Folate mouthwash: Effects on established gingivitis in periodontal patients

Abstract

A double blind study was designed to determine the effects of folate mouthwash (MW) on established gingivitis in non-pregnant adults. 60 subjects who had greater than 20 teeth, visible gingival inflammation around greater than 6 teeth, no complicated medical history, currently not receiving periodontal treatment or medication, and not wearing dentures, were randomly assigned to control or experimental groups. Full mouth assessment included plaque scores, gingival colour changes, bleeding tendency around every tooth and experience of disease and local factors. Subjects used 5 ml of MW twice daily for 4 weeks, rinsing for 1 min before expectorating. Experimental MW contained 5 mg folate per 5 ml. The control group used a placebo MW. A detailed 3-day diet record was kept by each subject. The oral examination was repeated after 4 weeks. Initially, groups were similar except that the experimental group exhibited more bleeding sites at the outset, but after 4 weeks, the experimental group showed a significant decrease in mean number of colour change sites (from 70.17 +/- 12.89 to 56.62 +/- 17.42) and in bleeding sites (from 48.59 +/- 24.28 to 29.28 +/- 19.64) compared with control group (colour: from 66.93 +/- 15.27 to 66.20 +/- 18.83; bleeding: from 36.93 +/- 16.96 to 39.47 +/- 16.67) p less than 0.001. Dietary analysis showed that few subjects ate greater than 200 micrograms folate daily. However, the level of dietary folate did not correlate with changes in inflammation in experimental subjects, r = 0.097. Folate MW appears to have an influence on gingival health through local rather than systemic influence.