Efficacy of 0.5% Hydrogen Peroxide Mouth Rinse as an Adjunct to Scaling in Chronic Gingivitis: A Randomised Controlled Trial

Authors

DOI:

https://doi.org/10.20883/medical.e1589

Keywords:

hydrogen peroxide, gingivitis, mouthrinse, periodontal therapy, plaque index, gingival index, randomised controlled trial

Abstract

Background. Chronic gingivitis is a plaque-induced inflammatory condition of the gingiva. While scaling and polishing are standard treatments, adjunctive antimicrobial mouth rinses may enhance clinical outcomes. Hydrogen peroxide, an oxygen-releasing bactericidal agent, is a safe and accessible adjunct.
Aim. To evaluate the effectiveness of daily 0.5% hydrogen peroxide rinsing as an adjunct to scaling in improving gingival health and reducing plaque in chronic gingivitis patients.
Subjects and methods. Forty systemically healthy adults were randomly assigned to two groups. The control group received scaling and polishing plus oral hygiene instructions, while the test group received scaling and polishing plus twice-daily rinsing with 10 ml of 0.5% hydrogen peroxide for 14 days. Gingival Index (GI) and Plaque Index (PI) were recorded at baseline and post-intervention by the same examiner. Data were analysed using paired and independent t-tests (p<0.05).
Results. Both groups showed significant reductions in GI and PI scores after 14 days (p<0.001). In the control group, mean GI decreased from 2.04±0.31 to 1.28±0.27, while in the test group, it decreased from 2.06±0.34 to 0.88±0.19, with a significant difference between groups (p<0.001). Similarly, the mean PI decreased from 1.93±0.26 to 1.21±0.24 in the control group and from 1.91±0.29 to 0.83±0.21 in the test group, showing significantly greater improvement in the hydrogen peroxide group (p<0.001). No serious adverse effects were reported.
Conclusions. Daily use of 0.5% hydrogen peroxide as an adjunct to scaling significantly improves gingival health and reduces plaque compared to scaling alone. It is a safe, effective, and low-cost adjunctive therapy for chronic gingivitis.

Downloads

Download data is not yet available.

Author Biographies

  • Omar A. Huni, Libyan International University

    Department of Periodontics, Libyan International Medical University, Benghazi, Libya

  • Muna S. Elburki, University of Benghazi

    Department of Periodontics, Faculty of Dentistry, University of Benghazi, Benghazi, Libya

  • Malek A. Abdulmatlob, University of Benghazi

    Department of Periodontics, Faculty of Dentistry, University of Benghazi, Benghazi, Libya

  • Ayman S. Najem, University of Benghazi

    Department of Pedodontics, Faculty of Dentistry, University of Benghazi, Benghazi, Libya

  • Marei H. Mugrabi, University of Benghazi

    Department of Periodontics

References

Trabelsi AO. Evaluation of the effectiveness of mouth rinses containing hydrogen peroxide and chlorhexidine in gingivitis and periodontitis patients: a literature review. PQDT-Global. 2024.

Boccalari E, Tadakamadla SK, Occhipinti C, Lanteri V, Maspero C. Evaluation of the effectiveness of a novel mouth rinse containing hyaluronic acid and hydrogen peroxide on gingivitis: a randomized pilot controlled trial. Clin Exp Dent Res. 2022;8(3):673-679. https://doi.org/10.1002/cre2.572 DOI: https://doi.org/10.1002/cre2.498

Farina R, Simonelli A, Trombelli L, Preshaw PM. Clinical efficacy of interventions based on professional mechanical plaque removal in the treatment of dental biofilm-induced gingivitis: a systematic review and meta-analysis. J Clin Periodontol. 2026;53(4):572-595. https://doi.org/10.1111/jcpe.14251 DOI: https://doi.org/10.1111/jcpe.70083

Guerra F, Mazur M, Corridore D, et al. Periodontitis and the microbiome: a systematic review and meta-analysis. Minerva Stomatol. 2018;67(6):250-258. https://doi.org/10.23736/S0026-4970.18.04142-9 DOI: https://doi.org/10.23736/S0026-4970.18.04198-5

Mazur M, Vitiello F, Ndokaj A, Izzetti R, Tosco V, Corridore D, et al. Improved plaque-induced gingivitis in students using calibrated interdental brushes: results of a 3-month multicenter educational intervention. J Clin Med. 2025;14:5738. https://doi.org/10.3390/jcm14235738 DOI: https://doi.org/10.3390/jcm14165738

Carrouel F, Kanoute A, Faye D, et al. Impact of interdental brushing on pregnancy-associated gingivitis: a secondary analysis of a randomized controlled trial. J Clin Periodontol. 2026;53(4):539-549. https://doi.org/10.1111/jcpe.14224 DOI: https://doi.org/10.1111/jcpe.70085

Mazur M, Ndokaj A, Jedlinski M, Ardan R, Bietolini S, Ottolenghi L. Impact of green tea (Camellia sinensis) on periodontitis and caries: a systematic review and meta-analysis. Jpn Dent Sci Rev. 2021;57:1-11. https://doi.org/10.1016/j.jdsr.2020.11.003 DOI: https://doi.org/10.1016/j.jdsr.2020.11.003

Muniz FWMG, Cavagni J, Langa GPJ, Stewart B, Malheiros Z, Rösing CK. A systematic review of the effect of oral rinsing with hydrogen peroxide on clinical and microbiological parameters related to plaque, gingivitis and microbes. Int J Dent. 2020;2020:8841722. https://doi.org/10.1155/2020/8841722 DOI: https://doi.org/10.1155/2020/8841722

Khudhair AH, Ahmed MAA. A randomized clinical trial on the clinical and immunological efficacy of a mouth rinse containing hydrogen peroxide and hyaluronic acid in patients with gingivitis. Dentistry. 2023;3000(1):a001.

Kamolnarumeth K, Thussananutiyakul J, Lertchwalitanon P, Rungtanakiat P, Mathurasai W, Sooampon S, et al. Effect of mixed chlorhexidine and hydrogen peroxide mouthrinses on developing plaque and stain in gingivitis patients: a randomized clinical trial. Clin Oral Investig. 2021;25(4):1697-1704. https://doi.org/10.1007/s00784-020-03470-3 DOI: https://doi.org/10.1007/s00784-020-03470-7

Žekonis G, Šadzevičienė R, Balnytė I, Noreikienė V, Šidlauskaitė GM, Šadzevičiūtė E, et al. Clinical and microbiological effects of weekly supragingival irrigation with aerosolized 0.5% hydrogen peroxide and formation of cavitation bubbles in gingival tissues after this irrigation: a six-month randomized clinical trial. Oxid Med Cell Longev. 2020;2020:3852431. https://doi.org/10.1155/2020/3852431 DOI: https://doi.org/10.1155/2020/3852431

Boccalari E, Khijmatgar S, Occhipinti C, Del Fabbro M, Inchingolo F, Tartaglia GM. Effect of hydrogen peroxide and hyaluronic acid in mouth rinse after third molar extraction: a triple-blind parallel randomized controlled clinical trial. Eur Rev Med Pharmacol Sci. 2024;28(13):3946-3957. https://doi.org/10.26355/eurrev_202407_36709

Hoseyni S, Rostamzadeh M, Salimizand H, Azadnia A, Rahimi F, Khalifehzadeh S. Efficacy of preprocedural mouth rinses (chlorhexidine, essential oil and hydrogen peroxide) in reducing bacterial aerosols during dental scaling. BMC Oral Health. 2025;25:1004. https://doi.org/10.1186/s12903-025-05891-3 DOI: https://doi.org/10.1186/s12903-025-06308-4

Mahaseni Aghdam H, Kasirolvalad S, Lasemi E, Farahmand M, Ardalani R, Shalalvand M. Comparative effects of hydrogen peroxide (Nanosil) and chlorhexidine mouthwashes on healing and pain after impacted mandibular third molar surgery: a randomized clinical trial. BMC Oral Health. 2025;25:1426. https://doi.org/10.1186/s12903-025-06312-1 DOI: https://doi.org/10.1186/s12903-025-06812-7

Basudan AM, Abas I, Shaheen MY, Alghamdi HS. Effectiveness of topical oxygen therapy in gingivitis and periodontitis: clinical case reports and review of the literature. J Clin Med. 2024;13:1451. https://doi.org/10.3390/jcm13051451 DOI: https://doi.org/10.3390/jcm13051451

Deepa A, Katuri KK, Swetha C, Shivani CRN, Boyapati R, Ravindranath D. Clinical and microbiological efficacy of 0.25% sodium hypochlorite as a subgingival irrigant in chronic periodontitis patients: a pilot study. World J Dent. 2023;14(9):745-750. https://doi.org/10.5005/jp-journals-10015-2287 DOI: https://doi.org/10.5005/jp-journals-10015-2306

Kardaras G, Christodorescu R, Boariu M, Rusu D, Belova A, Chinnici S, et al. A low-cost protocol using the adjunctive action of povidone–iodine irrigations and sodium hypochlorite rinsing solution in step 2 of periodontal therapy for patients with stage III–IV periodontitis: a single-blind randomized controlled trial. Dent J. 2024;12:144. https://doi.org/10.3390/dj12050144 DOI: https://doi.org/10.3390/dj12050144

Löe H, Silness J. Periodontal disease in pregnancy I. Prevalence and severity. Acta Odontol Scand. 1963;21:533-551. https://doi.org/10.3109/00016356309011240 DOI: https://doi.org/10.3109/00016356309011240

Silness J, Löe H. Periodontal disease in pregnancy II. Correlation between oral hygiene and periodontal condition. Acta Odontol Scand. 1964;22:121-135. https://doi.org/10.3109/00016356408993968 DOI: https://doi.org/10.3109/00016356408993968

Chapple ILC, Mealey BL, Van Dyke TE, Bartold PM, Dommisch H, Eickholz P, 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 1):S74-S84. https://doi.org/10.1002/JPER.17-0721 DOI: https://doi.org/10.1002/JPER.17-0721

Rajendiran M, Trivedi HM, Chen D, Gajendrareddy P, Chen L. Recent development of active ingredients in mouthwashes and toothpastes for periodontal diseases. Molecules. 2021;26:2001. https://doi.org/10.3390/molecules26072001 DOI: https://doi.org/10.3390/molecules26072001

Dumitrel SI, Matichescu A, Dinu S, Buzatu R, Popovici R, Dinu DC, et al. New insights regarding the use of relevant synthetic compounds in dentistry. Molecules. 2024;29:3802. https://doi.org/10.3390/molecules29163802 DOI: https://doi.org/10.3390/molecules29163802

Hrishi TS, Kundapur PP, Bhat GS, Vishwanath S, Kamath S. Efficacy of subgingival ozone irrigation for management of chronic periodontitis: a clinical, microbiological and biochemical study. J Cont Med A Dent. 2020;8:62-69. https://doi.org/10.18049/jcmad/8113

Alassy H, Pizarek JA, Kormas I, Pedercini A, Wolff LF. Antimicrobial adjuncts in the management of periodontal and peri-implant diseases and conditions: a narrative review. Front Oral Maxillofac Med. 2021;3:22. https://doi.org/10.21037/fomm-21-42 DOI: https://doi.org/10.21037/fomm-20-84

Vergara-Buenaventura A, Castro-Ruiz C. Use of mouthwashes against COVID-19 in dentistry. Br J Oral Maxillofac Surg. 2020;58:924-927. https://doi.org/10.1016/j.bjoms.2020.08.017 DOI: https://doi.org/10.1016/j.bjoms.2020.08.016

Siddiqui AZ, Vellappally S, Fouad H, Muckarrum SM. Bactericidal and clinical efficacy of photochemotherapy in acute necrotizing ulcerative gingivitis. Photodiagnosis Photodyn Ther. 2020;29:101668. https://doi.org/10.1016/j.pdpdt.2020.101668 DOI: https://doi.org/10.1016/j.pdpdt.2020.101668

Niazi FH, Koppolu P, Tanvir SB, Samran A, Alqerban A. Clinical efficacy of photodynamic therapy in the treatment of necrotizing ulcerative periodontitis among HIV seropositive patients: a randomized controlled clinical trial. Photodiagnosis Photodyn Ther. 2020;29:101608. https://doi.org/10.1016/j.pdpdt.2019.101608 DOI: https://doi.org/10.1016/j.pdpdt.2019.101608

Al-Kheraif AA, Javed R, Al-Momani MM, Wasi A, Khan AA. Effectiveness of photodynamic therapy adjunct to oral debridement in improving clinical, microbiological and pain in necrotizing ulcerative gingivitis. J Biophotonics. 2023;16:e202300197. https://doi.org/10.1002/jbio.202300197 DOI: https://doi.org/10.1002/jbio.202300197

Garg J, Rg SM, Sinha S, Ghambhir S, Abbey P, Jungio MP. Antimicrobial activity of chlorhexidine and herbal mouthwash against the adherence of microorganisms to sutures after periodontal surgery: a clinical microbiological study. Cureus. 2022;14(12):e32306. https://doi.org/10.7759/cureus.32306 DOI: https://doi.org/10.7759/cureus.32907

Ahmed B, Ahmed F, Kumar A, Imran M, Iqubal MK, Al-Lami HA. Nanoparticle-based oral rinses for plaque control: a systematic review of efficacy and safety. Eur J Pharm Biopharm. 2026;218:114910. https://doi.org/10.1016/j.ejpb.2025.114910 DOI: https://doi.org/10.1016/j.ejpb.2025.114910

Meykadeh Z. Evaluating the efficacy of antimicrobial agents on the surface of implants contaminated with Staphylococcus aureus biofilms [master’s thesis]. The University of Texas School of Dentistry at Houston; 2025.

Herrera D, Serrano J, Roldán S, Sanz M. Is the oral cavity relevant in COVID-19 pandemic? Clin Oral Investig. 2020;24:2925-2930. https://doi.org/10.1007/s00784-020-03413-y DOI: https://doi.org/10.1007/s00784-020-03413-2

Tapashetti RP, Ansari MW, Fatima G, Bhutani N, Sameen N, Pushpalatha HM. Effects of probiotics mouthwash on levels of red complex bacteria in chronic periodontitis patients: a clinico-microbiological study. J Contemp Dent Pract. 2022;23:320-326. https://doi.org/10.5005/jp-journals-10024-3312 DOI: https://doi.org/10.5005/jp-journals-10024-3316

Nardi GM, Fais S, Casu C, et al. Mouthwash based on ozonated olive oil in caries prevention: a preliminary in vitro study. Int J Environ Res Public Health. 2020;17:9106. https://doi.org/10.3390/ijerph17239106 DOI: https://doi.org/10.3390/ijerph17239106

Casu C, Orrù G, Fais S, et al. Efficacy of ozonated water as a PS in photodynamic therapy: a tool for dental caries management? An in vitro study. J Public Health Res. 2023;12:22799036231182267. https://doi.org/10.1177/22799036231182267 DOI: https://doi.org/10.1177/22799036231182267

Published

2026-09-30

Issue

Section

Original Papers

How to Cite

1.
Huni OA, Elburki MS, Abdulmatlob MA, Najem AS, Mugrabi MH. Efficacy of 0.5% Hydrogen Peroxide Mouth Rinse as an Adjunct to Scaling in Chronic Gingivitis: A Randomised Controlled Trial. JMS [Internet]. 2026 Sep. 30 [cited 2026 Oct. 22];95(3):e1589. Available from: https://jms.ump.edu.pl/index.php/JMS/article/view/1589