A Comparative Evaluation of the Effects of Three Different Mouthwashes on Salivary pH in Patients Undergoing Fixed Orthodontic Treatment: A Randomized Clinical Trial.

Authors

Sruthi Jeevagan, Sathi Rami Reddy Mora, Mohamed Rahmankhan N, V Vijaykumar, Santhosh Kumar, Santha Kumari

Published in

Cureus. Volume 18. Issue 9. Pages e116931. Epub Sep 25, 2026.

Abstract

Introduction Orthodontic appliances have been reported to influence salivary composition and properties, including alterations in pH and buffering capacity, which may increase the vulnerability of patients to caries development. In addition to mechanical plaque control, mouthwashes and other chemical agents are frequently advised to improve oral hygiene in orthodontic patients. This randomized clinical experiment assesses and compares the effects of three distinct mouthwashes on the salivary pH level in patients receiving fixed orthodontic therapy. Methods This randomized parallel-group single-blind clinical trial involved 120 patients who attended fixed orthodontic treatment, randomly divided into three groups (n = 40 each): Hetafu CUTE, chlorhexidine, and Listerine mouthwash users. Every participant received two 10-15 mL rinses per day, each of which lasted 30-60 seconds. Saliva pH was measured using standard pH paper at baseline, directly after mouthwash use (five minutes), and one week after the beginning of the intervention. The results were analyzed using a mixed-design repeated-measures analysis of variance (ANOVA) with Greenhouse-Geisser correction, and Bonferroni-adjusted post-hoc comparisons were performed where appropriate. Statistical significance was set at p < 0.05. Results A total of 120 participants were included, with 40 in each group. Baseline salivary pH was comparable among the groups (p = 0.157). At five minutes, salivary pH was higher with Hetafu CUTE (7.75 ± 0.78) than with chlorhexidine (7.08 ± 1.00) and Listerine (7.15 ± 1.37) (p = 0.014). At one week, pH increased with Hetafu CUTE (7.93 ± 0.69) but decreased with chlorhexidine (6.78 ± 0.80) and Listerine (6.70 ± 1.34) (p < 0.001). The group × time interaction was statistically significant (p < 0.001), with Bonferroni-adjusted comparisons showing higher pH with Hetafu CUTE than chlorhexidine (p = 0.006) and Listerine (p = 0.023). Conclusion Within the scope of the study, the Hetafu CUTE mouth rinse showed a more pronounced and prolonged increase in saliva pH compared to Listerine and chlorhexidine. This characteristic may contribute to the maintenance of oral pH homeostasis and prevention of enamel demineralization and white spot lesions. However, further research, including large-scale randomized controlled trials, is warranted to validate these findings and establish the clinical efficacy of Hetafu CUTE.

PMID:
42928919
Bibliographic data and abstract were imported from PubMed on 26 Oct 2026.

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