Efficacy of mouthwashes based on natural products in biofilm formation and gingival inflammation in childhood: systematic review
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Abstract
Introduction: Mouthwashes are used as complements to oral hygiene in children, to improve the control of dental biofilm. Products derived from herbs and plants have gained prominence in the market. Objective: To analyze scientific evidence on the effectiveness of mouthwashes made from natural ingredients in controlling biofilm and gum inflammation in children, compared to chlorhexidine. Methods: A qualitative systematic review was carried out, with data research in June 2024, using electronic databases and gray literature. Results: Six randomized clinical trials were selected as they met the inclusion criteria. To assess the risk of bias in the chosen studies, the Cochrane Collaboration's RoB 2 tool for randomized studies and the GRADE method were used to determine the level of evidence and strength of recommendation. It was observed that mouthwashes containing natural ingredients such as Aloe Vera L., Azadirachta indica L., Triphala, and Cymbopogon citratus L. presented results comparable to chlorhexidine in reducing dental biofilm and gingival inflammation, according to periodontal indices. The quality of evidence is moderate to low. Future clinical trials should understand the limitations associated with the different compositions and mechanisms of action of natural products. Due to the heterogeneity of the studies, no meta-analysis was performed. Conclusion: Although mouthwashes made with plant extracts appear to be a complementary alternative in supporting the mechanical control of dental biofilm in children, the evidence derives from studies with moderate to low methodological quality. Registration in the PROSPERO database: CRD42022321139.
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