Comparative Evaluation of the Efficacy of Cetylpyridinium Chloride Mouthwash and Chlorhexidine Mouthwash in Plaque Reduction: A Systematic Review and Meta-analysis

Purpose of Review Data from previous research suggest that chlorhexidine gluconate (CHX) mouthwash and Cetylpyridinium Chloride (CPC) mouthwash effectively reduce dental plaque. However, a systematic review comparing the efficacy of both mouthwashes is lacking. This systematic review aimed to assess and compare the available data on the efficacy of CHX and CPC mouthwash in plaque removal. Recent Findings Two studies showed no significant difference in the plaque reduction of CPC mouthwash and CHX mouthwash. One study showed that CHX mouthwash was more effective in plaque reduction than CPC mouthwash. Whereas, in another study, it was found that CPC mouthwash was more effective in plaque reduction as compared to CHX mouthwash. One study showed that CPC mouthwash alone was effective in plaque reduction. However, the efficacy was lower than the combination of CHX and CPC mouthwash. Summary Chlorhexidine gluconate (CHX) mouthwash is considered a “gold-standard” due to its proven effectiveness in disrupting plaque biofilm. However, it has certain adverse effects. Cetylpyridinium chloride (CPC) mouthwash has been found to be effective in plaque reduction and prevention of gingivitis. Databases such as PubMed, Cochrane, Scopus, Lilacs, Science Direct, Web of Science, and Google Scholar were comprehensively searched. 5 articles were processed for data extraction based on the eligibility criteria out of which 3 articles were further processed for quantitative analysis. The results suggested positive antiplaque efficacy of CPC mouthwash which was comparable to CHX mouthwash. The meta-analysis showed no difference in the plaque reduction between chlorhexidine and CPC mouthwash with a 95% CI of SMD: 0.44 [-1.04, 1.92]; P = 0.56. It was also found that CPC mouthwash was well-tolerated and safe to use with fewer side effects. Based on the results, we concluded that the antiplaque efficacy of CHX mouthwash and CPC mouthwash is comparable. Hence, CPC mouthwash can be an effective alternative to CHX mouthwash with fewer adverse effects.