Effect of a tea tree oil mouthwash on plaque-induced gingivitis when comparing to chlorhexidine: an exploratory randomised clinical trial
Abstract
Gingivitis, the most common periodontal disease, is an inflammatory condition of the gingiva resulting from bacterial biofilm accumulation without periodontal attachment loss. Chlorhexidine (CHX) is the gold standard for chemical plaque control, yet its prolonged use is associated with undesirable side effects. Tea tree essential oil (TTO, Melaleuca alternifolia), with documented antimicrobial and anti-inflammatory properties, has emerged as a potential natural alternative. This exploratory randomized, controlled, triple-blind clinical trial evaluated the antimicrobial, cytotoxic, and clinical effects of a 1% TTO-based mouthwash compared with 0.12% CHX in 30 adults with plaque-induced gingivitis. Both mouthwashes significantly reduced plaque and gingival indices as well as bacterial counts after 15 days (p < 0.001), with no significant intergroup differences in clinical outcomes. CHX achieved a greater reduction in bacterial load, while TTO presented fewer adverse effects, limited to mild taste alteration and transient increase in salivary flow. Both formulations exhibited in vitro cytotoxicity, though clinical tolerance was high. These results suggest that, under the tested conditions, TTO formulation at 1% (v/v) exerts an antibacterial effect comparable to CHX, while displaying a dose-dependent pattern. Clinical Trial Registration https://doi.org/10.17605/OSF.IO/B5HCD.
How strong is the evidence?
Evidence Hub reads this as a randomized trial, done in people. Its evidence level is 2 of 5 (High · randomized trial). Randomized trials of a reasonable size are the strongest single-study design. Reported size: 30 participants or records.
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