The influence of a hydrogen peroxide and glycerol containing mouthrinse on plaque accumulation: a 3-day non-brushing model

A Systematic Review of the Effect of Oral Rinsing with H2O2 on Clinical and Microbiological Parameters Related to Plaque, Gingivitis, and Microbes

Background

Hydrogen peroxide (H₂O₂) has been used for more than a century clinically to control plaque and gingival inflammation, with unclear supporting evidence.

Aim

The aim of the present systematic review of the literature is to assess the effect of mouth rinses with H₂O₂ on dental plaque, gingival inflammation, and oral microorganisms.

Methods

Five databases (PubMed, Scopus, Embase, Cochrane Library, and Web of Science) were searched with the following focused question: what is the effect of hydrogen peroxide, in comparison to chlorhexidine or to a placebo solution, in oral microbiota control, dental plaque, and gingival inflammatory outcomes? Two independent examiners retrieved the articles and evaluated the evidence.

Results

The majority of included studies were performed with 1.5% H₂O₂. Results related to plaque accumulation generally demonstrate a slightly better effect of H₂O₂ as compared to placebo mouth rinses, however with a lower performance as compared to chlorhexidine. In terms of gingival inflammation, H₂O₂ performs better than placebo and more clearly demonstrates an anti-inflammation effect. No studies evaluated the effect of H₂O₂ against viruses or fungi. In terms of bacteria, H₂O₂ demonstrates an antibacterial effect.

Conclusion

Rinsing with H₂O₂ has the potential to affect plaque, gingivitis, and oral bacteria, as compared to placebo. However, the antibacterial results are not comparable to the performance of chlorhexidine.