A Systematic Review of the Effect of Oral Rinsing with H(2)O(2) on Clinical and Microbiological Parameters Related to Plaque, Gingivitis, and Microbes

BACKGROUND: Hydrogen peroxide (H(2)O(2)) has been used for more than a century clinically to control plaque and gingival inflammation, with unclear supporting evidence. AIM: The aim of the present systematic review of the literature is to assess the effect of mouth rinses with H(2)O(2) on dental plaque, gingival inflammation, and oral microorganisms. METHODS: Five databases (PubMed, Scopus, Embase, Cochrane Library, and Web of Science) were searched with the following focused question: what is the effect of hydrogen peroxide, in comparison to chlorhexidine or to a placebo solution, in oral microbiota control, dental plaque, and gingival inflammatory outcomes? Two independent examiners retrieved the articles and evaluated the evidence. RESULTS: The majority of included studies were performed with 1.5% H(2)O(2). Results related to plaque accumulation generally demonstrate a slightly better effect of H(2)O(2) as compared to placebo mouth rinses, however with a lower performance as compared to chlorhexidine. In terms of gingival inflammation, H(2)O(2) performs better than placebo and more clearly demonstrates an anti-inflammation effect. No studies evaluated the effect of H(2)O(2) against viruses or fungi. In terms of bacteria, H(2)O(2) demonstrates an antibacterial effect. CONCLUSION: Rinsing with H(2)O(2) has the potential to affect plaque, gingivitis, and oral bacteria, as compared to placebo. However, the antibacterial results are not comparable to the performance of chlorhexidine.