Effect of a sodium hypochlorite mouthwash on plaque and clinical parameters of periodontal disease‐a systematic review

OBJECTIVE: The present study aimed to establish the efficacy of sodium hypochlorite mouthwash (NaOCl‐MW) compared with a control mouthwash on plaque and clinical parameters of periodontal disease. METHODS: MEDLINE‐PubMed, Embase and Cochrane‐CENTRAL databases were searched for clinical trials on patients with gingivitis or periodontitis that assessed the effect of NaOCl‐MW in comparison with a negative or positive control on plaque index (PI), gingival index (GI), and bleeding index (BI) scores and probing pocket depth (PPD). Data were extracted from the eligible studies. RESULTS: Seven eligible papers were retrieved, which together represented six clinical trials. The studies showed considerable heterogeneity regarding methodological and clinical aspects that did not permit a meta‐analysis. Two of the three studies in which NaOCl‐MW was compared with a negative control showed that NaOCl‐MW significantly reduced PI, GI and BI, and no effect was found on PPD. In three studies, NaOCl‐MW was assessed using chlorhexidine mouthwash (CHX‐MW) as a positive control; no difference was found for GI and BI. One of the three comparisons showed a statistically significant PI score favouring NaOCl‐MW. One study measured PPD and found it to be significant in favour of NaOCl‐MW. CONCLUSIONS: Studies with a negative control group provided very weak quality evidence for a very small beneficial effect of NaOCl‐MW on PI, GI and BI scores. Studies with a positive control group provided very weak quality evidence that NaOCl‐MW had a similar effect as CHX‐MW on PI, GI and BI scores. The outcome for PPD was inconclusive.