Comparative Evaluation of Natural Mouthrinses and Chlorhexidine in Dental Plaque Management: A Pilot Randomized Clinical Trial.

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.