Curcumin mouthwashes for plaque and gingivitis

Tumeric

Curcumin is a natural spice that has historically been used as a remedy for both for systemic and oral inflammatory diseases. Several studies have investigated curcumin mouthwash for the control of plaque and gingivitis with conflicting results.

The aim of this review was to compare the efficacy of curcumin mouthwash on plaque and gingivitis in comparison with chlorhexidine (CHX).

Methods

Searches were conducted in the Medline/PubMed, Scopus, Web of Science, and Google Scholar databases with no restrictions on language. Randomised controlled trials (RCTs) comparing curcumin mouthwash with chlorhexidine mouthwash were considered.  Two reviewers independently extracted data and assessed study quality using the Cochrane risk of bias tool. Outcomes were calculated as standardized mean difference (SMD) with 95% confidence intervals (CI).

Results

  • 6 RCTs involving a total of 320 patients were included.
  • 5 studies were conducted in India, one in Iran.
  • All the studies enrolled patients with chronic gingivitis with no history of systemic diseases or pregnancy.
  • 5 studies were at high risk of bias, 1 at low risk.
  • All 6 studies reported that curcumin and CHX showed equivalent efficacy in reducing gingival inflammation but mixed results for plaque index and microbial load.
  • Meta-analysis (6 studies) showed no statistically significant difference between curcumin and CHX for plaque or gingival indices.
    • Plaque index SMD = 0.27 (95% I: −0.53 to 1.07)
    • Gingival index SMD = −0.13 (95%CI: −0.35 to 0.09)

Conclusions

The authors concluded: –

The results suggest that curcumin mouthwashes have promising anti-plaque and anti-gingivitis properties. Further clinical trials with adequate sample sizes and standardized methodologies are required to discern the efficacy of curcumin mouthwash in reducing plaque and gingivitis.

Comments

There is high quality evidence that CHX mouthwash used as an adjunct to mechanical oral hygiene procedures has good anti-plaque and anti-gingivitis properties (Dental Elf – 3rd Apr 2017). It does however have well known adverse effects including staining, taste disturbance and mouth soreness. Consequently, an effective mouthwash with similar efficacy and no or fewer adverse effects could be beneficial.

This new review looks at the efficacy of curcumin-based mouthwashes with all the included studies having been published since 2011. While the findings suggest that curcumin has similar efficacy to CHX this is based on a small number of small studies most of which (5) were at high risk of bias. Therefore, the findings should be viewed very cautiously and additional high quality well reported studies of appropriate size and duration are needed to clarify the effectiveness of curcumin-based mouthwashes.

Links

Primary Paper

Al-Maweri SA, Alhajj MN, Deshisha EA, Alshafei AK, Ahmed AI, Almudayfi NO, Alshammari SA, Alsharif A, Kassim S. Curcumin mouthwashes versus chlorhexidine in controlling plaque and gingivitis: A systematic review and meta-analysis. Int J Dent Hyg. 2021 May 20. doi: 10.1111/idh.12518. Epub ahead of print. PMID: 34013606.

Review protocol on PROSPERO

Other references

Dental Elf – 3rd Apr 2017

Chlorhexidine mouthrinse: Reduced plaque and gingivitis when used as adjunct to mechanical oral hygiene procedures

Picture Credits

Akopoly [CC BY-SA 4.0]

 

 

 

 

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