Lupine Publishers | Journal of Pediatric Dentistry with High Impact Factor
Abstract
Objectives: In this study, a comparative study was done on
the effects of Vi-One and Listerine fluoridated mouthwashes on the
reduction of dental plaque in pediatric patients between 7-11 years
of age in dental clinics of Sepideh and apple in Shiraz, Iran.
Listerine Smart Rinse Kids is a product of the United States and
Vi-One Junior mouth wash is the domestic production of the country
at Rozhin Corporation. This research was conducted by Mohammad
Karimi and Hassan Dehghan in 2018-2019.
Material and Methods: In this study, 100 individuals were
selected and divided into two groups of 50. During the study, no
other method of controlling the plaque was used. In this method,
the first group first used Vi-One mouthwash for 10 days and after
two weeks of rest and minimizing dental plaque, they used Listerine
for 10 days. While the second group used Listerine first, then
they applied Vi- One in the same way. The results of this review
were then evaluated.
Results: The mean of plaque index in total mouth and in
the posterior teeth area with the use of Listerine Smart Rinse Kids was
lower than that of Vi-One Junior mouth rinse. In another words,
Listerine had a better effect on plaque removal than the Vi-One
mouthwash in the posterior mandibular region.
Conclusion: The results show that although Listerine mouthwash had a better effect on dental plaque removal, none of the two
mouthwashes had a significant difference in effects on maxillary and mandibular jaws.
Keywords: Dental Plaque; Vi- One, Listerine, Fluoridated Mouthwash; Periodontal Diseases; Plaque Index
Introduction
Currently, dental caries and gingivitis are common oral and
dental diseases in this country. One element that can prevent
tooth decay is Fluoride. In the oral health program of the country,
fluoride mouth wash 2% was used to prevent dental caries in
elementary school students all over the country [1]. In the other
hand, dental plaque is an important factor in the formation of
dental caries and periodontal diseases. Leo and his colleagues
have identified dental plaque as the main cause of gingivitis [2].
With the use of mouthwashes, one can control the dental plaque,
chemically [3,4]. In fact, mechanical plaque removal is one of
the most common and effective methods for preventing caries
and inflammation of the gum [5]. Fluoride mouthwash usage is
contraindicated in children younger than six years of age due to
the risk of swallowing and causing systemic toxicity and fluorosis
[6-8]. Symptoms of acute oral fluoride toxicity in children include
severe nausea, vomiting, hyper salivation, abdominal pain, and
diarrhea [9]. In severe or fatal cases, these symptoms can be
followed by convulsions, cardiac arrhythmias, and coma [10-
12]. Laboratory and animal data have shown that prevention the
accumulation of plaque and consequently, reduction in dental
plaque can be achieved when fluorides is applied topically which
inhibits the bacterial multiplication [13]. The fluoride from mouth
rinse is retained in dental plaque and saliva to help prevent
dental
caries [14]. In one review, the average caries reduction in
nonfluoridated communities attributable to fluoride mouth rinse
was 31% [15]. Another study in Sweden reported that the use of
fluoride mouthwash along with brushing has a significant effect
in decreasing of dental caries [16]. Listerine Smart Rinse Kids has
been used for the purpose of this study. This product is an
alcoholfree mouthwash. The ingredients include Sodium fluoride 0.02%
(0.01% w/v fluoride ion), Water, Sorbitol, flavor, phosphoric acid,
Sucralose, Cetylpyridinium chloride, disodium phosphate, sodium
saccharin, menthol, blue 1 and green 3 [17]. One study reported
that use of this mouthwash can strengthen teeth 99% better than
brushing alone [18]. Another source indicated that it gives 12-
hour cavity protection [19]. Vi-one Junior Mouthwash is specially
designed for children. This mouth rinse contains Sodium fluoride
0.05%, Cetylpyridinium chloride 0.05% and Disodium phosphate
agents. The respective flavors contain sugar-free and harmless
sweetener. This brand also is an alcohol-free product [20]. The
purpose of this study was to compare the efficacy of two types of
mouthwashes, one the domestic mouthwash (Vi-One Junior) and
the other, the brand name Listerine Smart Rinse kids fluoridated
mouthwash in the removal of the dental plaque.
Material and Methods
This study was a cross-over clinical trial. The eligibilities for
entering in our study were as follow:
a) Children having at least 20 teeth with no large restorative area.
b) No history of periodontal Diseases.
c) Not having any Prosthodontic or Orthodontic appliances.
The condition for withdrawal from the study, if there was
any sign of reactions to any of these mouth rinses. There was no
obligation to have any food regimen.
The study population consisted of 100 patients who were in
a 50-member group. Before taking oral mouthwash, plaque index
was minimized, and all subjects underwent tooth scaling at the
beginning and, if necessary, teeth polishing were done before
taking mouthwash. Oral hygiene was assessed via a plaque index.
First, in both groups, the Silness-Löe plaque index was recorded. It
is an Index for evaluating the thickness of the plaque in the gingival
region, which measures the thickness of plaque on all surfaces (M,
B, D, and L) [21].
Coding for the plaque index was carried out according to the
criteria [22]:
a) Code 0: No plaque
b) Code 1: A film of plaque is adhering to the free gingival margin
and adjacent area of the tooth. The plaque may be seen in situ
only after application of disclosing solution or by using the
probe on the tooth surface.
c) Code 2: Moderate accumulation of soft deposits can be seen
with the naked eye within the gingival pocket, the tooth, or
gingival margin.
d) Code 3: Abundance of soft matter can be seen within the
gingival pocket and/or on the tooth, and gingival margin.
In this index, each tooth is divided into four surface area but
in our purposes in the present study, we modified the surfaces
area from 4 to 6; thus, we have three surfaces in the buccal area
(Mesiobuccal, Midbuccal, and Distobuccal) and three surfaces in
the lingual area (Mesiolingual, Midlingual and Distolingual). The
first group used Vi-One & Listerine mouthwash (kids mouthwash),
for 10 days in the following way. Needless to say, this process was
supervised by parents at home. The kids have to gargle 5 cc ’s of
Vi-One mouthwash 2 times per day for 30 seconds, and during this
period of time, no other plaque control methods and tooth brushing
should be used. At the end of the period of 10 days, the plaque
index was recorded again. Then, the subjects were given a week to
rest and stop using the mouthwash while they had permission to
start brushing like before. Again, the plaque index was minimized
for patients with polishing the teeth, and they used Listerine
mouthwash for 10 days. In the same way, 5 cc ‘s of the mouthwash
twice daily was used for 30 seconds, and at the end of the one-week
period, the plaque was recorded. For the second group, in the first
10 days, mouthwash. Listerine was prescribed and in the second
10 days, the Vi-One mouthwash was applied. All procedures were
performed according to the above pattern.
Results
Paired T-test was used for statistical analysis of the findings.
The findings showed when Listerine Smart Rinse Kids was used;
the mean of plaque index in all area of the mouth (especially in the
mandibular jaw and the posterior region) was significantly less
than the time Vi-One was applied. However, there was no significant
efficacy difference between the use of both types of mouthwash in
the upper jaw and the anterior region.
There was no significant difference between the mean plaque
index in Vi-One mouthwash between upper and lower jaw, and there
was no significant difference between the maxillary and lower jaw
in the case of Listerine Smart Rinse Kids either. The presence of this
indicator in both types of mouthwash in the anterior region was
significantly less than the posterior region. The mean and standard
deviation of the plaque index in both groups, as well as in different
regions of the mouth, are listed in Table 1.
Table 1: The amount of dental plaque in terms of area and type
of Mouthwash.
Discussion
In general, the anti-plaque properties of mouthwashes
are completed through bactericidal and bacteriostatic effects,
separation of microorganisms from dental surfaces, loosening of
joints to these surfaces or lowering of the surface tension of the
tooth [2,21,23]. Some mouthwashes can be useful for preventing
tooth decay or periodontitis [6,24]. Furthermore, mouthwashes
are recommended for children and adolescents with orthodontic
appliances or adults who need deep cleansing (such as curettage)
[6]. These types of mouthwashes were generally used before and
after surgery (especially Chlorhexidine) and have a very positive
effect on the treatment of gum and ulcerative inflammation [6].
Use of this type of mouthwash should not last longer than 2 to 3
weeks due to some side effects such as staining the teeth and soft
tissue staining, increased calculus deposition, unpleasant taste,
burning sensation, and mucosal irritation [6]. It’s time to use
this
mouthwash after brushing and before bedtime, and it’s best not
to eat anything after half an hour after use. Fluoride-containing
mouthwashes are another type of mouth rinse that has a fairly
large use. These mouthwashes have a significant effect on teeth
strengthening. Fluoride in the mouthwash cause bonding with
enamel and dentin, and with bonding with calcium and phosphorus,
they form Fluorapatite, which is more resistant to caries than
Hydroxyapatite. Fluorides also accelerate the mineralization,
repair the decayed teeth surfaces, and help to increase the reverse
processing of damaged tooth surface area [25,26]. Fluoride also
reduces the effect of oral bacteria on teeth. It is done by
interfering
with the function and formation of the microorganisms. The best
fluoride mouthwash protects the teeth against the acids which
are produced by dental plaques. “Neglecting the oral hygiene of
children leads to the accumulation of plaque and as a consequent
the formation of dental calculus which will have a devastating
effect
on the both child’s gums and teeth” [27].
In one study, the statics showed an alcohol-free mouthwash
containing a combination of 0.075% CPC and 0.05% Na F
produces statistically significant reductions in dental plaque and
gingivitis after three and six months compared to baseline [28].
In another research, Jessica E. Koopman, et al argued that the oral
microbial community displayed remarkable resilience towards
the disturbances it was presented with. The effects of the fluoride
mouthwash on the microbial composition were trivial [29]. On
the other side, in another study, the research showed that all four
fluoride mouth rinses were effective in decreasing the plaque levels
of S. Mutans [30]. In this study, we investigated the effect of two
mouthwashes of Listerine Smart Rinse Kids and Vi-One in which
Vi-One mouthwash in the posterior region was less efficient than
the Listerine mouthwash, and the interesting point that most kids
mentioned the taste of Listerine was more acceptable. Given that
the contents of sodium fluoride were equal in both mouthwashes,
due to the fact that Listerine mouthwash was more acceptable than
the mouthwash, it could be related to the other materials present
in this product which can be a part of the manufacturer’s secrets.
This difference in taste can be a factor in the effect of improving
Listerine’s efficacy in the posterior regions.
Conclusion
Listerine Smart Rinse Kids had a better effect on plaque removal
than the Vi-One mouthwash in the posterior mandibular region.
Both types of mouthwash had a better effect on the anterior region
than the posterior region, but none of the two mouth rinses had
a different effect on the maxillary and lower jaw. Although many
popular types of mouthwash may help to control dental plaque
and gingivitis, they should only be used as an adjunct to other
oral hygiene measures such as brushing and flossing. Fluoride
mouthwashes should be encouraged in children above the age of 6
with a high risk of caries.
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