Haps S, Slot DE, Berchier CE, Van der Weijden GA · Int J Dent Hyg · 2008Systematic review / meta-analysis
Eight studies: CPC rinses used alongside brushing gave a small but significant extra reduction in plaque and gum inflammation.
An antiseptic in many alcohol-free mouthwashes. Adds a small extra reduction in plaque and gum inflammation to brushing; can stain teeth.
Cetylpyridinium chloride is a positively charged antiseptic that disrupts bacterial membranes and clings to mouth surfaces for a few hours. It is the main active in many alcohol-free rinses, typically at 0.05-0.1%.
Because it is positively charged, the foaming agent in most toothpastes (sodium lauryl sulfate) can partly neutralise it. Using the rinse at a different time from brushing avoids this.
Systematic reviews find a small but significant added benefit for plaque and gingivitis when CPC rinses are used alongside brushing; a network meta-analysis ranked rinses above 0.05% CPC among the more effective. Results vary with the formula. For bad breath, a Cochrane review found only low-certainty evidence of modest improvement.
Eight studies: CPC rinses used alongside brushing gave a small but significant extra reduction in plaque and gum inflammation.
53 six-month trials. Among rinses, essential oils, chlorhexidine (0.10% or more) and cetylpyridinium chloride (above 0.05%) had the largest effects on gingivitis, with essential oils ranking highest; active toothpastes differed little from each other, with baking soda among the weakest.
44 mostly short trials: evidence for every bad-breath intervention was low to very low certainty. Brushing plus a CPC rinse modestly improved examiner odour scores (low certainty); no product could be shown to be better than another.