Antiplaque and antigingivitis efficacy of cetylpyridinium chloride with zinc lactate compared with essential oil mouthrinses: Randomized clinical trial

J Am Dent Assoc. 2021 Feb;152(2):105-114. doi: 10.1016/j.adaj.2020.09.021. Epub 2020 Dec 24.


Background: The authors of this study aimed to evaluate the clinical antiplaque and antigingivitis effects of 3 oral hygiene regimens: toothbrushing with standard fluoride toothpaste and manual toothbrush and using a mouthrinse containing cetylpyridinium chloride, zinc lactate, and fluoride (CPC + Zn + F) in an alcohol-free base; toothbrushing with standard fluoride toothpaste and manual toothbrush and using a mouthrinse containing essential oils (EO) in an alcohol-free base; and toothbrushing with manual toothbrush and standard fluoride toothpaste and manual toothbrush (control).

Methods: The participants (N = 120) were randomly assigned to study groups and followed the assigned regimens twice daily for 6 weeks. The participants were examined by a calibrated examiner for the Quigley-Hein plaque index (Turesky modification) and Löe-Silness gingival index at baseline, week 4, and week 6. Statistical analyses were performed separately for plaque and gingival indexes by means of analysis of variance, paired t test, and analysis of covariance (α = 0.05).

Results: At week 4, the CPC + Zn + F group presented additional reductions in dental plaque compared with EO and control groups of (21.4% [P < .001] and 31.4% [P < .001], respectively). After 6 weeks, these values were 26.7% (P < .001) and 44.8% (P < .001), respectively. For Löe-Silness gingival index, additional reduction in the CPC + Zn + F group compared with EO were 10.6% (P < .001) and 13.7% (P < .001) at 4 and 6 weeks, respectively. Compared with control, these reductions were 13.6% (P < .001) and 17.8% (P < .001), respectively.

Conclusions: The regimen including a mouthrinse containing CPC + Zn + F presented higher antiplaque and antigingivitis effects than EO and control regimens.

Practical implications: A mouthrinse containing CPC + Zn + F is an effective protocol for the control of dental plaque and gingivitis.

Keywords: Mouthrinses; cetylpyridinium; dental plaque; essential oils; gingivitis.

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Anti-Infective Agents, Local* / therapeutic use
  • Cetylpyridinium / therapeutic use
  • Dental Plaque Index
  • Dental Plaque* / prevention & control
  • Gingivitis* / prevention & control
  • Humans
  • Lactates
  • Mouthwashes / therapeutic use
  • Oils, Volatile* / therapeutic use
  • Toothbrushing
  • Zinc / therapeutic use


  • Anti-Infective Agents, Local
  • Lactates
  • Mouthwashes
  • Oils, Volatile
  • Cetylpyridinium
  • Zinc