The effect of antiseptic oral sprays on dental plaque and gingival inflammation: A systematic review and meta-analysis

Int J Dent Hyg. 2019 Feb;17(1):16-26. doi: 10.1111/idh.12331. Epub 2018 Feb 6.

Abstract

Objectives: To review the effectiveness of antiseptic oral sprays on oral health.

Methods and materials: Three electronic databases (PubMed, Cochrane Library and Web of Science) were systematically searched to identify relevant studies. Only randomized controlled trials (RCTs) comparing the effect of oral sprays to placebo/control spray or mouthrinse on dental plaque and gingival inflammation were included.

Results: Among a total of 996 papers, 20 effective studies fulfilled the selection criteria, and 8 studies were suitable for inclusion in meta-analyses. A meta-analysis of three studies using a 0.2% chlorhexidine (CHX) spray intervention, without prophylaxis at baseline, showed reductions in Plaque Index (PI) (Silness and Löe) and Gingival Index (GI) (Silness and Löe) scores of 0.74 (95% CI: -1.03 to -0.45) and 0.22 (95% CI: -0.38 to -0.06), respectively. Five studies provided a prophylaxis for subjects before study initiation. Three of these five studies used 0.2% CHX spray. A meta-analysis demonstrated an increase of 0.18 (95% CI: -0.01 to 0.37) in PI (Silness and Löe) scores. Two RCTs compared 0.12% and 0.2% CHX spray, and a meta-analysis showed increases of 1.71 (95% CI: 1.27 to 2.14) and 1.58 (95% CI: 1.23 to 1.93), respectively, in PI (Quigley and Hein) scores. Of the RCTs not amenable to meta-analysis, eight studies reported significant improvements in PI and GI scores.

Conclusions: Available evidence suggests that oral sprays are an acceptable delivery method for antiseptic agents. Further high-quality studies are warranted to determine the effectiveness of alternative chemotherapeutic agents delivered via oral sprays on oral health.

Keywords: gingivitis; meta-analysis; oral hygiene; plaque; systematic review.

Publication types

  • Meta-Analysis
  • Systematic Review

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Anti-Infective Agents, Local / administration & dosage*
  • Child
  • Chlorhexidine / administration & dosage*
  • Databases, Bibliographic
  • Dental Plaque / diagnosis
  • Dental Plaque / prevention & control*
  • Dental Plaque Index
  • Female
  • Gingivitis / diagnosis
  • Gingivitis / prevention & control*
  • Humans
  • Male
  • Middle Aged
  • Oral Hygiene
  • Oral Sprays*
  • Periodontal Index
  • Randomized Controlled Trials as Topic
  • Young Adult

Substances

  • Anti-Infective Agents, Local
  • Oral Sprays
  • Chlorhexidine