Comparative Efficacy of Chlorhexidine and Sodium Bicarbonate Dentifrices in Plaque and Gingival Inflammation Reduction: A Randomized Controlled Trial

Rabia Syed; Ruqqia Jehan; Imtiaz Ali

doi:10.65293/jbkcd.v2i02.26

Authors

Rabia Syed Senior Dental Surgeon, Oral and Maxillofacial Surgery, Ayub College of Dentistry, Abbottabad, Khyber Pakhtunkhwa, Pakistan.
Ruqqia Jehan Assistant Professor, Oral and Maxillofacial Surgery, College CIMS Dental College, Multan, Punjab, Pakistan.
Imtiaz Ali Assistant Professor, Department of OMFS, Saidu College of Dentistry, Swat, Khyber Pakhtunkhwa, Pakistan.

DOI:

https://doi.org/10.65293/jbkcd.v2i02.26

Keywords:

Chlorhexidine, Sodium Bicarbonate, Plaque Index, Gingival Inflammation, Bleeding on Probing, Oral Hygiene, Randomized Controlled Trial

Abstract

Objective: To compare the efficacy and tolerability of chlorhexidine versus sodium bicarbonate dentifrices for reducing plaque and gingival inflammation over 6 weeks in orthodontic patients.

Methods: In this randomized, double-blind, parallel-group trial, 120 participants were allocated 1:1 to chlorhexidine or sodium bicarbonate dentifrice. Participants brushed twice daily for 6 weeks using standardized toothbrushes and the Charters’ technique. Plaque Index (PI), Gingival Index (GI), and Bleeding on Probing (BOP) were assessed at baseline and 6 weeks. Adverse events and adherence were recorded. A linear mixed-effects model assessed group, time, and group×time effects; results are presented with p-values.

Results: Both groups showed significant improvements from baseline. Compared with sodium bicarbonate, chlorhexidine produced greater reductions in PI (≈42.9% vs. 30.0%), GI (≈44.4% vs. 23.5%), and BOP (≈59.8% vs. 39.3%) (all p<0.05). Taste alteration and tooth staining occurred more frequently with chlorhexidine. Subgroup analyses indicated attenuated improvements among smokers compared with non-smokers.

Conclusion: Over 6 weeks, chlorhexidine dentifrice demonstrated superior antiplaque and anti-gingivitis efficacy but with more adverse effects, whereas sodium bicarbonate offered fewer side effects and moderate efficacy. Smoking status negatively impacted outcomes in both groups. Long-term studies are warranted to evaluate sustained benefits and tolerability.

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