Tea Tree Oil versus Chlorhexidine Mouthwash in Treatment of Gingivitis: A Pilot Randomized, Double Blinded Clinical Trial
Objective The study evaluated the efficacy of tea tree oil for the treatment of gingivitis.
Materials and Methods The tea tree oil was administered in the form of mouthwash and then compared with a mouthwash with chlorhexidine 0.12%. Both treatments were domestic and lasted for 14 days. Patients were chosen according to random criteria, aged between 18 and 60 years, and who showed a clinically evident gingivitis. In clinical evaluation, the following clinical criteria were taken into consideration: gingival index (GI), plaque index (PI), bleeding index (BI), probing depth (PD), the presence of dental dyschromia, and the presence of taste alteration. The subjects were evaluated before (T0) and after the treatment (T1), and the data collected for each patient were recorded on a periodontal chart.
Results The comparison showed that tea tree oil offered a better improvement in the evaluation of PI, BOP, and PD; furthermore, it did not cause dental dyschromia and taste alteration. In group A, treated with tea tree oil, PI decreased from 53.25 to 5.50% and BI from 38.41 to 4.22%. In group B, treated with chlorhexidine PI decreased from 47.69 to 2.37% and BI from 32.93 to 6.28%. Instead, the subjects using chlorhexidine 0.12% blamed a distaste for the product that caused a slight taste alteration; 20% of them showed iatrogenic dental dyschromia.
Conclusions The collected data showed the efficacy of both treatments. Although further research works will be necessary, this study showed that tea tree oil could be an effective nontoxic substitute for the therapy of gingivitis.
13. März 2020 (online)
Thieme Medical and Scientific Publishers Private Ltd.
A-12, Second Floor, Sector -2, NOIDA -201301, India
- 1 Germano F, Bramanti E, Arcuri C, Cecchetti F, Cicciù M. Atomic force microscopy of bacteria from periodontal subgingival biofilm: Preliminary study results. Eur J Dent 2013; 7 (02) 152-158
- 2 Fiorillo L, Cervino G, Laino L. et al. Porphyromonas gingivalis, periodontal and systemic implications: a systematic review. Dent J (Basel) 2019; 7 (04) E114
- 3 James P, Worthington HV, Parnell C. et al. Chlorhexidine mouthrinse as an adjunctive treatment for gingival health. Cochrane Database Syst Rev 2017; 3: CD008676
- 4 Little JW. Complementary and alternative medicine: impact on dentistry. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2004; 98 (02) 137-145
- 5 Ercan N, Erdemir EO, Ozkan SY, Hendek MK. The comparative effect of propolis in two different vehicles; mouthwash and chewing-gum on plaque accumulation and gingival inflammation. Eur J Dent 2015; 9 (02) 272-276
- 6 Carvalho C, Fernandes WHC, Mouttinho TBF, Souza DM, Marcucci MC, D’Alpino PH. Evidence-based studies and perspectives of the use of Brazilian green and red propolis in dentistry. Eur J Dent 2019; 13 (03) 459-465
- 7 Cicciù M, Fiorillo L, Cervino G. Chitosan use in dentistry: a systematic review of recent clinical studies. Mar Drugs 2019; 17 (07) E417
- 8 Manion CR, Widder RM. Essentials of essential oils. Am J Health Syst Pharm 2017; 74 (09) e153-e162
- 9 Gnatta JR, Pinto FM, Bruna CQ, Souza RQ, Graziano KU, Silva MJ. Comparison of hand hygiene antimicrobial efficacy: Melaleuca alternifolia essential oil versus triclosan. Rev Lat Am Enfermagem 2013; 21 (06) 1212-1219
- 10 Budzyńska A, Wieckowska-Szakiel M, Sadowska B, Kalemba D, Rózalska B. Antibiofilm activity of selected plant essential oils and their major components. Pol J Microbiol 2011; 60 (01) 35-41
- 11 Carson CF, Hammer KA, Riley TV. Melaleuca alternifolia (tea tree) oil: a review of antimicrobial and other medicinal properties. Clin Microbiol Rev 2006; 19 (01) 50-62
- 12 Groppo FC, Ramacciato JC, Simões RP, Flório FM, Sartoratto A. Antimicrobial activity of garlic, tea tree oil, and chlorhexidine against oral microorganisms. Int Dent J 2002; 52 (06) 433-437
- 13 Carson CF, Ashton L, Dry L, Smith DW, Riley TV. Melaleuca alternifolia (tea tree) oil gel (6%) for the treatment of recurrent herpes labialis. J Antimicrob Chemother 2001; 48 (03) 450-451
- 14 Calcabrini A, Stringaro A, Toccacieli L. et al. Terpinen-4-ol, the main component of Melaleuca alternifolia (tea tree) oil inhibits the in vitro growth of human melanoma cells. J Invest Dermatol 2004; 122 (02) 349-360
- 15 Bozzuto G, Colone M, Toccacieli L, Stringaro A, Molinari A. Tea tree oil might combat melanoma. Planta Med 2011; 77 (01) 54-56
- 16 Casarin M, Pazinatto J, Santos RCV, Zanatta FB. Melaleuca alternifolia and its application against dental plaque and periodontal diseases: a systematic review. Phytother Res 2018; 32 (02) 230-242
- 17 Salvatori C, Barchi L, Guzzo F, Gargari M. A comparative study of antibacterial and anti-inflammatory effects of mouthrinse containing tea tree oil. Oral Implantol (Rome) 2017; 10 (01) 59-70
- 18 Syed TA, Qureshi ZA, Ali SM, Ahmad S, Ahmad SA. Treatment of toenail onychomycosis with 2% butenafine and 5% Melaleuca alternifolia (tea tree) oil in cream. Trop Med Int Health 1999; 4 (04) 284-287
- 19 Takarada K, Kimizuka R, Takahashi N, Honma K, Okuda K, Kato T. A comparison of the antibacterial efficacies of essential oils against oral pathogens. Oral Microbiol Immunol 2004; 19 (01) 61-64
- 20 Warnke PH, Sherry E, Russo PA. et al. Antibacterial essential oils reduce tumor smell and inflammation in cancer patients. J Clin Oncol 2005; 23 (07) 1588-1589
- 21 Pazyar N, Yaghoobi R, Bagherani N, Kazerouni A. A review of applications of tea tree oil in dermatology. Int J Dermatol 2013; 52 (07) 784-790
- 22 Di Vito M, Mattarelli P, Modesto M. et al. In vitro activity of tea tree oil vaginal suppositories against Candida SPP and probiotic vaginal microbiota. Phytother Res 2015; 29 (10) 1628-1633
- 23 Buck DS, Nidorf DM, Addino JG. Comparison of two topical preparations for the treatment of onychomycosis: Melaleuca alternifolia (tea tree) oil and clotrimazole. J Fam Pract 1994; 38 (06) 601-605
- 24 Elliott C. Tea tree oil poisoning. Med J Aust 1993; 159 (11-12) 830-831
- 25 de AC Groot, Weyland JW. Systemic contact dermatitis from tea tree oil. Contact Dermat 1992; 27 (04) 279-280
- 26 Penfold AR, Morrison FR. Recent developments in Australian essential oils. Australas J Pharm 1946; 27 (321) 723
- 27 Chapple ILC, Mealey BL, Van Dyke TE. et al. Periodontal health and gingival diseases and conditions on an intact and a reduced periodontium: Consensus report of workgroup 1 of the 2017 World Workshop on the Classification of Periodontal and Peri-Implant Diseases and Conditions. J Periodontol 2018; 89 (Suppl. 01) S74-S84
- 28 Claydon NC. Current concepts in toothbrushing and interdental cleaning. Periodontol 2000 2008; 48: 10-22
- 29 Loe H, Theilade E, Jensen SB. Experimental gingivitis in man. J Periodontol 1965; 36: 177-187
- 30 Tatakis DN, Trombelli L. Modulation of clinical expression of plaque-induced gingivitis. I. Background review and rationale. J Clin Periodontol 2004; 31 (04) 229-238
- 31 Jones CG. Chlorhexidine: is it still the gold standard?. Periodontol 2000 1997; 15: 55-62
- 32 Kamath NP, Tandon S, Nayak R, Naidu S, Anand PS, Kamath YS. The effect of aloe vera and tea tree oil mouthwashes on the oral health of school children. Eur Arch Paediatr Dent 2019; DOI: 10.1007/s40368-019-00445-5.
- 33 Arweiler NB, Donos N, Netuschil L, Reich E, Sculean A. Clinical and antibacterial effect of tea tree oil–a pilot study. Clin Oral Investig 2000; 4 (02) 70-73
- 34 Soukoulis S, Hirsch R. The effects of a tea tree oil-containing gel on plaque and chronic gingivitis. Aust Dent J 2004; 49 (02) 78-83
- 35 Saxer UP, Stäuble A, Szabo SH, Menghini G. Effect of mouthwashing with tea tree oil on plaque and inflammation [article in French, German]. Schweiz Monatsschr Zahnmed 2003; 113 (09) 985-996
- 36 Fiorillo L. Chlorhexidine gel use in the oral district: a systematic review. Gels 2019; 5 (02) E31
- 37 Hammer KA, Carson CF, Riley TV, Nielsen JB. A review of the toxicity of Melaleuca alternifolia (tea tree) oil. Food Chem Toxicol 2006; 44 (05) 616-625
- 38 Quaranta A, Ronconi LF, Di Carlo F, Vozza I, Quaranta M. Electrochemical behaviour of titanium in ammine and stannous fluoride and chlorhexidine 0.2 percent mouthwashes. Int J Immunopathol Pharmacol 2010; 23 (01) 335-343
- 39 Guerra F, Pasqualotto D, Rinaldo F. et al. Therapeutic efficacy of chlorhexidine-based mouthwashes and its adverse events: Performance-related evaluation of mouthwashes added with Anti-Discoloration System and cetylpyridinium chloride. Int J Dent Hyg 2019; 17 (03) 229-236