Comparative Evaluation of Natural Mouthrinses and Chlorhexidine in Dental Plaque Management: A Pilot Randomized Clinical Trial
Ioana Elena Lile, Tareq Hajaj, Ioana Veja, T. Hosszu, L. Vaida, Liana Todor, O.L. Stana, Ramona Amina Popovici, Diana Marian
Abstract
Aim: This study evaluated the efficacy of mouthrinses containing natural compounds—specifically, propolis and green tea extracts—in reducing bacterial dental plaque compared to a placebo and a 0.2% chlorhexidine rinse. We hypothesized that these natural compounds would significantly reduce plaque accumulation, with efficacy comparable to chlorhexidine. Objective: The objective was to evaluate the short-term efficacy of two natural mouthrinses—10% propolis and 5% green tea—compared to a placebo and 0.2% chlorhexidine in reducing dental plaque. Trial Design: The trial design was a randomized, placebo-controlled, parallel-group clinical trial with a 1:1:1:1 allocation ratio. Materials and Methods: In a single-blind, randomized, controlled trial, 60 healthy adult volunteers received a professional mechanical plaque removal (PMPR) and were then randomized into four groups (n = 15 each): a propolis mouthwash, a green tea mouthwash, a 0.2% chlorhexidine mouthwash (positive control), and a placebo rinse. The participants rinsed twice daily for four weeks in addition to standard tooth brushing. The plaque levels were assessed using the Silness–Löe plaque index at baseline and after four weeks. The data were analyzed using ANOVA and post hoc tests (α = 0.05). Ethical approval and informed consent were obtained. Results: All groups had similar baseline plaque scores (≈2.5). After four weeks, the propolis and green tea groups showed significant reductions in plaque (mean indices of 1.02 and 1.12, respectively) compared to the placebo group (mean index = 2.01, p < 0.001). The chlorhexidine group achieved a mean plaque index of 0.90. The propolis rinse showed no significant difference from chlorhexidine (p = 0.40), indicating comparable efficacy. The green tea rinse had a slightly higher plaque index than chlorhexidine (p = 0.03). No significant adverse effects were reported. Conclusions: Mouthwashes containing 10% propolis or 5% green tea significantly reduced dental plaque, with propolis demonstrating efficacy comparable to 0.2% chlorhexidine.