Clinical Oral Investigations

, Volume 22, Issue 3, pp 1439–1448 | Cite as

Interaction between chlorhexidine and fluoride in a mouthrinse solution—a 4-day and 6-week randomized clinical pilot study

  • Oscar Villa
  • Per Ramberg
  • Hidekazu Fukui
  • Claes-Göran Emilson
  • Georgios Papanikolaou
  • Lars Heijl
  • Dowen Birkhed
Original Article



The aim of the present investigation was to study if there is a reduced clinical effect and fluoride retention of a mouthrinse solution containing both chlorhexidine (CHX) and sodium fluoride (NaF).

Material and methods

Two clinical trials were designed as double-blind, randomized, cross-over studies. In study I, 16 healthy subjects were asked to rinse twice daily for 1 min during 4 days of no tooth brushing with four solutions: (1) 0.12% CHX + 0.2% NaF, (2) 0.2% NaF, (3) 0.12% CHX, and (4) placebo. In study II, another 16 healthy subjects rinsed with the same four solutions twice daily after tooth brushing during a 6-week period. Plaque formation, gingivitis, and microbiological samples from plaque and saliva, as well as fluoride retention, were analyzed.


Both studies showed that both CHX + NaF and CHX mouthrinses had the same clinical effect with regards to plaque formation and microflora in plaque and saliva. Similarly, fluoride retention was not altered by the CHX + NaF mouthrinse compared to the NaF solution.


The combination of CHX and NaF in a mouthrinse showed the same clinical effect as the CHX solution. The retention of fluoride in the oral cavity was not affected by the combination of NaF and CHX.

Clinical relevance

A mouthrinse solution containing a mixture of CHX and NaF may be an interesting product for risk patients for caries and periodontal disease. However, this should be verified in further long-term clinical studies.


Chlorhexidine Clinical trial Dental plaque Fluoride Gingivitis Microbiology Mouthwash 



The authors are thankful to Ann-Britt Lundberg for skilful technical assistance, Tommy Johnsson for statistical advice, and Anna Elmblad and Magnus Nylén at Actavis for support of the test solutions and toothpaste.

Funding information

The study was funded by the University of Gothenburg and by Actavis AB.

Compliance with ethical standards

Conflicts of interest

The mouthrinse solutions and coded bottles were kindly provided by Actavis AB (Stockholm, Sweden). The authors declare no conflicts of interest.

Ethical approval

The study has been approved by the Regional Ethical Review Board at the University of Gothenburg (Dnr 745-11) and has therefore been performed in accordance with the ethical standards laid down in the 1964 Helsinki Declaration and its later amendments.

Informed consent

Informed consent was obtained from all individual participants included in the study.


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Copyright information

© Springer-Verlag GmbH Germany 2017

Authors and Affiliations

  1. 1.Department of Periodontology, Institute of Clinical DentistryUniversity of OsloOsloNorway
  2. 2.Institute of Odontology, Sahlgrenska AcademyUniversity of GothenburgGothenburgSweden
  3. 3.Satsuki Dental OfficeNaganoJapan
  4. 4.Department of Cariology, Institute of Odontology, Sahlgrenska AcademyUniversity of GothenburgGothenburgSweden
  5. 5.IoanninaGreece
  6. 6.LandalatandläkarnaGothenburgSweden
  7. 7.Fersens vägMalmöSweden

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