Effects of antimicrobial mouthwashes on the human oral microbiome: Systematic review of controlled clinical trials.

Autor: do Amaral GCLS; Department of Stomatology, School of Dentistry, University of São Paulo, Sao Paulo, Brazil., Hassan MA; Department of Stomatology, School of Dentistry, University of São Paulo, Sao Paulo, Brazil., Sloniak MC; Department of Stomatology, School of Dentistry, University of São Paulo, Sao Paulo, Brazil., Pannuti CM; Department of Stomatology, School of Dentistry, University of São Paulo, Sao Paulo, Brazil., Romito GA; Department of Stomatology, School of Dentistry, University of São Paulo, Sao Paulo, Brazil., Villar CC; Department of Stomatology, School of Dentistry, University of São Paulo, Sao Paulo, Brazil.
Jazyk: angličtina
Zdroj: International journal of dental hygiene [Int J Dent Hyg] 2023 Feb; Vol. 21 (1), pp. 128-140. Date of Electronic Publication: 2022 Aug 19.
DOI: 10.1111/idh.12617
Abstrakt: Objectives: This review aimed to assess the impact of mouthwashes on the composition of the human oral microbiome.
Method: An electronic search algorithm was adapted to MEDLINE-PubMed, Scopus, Embase and ISI Web of Science, and reference lists of relevant sources were manually searched. Inclusion criteria were controlled clinical trials published in English whose population were adult individuals who rinse with antimicrobial mouthwashes and that analysed changes in the oral microbiome by metataxonomy, metagenomics or phylogenetic microarray. Identified studies were screened and assessed following the PRISMA guidelines, and results were compiled into qualitative synthesis of the evidence.
Results: Five controlled clinical studies were included. These studies found associations between the daily use of mouthwashes and changes in the oral microbiome, but the nature of the effect varied according to the mouthwash. Chlorhexidine (CHX) rinses lowered microbial diversity. While 7-day use of CHX led to increases in the abundance of Neisseria, Streptococcus and Granulicatella and a decrease in the abundance of Actinomyces, its prolonged use led to widespread reductions in several genera and species. Cetylpyridinium chloride-containing mouthwashes specifically lowered the abundance of gingivitis-associated genera. In contrast, N-acetyl cysteine-based mouthwashes did not promote changes in the oral microbiome.
Conclusions: Despite substantial heterogeneity, we found evidence to support the hypothesis that CHX and CPC mouthwashes promote changes in oral microbial structure and/or reductions in community diversity that favour the resolution of dysbiosis. However, future large population-based studies of adequate duration are needed to fully understand the extent to which antimicrobial mouthwashes modulate the microbiome.
(© 2022 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.)
Databáze: MEDLINE
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