Properly performed daily mechanical biofilm control is the most important prevention strategy for
periodontal diseases. However, proper mechanical biofilm control is not performed effectively by the majority of the population, mainly due to lack of motivation and of manual dexterity. Local biofilm retention factors may aggravate home
oral hygiene quality. For this reason, patients wearing
fixed orthodontic appliances comprise a group that may benefit from the daily use of
mouthwashes. The purpose of this review was to perform a systematic search in the literature on
antiseptics used to control supragingival biofilm and
gingivitis in orthodontic patients. Six studies investigating the effect of
chlorhexidine and 5 studies evaluating the effect of the daily use of
antiseptics were found.
Chlorhexidine showed better results in reducing plaque and
gingivitis. However, because of its adverse effects after continuous use, it should not be indicated for long-term periods. Among the agents considered for daily use, the fixed combination of
essential oils was the only one evaluated in a clinical trial, in which a comparative group presented a statistically significant clinical impact. There is no direct evidence supporting the indication of
antiseptic agents for orthodontic patients other than
chlorhexidine and
essential oils. It can be concluded that, for patients undergoing orthodontic treatment,
chlorhexidine should be considered for treating acute gingival
inflammation, whereas
essential oils should be indicated for long-term daily use in controlling supragingival biofilm.