Assessment of the Association between Mouthwash Use and Plaque Accumulation in a Cross-Sectional Study

Abstract

Introduction: Plaque accumulation is a major risk factor for gingival inflammation and periodontal disease. While tooth brushing is the cornerstone of oral hygiene, mouthwash is often used as an adjunct to reduce plaque and improve oral health.

Objective: To evaluate the association between mouthwash use and plaque accumulation among adults.

Methodology: A cross-sectional study was conducted at Mardan Medical Complex, Pakistan, from January to December 2023, enrolling 252 participants (mean age: 28.7 ± 8.4 years). Plaque scores were recorded using WHO Oral Health Survey (5th edition) criteria. Mouthwash use, brushing frequency, and demographic data were collected via structured questionnaires. Statistical analysis included chi-square, ANOVA, and multiple linear regression, with p < 0.05 considered significant.

Results: Regular mouthwash use was reported by 41.3% of participants, occasional use by 28.6%, and no use by 30.2%. Mean plaque scores were significantly lower among regular users (1.43 ± 0.35) compared to occasional (1.77 ± 0.41) and non-users (2.18 ± 0.47) (p < 0.001). Chlorhexidine users showed the lowest mean plaque scores (1.38 ± 0.29). Gender differences were significant on univariate analysis (p = 0.04) but not after adjustment in regression. Multiple regression identified regular mouthwash use (β = −0.63, p < 0.001) and higher brushing frequency (β = −0.52, p < 0.001) as independent predictors of lower plaque scores.

Conclusion: Regular mouthwash use, particularly chlorhexidine, and frequent tooth brushing significantly reduce plaque accumulation and should be encouraged as part of routine oral hygiene.