Efficacy and safety of essential-oil-containing mouthrinses for plaque and gingivitis control in people with diabetes: an examiner-blind, randomised controlled trial

AIMS: To evaluate the anti-plaque and anti-gingivitis efficacy and the safety of essential-oil-containing mouthrinses in people with diabetes, a group at high periodontal disease risk. MATERIALS AND METHODS: This Phase IV, examiner-blind trial randomised 154 adults with type 1 (n = 15) or type 2 (n = 139) diabetes to use alcohol-containing essential oil (ACEO), alcohol-free essential oil (AFEO), or negative control mouthrinses alongside twice-daily brushing for 12 weeks. Assessments included a plaque index (TPI), gingival index (MGI), bleeding index (EBI), participant survey and adverse event monitoring. RESULTS: The essential-oil-containing mouthrinses (ACEO/AFEO) significantly reduced the primary endpoints of mean TPI (24.7%/13.2%) and mean MGI (37.2%/32.8%), versus the negative control, at Week 12 (p < 0.001). Both mouthrinses reduced EBI (68.7%/72.6%; p < 0.001), and participants reported better oral health experiences, versus negative control, at Week 12. Overall, 26.2% of participants were unaware of their elevated oral health risk due to diabetes, and 37.9% reported receiving no oral health guidance from healthcare providers. The mouthrinses showed good soft tissue tolerance. CONCLUSIONS: Essential-oil-containing mouthrinses significantly improved periodontal health in people with diabetes, when compared with a negative control rinse, and may serve as a valuable adjunct to mechanical oral hygiene in this population. The identified knowledge gap highlights the need for collaboration between primary, diabetes and dental practitioners to enhance patient outcomes through integrated care.