Comparison of 0.2% chlorhexidine mouthwash with and without anti-discoloration system in patients with chronic periodontitis: A randomized controlled clinical trial

Background. Chemical plaque control, an adjunct to mechanical approaches, could improve the maintenance of patients with different types of periodontitis. Chlorhexidine, the gold standard in chemical plaque control, might have some side effects; the most determining one is tooth discoloration. Anti-discoloration systems (ADS) have been added to minimize brownish tooth discoloration. This study aimed to evaluate the staining potential and clinical efficacy of chlorhexidine with and without ADS in patients with chronic periodontitis. Methods. In this randomized controlled trial, 46 patients with chronic periodontitis were randomly allocated to two groups. Each patient used 10 mL of mouthwash A (CHX without ADS) or B (CHX with ADS, including sodium metabisulfite and ascorbic acid) twice a day for two weeks. After a two-week interval, they used the second mouthwash. At the beginning and the end of each two-week cycle, plaque index (PI), bleeding on probing (BoP), and staining index were recorded. Results. There was no significant difference between mouthwash A and B in the reduction of BoP and PI. The staining index was significantly lower after rinsing with mouthwash B compared to mouthwash A. Conclusion. CHX mouthwash containing ADS has similar efficacy in microbial plaque control and reduction of BOP as CHX without ADS, with the advantage of lower stain formation on tooth surfaces in patients with chronic periodontitis.