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Plaque Control

Oral hygiene has been targeted by manufacturers and advertisers in a big way in recent years, with numerous new products to reduce plaque and sweeten breath. Are they effective?

Pre-brushing mouthwash - a controlled trial

Twenty subjects with tooth staining entered a double-blind placebo-controlled cross-over study [1]. They used a pre-brushing mouthwash (Plax) or a placebo for 14 days, followed by a one month 'washout' (sic) and then the alternative treatment. The area of stain was assessed before and after the use of each mouthwash from clinical photographs.

The percentages of stained areas (with blind assessment) changed very little throughout the study, with no statistical differences.

This paper also reports an in-vitro study on extracted third molar teeth. They were stained with either tea of chlorhexidine, and then brushed in a standardised manner after standard exposure to Plax or placebo. The mean area of staining fell after brushing by 19% after exposure to Plax and by 17% after exposure to placebo. There were no differences in staining intensity.

The results of this study do not support the marketing hype. Mouthwash containing alcohol has been linked to buccal cancers, and even though most products do not contain the high levels as seen in the past, if they don't work, why bother?


DC Mills, SR Smith, L Chung. The effect of using a pre-brushing mouthwash (PLax) on removal of tooth stain in vivo and in vitro. Journal of Clinical Periodontology 1994 21: 13-16.

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