Can using mouth-rinse reduce the pain of periodontal treatment?
PD Dr. Kristina Bertl, PhD MSc MBA
To achieve a high level of compliance among periodontitis patients in the maintenance phase of treatment, it is important to make this maintenance therapy, including professional mechanical plaque removal, as pleasant as possible. Unfortunately, however, patients often experience pain during cleaning with (ultra)sonic devices, which could reduce their compliance later on and, in particular, in the long term.
Derman et al. (2021) posed an interesting question relating to this issue: Can a ‘pretreatment’ before maintenance therapy reduce patients’ pain during therapy? Specifically, their study of 155 patients tested whether using a mouth-rinse solution containing an active substance against dentine sensitivity for one week before maintenance therapy could lead to a reduction in pain during therapy. The following parameters/data should be noted in relation to this study:
- Three mouth-rinse solutions were tested (two with an active substance against dentine sensitivity and one control mouth-rinse solution)
– Listerine sensitive professional (active substance: di-potassium oxalate)
– Elmex sensitive professional (active substance: arginine)
– Alverde natural mouth-rinse (control mouth-rinse)
- The mouth-rinse solution was used for one week before maintenance therapy, twice daily for one minute.
- The patients’ pain sensation during two maintenance therapy sessions (with and without rinsing in the week before) was recorded and the results compared.
- The study included both periodontally healthy and periodontally compromised patients.
The authors concluded that, in general, no predictable reduction in pain could be obtained; i.e., not all patients showed a positive effect. Nonetheless, approximately 50% of patients in both test groups reported a subjective reduction in pain as a result of the one-week ‘pretreatment’ with a mouth-rinse solution. Compared directly, Listerine sensitive professional performed better than Elmex sensitive professional . Specifically, the patients who rinsed with Listerine sensitive professional for one week before therapy were more likely to report a reduction in pain during maintenance therapy and less likely to report no improvement at all. In general, these effects were greater among periodontally compromised patients (i.e. patients who had already experienced loss of attachment) than among periodontally healthy patients.
In summary, a pretreatment of this type can help to reduce pain sensation during maintenance therapy for approximately one patient in two – particularly among patients with periodontitis. It’s worth a try!
Sonja H. M. Derman, Eva-Maria Lantwin, Anna Greta Barbe & Michael J. Noack. Does a pretreatment with a dentine hypersensitivity mouth-rinse compensate the pain caused by professional mechanical plaque removal? A single-blind randomized controlled clinical trial. Clin Oral Invest (2021) 25:3151–3160 https://doi.org/10.1007/s00784-020-03643-4