Analogous assay between green tea mouthwash, listerine mouthwash and chlorhexidine mouthwash in plaque reduction, on orthodontic patients: a randomized cross-over study


  • Ramyathilagam Raju Department of Public Health Dentistry, Priyadarshini Dental College and Hospital, Chennai, Tamil Nadu, India
  • Angeline Divya Department of Public Health Dentistry, Priyadarshini Dental College and Hospital, Chennai, Tamil Nadu, India
  • Ganesh Rajendran Department of Public Health Dentistry, Priyadarshini Dental College and Hospital, Chennai, Tamil Nadu, India
  • James Rufus John School of Science and Health, Western Sydney University, Campbelltown, NSW, Australia



Chlorhexidine, Green tea, Listerine, Fixed appliance, Plaque, Relapse period


Background: The aim of the study was to compare the efficiency of green tea mouthwash, Listerine mouthwash and Chlorhexidine mouthwash in plaque reduction among orthodontic patients.

Methods: The study employed a double blinded, simple randomized, cross over design with a control group consisting of 30 orthodontic patients undergoing fixed appliance therapy. All the subjects were divided into group 1 (Green tea), group 2 (Listerine) and group 3 (Chlorhexidine) as 10 subjects per group. Gingival status was assessed using Sulcus Bleeding Index and plaque accumulation was assessed using Turesky-Gilmore-Glickman modification of Quigley Hein Index. After a relapse period of 15 days, group 1 and 2 were crossed over, however, group 3 remained the same. Indices were again recorded at baseline and 15th day.

Results: The mean gingival and plaque score was reduced in all the three groups. However, green tea mouthwash was estimated to have the highest mean difference from 2.17 ± 0.610 at baseline to 1.48 ± 0.474 on the 15th day.

Conclusions: Effective use of mouthwashes as supplements for tooth brushing has proved to be beneficial in oral hygiene and maintenance. The findings of this study provide useful insights on the effectiveness of different compositions of mouthwashes. 


Page RC, Kornman KS. The pathogenesis of human periodontitis: An introduction. Periodontol. 1997;14:9-11.

Balagopal S, Arjunkumar R. Chlorhexidine: The gold standard antiplaque agent. J Pharm Sci Res. 2013;5(12):270-4.

Santos A. Evidence-based control of plaque and gingivitis. J Clin Periodontal. 2003;30 Suppl 5:13-6.

Allaker RP, Douglas CI. Novel anti-microbial therapies for dental plaque-related diseases. Int J Antimicrob Agents. 2009;33(1):8-13.

Taylor PW, Hamilton-Miller JM, Stapleton PD. Antimicrobial properties of green tea catechins. Food Sci Technol Bull. 2005;2:71-81.

Kaur H, Jain S, Kaur A. Comparative evaluation of the antiplaque effectiveness of green tea catechin mouthwash with chlorhexidine gluconate. J Indian Society Periodontol. 2014;18(2):178.

Farah CS, McIntosh L, McCullough MJ. Mouthwashes. Australian Prescriber. 2009;32(6):162-4.

Khalessi AM, Pack AR, Thomson WM, Tompkins GR. An in vivo study of the plaque control efficacy of Persica: A commercially available herbal mouthwash containing extracts of Salvadorapersica. Int Dent J. 2004;54:279-83.

Arweiler NB, Donos N, Netuschil L, Reich E, Sculean A. Clinical and antibacterial effect of tea tree oil: A pilot study. Clin Oral Investig. 2000;4:70-3.

Haffajee AD, Yaskell T, Socransky SS. Antimicrobial effectiveness of an herbal mouthrinse compared with an essential oil and a chlorhexidinemouthrinse. J Am Dent Assoc. 2008;139:606-11.

Brecx M, Macdonald LL, Legary K, Cheang M, Forgay MG. Long-term effects of Meridol and chlorhexidine mouth rinses on plaque, gingivitis, staining, and bacterial vitality. J Dent Res. 1993;72:1194-7.

Cabrera C, Artacho R, Giménez R. Beneficial effects of green tea—a review. J Am Coll Nutr. 2006;25(2):79-99.

Gershon-cohen J, Mcclendon HF. Fluorine in tea and caries in rats. Nature. 1954;173:304-5.

Soukoulis S, Hirsch R. The effects of a tea tree oil-containing gel on plaque and chronic gingivitis. Aust Dent J. 2004;49:78-83.

Elvin-Lewis M, Steelman R. The anticariogenic effects of tea drinking among Dallas children. J Dent Res. 1968;65:198.

Rosen S, Elvin-Lewis M, Beck FM, Beck EX. Anticariogenic effects of tea in rats. J Dent Res. 1984;63:658-60.

Touyz LZ, Amsel R. Anticariogenic effects of black tea (Camellia sinensis) in caries prone-rats. Quintessence Int. 2001;32:647-50.

Lee MJ, Lambert JD, Prabhu S, Meng X, Lu H, Maliakal P, et al. Delivery of tea polyphenols to the oral cavity by green tea leaves and black tea extract. Cancer Epidemiol Biomarkers Prev. 2004;13:132-7.

Krahwinkel T, Willershausen B. The effect of sugar-free green tea chew candies on the degree of inflammation of the gingiva. Eur J Med Res. 2000;5:463-7.

Osawa K, Matsumoto T, Yasuda H, Kato T, Naito Y, Okuda K. The inhibitory effect of plant extracts on the collagenolytic activity and cytotoxicity of human gingival fibroblasts by Porphyromonasgingivalis crude enzyme. Bull Tokyo Dent Coll. 1991;32:1-7.

Demeule M, Brossard M, Pagé M, Gingras D, Béliveau R. Matrix metalloproteinase inhibition by green tea catechins. Biochim Biophys Acta. 2000;1478:51-60.

Okamoto M, Sugimoto A, Leung KP, Nakayama K, Kamaguchi A, Maeda N. Inhibitory effect of green tea catechins on cysteine proteinases in Porphyromonasgingivalis. Oral Microbiol Immunol. 2004;19:118-20.

Okamoto M, Leung KP, Ansai T, Sugimoto A, Maeda N. Inhibitory effects of green tea catechins on protein tyrosine phosphatase in Prevotellaintermedia. Oral Microbiol Immunol 2003;18:192-5.

Sakanaka S, Okada Y. Inhibitory effects of green tea polyphenols on the production of a virulence factor of the periodontal-disease-causing anaerobic bacterium Porphyromonasgingivalis. J Agric Food Chem. 2004;52:1688-92.

Brecx M, Netuschil L, Reichert B, Schreil G. Efficacy of Listerine, Meridol and chlorhexidine mouthrinses on plaque, gingivitis and plaque bacteria vitality. J Clin Periodontol. 1990;17:292-7.

Lang NP, Brecx M. Chlorhexidine digluconate: An agent for chemical plaque control and prevention of gingival inflammation. J Periodont Res. 1986;21:74-89.

Löe H, Schiött CR, Karring G, Karring T. Two years oral use of chlorhexidine in man. I. General design and clinical effects. J Periodontal Res. 1976;11:135-44.

Webb P, Bain C. Essential epidemiology: an introduction for students and health professionals. Cambridge University Press; 2010.




How to Cite

Raju, R., Divya, A., Rajendran, G., & John, J. R. (2017). Analogous assay between green tea mouthwash, listerine mouthwash and chlorhexidine mouthwash in plaque reduction, on orthodontic patients: a randomized cross-over study. International Journal Of Community Medicine And Public Health, 4(5), 1429–1435.



Original Research Articles