Essential oils compared to chlorhexidine with respect to plaque and parameters of gingival inflammation: a systematic review

Background: The purpose of this review is to systematically evaluate the effects of an essential-oil mouthwash (EOMW) compared to a chlorhexidine mouthwash with respect to plaque and parameters of gingival inflammation.
Methods: PubMed/MEDLINE and Cochrane CENTRAL databases were searched for studies up to and including September 2010 to identify appropriate articles. A comprehensive search was designed, and the articles were independently screened for eligibility by two reviewers. Articles that evaluated the effects of the EOMWcompared to chlorhexidine mouthwashwere included. Where appropriate, a meta-analysis was performed, and weighted mean differences (WMDs) were calculated.
Results: A total of 390 unique articles were found, of which 19 articles met the eligibility criteria. A meta-analysis of long-term studies (duration ‡4 weeks) showed that the chlorhexidine mouthwash provided significantly better effects regarding plaque control than EOMW (WMD: 0.19; P = 0.0009). No significant difference with respect to reduction of gingival inflammation was found between EOMW and chlorhexidine mouthwash (WMD: 0.03; P = 0.58).
Conclusion: In long-term use, the standardized formulation of EOMWappeared to be a reliable alternative to chlorhexidine mouthwash with respect to parameters of gingival inflammation.