Efficacy of Herbal vs. Chlorhexidine Mouthwash in Experimental Gingivitis: A Cross-over Clinical and Microbiological Study

Background: Chlorhexidine (CHX) is an effective antiseptic rinse for managing gingival inflammation; however, side effects such as staining and altered taste limit its long-term use. StellaLife^® (SL), an herbal-based mouth rinse and a gel, has shown promising in vitro effects, including enhanced biocompatibility and wound healing. This study aimed to compare the clinical efficacy of SL and 0.12% CHX in an experimental gingivitis model. Methods: In this randomized, controlled, cross-over clinical trial, 34 dental students received both treatment regimens in alternating two-week phases following prophylaxis. Group 1 used SL (mouth rinse and the gel) and then crossed over to CHX with placebo gel. Group 2 followed the reverse sequence. Participants refrained from oral hygiene during treatment phases. Clinical parameters and gingival crevicular fluid (GCF) were assessed at baseline and post-treatment. Paired t-tests and Bonferroni corrections were applied (p < 0.05). Bacterial count was determined by an external laboratory using a PCR test. Mean values for bacteria after SL and CHX use measured in genome copies/mL for Aggregatibacter actinomycetemcomitans, P. gingivalis, T. denticola, T. forsythia and F. nucleatum. Results: No statistically significant differences were observed between the SL and CHX groups for PI (p = 0.057), GI (p = 0.960), PD (p = 0.112), BOP (p = 0.895), GR (p = 0.768), CAL (p = 0.112), or GCF (p = 0.951). Both regimens improved periodontal parameters similarly. No significant differences were found between CHX and SL use in respect to periodontal pathogenic bacteria in the oral cavity. Conclusions: SL demonstrated clinical efficacy comparable to CHX in managing experimental gingivitis. Given its favorable safety profile, SL may serve as a promising alternative to CHX, though larger and longer-term studies are warranted.