Terminalia Chebula Mouthwash vs. Chlorhexidine for Gums

Key Findings

The study concluded that a 10% Terminalia chebula mouth rinse significantly reduced dental plaque, gingival inflammation, and improved salivary pH over 14 days, with efficacy statistically equivalent to 0.12% chlorhexidine. No significant differences in clinical outcomes were observed between the T. chebula and chlorhexidine groups (P > 0.05) at any timepoint. Both active treatments outperformed the saline control group. The extract demonstrated comparable anti-plaque and anti-gingivitis effects to the gold-standard chlorhexidine rinse within the 2-week period.

Study Design

This was a double-blind, randomized, parallel-group controlled trial conducted over 14 days. Seventy-eight participants with plaque-induced gingivitis were randomly assigned to one of three groups (n=26 per group): 10% Terminalia chebula extract mouth rinse, 0.12% chlorhexidine mouth rinse, or saline control. Clinical periodontal parameters (plaque index, gingival index, bleeding index) and salivary pH were assessed at baseline (day 0), day 7, and day 14. The study design ensured allocation concealment and blinded outcome assessment.

Dosage & Administration

Participants in the intervention groups used 10 mL of their assigned mouth rinse twice daily (morning and evening) for 14 consecutive days. The Terminalia chebula formulation was a 10% aqueous extract, while the comparator was 0.12% chlorhexidine gluconate. Rinsing duration and technique were standardized across groups. The saline group served as the negative control.

Results & Efficacy

Both the T. chebula and chlorhexidine groups showed statistically significant reductions in all periodontal indices (plaque, gingival, bleeding) from baseline to days 7 and 14 (P < 0.05 within groups). Salivary pH increased significantly in both active groups, indicating neutralization of acidity. Crucially, no statistically significant differences were found between the T. chebula and chlorhexidine groups for any parameter at any assessment point (P > 0.05). Effect sizes for within-group improvements were not quantified in the provided summary, but the equivalence in clinical outcomes between active treatments was the primary conclusion. The saline group showed minimal changes.

Limitations

The study had a short duration (14 days), preventing assessment of long-term efficacy or safety. Sample size (n=26 per group) provided limited statistical power to detect small but potentially clinically relevant differences between active treatments. No microbiological data (e.g., bacterial counts) was reported to support the claimed "microbial plaque" reduction. The study did not evaluate common chlorhexidine side effects (tooth staining, taste alteration), which would be critical for establishing T. chebula's advantage. Participant demographics (age, gender, oral hygiene habits) were not detailed in the provided summary.

Clinical Relevance

For individuals seeking natural oral care alternatives, this study suggests a 10% Terminalia chebula mouth rinse may provide short-term plaque and gingivitis control equivalent to chlorhexidine 0.12% without the typical side effects associated with prolonged chlorhexidine use (though side effects weren't measured here). Users could consider it as a potential adjunct for managing mild gingivitis, particularly if chlorhexidine tolerance is an issue. However, the 2-week timeframe means it cannot replace mechanical plaque control (brushing/flossing) for sustained periodontal health, and long-term safety/efficacy remains unverified by this trial.