Commentary

Effective toothbrushing at least twice a day using a fluoridated toothpaste is an essential component of any oral health regime. However, there are times when this is not always possible, for example following surgery or in patients with additional needs. For these patients assisted toothbrushing and the use of chemotherapeutic agents may be helpful. Mouthrinses are one method of delivering these agents although oral sprays are a potential alternative. The aim of this review was to assess the efficacy of antiseptic oral sprays for the control of plaque and gingivitis.

The literature search of this review involved three major databases, although restricting the included studies to those published in English might have excluded some studies, a point noted by the authors. Twenty RCTs were included although seven of them involved fewer than 20 patients. The studies were also of short duration with only two of them being longer than two months. A range of chemotherapeutic agents were employed although chlorhexidine was the most commonly used, however even with this agent there was considerable variation in the treatment protocols used between the studies. The authors assessed study quality using the Cochrane risk of bias tool although only the overall summary is presented in the published article rather than individual study data. In the discussion the authors highlight that a large majority of studies did not report on randomisation allocation concealment blinding or sample size calculation which raises questions about the overall quality of the included studies.

While meta-analysis suggests that small reductions can be demonstrated in the short-term studies the clinical relevance of these findings is uncertain. Further well designed, conducted and reported studies of the appropriate size and duration are needed to clarify the real clinical effectiveness of these agents.