A randomized double‐blind clinical trial to evaluate the efficacy of chlorhexidine, antioxidant, and hyaluronic acid mouthwashes in the management of biofilm‐induced gingivitis

Research output: Contribution to journalArticlepeer-review


  • Ali A. Abdulkareem
  • Zaid A. Al Marah
  • Hayder R. Abdulbaqi
  • Ali J. Alshaeli
  • Michael Milward

Colleges, School and Institutes

External organisations

  • College of Dentistry University of Baghdad Baghdad Iraq
  • Faculty of Dentistry Dijlah University College Baghdad Iraq


Objectives: To investigate the antiplaque and antigingivitis efficacy in addition to evaluating side effects and subjects’ perceptions of three commercially available mouthwashes. Methods: This study was a double-blind, parallel, and short-term trial. A total of 75 dental students with biofilm-induced gingivitis were included in the final analysis of the current study. Clinical parameters (plaque index and bleeding on probing) and the staining effect were measured at baseline and after 7 days. In addition, a VAS-based assessment questionnaire was completed by the participants. Results: All interventions significantly reduced plaque scores, but chlorhexidine (CHX) had a significantly higher effect than the hyaluronic acid (HA) and antioxidant mouthwashes. However, all mouthwashes significantly reduced the total bleeding scores to <10% in 53% of the patients, compared to the baseline record. Additionally, teeth underwent shade changes in association with all interventions by the end of the study. Analysis of feedback about the mouthwashes showed that the participants seemed to prefer the HA mouthwash over the other mouthwashes. Conclusions: CHX remains the most effective antiplaque mouthwash although HA and antioxidants are as effective as CHX in reducing bleeding. In addition, based on its better acceptance by the participants, HA is potentially a good alternative to CHX.


Original languageEnglish
Pages (from-to)268-277
Number of pages10
JournalInternational Journal of Dental Hygiene
Issue number3
Early online date26 Feb 2020
Publication statusPublished - 1 Aug 2020


  • chlorhexidine, dental biofilm, mouth rinse/wash, oral hygiene, staining

ASJC Scopus subject areas