218 - Chlorhexidine Use in Patients with Special Health Care Needs

Abstract:

Purpose:
To evaluate the effectiveness of chlorhexidine (CHX)-containing products as adjuncts to mechanical oral hygiene in improving periodontal outcomes in patients with special health care needs (SHCN).



Methods:
Electronic searches of PubMed, Embase, and Web of Science were conducted for studies published from January 1945 through December 31, 2024. Randomized controlled trials assessing the periodontal effects of CHX-containing products in patients with SHCN were included. Primary outcomes were changes in plaque index (PI) and gingival index (GI); secondary outcomes included adverse effects and changes in oral bacterial profiles. Random-effects meta-analyses were performed using Hedges’ g for PI and mean differences for GI. Risk of bias was assessed using the Cochrane Risk of Bias 2 tool, and certainty of evidence was evaluated using the GRADE framework.



Results:
Twelve randomized controlled trials involving 1,135 participants were included. CHX use significantly reduced plaque compared with control (Hedges’ g = −1.49; 95% CI −2.07 to −0.91; P < .001) and significantly decreased gingival inflammation (mean difference = −0.21; 95% CI −0.31 to −0.12; P < .001). Subgroup analyses showed more consistent benefits with 0.2% CHX and with spray or topical delivery. Longer treatment duration was associated with greater plaque reduction. Tooth staining and taste alteration were the most commonly reported adverse effects and were generally mild and reversible.



Conclusions:
Short-term adjunctive CHX use (2–6 weeks), particularly for 4–6 weeks, significantly improves plaque and gingival outcomes in patients with SHCN and appears clinically effective and well tolerated under professional supervision.

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