New survey reveals patients may need support beyond mechanical cleaning alone

Over 95% of dental professionals have reported that they often see patients who are struggling to manage their plaque levels at home through mechanical cleaning alone, according to a recent survey conducted by Johnson & Johnson, the makers of LISTERINE®, which surveyed 721 oral health care professionals in April 2021.1

In addition, out of the 721 dental professionals surveyed, over 80% responded that they still struggle to improve their patients' mechanical cleaning to a level where plaque is manageable following further oral health education.1

So, whilst the standard recommendation remains to brush the teeth and clean interdentally, the overwhelming response from over 700 oral health care professionals suggests more may be needed to support some patients’ plaque levels over and above mechanical cleaning and oral health education.1,2

Beyond brushing and interdental cleaning

Looking at the evidence base for adjunctive plaque management, Figuero and colleagues (2019) recently concluded that adjunctive antiseptics in mouthwash provide statistically significant reductions in plaque compared to mechanical cleaning alone at six months.2

This was the outcome of a systematic review and meta-analysis exploring the adjunctive use of 11 different mouth rinse formulations.2

They also came to the conclusion that, ‘… despite the high variability in the number of studies comparing each active agent and the different risks of bias, CHX [chlorhexidine] and EOs [essential oils], in mouthrinses appeared to be the most effective active agents for plaque … control.’2

The Figuero and colleagues’ (2019) outcomes add to the pre-existing evidence base presented by Araujo and colleagues (2015), which was the first meta-analysis to demonstrate the clinically significant, site-specific benefit of adjunctive essential oil mouthwash in people within a six-month period (that is, between dental visits).3

The analysis revealed that 36.9% of subjects using mechanical methods with essential oil-containing mouthwash experienced at least 50% plaque-free sites after 6 months, compared to just 5.5% of patients using mechanical methods alone.3

Adjunctive options for your patients

Within the Johnson & Johnson Ltd. mouthwash range, it has been demonstrated that, when used as an adjunct to mechanical cleaning, LISTERINE® Total Care, an essential oil mouthwash, manages plaque levels, to help prevent gingivitis.4

LISTERINE® Total Care may therefore support the efforts of a patient requiring early intervention, by virtue of its essential oil formulation consisting of eucalyptol, thymol, menthol and methyl salicylate, all of which are proven to:

• Penetrate the plaque biofilm5

• Manage the bacterial load of the mouth6

• Reduce maturation of remaining biofilm colonies.7


It has been demonstrated that, when used as an adjunct to mechanical cleaning, LISTERINE® Total Care is proven to achieve 5x more plaque-free sites than mechanical methods alone, which may help to prevent gum disease.3

Through our range of mouthwashes, Johnson and Johnson Ltd. help dental teams work in partnership with patients, with specific products designed to improve home care routine outcomes significantly, which help to support the prevention or management of periodontal disease when used in conjunction with mechanical cleaning.


1. Johnson & Johnson Ltd. Survey 2021. Data on file

2. Figuero E et al. Efficacy of adjunctive therapies in patients with gingival inflammation. A systematic review and meta-analysis.; 23 December 2019

3. Araujo MWB et al. Meta-analysis of the effect of an essential oil-containing mouthrinse on gingivitis and plaque. JADA 2015; 146: 610-622

4. Boyle et al. Mouthwash use and the prevention of plaque, gingivitis and caries. Head & Neck Oral Diseases 2014; 20(1): 1-76

5. Pan et al. Determination of the in situ bactericidal activity of an essential oil mouthrinse using a vital stain method. J Clin Periodontol 2000; 27: 256-261

6. Minah et al. Effects of 6 months use of an antiseptic mouthrinse on supragingival dental plaque microflora. J Clin Periodontol. 1989; 16: 347-352

7. Johnson & Johnson. Data on file (2)