Comparison Of Clinical Effects Of Listerine And Chlorhexidine Mouth Wash In Patients Undergoing Fixed Orthodontic Treatment

NCT ID: NCT07119840

Last Updated: 2025-11-26

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

RECRUITING

Clinical Phase

NA

Total Enrollment

60 participants

Study Classification

INTERVENTIONAL

Study Start Date

2025-08-01

Study Completion Date

2025-12-30

Brief Summary

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This randomized clinical trial aims to compare the effectiveness of Listerine and Chlorhexidine mouthwashes in improving periodontal health in patients undergoing fixed orthodontic treatment. Gingival Index and Plaque Index will be assessed at baseline, 2 weeks, and 4 weeks.

Detailed Description

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Orthodontic treatment using fixed appliances can significantly impair oral hygiene due to the presence of brackets, bands, and wires, which create retentive areas that promote plaque accumulation. This buildup can result in gingival inflammation, leading to gingivitis or even periodontitis if not managed effectively. Mechanical plaque control, such as brushing and flossing, is often insufficient under these conditions. Thus, adjunctive chemical plaque control agents like mouthwashes are commonly recommended.

Chlorhexidine (CHX) is widely considered the gold standard for chemical plaque control due to its broad-spectrum antimicrobial activity and prolonged substantivity in the oral cavity. However, CHX is associated with side effects such as tooth staining, altered taste sensation, and mucosal irritation, limiting its long-term use. In contrast, Listerine is a commercially available essential oil-based mouthwash that has demonstrated anti-plaque and anti-inflammatory properties without the same level of side effects.

This double-blind, randomized controlled trial aims to compare the clinical efficacy of CHX (0.12%) and Listerine mouthwash in improving periodontal health among patients undergoing fixed orthodontic treatment. The study will be conducted over a period of 4 weeks at the Orthodontics Department of Saidu College of Dentistry, Swat. A total of 60 participants (30 per group), aged between 13 and 25 years, will be enrolled using non-probability consecutive sampling. Participants will be randomized into two groups using block randomization: one receiving CHX and the other Listerine, both in identical, unlabelled bottles to ensure blinding of both the investigator and participants.

The primary outcome measures are changes in Plaque Index (PI) and Gingival Index (GI), assessed at baseline (Day 0), 2 weeks, and 4 weeks. Oral examinations will be conducted by calibrated examiners using standard indices and WHO probes. Data will be analyzed using R software, with t-tests applied to compare mean scores between groups. Age and gender will be considered as potential effect modifiers.

The study is designed to evaluate whether Listerine, as a more tolerable alternative, provides comparable or superior improvements in periodontal health compared to CHX in orthodontic patients. If proven effective, Listerine may serve as a safer, more acceptable option for long-term use during orthodontic treatment.

Conditions

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Gingivitis Dental Plaque

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

A two-arm, parallel group design where participants are randomly assigned to receive either Chlorhexidine or Listerine mouthwash for 4 weeks. Each participant remains in their assigned intervention group throughout the study without crossover.
Primary Study Purpose

TREATMENT

Blinding Strategy

DOUBLE

Participants Caregivers
Participants will be randomly assigned to either the Chlorhexidine or Listerine group using a block randomization method. To ensure blinding, both mouthwashes will be dispensed in identical, unlabelled bottles. Neither the participants, the care providers will be aware of the group allocation throughout the study period.

Study Groups

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Listerine Group

Participants will receive Listerine mouthwash in unlabelled bottles once daily for 4 weeks.

Group Type EXPERIMENTAL

Listerine Mouthwash Product

Intervention Type DRUG

Participants in this group will receive Listerine mouthwash containing essential oils (menthol, thymol, eucalyptol, and methyl salicylate). They will be instructed to rinse once daily with 10 ml of the solution for 30 seconds after brushing, over a period of 4 weeks. The mouthwash will be dispensed in unlabelled bottles to maintain blinding. Standard oral hygiene instructions will be given.

Chlorhexidine Group

Participants will receive chlorhexidine mouthwash in unlabelled bottles once daily for 4 weeks.

Group Type ACTIVE_COMPARATOR

Chlorhexidine mouthwash

Intervention Type DRUG

Participants in this group will receive Chlorhexidine mouthwash at a concentration of 0.12%. They will be instructed to rinse once daily with 10 ml of the solution for 30 seconds after brushing, over a period of 4 weeks. The mouthwash will be dispensed in unlabelled bottles to maintain blinding. Standard oral hygiene instructions will be given.

Interventions

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Listerine Mouthwash Product

Participants in this group will receive Listerine mouthwash containing essential oils (menthol, thymol, eucalyptol, and methyl salicylate). They will be instructed to rinse once daily with 10 ml of the solution for 30 seconds after brushing, over a period of 4 weeks. The mouthwash will be dispensed in unlabelled bottles to maintain blinding. Standard oral hygiene instructions will be given.

Intervention Type DRUG

Chlorhexidine mouthwash

Participants in this group will receive Chlorhexidine mouthwash at a concentration of 0.12%. They will be instructed to rinse once daily with 10 ml of the solution for 30 seconds after brushing, over a period of 4 weeks. The mouthwash will be dispensed in unlabelled bottles to maintain blinding. Standard oral hygiene instructions will be given.

Intervention Type DRUG

Other Intervention Names

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Essential Oil Mouthwash CHX Mouthwash

Eligibility Criteria

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Inclusion Criteria

* Aged 13-40 years
* Permanent dentition (including first molars)
* Willing to undergo orthodontic treatment and follow instructions

Exclusion Criteria

* Systemic illness (e.g., diabetes, heart disease, hepatitis)
* Pregnant/lactating females
* Tobacco use
* History of allergies to mouthwash/toothpaste
* Use of mouthwash in past 3 months
* Abnormal oral morphology or parafunctional habits
Minimum Eligible Age

13 Years

Maximum Eligible Age

40 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

Yes

Sponsors

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Saidu College of Dentistry

OTHER

Sponsor Role collaborator

Khyber Medical University Peshawar

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Fazli Rabi, MPH*

Role: PRINCIPAL_INVESTIGATOR

Khyber Medical University

Dr Naveed Sadiq, PhD

Role: PRINCIPAL_INVESTIGATOR

Khyber Medical University

Locations

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Saidu College of Dentistry

Swāt, KPK, Pakistan

Site Status RECRUITING

Countries

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Pakistan

Central Contacts

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Fazli Rabi, MPH*

Role: CONTACT

+92 307 5663219

Dr Naveed Sadiq, PhD

Role: CONTACT

+92 334 9777904

Facility Contacts

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Fazli Rabi, MPH

Role: primary

+92 307 5663219

Dr Naveed Sadiq, PhD

Role: backup

+92 334 9777904

References

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Dehghani M, Abtahi M, Hasanzadeh N, Farahzad Z, Noori M, Noori M. Effect of Propolis mouthwash on plaque and gingival indices over fixed orthodontic patients. J Clin Exp Dent. 2019 Mar 1;11(3):e244-e249. doi: 10.4317/jced.55026. eCollection 2019 Mar.

Reference Type BACKGROUND
PMID: 31001394 (View on PubMed)

Alavi S, Yaraghi N. The effect of fluoride varnish and chlorhexidine gel on white spots and gingival and plaque indices in fixed orthodontic patients: A placebo-controlled study. Dent Res J (Isfahan). 2018 Jul-Aug;15(4):276-282.

Reference Type BACKGROUND
PMID: 30123305 (View on PubMed)

Priya BM, Anitha V, Shanmugam M, Ashwath B, Sylva SD, Vigneshwari SK. Efficacy of chlorhexidine and green tea mouthwashes in the management of dental plaque-induced gingivitis: A comparative clinical study. Contemp Clin Dent. 2015 Oct-Dec;6(4):505-9. doi: 10.4103/0976-237X.169845.

Reference Type BACKGROUND
PMID: 26681856 (View on PubMed)

Zuttion GS, Juarez HAB, Lima BD, Assumpcao DP, Daneris AP, Tuchtenhagen IH, Casarin M, Muniz FWMG. Comparison of the anti-plaque and anti-gingivitis efficacy of Chlorhexidine and Malva mouthwashes: Randomized crossover clinical trial. J Dent. 2024 Nov;150:105313. doi: 10.1016/j.jdent.2024.105313. Epub 2024 Aug 22.

Reference Type BACKGROUND
PMID: 39173823 (View on PubMed)

Atassi F, Awartani F. Oral hygiene status among orthodontic patients. J Contemp Dent Pract. 2010 Jul 1;11(4):E025-32.

Reference Type BACKGROUND
PMID: 20953561 (View on PubMed)

Other Identifiers

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KMU/DIR/CTU/2025/005

Identifier Type: -

Identifier Source: org_study_id

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