Effectiveness of a herbal mouthrinse on de novo plaque formation


  • Jippy R.S. Coorg Institute of Dental Sciences
  • Ananda S.R.
  • Jithesh Jain






Chlorhexidine, Chemical, Plaque Control, Ayurvedic, Mouthwash


Background: Herbal mouthrinses have been recently introduced with the objective of achieving effective plaque control. Till date, chlorhexidine has been a gold standard with regard to anti-plaque agents.

Objectives: To compare the effeciveness of the herbal mouthrinse (Hiora) against chlorhexidine mouthrinse.

Methods:The study is a randomized, double blind, crossover clinical study. At the baseline, the volunteers brush their teeth using toothpaste without any active ingredient for 2 minutes. Oral prophylaxis was performed to ensure that the teeth are free of plaque, stains and calculus. Each subject was randomly assigned to both the experimental groups. During the trials, the volunteers were rinsed their mouths, according to the assigned random sequence of treatments: Chlorhexidine as chemical and HiOra as herbal mouthrinse. Both the mouthrinses were packed in similar coloured bottles but labeled differently and randomly administered to the subjects by a blinded operator. Each subject received oral and written instructions on the use of mouth rinses. After one week, the study subjects were asked to suspend their oral hygiene for 24 hours, and accumulated plaque was re-evaluated with erythrosine. The plaque index was recorded in the six selected teeth at the end of the trial. After the trial period, the usual oral hygiene habits resumed.

Results: There were no statistically significant differences between herbal and chemical mouthrinses.

Conclusion: Herbal mouth rinses may be as effective as chlorhexidine as chemical anti-plaque agents with fewer side effects.


[1] Narayanaswami V. Origin and development of ayurveda: (a brief history). Ancient Science of Life. 1981; Jul; 1(1):1-7.

[2] Marsh PD, Bradshaw DJ. Dental plaque as a biofilm. Journal of Industrial Microbiology 1995; 15: 169–175.


[3] Axelsson P. Mechanical plaque control. In: Lang NP, Karring T, eds. Proceedings of the 1st European Workshop on Periodontology. Chicago, Quintessence, 1993, 1: 219–243.

[4] Marsh PD. Microbiological aspects of the chemical control of plaque and gingivitis. Journal of Dental Research 1992; 71: 1431–1438. https://doi.org/10.1177/00220345920710071501.

[5] Baker PJ, Coburn RA, Genco RJ, Evans RT. Structural determinants of activity of chlorhexidine and alkyl bisbiguanides against the human oral flora. Journal of Dental Research 1987; 66:1099-106.https://doi.org/10.1177/00220345870660060301.

[6] Adams D, Addy M. Mouthrinses. Advances in Dental Research 1994; 8: 291–301.https://doi.org/10.1177/08959374940080022401.

[7] Moran JM. Chemical plaque control – prevention for the masses. Periodontology 2000 1997; 15: 109–117.


[8] Baehni PC, Takeuchi Y. Anti-plaque agents in the prevention of biofilm-associated oral diseases. Oral Diseases 2003; 9(Suppl. 1): 23–29.https://doi.org/10.1034/j.1601-0825.9.s1.5.x.

[9] Scheie AA. Modes of action of currently known chemical antiplaque agents other than chlorhexidine. Journal of Dental Research 1989; 68:1609‑16.

[10] White DJ, Barker ML, Klukowska M. In vivo antiplaque efficacy of combined antimicrobial dentifrice and rinse hygiene regimens. American Journal of Dentistry 2008; 21:189-96.

[11] Fine DH, Markowitz K, Furgang D, Goldsmith D, Charles CH, Lisante TA, et al. Effect of an essential oil‑containing antimicrobial mouthrinse on specific plaque bacteria in vivo. Journal of Clinical Periodontology 2007; 34:652-7.https://doi.org/10.1111/j.1600-051X.2007.01096.x.

[12] Balenseifen JW, Madonia JV. Study of dental plaque in orthodontic patients. Journal of Dental Research 1970; 49:320‑4.


[13] Kocak MM, Ozcan S, Kocak S, Topuz O, Erten H. Comparison of the efficacy of three different mouthrinse solutions in decreasing the level of Streptococcus mutansin saliva. European Journal of Dentistry 2009; 3:57‑61.

[14] Wigger‑Alberti W, Gysen K, Axmann EM, Wilhelm KP. Efficacy of a new mouthrinse formulation on the reduction of oral malodourin vivo. A randomized, double‑blind, placebo‑controlled, 3 week clinical study. Journal of Breath Research 2010; 4:017102.


[15] Moran J, Addy M, Kohut B, Hovliaras CA, Newcombe RG. Efficacy of mouthrinses in inhibiting the development of supragingival plaque over a 4‑day period of no oral hygiene. Journal of Periodontology 1994; 65:904‑7


[16] H. R. Chitme, R. Chandra, and S. Kaushik, “Studies on antidiarrheal activity of calotropisgigantea R. Br. in Experimental animals,†Journal of Pharmacy & Pharmaceutical Science 2003; 7: 70–75.

[17] Narayan A, Mendon C.Comparing the effect of different mouthrinses on de nevo plaque formation. Journal of Contemporary Dental Practice 2012; 13(4): 460-463.


[18] Jagdish L, Anand VK, Kaviyarasan V. Effect of triphala on dental biofilm. Indian Journal of Science and Technology 2009; 2(1):30-33.

[19] Versteeg PA, NAM Rosema, Hoenderdos NL, Slot DE, Van der Weijden GA The plaque inhibitory effect of a CPC mouthrinse in a 3-day plaque accumulation model – a cross-over study International Journal of Dental Hygiene 2010;8:269-275.


[20] Rodrigues IS, de Oliveira DB, de Menezes PC, da Costa FN, Carlos MX, Pereira SL Effect of Lippiasidoides in mouthrinses on de novo plaque formation: a double-blind clinical study in humans. Indian Journal of dental Research 2013; Sep-Oct; 24(5):533-6. https://doi.org/10.4103/0970-9290.123360.

[21] Ulkur F, Arun T, Ozdemir F The effects of three different mouth rinses in a 4-day supragingival plaque regrowth study.EuropeanJournal of Dentistry 2013; Jul;7(3):352-8.


[22] Rivera S, Yévenes I, Reyes J, Norero H. Comparative effect again mouthrinses-gel of chlorexidinewithcommercial mouthrinses in the growth of plaque in 24 hours. Av Periodoncia 2006; 18:163-9.

[23] Claydon N, Addy M. The use of plaque area and plaque index to measure the effect of fluoride and chlorhexidine toothpastes on 24-h plaque regrowth. Journal of Clinical Periodontology 1995; 22:540-2.https://doi.org/10.1111/j.1600-051X.1995.tb00802.x.

[24] Sherp HW. Dental caries. Prospects for prevention. Science 1971; 173:1199-1205.https://doi.org/10.1126/science.173.4003.1199.

[25] Glavind L. Effect of monthly professional mechanical tooth cleaning on periodontal health in adults. Journal of Clinical Periodontology1977; 4: 100-06.


[26] Laher A and Cleaton-Jones PE. Chlorhexidine rinsing in physically handicapped puoils in Katlehong. Journal of the Dental Association of South Africa 1996; 51: 343-46.

[27] Heasman PA and Seymour SS. Pharmacological control of periodontal diseas (1). Antiplaque agents. Journal of Dentistry 1995; 22: 323-26.https://doi.org/10.1016/0300-5712(94)90083-3.

[28] Van Strydonck DA, Slot DE, Van der Velden U, Van der WeijdenF.Effect of a chlorhexidine mouthrinse on plaque, gingival inflammation and staining in gingivitis patients: a systematic review. Journal of Clinical Periodontology 2012 Nov; 39(11):1042-55. Epub 2012 Sep 7.


[29] RupaliKalsi, K. L. Vandana, and ShobhaPrakash. Effect of local drug delivery in chronic periodontitis patients: A metaanalysis. Journal of Indian Society of Periodontology 2011; 15(4): 304–309.https://doi.org/10.4103/0972-124X.92559.

[30] Fardal O, Turnbull RS (1986). A review of the literature on use of chlorhexidine in dentistry. Journal of the American Dental Association. 112: 863-869.https://doi.org/10.14219/jada.archive.1986.0118.

[31] Lang NP, Catalanotto F A, Antezak A A. Quality specific taste impairement following the application of Digluconate mouthrinses. Journal of clinical Periodontology 1988; 15: 43-48.


[32] Kaim JM, Gultz J, Do L and Scherer W. An in vitro investigation of the antimicrobial activity of an herbal mouthrinse. Journal of Clinical Dentistry(1998) 9: 46-48.

[33] Malhotra R, et al. Comparison of the effectiveness of a commercially available herbal mouthrinse with chlorhexidine gluconate at the clinical and patient level. Journal of Indian Society of Periodontology 2011; 15(4):349-52.https://doi.org/10.4103/0972-124X.92567.

[34] Masoumeh K, et al. Comparison of the antimicrobial effects of persica mouthwash and 0.2% chlorhexidine on aggregatibacterActinomycetemcomitans of healthy individuals and patients with chronic periodontitis. Research Journal of Medical Science 2012; 6(1):18-21.https://doi.org/10.3923/rjmsci.2012.18.21.

[35] Singh A, Daing A, Dixit J. The effect of herbal, essential oil and chlorhexidine mouthrinse on de novo plaque formation. International Journal of Dental Hygiene 2012; 11(1) 48–52.


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