Comparative evaluation of chlorhexidine, chlorhexidine anti discoloration system & herbal mouth rinses on tooth discoloration and anti-plaque activity in fixed orthodontic patients –A randomized controlled trial

Background: The placement of orthodontic appliances leads to plaque accumulation and demineralization of teeth.During the active phase of orthodontic treatment, along with mechanical tooth cleaning, chemical mouth rinse agents are beneficial in reducing bacterial count and plaque accumulation.But Chlorhexidine gluconate mouthwash cause some side effects like discoloration of the tooth and restoration.The purpose of this study was to compare the effect of chlorhexidine anti-discoloration system, Hi-ora, and Chlorhexidine mouthwash on tooth discoloration, and anti-plaque activity in patients undergoing fixed orthodontic treatment.Objective: Chlorhexidine gluconate is currently the most effective oral antimicrobial agent against microorganisms, but discoloration of the teeth prevents its long-term use and can reduce patient cooperation.In this study, the effect of chlorhexidine, chlorhexidine anti-discoloration system, and herbal mouthwash on stain index and anti-plaque activity in fixed orthodontic patients were compared. Materials and Methods:This study was performed as a single blinded randomized controlled trial on 60 patients undergoing fixed orthodontic treatment in the age group of 14-30 years.The patients were categorized into four groups, Water was given to Group 1, Hexidine 0.2% mouthwash to Group 2, Chlorhexidine anti discoloration system to Group 3, and HiOra mouthwash to Group 4. Plaque scores were recorded using the Silness J and Loe H plaque simplified index, Stain scores were recorded by using MacPherson's Modified Lobene stain index.Results: There was significant mean difference in the Plaque index between Group 1 and Group 2, Group 3, Group 4. No significant mean difference in the Plaque index among Group 2, Group 3, Group 4. Significant mean differences existed in the Stain index between Group 2 and Group 3. Conclusion: Hexidine 0.2% mouthwash, Clohex ADS mouthwash, and Hiora herbal mouthwash showed similar anti-plaque activity.Chlorhexidine Anti Discoloration System is more effective in reducing tooth staining.Hiora mouthwash does not produce stains on tooth surfaces.