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Abstract

Background: Oral health is crucial for overall well-being, with oral bacteria playing a significant role in the development of periodontal diseases, tooth decay, and halitosis. Antimicrobial mouthwashes are commonly used to reduce microbial load and improve oral hygiene. However, their efficacy in reducing oral bacteria remains a subject of debate, with varied results across studies. Objective: This meta-analysis aimed to evaluate the efficacy of antimicrobial mouthwashes in reducing oral bacteria compared to placebo and other standard oral hygiene practices. Methods: A comprehensive search of databases (PubMed, Cochrane Library, and Scopus) was conducted for randomized controlled trials (RCTs) published between 2000 and 2023. The inclusion criteria focused on studies that measured bacterial counts in saliva or plaque after using antimicrobial mouthwashes. Data were extracted for the type of mouthwash, duration of use, and bacterial outcomes. A random-effects model was employed to calculate standardized mean differences (SMDs) in bacterial reduction. Results: A total of 25 RCTs met the inclusion criteria. The meta-analysis demonstrated that antimicrobial mouthwashes significantly reduced oral bacteria compared to placebo (SMD = 0.80, 95% CI: 0.63 to 0.97, p < 0.001). Subgroup analyses revealed that chlorhexidine mouthwashes were the most effective, followed by essential oils and cetylpyridinium chloride. The effectiveness was more pronounced with longer usage durations, particularly when used in conjunction with brushing. Conclusion: Antimicrobial mouthwashes, especially those containing chlorhexidine, effectively reduce oral bacteria and contribute to oral hygiene. While these mouthwashes can be beneficial, they should be used as an adjunct to regular brushing rather than a sole treatment. Further studies are needed to assess the long-term impact of these mouthwashes on oral health and their potential side effects