Findings

What do systematic reviews say?

45 questions · 49 findings · 2 reviews · Periodontology · All outcomes

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No studies found 1 · 2%GRADE not reported 25 · 51%Very low 19 · 38.8%Low 3 · 6.1%Moderate 1 · 2%High 0 · 0%

Chlorhexidine mouthwash vs placebo

Cariogenic bacteria (Mutans streptococci) · People undergoing orthodontic treatment (any age; 9 to 34 years in included studies)

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

1 finding from 1 review

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

Cariogenic bacteria (Mutans streptococci) · People undergoing orthodontic treatment (any age; 9 to 34 years in included studies)

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

1 finding from 1 review

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

Herbal mouthwash vs placebo

Plaque · People undergoing orthodontic treatment (any age; 9 to 34 years in included studies)

Herbal mouthwash reduced some plaque-related indices versus placebo, with low-certainty evidence.

1 finding from 1 review

The efficacy of mouthwashes on oral microorganisms and gingivitis in patients undergoing orthodontic treatment:… 2023 All outcomes
≤ 3 months
PI was significantly reduced compared to placebo [56]; VPI was significantly reduced compared to placebo [41]; PI was insignificantly reduced compared to placebo [19].
3 studies
Low

Fluoride mouthwash vs Blank control

Cariogenic bacteria (Mutans streptococci) · People undergoing orthodontic treatment (any age; 9 to 34 years in included studies)

Short-term fluoride mouthwash reduced Mutans streptococci, but certainty is very low.

2 findings from 1 review

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 baseline according to two studies [33; 34].
2 studies
Very low
The efficacy of mouthwashes on oral microorganisms and gingivitis in patients undergoing orthodontic treatment:… 2023 All outcomes
≥ 12 months
Colony count of MS was similar to blank control according to two studies [37; 59].
2 studies
Very low

Chlorhexidine mouthwash vs Placebo mouthwash

Probing pocket depth (PPD/PD) · Orthodontic patients (any age) undergoing orthodontic treatment (mostly fixed appliances)

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

1 finding from 1 review

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

Plaque · Orthodontic patients (any age) undergoing orthodontic treatment (mostly fixed appliances)

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).

1 finding from 1 review

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

Cetylpyridinium chloride mouthwash vs Blank control

Plaque · Orthodontic patients (any age) undergoing orthodontic treatment (mostly fixed appliances)

CPC mouthwash may reduce plaque-related indexes versus blank control in the short term, but the evidence is very uncertain (very low certainty).

1 finding from 1 review

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)
BBPI was significantly reduced compared to blank control [47]. PI was significantly reduced compared to blank control [50]. The amount of dental plaque was significantly reduced compared to baseline [38].
3 studies
Very low

Herbal mouthwash vs placebo

Cariogenic bacteria (Mutans streptococci) · People undergoing orthodontic treatment (any age; 9 to 34 years in included studies)

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

1 finding from 1 review

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 placebo [52]; colony count was slightly reduced compared to placebo in a short time in one study [40].
2 studies
Very low

Fluoride mouthwash vs Blank control

Gingival inflammation-related index · Orthodontic patients (any age) undergoing orthodontic treatment (mostly fixed appliances)

Short-term fluoride mouthwash has uncertain effects on gingival inflammation-related indexes versus blank control (very low certainty).

1 finding from 1 review

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)
MGI' and BI' was significantly reduced compared to baseline [34]. BOP and GI was slightly lower compared to blank control [46].
2 studies
Very low

Fluoride mouthwash vs Blank control

Plaque · People undergoing orthodontic treatment (any age; 9 to 34 years in included studies)

Long-term fluoride mouthwash showed mixed plaque-index effects, with very low-certainty evidence.

2 findings from 1 review

The efficacy of mouthwashes on oral microorganisms and gingivitis in patients undergoing orthodontic treatment:… 2023 All outcomes
≥ 12 months
PI was similar to blank control [37]; API was slightly reduced compared to blank control and significant at 6 and 9 months [59].
2 studies
Very low
The efficacy of mouthwashes on oral microorganisms and gingivitis in patients undergoing orthodontic treatment:… 2023 All outcomes
≤ 3 months
TI was significantly reduced compared to baseline [34]; PI was significantly reduced compared to baseline but similar to blank control [46].
2 studies
Very low

Fluoride mouthwash vs Blank control

Cariogenic bacteria (Lactobacilli colony count) · Orthodontic patients (any age) undergoing orthodontic treatment (mostly fixed appliances)

Long-term (>=12 months) fluoride mouthwash may make little or no difference to Lactobacilli colony counts versus blank control (very low certainty).

1 finding from 1 review

The efficacy of mouthwashes on oral microorganisms and gingivitis in patients undergoing orthodontic treatment:… 2023 All outcomes
>=12 months (long-term) · Orthodontic patients undergoing orthodontic treatment (randomized controlled trials; multiple countries)
Colony count of LB was similar to blank control according to two studies [37, 59].
2 studies
Very low

Chlorhexidine mouthwash vs Blank control

Gingival index (GI) · Orthodontic patients (any age) undergoing orthodontic treatment (mostly fixed appliances)

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).

1 finding from 1 review

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

Herbal mouthwash vs placebo

Gingival inflammation-related index · People undergoing orthodontic treatment (any age; 9 to 34 years in included studies)

Herbal mouthwash reduced gingival inflammation-related indices versus placebo, but certainty is very low.

1 finding from 1 review

The efficacy of mouthwashes on oral microorganisms and gingivitis in patients undergoing orthodontic treatment:… 2023 All outcomes
≤ 3 months
GBI was significantly reduced compared to placebo [41]; GBI was significantly reduced compared to placebo [56]; BI was significantly reduced compared to placebo [40].
3 studies
Very low

Herbal mouthwash vs Blank control

Gingival index (GI) · Orthodontic patients (any age) undergoing orthodontic treatment (mostly fixed appliances)

Herbal mouthwash probably reduces the Gingival Index versus blank control in the short term (WMD -0.20, 95% CI -0.32 to -0.09; moderate certainty).

1 finding from 1 review

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 -0.20 [-0.32, -0.09]
3 studies · 132 participants
Moderate

Chlorhexidine mouthwash vs placebo

Plaque index (PI) / oral hygiene · People undergoing orthodontic treatment (any age; 9 to 34 years in included studies)

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

1 finding from 1 review

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

Probiotic mouthwash (e.g., Lactobacillus-based) vs Blank control

Cariogenic bacteria (Mutans streptococci) · Orthodontic patients (any age) undergoing orthodontic treatment (mostly fixed appliances)

Probiotic mouthwash has inconsistent effects on Mutans streptococci colony counts versus blank control; the evidence is very uncertain (very low certainty).

1 finding from 1 review

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 MS was significantly reduced compared to blank control [53]. Colony count of MS was insignificantly increased compared to baseline [33].
2 studies
Very low

Chlorhexidine mouthwash vs Placebo mouthwash

Gingival index (GI) · Orthodontic patients (any age) undergoing orthodontic treatment (mostly fixed appliances)

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).

1 finding from 1 review

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

Herbal mouthwash vs Blank control

Plaque · People undergoing orthodontic treatment (any age; 9 to 34 years in included studies)

Herbal mouthwash reduced several plaque-related indices, but certainty is very low.

1 finding from 1 review

The efficacy of mouthwashes on oral microorganisms and gingivitis in patients undergoing orthodontic treatment:… 2023 All outcomes
≤ 3 months
PI was significantly reduced compared to baseline [39; 48; 54; 58]; BBPI was significantly reduced compared to blank control [47]; TI and dental plaque amount were significantly reduced compared to baseline [45; 38].
8 studies
Very low

Chlorhexidine mouthwash vs Blank control

Total bacteria (colony count) · Orthodontic patients (any age) undergoing orthodontic treatment (mostly fixed appliances)

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

1 finding from 1 review

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

Herbal mouthwash vs Blank control

Gingival inflammation-related index · People undergoing orthodontic treatment (any age; 9 to 34 years in included studies)

Herbal mouthwash reduced some gingival inflammation-related indices, but certainty is very low.

1 finding from 1 review

The efficacy of mouthwashes on oral microorganisms and gingivitis in patients undergoing orthodontic treatment:… 2023 All outcomes
≤ 3 months
CPI was significantly reduced compared to baseline [35]; SBI was significantly reduced while MGI was similar compared to baseline [45]; BOP was significantly reduced compared to blank control [39].
3 studies
Very low