Evaluation of Probiotic, Chlorhexidine, and Fluoride Mouthwashes in Orthodontic Preventive Care- A Randomized Controlled Trial

Shyama Kunwar Deora,
Vivek Reddy Ganugapanta,
singaraju gowri sankar,
Rayala Bharghav,
Ubbarapu Lakhsmi Niharika,
Prasad Mandava*

Abstract

Introduction: Fixed orthodontic appliance therapy can lead to increased plaque accumulation, gingivitis, and white spot lesions (WSL) due to difficulties in maintaining proper oral hygiene. Objective: This study aims to compare the effectiveness of three different mouthwashes—Probiotic, Fluoridated, and Chlorhexidine (CHX) mouthwashes, in reducing plaque formation, gingivitis, and WSL during the early stages of orthodontic treatment. Materials and Methods: A randomized, three-arm- parallel study was conducted with 72 subjects undergoing fixed orthodontic therapy, divided equally into three active groups. Group I used Probiotic mouthwash, Group II used 0.2% Sodium fluoride mouthwash, and Group III used 0.2% Chlorhexidine mouthwash. Gingival Index (GI), Orthodontic Plaque Index (OPI), Bleeding on Probing (BOP), and WSL were assessed at baseline (T0), 4 weeks (T1), 8 weeks (T2), and 12 weeks (T3). Interventions were administered from T1 to T2 for 4 weeks and withdrawn. Intergroup and intra-group comparisons across the groups were assessed by non-parametric Kruskal-Wallis and Friedman tests. Results: Intra-group improvements in OPI, GI, BOP, and WSL over time for all three groups. Probiotic mouthwash showed the most substantial reduction in BOP (34% from baseline), followed by chlorhexidine (19%), and fluoride (11%) at the end of the 12th week. Fluoride mouthwash was most effective in reducing the OPI (15% from baseline) and WSL, while chlorhexidine was most effective in reducing the GI (15% from baseline). Inter-group comparisons revealed no statistically significant differences in the effectiveness of the three mouthwashes. Conclusion: All three mouthwashes improved oral hygiene indices over time, there were no significant differences between the probiotic, fluoridated, and chlorhexidine groups in their overall effectiveness.