Alcohol-free essential oils containing mouthrinse efficacy on three-day supragingival plaque regrowth: a randomized crossover clinical trial

Trials. 2017 Mar 31;18(1):154. doi: 10.1186/s13063-017-1901-z.


Background: To evaluate the antiplaque effects of an alcohol-free mouthrinse containing essential oils-Listerine Zero (LZ)-and an alcohol-based essential oils mouthrinse (EO+) compared with a positive control of 0.20% chlorhexidine mouthrinse (CHX) and a negative control of a placebo solution (saline), using an in vivo plaque regrowth model of three days.

Methods: The study was designed as a double-masked, randomized, crossover clinical trial, involving 21 volunteers to compare four different mouthrinses, using a three-day plaque regrowth model. After receiving thorough professional prophylaxis at baseline, over the next three days each volunteer refrained from all oral hygiene measures and performed two daily rinses with 15 mL of the test mouthrinses. EO+ was compared with LZ. CHX rinse served as a positive control and a placebo solution as a negative control. At the end of each experimental period, the Plaque Index (PI) was assessed and a panelist completed through a visual analogue scale (VAS) questionnaire evaluating the organoleptic properties of each product. Each participant underwent a 14-day washout period and then there was another allocation.

Results: LZ showed the same inhibitory activity on plaque regrowth compared with EO+ in the whole mouth (PI = 1.72 versus 1.65, respectively), but there was less of an effect compared to the CHX (overall PI of 1.07) and a more efficient activity than the saline solution negative control (PI = 2.31). The difference of 0.07 between LZ and EO+ was not statistically significant.

Conclusions: LZ seems to have the same inhibiting effect on plaque regrowth as EO+ and a less inhibiting effect than the CHX control. Both LZ and EO+, as well as the CHX control, show a better inhibiting effect on plaque regrowth than the placebo solution.

Trial registration:, NCT02894593 . Registered on 4 September 2016.

Keywords: Alcohol-free; Chlorhexidine; Dental plaque; Essential oils; Mouthrinse.

Publication types

  • Comparative Study
  • Randomized Controlled Trial

MeSH terms

  • Administration, Oral
  • Adult
  • Anti-Infective Agents, Local / administration & dosage*
  • Anti-Infective Agents, Local / adverse effects
  • Bacteria / drug effects*
  • Bacteria / growth & development
  • Chlorhexidine / administration & dosage*
  • Chlorhexidine / adverse effects
  • Cross-Over Studies
  • Dental Plaque / diagnosis
  • Dental Plaque / microbiology
  • Dental Plaque / prevention & control*
  • Dental Plaque Index
  • Double-Blind Method
  • Drug Combinations
  • Female
  • Humans
  • Italy
  • Male
  • Mouthwashes / administration & dosage*
  • Mouthwashes / adverse effects
  • Oils, Volatile / administration & dosage*
  • Oils, Volatile / adverse effects
  • Salicylates / administration & dosage*
  • Salicylates / adverse effects
  • Surveys and Questionnaires
  • Terpenes / administration & dosage*
  • Terpenes / adverse effects
  • Time Factors
  • Treatment Outcome
  • Young Adult


  • Anti-Infective Agents, Local
  • Drug Combinations
  • Mouthwashes
  • Oils, Volatile
  • Salicylates
  • Terpenes
  • Listerine
  • Chlorhexidine

Associated data