568 Chlorhexidine mouthrinse effective short-term adjunct for dental plaque reduction

April 16, 2018

written by Brian McAvoy

Clinical question

How effective is chlorhexidine mouthrinse as an adjunct to mechanical oral hygiene procedures for the control of gingivitis and plaque?

Bottom line

There was high-quality evidence of a large reduction in dental plaque with chlorhexidine mouthrinse used as an adjunct to mechanical oral hygiene procedures for 4 to 6 weeks and 6 months. There was also high-quality evidence of a reduction in gingivitis in individuals with mild gingival inflammation on average (mean score of 1 on the 0 to 3 Gingival Index scale), that was not considered to be clinically relevant. There was no evidence that one concentration of chlorhexidine mouthrinse was more effective than another. Rinsing with chlorhexidine mouthrinse for 4 weeks or longer causes extrinsic tooth staining. There were also other adverse effects, such as calculus build-up, transient taste disturbance and effects on the oral mucosa (soreness, irritation, mild desquamation and mucosal ulceration/erosions). Chlorhexidine mouthrinse is indicated in particular clinical situations for short periods of time.


Over half of the included studies were either funded directly, received support for the study or were affiliated in some way with industry.


Dental plaque associated gingivitis is a reversible inflammatory condition caused by accumulation and persistence of microbial biofilms on the teeth. In susceptible individuals, gingivitis may lead to periodontitis and loss of the soft tissue and bony support for the tooth. It is thought that chlorhexidine mouthrinse may reduce the build-up of plaque, thereby reducing gingivitis.

Cochrane Systematic Review

James P et al. Chlorhexidine mouthrinse as an adjunctive treatment for gingival health. Cochrane Reviews, 2017, Issue 3. Art. No.: CD008676.DOI: 10.1002/14651858. CD008676.pub3. This review contains 51 studies involving 5345 participants.

Pearls are an independent product of the Cochrane primary care group and are meant for educational use and not to guide clinical care.