Effectiveness and acceptability of aqueous cinnamon extract mouth rinse in maintaining salivary and tongue-coating pH in comparison with 0.2% chlorhexidine mouthwash: a randomized controlled trial

Context: Salivary pH is a fair indicator of health for extracellular fluids and their alkaline mineral reserves. Similarly, tongue pH is indicative of the existing flora and conditions of the tongue. Objectives: The purpose of the study was to evaluate effectiveness and acceptability of aqueous cinnamon extract mouthrinse in maintaining salivary and tongue coating pH as compared to 0.2% chlorhexidine mouthwash. Setting and Design: A randomized, parallel-group study was conducted among 70 volunteer subjects, who were randomly assigned to two groups of 35 each (20% aqueous cinnamon extract and 0.2% chlorhexidine mouthwash). Materials and Methods: Salivary pH was measured by a digital pH meter, while tongue pH was assessed using color changing pH strips. Participants were asked to rinse with the respective mouthwash (10 ml for 1 minute) and expectorate. Salivary and tongue pH were recorded 5 and 30 minutes after rinsing. Participants were instructed to use the mouthwash twice a day in the prescribed manner. The same procedure was repeated on third and seventh day. Responses to a questionnaire related to taste acceptability were collected on the last day. Data were analyzed statistically using repeated measure analysis of variance and Student’s t-test. Results: Mean salivary pH values showed significant increase throughout the duration of the study after rinsing with both cinnamon and chlorhexidine mouthwashes (p<0.05). Tongue coating pH showed an increase toward alkalinity in both the groups, but this difference was statistically significant only in the cinnamon extract group 30 minutes after rinsing and on third day. Both agents performed equally well and were equally accepted; there was no statistically significant difference between the two groups. Conclusion: Traditional herbal products such as cinnamon can able to regulate the salivary and tongue coating pH as well as standard chlorhexidine mouthwash.