What do systematic reviews say?

Chlorhexidine mouthwash vs placebo

Chlorhexidine mouthwash reduced Mutans streptococci versus placebo, but certainty is very low.

• The efficacy of mouthwashes on oral microorganisms and gingivitis in patients undergoing orthodontic treatment:… 2023 All outcomes

  ≤ 3 months
  Colony count of MS was significantly reduced compared to placebos according to three studies [34; 48; 52]; colony count of MS was slightly reduced compared to placebo in a short time in one study [40].
  4 studies
  Very low

Chlorhexidine mouthwash vs Blank control

Chlorhexidine mouthwash reduced Mutans streptococci versus blank control, but certainty is very low.

• The efficacy of mouthwashes on oral microorganisms and gingivitis in patients undergoing orthodontic treatment:… 2023 All outcomes

  ≤ 3 months
  Colony count of MS was significantly reduced compared to blank control according to one study [53]; one study reported a significant reduction compared to baseline [51].
  2 studies
  Very low

Chlorhexidine mouthwash vs placebo

Chlorhexidine mouthwash reduced Plaque Index versus placebo, but certainty is very low.

• The efficacy of mouthwashes on oral microorganisms and gingivitis in patients undergoing orthodontic treatment:… 2023 All outcomes

  ≤ 3 months
  Plaque Index was significantly reduced compared to placebos according to two studies [20; 32].
  2 studies
  Very low

Chlorhexidine mouthwash vs Salt and soda mouthwash

Chlorhexidine mouthwash showed no clear difference in mucositis eradicated compared with salt and soda mouthwash; GRADE not reported.

• Interventions for treating oral mucositis for patients with cancer receiving treatment 2010 · Cochrane All outcomes
  RR 1.10 [0.90, 1.35]
  1 study · 138 participants
  GRADE not reported

Chlorhexidine mouthwash vs Salt and soda mouthwash

Chlorhexidine mouthwash showed no clear difference in time to heal mucositis (days) compared with salt and soda mouthwash; GRADE not reported.

• Interventions for treating oral mucositis for patients with cancer receiving treatment 2010 · Cochrane All outcomes
  MD -0.40 [-1.49, 0.69]
  1 study · 100 participants
  GRADE not reported

Chlorhexidine mouthwash vs Salt and soda mouthwash

Chlorhexidine mouthwash showed no clear difference in average pain scores (0-100 VAS) compared with salt and soda mouthwash; GRADE not reported.

• Interventions for treating oral mucositis for patients with cancer receiving treatment 2010 · Cochrane All outcomes
  MD -3.50 [-13.35, 6.35]
  1 study · 63 participants
  GRADE not reported

Mouthwash (amine/stannous fluoride; or chlorhexidine + cetylpyridinium + zinc) vs Chlorhexidine mouthwash or tap water

• Interventions for managing halitosis 2019 · Cochrane All outcomes

  7 days
  Wigger-Alberti 2010 mouthwash data (ASF; CHX + CPC + Zn; CHX; tap water) were calculated from a graph (Additional Table 1) but not included, as the report did not give details of sample size per group.
  1 study
  GRADE not reported

Chlorhexidine + zinc acetate mouthwash vs Placebo mouthwash

The review found no eligible studies for this question.

• Interventions for managing halitosis 2019 · Cochrane All outcomes

  mean 3 months
  Adverse events: listed in the Summary of findings table but no data reported. No data were reported for adverse events.
  0 studies
  No studies found

Chlorhexidine + zinc acetate mouthwash vs Placebo mouthwash

The review found no eligible studies for this question.

• Interventions for managing halitosis 2019 · Cochrane All outcomes

  mean 3 months
  Patient-reported OLT score: listed in the Summary of findings table but no data reported. No data were reported for patient-reported OLT score.
  0 studies
  No studies found

Chlorhexidine + zinc acetate mouthwash vs Placebo mouthwash

It is very uncertain whether chlorhexidine + zinc acetate mouthwash changes dentist-reported organoleptic test (OLT) score (scale 0 to 5) compared with placebo mouthwash (very low certainty).

• Interventions for managing halitosis 2019 · Cochrane All outcomes

  mean 3 months
  MD -0.2 [-0.58, 0.18]
  1 study · 44 participants
  Very low

Antiseptic mouthwash (e.g. chlorhexidine) vs Another topical agent or placebo

The review found no eligible studies for this question.

• Topical treatments for HIV‐related oral ulcers 2012 · Cochrane All outcomes
  No studies were included in this review. A total of 233 abstracts were retrieved; 25 were selected as potentially eligible but all were excluded (10 reported systemic rather than topical treatment; 3 non‐RCTs; 6…
  0 studies
  No studies found

Antiseptic mouthwash (e.g. chlorhexidine) vs Another topical agent or placebo

The review found no eligible studies for this question.

• Topical treatments for HIV‐related oral ulcers 2012 · Cochrane All outcomes
  No studies were included in this review. A total of 233 abstracts were retrieved; 25 were selected as potentially eligible but all were excluded (10 reported systemic rather than topical treatment; 3 non‐RCTs; 6…
  0 studies
  No studies found

Antiseptic mouthwash (e.g. chlorhexidine) vs Another topical agent or placebo

The review found no eligible studies for this question.

• Topical treatments for HIV‐related oral ulcers 2012 · Cochrane All outcomes
  No studies were included in this review. A total of 233 abstracts were retrieved; 25 were selected as potentially eligible but all were excluded (10 reported systemic rather than topical treatment; 3 non‐RCTs; 6…
  0 studies
  No studies found

Antiseptic mouthwash (e.g. chlorhexidine) vs Another topical agent or placebo

The review found no eligible studies for this question.

• Topical treatments for HIV‐related oral ulcers 2012 · Cochrane All outcomes
  No studies were included in this review. A total of 233 abstracts were retrieved; 25 were selected as potentially eligible but all were excluded (10 reported systemic rather than topical treatment; 3 non‐RCTs; 6…
  0 studies
  No studies found

Antiseptic mouthwash (e.g. chlorhexidine) vs Another topical agent or placebo

The review found no eligible studies for this question.

• Topical treatments for HIV‐related oral ulcers 2012 · Cochrane All outcomes
  No studies were included in this review. A total of 233 abstracts were retrieved; 25 were selected as potentially eligible but all were excluded (10 reported systemic rather than topical treatment; 3 non‐RCTs; 6…
  0 studies
  No studies found

Chlorhexidine mouthwash vs Placebo mouthwash

Chlorhexidine mouthwash may reduce pocket probing depth versus placebo in the short term (low certainty).

• The efficacy of mouthwashes on oral microorganisms and gingivitis in patients undergoing orthodontic treatment:… 2023 All outcomes

  <=3 months (short-term) · Orthodontic patients undergoing orthodontic treatment (randomized controlled trials; multiple countries)
  PD was significantly reduced except mid-lingual site compared to placebo [32]. The changes of PD were significantly higher compared to placebo [56].
  2 studies
  Low

Chlorhexidine mouthwash vs Blank control

Chlorhexidine mouthwash may reduce the Plaque Index versus blank control in the short term (WMD -0.70, 95% CI -1.12 to -0.27), but the evidence is very uncertain (very low certainty).

• The efficacy of mouthwashes on oral microorganisms and gingivitis in patients undergoing orthodontic treatment:… 2023 All outcomes

  <=3 months (short-term) · Orthodontic patients undergoing orthodontic treatment (randomized controlled trials; multiple countries)
  WMD -0.70 [-1.12, -0.27]
  4 studies · 188 participants
  Very low

Chlorhexidine mouthwash vs Blank control

Chlorhexidine mouthwash may reduce the Gingival Index versus blank control in the short term (WMD -0.54, 95% CI -0.96 to -0.13), but with very high heterogeneity the evidence is very uncertain (very low certainty).

• The efficacy of mouthwashes on oral microorganisms and gingivitis in patients undergoing orthodontic treatment:… 2023 All outcomes

  <=3 months (short-term) · Orthodontic patients undergoing orthodontic treatment (randomized controlled trials; multiple countries)
  WMD -0.54 [-0.96, -0.13]
  6 studies · 274 participants
  Very low

Chlorhexidine mouthwash vs Placebo mouthwash

Chlorhexidine mouthwash probably reduces the Gingival Index versus placebo in the short term (WMD -0.45, 95% CI -0.70 to -0.20; low certainty).

• The efficacy of mouthwashes on oral microorganisms and gingivitis in patients undergoing orthodontic treatment:… 2023 All outcomes

  <=3 months (short-term) · Orthodontic patients undergoing orthodontic treatment (randomized controlled trials; multiple countries)
  WMD -0.45 [-0.70, -0.20]
  3 studies · 98 participants
  Low

Chlorhexidine mouthwash vs Blank control

Chlorhexidine mouthwash may reduce total bacteria colony counts versus blank control in the short term, but the evidence is very uncertain (very low certainty).

• The efficacy of mouthwashes on oral microorganisms and gingivitis in patients undergoing orthodontic treatment:… 2023 All outcomes

  <=3 months (short-term) · Orthodontic patients undergoing orthodontic treatment (randomized controlled trials; multiple countries)
  Colony count of total bacteria were significantly reduced compared to placebos according to two studies [34, 43].
  2 studies
  Very low