Empirical Analysis of the Effectiveness of Chlorhexidine Gluconate Versus Herbal Mouth Rinses in Plaque Control Among Patients at a Lagos Teaching Hospital

Herbal mouth rinses derived from plants including Azadirachta indica and Psidium guajava are widely used in Nigeria as alternatives to chlorhexidine, yet comparative clinical evidence for their efficacy in plaque control in Nigerian patients is limited and often methodologically weak. This study empirically compared the effectiveness of 0.2 percent chlorhexidine gluconate mouth rinse, neem (Azadirachta indica) extract rinse, and guava (Psidium guajava) leaf extract rinse in reducing plaque and gingivitis in adult patients at Lagos University Teaching Hospital dental outpatient clinic. A randomised controlled trial assigned 120 adult patients with mild to moderate gingivitis to one of three groups (n = 40 each) for a 4-week supervised mouth rinsing period. Plaque index and gingival index were recorded at baseline, 2, and 4 weeks by a blinded examiner. At 4 weeks, chlorhexidine showed the greatest plaque reduction (mean plaque index reduction of 1.12), followed by guava extract (0.89) and neem extract (0.74), with all three significantly outperforming baseline (p < 0.001). The differences between active groups were statistically significant (p < 0.05). Gingival index improvements showed a similar pattern. Chlorhexidine showed the most tooth staining. Patient satisfaction with taste was significantly higher for the guava rinse. The study provides clinically useful comparative data for Nigerian clinical practice and recommends standardised preparation of herbal rinses for inclusion in clinical trials, patient preference consideration in oral hygiene product recommendation, and further evidence synthesis on herbal dentistry products. Keywords: chlorhexidine, herbal mouth rinse, plaque control, gingivitis, Lagos University Teaching Hospital