556656221086192. [PMID: 35261292 DOI: 10.1177/10556656221086192] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
OBJECTIVE To evaluate and compare the effect of honey or saline mouth bath for wound care on the rate of re-epithelisation of the lateral palatal defects and occurrence of early postoperative complications following palatoplasty. METHODOLOGY This was a prospective randomized study on participants with non-syndromic cleft palate conducted at a tertiary health institution in Lagos, Nigeria. The test group received oral honey drops for post-operative care for an initial period of two weeks post-surgery, while the control group had regular oral toileting using a warm saline solution. The primary outcome was epithelisation of lateral palatal defect at 2- and 4-weeks post repair. Descriptive and comparative statistics were computed, and the p-value was set at <0.05. RESULTS Fifty participants were recruited into the study, 24 in the Test group and 26 in the Control group. The frequency of occurrence of oronasal fistula in the Test group was 4.0% while in the Control group was 10.0%, however, this was not statistically significant. Complete epithelisation of the lateral palatal defect was clinically observed in 66.7% of the participants in the Test group at 2 weeks post-operation, while only 38.5% of participants in the Control group had clinically observed complete epithelisation at the same time point (β = 1.70, p = .035, 95% CI 1.122-26.533). At four weeks, all wounds had epithelised irrespective of the study group. CONCLUSION The application of honey appears to aid earlier epithelization of palatal surgical wounds following cleft palate repair and reduced the incidence of palatal fistula.
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Affiliation(s)
- Adegbayi Adeola Adekunle
- Fellow, Department of Oral and Maxillofacial Surgery, 291389Lagos University Teaching Hospital, Idi - Araba, Lagos
| | - Olutayo James
- Associate Professor, Department of Oral and Maxillofacial Surgery, College of Medicine, University of Lagos/ Lagos University Teaching Hospital, Idi, Araba, Lagos
| | - Emmanuel Onyebuchi Onuoha
- Senior Resident, Department of Oral and Maxillofacial Surgery, 291389Lagos University Teaching Hospital, Idi, Araba, Lagos
| | - Wasiu Lanre Adeyemo
- Professor, Department of Oral and Maxillofacial Surgery, College of Medicine, 98002University of Lagos/Lagos University Teaching Hospital, Idi, Araba, Lagos
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Supportive Home Remedies for Orofacial Pain during the Coronavirus Disease 2019 Pandemic: Their Value and Limitations. Int J Dent 2022; 2022:2005935. [PMID: 35069740 PMCID: PMC8771145 DOI: 10.1155/2022/2005935] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2021] [Accepted: 01/06/2022] [Indexed: 12/03/2022] Open
Abstract
Background The coronavirus disease 2019 (COVID-19) pandemic has impeded access to timely dental care, and there is an urgent need for adjuvant therapies that can reduce orofacial pain in emergencies. Aims To provide information on the benefits and limitations of eight representative home remedies as palliative care for orofacial pain during the coronavirus disease 2019 (COVID-19) pandemic. Methods PubMed and Medline were electronically searched for eight home remedies for orofacial pain that can be used in COVID-19. Papers published in English in the past 30 years were considered. Among the published studies suitable for the research purpose, those in which the abstract and body text were confirmed were targeted, and duplicate studies were excluded. Finally, 86 studies were included. Results There is extensive and high-level scientific evidence for the application of tooth brushing and flossing, mouth rinsing with chlorhexidine, use of over-the-counter pain medication, and application of cryotherapy in emergencies. Gargling with salt water, brushing with bamboo salt, gargling with garlic juice, and oil pulling are traditional methods used for centuries. The use of natural products for orofacial pain has a significant empirical effect but has weak scientific evidence. Conclusions Knowing the correct application method, effects, and side effects is desirable to use these methods appropriately in emergencies. However, scientific evidence is unclear and generally lacking for home remedies to be the main treatment strategy, and there are clear limitations to their use as a single main treatment.
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Adekunle AA, Egbunah UP, Erinoso OA, Adeyemo WL. Effectiveness of warm saline mouth bath in preventing alveolar osteitis: A systematic review and meta-analysis. J Craniomaxillofac Surg 2021; 49:980-988. [PMID: 34509363 DOI: 10.1016/j.jcms.2021.09.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2021] [Revised: 08/24/2021] [Accepted: 09/02/2021] [Indexed: 11/17/2022] Open
Abstract
This systematic review and meta-analysis aimed to assess the effectiveness of a warm saline mouth bath (WSMB) in preventing dry socket after tooth extractions. A systematic search for randomized controlled trials published until August 30, 2020, in seven databases was conducted: Cochrane, PubMed, Ovid Medline, Google Scholar, and OpenGrey databases, ClinicalTrials.gov, and the World Health Organization International Clinical Trials Registry. The inclusion criteria were studies investigating the use of a warm saline mouth bath postoperatively in a population of participants who had a tooth extraction, compared to no mouth rinse at all/any other mouth rinse. The primary outcome assessed in the studies was the incidence of alveolar osteitis. Only eight randomized studies met all inclusion criteria and were selected for qualitative analysis. Six of the studies compared WSMB with antimicrobial rinses, and two studies compared WSMB with no-rinse. This review found no significant difference (P > 0.05) in the incidence of alveolar osteitis between WSMB and other antimicrobial rinses. Based on the results of this review, WSMB has potential in reducing post-operative complications such as alveolar osteitis following a routine or surgical extraction of teeth. However, more studies are needed to validate these findings, as most of the studies reviewed had a high level of bias.
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Affiliation(s)
- Adegbayi Adeola Adekunle
- Post-Fellowship Senior Registrar, Department of Oral and Maxillofacial Surgery, Lagos University Teaching Hospital, Idi - Araba, Lagos, Nigeria.
| | - Uchenna Patrick Egbunah
- Registrar, Department of Oral and Maxillofacial Surgery, Lagos University Teaching Hospital, Idi - Araba, Lagos, Nigeria.
| | - Olufemi Akinwunmi Erinoso
- Senior Registrar, Department of Oral and Maxillofacial Surgery, Lagos State University Teaching Hospital, Ikeja, Lagos, Nigeria.
| | - Wasiu Lanre Adeyemo
- Professor/ Consultant, Department of Oral and Maxillofacial Surgery, College of Medicine, University of Lagos/ Lagos University Teaching Hospital, Idi - Araba, Lagos, Nigeria.
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Collins JR, Veras K, Hernández M, Hou W, Hong H, Romanos GE. Anti-inflammatory effect of salt water and chlorhexidine 0.12% mouthrinse after periodontal surgery: a randomized prospective clinical study. Clin Oral Investig 2021; 25:4349-4357. [PMID: 33389135 DOI: 10.1007/s00784-020-03748-w] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2020] [Accepted: 12/18/2020] [Indexed: 11/30/2022]
Abstract
OBJECTIVES The purpose of this study was to compare the anti-inflammatory efficacy of sodium chloride- and a 0.12% chlorhexidine mouth rinses in patients undergoing minimal invasive periodontal surgery. MATERIALS AND METHODS Forty-seven patients with a diagnosis of periodontitis and indication for access flap procedure were randomly selected. Group A: a sodium chloride (salt)water-based mouth rinse (test group) or group B: a 0.12% chlorhexidine mouth rinse (control group) administered after surgery. Gingival Index (GI) were evaluated in the whole mouth and in the surgical site at baseline (T1), a week later (T2), and 12 weeks (T3) after the treatment. Total MMP activity was measured in GCF using a commercial kit and plate reader. Medians of total MMP activity and GI were compared for time intervals T1 vs. T2, T1 vs. T3, and T2 vs T3 using Friedman tests and Wilcoxon signed rank tests, and were also compared between test and control using Mann-WhitneyU tests at each timepoint. RESULTS The average GI values showed significant differences between baseline and T2 (p = 0.0005) and baseline and T3 (p = 0.003) in the test group. CONCLUSION The sodium chloride-mouth rinse use after periodontal surgery seems to have similar anti-inflammatory properties as CHX mouth rinse and can be used regularly postoperatively after periodontal surgical procedures. CLINICAL RELEVANCE The use of salt water mouthwash showed an anti-inflammatory effect similar to CHX 0.12% after minimal invasive periodontal surgery. Salt water mouthwash is accessible to the world population and can contribute on the healing process after periodontal surgery.
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Affiliation(s)
- James Rudolph Collins
- Department of Periodontology, School of Dentistry, Pontificia Universidad Católica Madre y Maestra (PUCMM), Santo Domingo, Dominican Republic.
| | - Kenia Veras
- Department of Periodontology, School of Dentistry, Pontificia Universidad Católica Madre y Maestra (PUCMM), Santo Domingo, Dominican Republic
| | - Marcela Hernández
- Department of Pathology and Oral Medicine, School of Dentistry, Universidad de Chile, Santiago, Chile
| | - Wei Hou
- Department of Family, Population and Preventive Medicine, School of Medicine, Stony Brook, NY, USA
| | - Houlin Hong
- Department of Family, Population and Preventive Medicine, School of Medicine, Stony Brook, NY, USA
| | - Georgios E Romanos
- Department of Periodontology, School of Dental Medicine, Stony Brook University, Stony Brook, NY, USA
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Facial cortical bone regeneration post-extraction in non-grafted sockets allows for early implant placement and long-term functional stability. Arch Oral Biol 2020; 112:104678. [PMID: 32062103 DOI: 10.1016/j.archoralbio.2020.104678] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2019] [Revised: 12/13/2019] [Accepted: 02/05/2020] [Indexed: 11/21/2022]
Abstract
OBJECTIVE To evaluate posterior implant placement feasibility shortly after tooth extraction in non-grafted sockets with and without dehiscence at the time of extraction. DESIGN Ninety-five patients requiring posterior extractions entered this cross-sectional study. They were divided in three groups after extraction: G1 without dehiscence, G2 with dehiscence ≤5 and G3 > 5 mm. CBCT were taken prior to implant placement at an average of 12-weeks post-extraction to evaluate the need for grafting, cortical bone formation and bucco-lingual width (BLW). Actual BLW (n = 60) were compared to minimum expected BLW in 3 scenarios of BLW thickness averaging 6.4-7.4-8.4 mm. Peri-implant tissues were assessed for pocket formation and inflammation following established success criteria. RESULTS New cortical bone formation and sufficient BLW made implant placement feasible in sites with and without dehiscence at the time of extraction after an average healing time of 11.9 ± 2.4weeks (range: 8-18). Total average CBCT BLW was 10.1 ± 1.6 mm. All groups had a significantly higher BLW, than scenarios 1-3 (p < 0.0001). Molars were 20 times more likely than premolars to heal with BLW>10 mm (OR = 20; RR = 4.2; CI95 %: 5.3-74.2; p < 0.0001). Dehiscence sockets were 1.5 times more likely than non-dehiscenced sockets to present BLW ≤ 10 mm (OR = 1.5; RR = 0.6; CI95 %:0.9-2.5; p = 0.08). A band of keratinized tissue was present in all implants and success rates were 100 % at an average follow-up of 51.0 ± 23.4 months. CONCLUSION Implant placement is feasible without socket grafting shortly after tooth extraction. Non-grafted sockets present a significant osteogenic potential. Dehiscence sockets are likely to self-repair by forming a new cortical plate. The unassisted regenerated intra-socket bone allows for functional implant stability long-term.
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