ORIGINAL RESEARCH article
Front. Oral Health
Sec. Preventive Dentistry
Volume 6 - 2025 | doi: 10.3389/froh.2025.1656328
This article is part of the Research TopicBest Practices in Home Plaque Removal: Past, Present, and Future PerspectivesView all articles
Does Chlorhexidine Improve Periodontal Health and Bacterial Profiles in Patients with Special Health Care Needs? A Systematic Review and Meta-Analysis
Provisionally accepted
- 1University of Washington, Seattle, United States
- 2private practice, Taichung, Taiwan
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The purpose of this systematic review was to evaluate the effectiveness of chlorhexidine (CHX)-containing products as adjuncts to mechanical oral hygiene practices in maintaining gingival health in patients with intellectual disability.Methods: An electronic search was conducted in three databases-PubMed, Embase, and Web of Science-1945-December 31, 2024. Two calibrated independent reviewers assessed the selected studies based on the inclusion and exclusion criteria. The main outcomes measured were changes in the gingival index, plaque index, and complications. A meta-analysis was performed to analyze the efficiency of adjunct CHX products compared with controls (mechanical plaque removal only). Additionally, meta-regression was conducted to investigate the factors contributing to these outcomes.Results: Twelve randomized controlled trials involving individuals with special health care needs (SHCN) were included across varied clinical settings. CHX use was associated with a statistically significant reduction in plaque accumulation (Hedges' g = -1.491; 95% CI: -2.067 to -0.914; P < .001; I² = 37.3%), with the greatest reductions observed in studies using spray and gel delivery methods. Gingival inflammation also decreased significantly across studies (mean difference = -0.214; 95% CI: -0.306 to -0.121; P < .001), with 0.2% CHX formulations demonstrating the most consistent improvement.In patients with SHCN short-term use (4-6 weeks), especially with 0.2% formulations, appeared to offer the greatest benefit while maintaining acceptable tolerability. While adverse effects such as tooth staining and taste alterations are common, they are generally mild and self-limiting. These findings support the shortterm use of CHX as an adjunctive measure in oral hygiene management for individuals with SHCN, with use tailored to the patient's needs and monitored closely by a dental provider to minimize complications.
Keywords: Chlorhexidine, Evidence Based Dentistry, Oral Hygiene, Periodontal Index, Intellectual Disability, Developmental Disabilities
Received: 29 Jun 2025; Accepted: 13 Oct 2025.
Copyright: © 2025 Sharma, Liu, Hsu, Sheyda, Forsyth and Nelson. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Travis Nelson, tmnelson@uw.edu
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