MILAN, Italy: At a press briefing hosted by consumer health company Kenvue during the 2026 International Symposium on Dental Hygiene (ISDH) in Milan, experts discussed two recent professional reports that bring together scientific evidence and clinical guidance to provide practical recommendations for the prevention and management of periodontal disease. The discussion focused on approaches to controlling supragingival biofilm and gingival inflammation, including the selective use of antiseptic mouthrinse as an adjunct to toothbrushing and interdental cleaning.
The publications discussed were the American Dental Hygienists’ Association (ADHA) white paper, titled Redefining the Management and Prevention of Periodontal Disease: Practical Guidance for the Practicing Hygienist in Navigating Clinical Decision-Making and Patient Engagement, and the Principles for Oral Health report, which arose from the eponymous initiative coordinated by the Spanish Society of Periodontology and Osseointegration. Although the publications were developed in different professional and healthcare contexts, their recommendations reach broadly aligned conclusions and draw on some of the same evidence. This includes the European Federation of Periodontology’s S3-level clinical practice guideline for the treatment of Stage I–III periodontitis, the American Dental Association’s home oral care recommendations and the American Academy of Periodontology’s guidelines for periodontal therapy.
Both reports emphasise toothbrushing and interdental cleaning as the basis of home oral care. They also conclude that, for certain patients, an antiseptic mouthrinse may be considered as part of an individualised approach to managing supragingival plaque and gingival inflammation. More specifically, they identify circumstances in which adjunctive use may be warranted and refer to evidence relating to particular antiseptics and formulations. In both publications, mouthrinse is positioned as an adjunct to mechanical plaque control rather than as a substitute for brushing or interdental cleaning.
Evidence and clinical considerations
During the briefing, Dr Luigi Nibali, professor of periodontics at King’s College London in England, discussed the burden of periodontal disease and the importance of recognising and managing gingival inflammation. Dr Ana Molina, vice-president of the Spanish Society of Periodontology and Osseointegration, presented the Principles for Oral Health report and explained how the evidence synthesised in clinical guidelines informed the report’s practical recommendations.
Dr JoAnn Gurenlian, director of education, research and advocacy at ADHA, presented the association’s white paper and discussed the role of dental hygienists in the prevention of periodontal disease and in patient education. Simone Ruzario, president-elect of the British Society of Dental Hygiene and Therapy, addressed the potential implications of the scientific evidence reviewed at the briefing for dental hygiene and dental therapy practice.
Identifying patients who may benefit
The European Federation of Periodontology guideline states that adjunctive antiseptics may be considered during supportive periodontal care to assist with the control of gingival inflammation in patients with periodontitis. The Principles for Oral Health report similarly discusses the use of specific antiseptic formulations alongside mechanical biofilm control in patients for whom local, behavioural or systemic factors may make it difficult to achieve or maintain periodontal health.
The ADHA white paper cites a randomised clinical trial that evaluated a three-step home care regimen consisting of toothbrushing, flossing and use of a mouthrinse containing a defined formulation of four essential oils. The regimen showed significantly greater reductions in whole-mouth supragingival plaque, gingivitis and gingival bleeding than toothbrushing alone. The findings should be interpreted as evidence relating to the complete regimen rather than to mouthrinse use in isolation.
Both publications highlight persistent gingival inflammation and difficulty achieving effective mechanical plaque control as factors that may warrant the use of an adjunctive mouthrinse. Among the local challenges they list are dental crowding, complex restorations, orthodontic appliances and implant-supported restorations. They also identify reduced manual dexterity and frailty as patient-related considerations.
Additionally, the publications suggest that systemic conditions associated with increased periodontal risk, including diabetes, should be considered separately as part of the patient’s overall risk profile. Both state that recommendations should take account of the clinical indication, the evidence supporting the particular formulation, potential adverse effects and the need for regular reassessment during supportive care.
The ADHA white paper was developed with support from Kenvue. The Principles for Oral Health initiative was sponsored by Kenvue brand Listerine.
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