Ingredient Comparison
A Proven Formula For Success
LISTERINE® Antiseptic mouthrinse formulations offer an unmatched depth and breadth of clinical data documenting efficacy and safety.
One head-to-head comparison shows that, at 6 months, LISTERINE® Antiseptic and the prescription mouthrinse had comparable antiplaque and antigingivitis activity. Also, importantly, subjects receiving prescription mouthrinse had significantly more extrinsic tooth stain and calculus formation than subjects receiving LISTERINE® Antiseptic.
Studies have also shown the ingredients Cetylpyridinium Chloride (CPC) and Chlorhexidine (CHX) may interact with toothpastes, resulting in diminished activities. Both have also been linked to significant tooth staining. Recommend LISTERINE® Antiseptic to help patients achieve clinically proven plaque and gingivitis control while avoiding the potential drawbacks of other mouthrinse ingredients.
LISTERINE® Antiseptic with Four Essential Oils
All flavors of LISTERINE® Antiseptic contain the same fixed combination of four essential oils:
- eucalyptol (0.092%)
- menthol (0.042%)
- methyl salicylate (0.060%)
- thymol (0.064%)
LISTERINE® Antiseptic is the leading non-prescription mouthrinse and has received the ADA Seal of Acceptance for helping to prevent and reduce supragingival plaque and gingivitis
- Proven in multiple long-term clinical studies to significantly reduce supragingival plaque by up to 56% and gingivitis by up to 36%, even in hard-to-reach areas
- Proven to penetrate plaque biofilm in vitro and in vivo to kill bacteria
There is no known interaction between essential oils and toothpaste ingredients, hence, rinsing with water is not required after brushing and prior to rinsing with LISTERINE® Antiseptic
- Does not promote calculus formation1,2
- Two 6-month studies required by the ADA revealed no alterations in microbial balance, emergence of resistant strains, or opportunistic organisms
Mouthrinses Containing CPC
Cetylpyridinium chloride (CPC) is not a novel ingredient. The quaternary-ammonium salt was first discussed in the literature in 1939. CPC is included in a number of cosmetic and therapeutic mouthrinse formulations, such as Scope, Cepacol, Viadent Advanced Care, Crest Pro-Health, and BreathRx, at levels up to 0.075%
No CPC-containing mouthrinse currently carries the ADA Seal of Acceptance for plaque and gingivitis reduction
- Not all clinically tested CPC formulations have demonstrated supragingival plaque and gingivitis efficacy3-5
- There is limited long-term clinical evidence supporting the efficacy of CPC mouthrinses in fighting supragingival plaque and gingivitis6-8
Toothpastes can reduce the antimicrobial activity of CPC, especially if rinse is used immediately after brushing:
- Inhibition of activity has been attributed to interaction with common ingredients in toothpastes
- In a clinical study evaluating the efficacy of a mouthrinse containing 0.075% CPC, the study protocol for the partially supervised procedures required subjects to rinse their mouth with water immediately prior to rinsing with assigned mouthrinse
- Rinsing with water or waiting for a period of time after brushing before using a CPC-containing mouthrinse is recommended to clear toothpaste ingredients from the mouth and maintain antimicrobial activity
- Certain CPC-containing mouthrinse labels require an additional water rinse prior to using the mouthrinse which is less convenient, and may affect compliance
- Two 6-month studies demonstrated clinically significant increases in objectionable tooth stain6-7
- Short-term studies also showed an increase in extrinsic stain4,9
Mouthrinses Containing CHX
Chlorhexidine (CHX) is the active ingredient in prescription mouthrinses (such as Peridex®)
Only one prescription mouthrinse with CHX has earned the ADA Seal of Acceptance for helping to prevent and reduce supragingival plaque and gingivitis
One head-to-head comparison shows that, at 6 months, LISTERINE® Antiseptic and the prescription mouthrinse had comparable antiplaque and antigingivitis activity. Also, importantly, subjects receiving prescription mouthrinse had significantly more extrinsic tooth stain and calculus formation than subjects receiving LISTERINE® Antiseptic10
Toothpastes can significantly reduce the antimicrobial activity of CHX:
- Reduction of activity is due to interaction with common toothpaste ingredients, such as sodium lauryl sulfate11
- According to authors of one study, patients should delay rinsing for at least 30 minutes to 2 hours after brushing to minimize reduction in antiplaque activity11
CHX is linked to tooth staining and other side effects as described in the Peridex® prescribing information, including12:
- Peridex® may cause some tooth discoloration, or increases in tartar (calculus) formation, particularly in areas where stain and tartar usually form
- It is important that patients see their dentists for stain or tartar removal at least every six months or more frequently if recommended by their dentists
- Peridex® may cause permanent discoloration of some front-tooth fillings
- Peridex® stains the tongue and aesthetic restorations
- Peridex® can alter taste perception and irritate oral soft tissue
Learn more about LISTERINE® Antiseptic:
REFERENCES:
1.Overholser CD, Meiller TF, DePaola LG, Minah GE, Niehaus C. Comparative effects of 2 chemotherapeutic mouthrinses on the development of supragingival dental plaque and gingivitis. J Clin Periodontol. 1990;17:575-579. 2.Data on file, McNEIL-PPC, Inc. 3.Oral health care drug products for over-the-counter human use: antigingivitis/antiplaque drug products: establishment of a monograph: proposed rules. Part III, Department of Health and Human Services, Food and Drug Administration. Federal Register. 2003;68:32248. 4.Ciancio SG, Mather ML, Bunnell HL. The effect of a quaternary ammonium-containing mouthwash on formed plaque. Pharmacol Ther Dent. 1978;3:1-6. 5.Moran J, Addy M. The effects of a cetylpyridinium chloride prebrushing rinse as an adjunct to oral hygiene and gingival health. J Periodontol. 1991;62:562-564. 6.Stookey GK, et al. A clinical study assessing the safety and efficacy of two mouthrinses with differing concentrations of an active ingredient in commercially-available mouthrinses–Study 005293. Unpublished study in OTC Vol. 210421 (FDA Docket No. 81N-033P, BKG2–Ref. 69; 68 Fed. Reg. at 32277); see also Witt JJ, Isaacs RL, Mau M, Beiswanger B, Stookey GK. Efficacy of two experimental CPC mouthrinses in a 6-month study. The IADR/AADR/CADR 83rd General Session (March 9-12, 2005), Baltimore, MD. Abstract #3598. 7.Segreto, V. A., A Clinical Investigation to Assess the Effects on Plaque, Gingivitis, and Staining Potential of an Experimental Mouthrinse–Study 002393, unpublished study in OTC Vol. 210421(FDA Docket No. 81N-033P, BK G2 - Ref. 68; Fed. Reg. at 32277). 8.Allen DR, Davies R, Bradshaw B, et al. Efficacy of a mouthrinse containing 0.05% cetylpyridinium chloride for the control of plaque and gingivitis: A 6-month clinical study in adults. Compend Contin Educ Dent. 1998;19(suppl):20-26. 9.Lobene RR, Kashket S, Soparkar PM, Shloss J, Sabine ZM. The effect of cetylpyridinium chloride on human plaque bacteria and gingivitis. Pharmacol Ther Dent. 1979;4:33-46. 10.Charles CH, Mostler KM, Bartels LL, Mankodi SM. Comparative antiplaque and antigingivitis effectiveness of a chlorhexidine and an essential oil mouthrinse: 6-month clinical trial. J Clin Periodontol. 2004;31:878-884. 11.Barkvoll P, Rolla G, Svendsen AK. Interaction between chlorhexidine digluconate and sodium lauryl sulfate in vivo. J Clin Periodontol. 1989;16:593-595. 12.Peridex® (0.12% chlorhexidine gluconate) Oral Rinse [prescribing information]. Phoenix, Ariz: Zila, Inc; 2004.
