Effects of antiseptic mouthwash on resting metabolic rate: a randomized, double-blind, crossover study
Abstract
The nitrate-nitrite-nitric oxide pathway has emerged as a significant source of nitric oxide (NO) bioactivity. Dietary intake of inorganic nitrate has a number of cardiovascular effects as well as a decrease in oxygen cost during exercise and a reduction in resting metabolic rate (RMR). Oral bacteria have a key role in bioactivation of inorganic nitrate since they catalyse the conversion of salivary nitrate to the more reactive nitrite anion. Recent studies demonstrate that blood pressure increases with the use of an antiseptic mouthwash, indicating that endogenous, NO-synthase derived nitrate is recycled into nitrite and NO, sufficiently to modulate cardiovascular function. Here we tested if also RMR would be affected by an antiseptic mouthwash. Seventeen healthy normotensive female subjects (23 ± 4 y) participated in this randomized, double-blinded, crossover study. During two 3-day periods separated by 28 days the subjects consumed a diet low in nitrate combined with rinsing their mouth three times daily with a chlorhexidine-containing mouthwash (mouthwash) or placebo mouthwash (placebo) with similar taste but no antiseptic properties. Resting metabolic rate (RMR) was measured by indirect calorimetry and 24 h ambulatory blood pressure recordings were obtained after each intervention together with blood, saliva and urine samples. Treatment with chlorhexidine-containing mouthwash effectively reduced oral conversion of nitrate to nitrite but had no effect on plasma levels of these anions or plasma cGMP. RMR and 24 h ambulatory blood pressure were unaffected by the intervention. We conclude that in young healthy females an antiseptic mouthwash was effective in disrupting oral bacterial nitrate conversion to nitrite, but this was not associated with changes in plasma nitrite, RMR or blood pressure.
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Two included studies found no significant difference in plasma nitrate or nitrite concentration between mouthwash and control.
“Two studies did not find any difference in plasma nitrate or nitrite concentration.”
From Do Changes in Oral Microbiota Correlate With Plasma Nitrite Response? A Systematic Review (2019) · cites this paper as Sundqvist et al., 2016
In one included study, no difference in blood pressure between test and control group was reported.
“One study did not report any difference between test and control group (Sundqvist et al., 2016).”
From Do Changes in Oral Microbiota Correlate With Plasma Nitrite Response? A Systematic Review (2019) · cites this paper as Sundqvist et al., 2016
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- Authors
- Sundqvist, M. L., Lundberg, J. O., & Weitzberg, E.
- Affiliations
- Karolinska University Hospital (SE)
- Karolinska Institutet (SE)
- Corresponding author
- Weitzberg, Eddie
- Venue
- Nitric Oxide
- Publisher
- Elsevier BV
- Published
- 2016-12
- Volume
- 61
- Pages
- 38-44
- ISSN
- 1089-8603 (ISSN-L)
- OpenAlex
- W2535689489
- Cited by
- 46
- References
- 34
- Citations by year
- 2026: 4 · 2025: 8 · 2024: 7 · 2023: 7 · 2022: 2 · 2021: 3 · 2020: 7 · 2019: 7 · 2016: 1
- FWCI
- 3.97
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Nitric Oxide (publishedVersion)
- PubMed (publishedVersion)
- Funders
- Rocky Mountain Research Station
- Topics
- Health Sciences › Dentistry › Periodontics › Oral microbiology and periodontitis research
- Health Sciences › Medicine › Physiology › Nitric Oxide and Endothelin Effects
- Health Sciences › Dentistry › Periodontics › Oral Health Pathology and Treatment
- Keywords
- antiseptic mouthwash, chlorhexidine, resting metabolic rate, nitrate-nitrite-nitric oxide pathway, oral bacteria, salivary nitrate, plasma nitrite, blood pressure, cyclic GMP, ambulatory blood pressure
- MeSH terms
- Adult, Anti-Infective Agents, Local, Basal Metabolism, Blood Pressure, Breath Tests, Calorimetry, Indirect, Chlorhexidine, Diet, Double-Blind Method, Female, Humans, Mouthwashes, Nitrates, Nitric Oxide, Nitrites, Surveys and Questionnaires, Saliva, Vegetables, Cross-Over Studies, Young Adult
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