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CompletedNCT07865416Updated Oct 8, 2026

Clinical Outcomes of Different Mouth Rinses During Clear Aligner Orthodontic Therapy

An interventional study of Alum Mouth Rinse and Triphala-based Herbal Mouth Rinse in Plaque-Induced Gingivitis and Orthodontic Treatment, sponsored by Manav Rachna International Institute of Research and Studies. Completed at 1 site in India. Open to participants aged 18 Years to 35 Years. Per ClinicalTrials.gov, last updated 2026-10-08.

Sponsored by Manav Rachna International Institute of Research and Studies · Not applicable, Interventional, and Treatment

From the registry’s dates

  • Registered 1 year 9 months after the study started (first participant enrolled Dec 2024, registered Sep 2026).
Updated Oct 8, 2026Newly registeredGo to Updates ↓
Phase
Not applicable
Study type
Interventional
Enrollment
30
Allocation
Randomized
Ages
18 Years to 35 Years
Sex
All
01

Study summary

This pilot randomized controlled clinical trial will evaluate the feasibility and preliminary clinical effects of three mouth rinses-alum, Triphala-based herbal mouth rinse, and 0.2% chlorhexidine-in adults undergoing clear aligner orthodontic treatment.

Clear aligners and bonded attachments may contribute to plaque accumulation and gingival inflammation. Mouth rinses may provide an additional measure for controlling plaque and gingival inflammation during orthodontic treatment. Chlorhexidine is a commonly used antimicrobial mouth rinse, while alum and Triphala are being evaluated as alternative agents.

A total of 30 adults aged 18-35 years undergoing active clear aligner therapy and presenting with mild to moderate plaque-induced gingivitis will be randomly assigned in equal numbers to one of three groups. Participants will use their assigned mouth rinse twice daily for 30 days.

Gingival inflammation will be assessed using the Gingival Index, and plaque accumulation will be assessed using the Plaque Index at baseline, 15 days, and 30 days. Salivary Streptococcus mutans levels will also be assessed. Compliance with mouth-rinse use and other feasibility measures, including recruitment and retention, will be recorded.

The study is intended as a pilot trial to assess feasibility, estimate variability and preliminary treatment effects, and provide information for the design of a future adequately powered clinical trial.

Read the detailed description

This is a pilot, randomized, parallel-group, three-arm controlled clinical trial designed to evaluate the preliminary clinical effects and feasibility of three mouth rinses in adults undergoing active clear aligner orthodontic therapy.

Participants will be recruited from the Department of Orthodontics and Dentofacial Orthopaedics, Manav Rachna Dental College, Manav Rachna International Institute of Research and Studies (MRIIRS), Faridabad, India. Eligible participants will be adults aged 18-35 years undergoing active clear aligner therapy, with at least 20 natural teeth and mild to moderate plaque-induced gingivitis. Participants must be willing to comply with the study procedures and provide written informed consent.

A total of 30 participants will be allocated in a 1:1:1 ratio to three intervention groups using computer-generated block randomization with a block size of three. Allocation will be concealed using sequentially numbered opaque sealed envelopes prepared by an independent investigator.

The three intervention groups will receive either 0.02 M potassium aluminum sulfate (alum) mouth rinse, a Triphala-based herbal mouth rinse, or 0.2% chlorhexidine gluconate mouth rinse. Participants will use 10 mL of the assigned mouth rinse twice daily for 30 days and will be instructed to rinse for 60 seconds before expectorating. Participants will continue their usual toothbrushing practices and maintain their prescribed clear aligner wear.

Clinical assessments will be performed at baseline, 15 days, and 30 days. The primary clinical outcome is change in Gingival Index from baseline to 30 days. Secondary outcomes include changes in Plaque Index and salivary Streptococcus mutans counts, together with feasibility measures such as recruitment, retention, and adherence to the mouth-rinse regimen.

Plaque and gingival inflammation will be assessed using standardized clinical indices. Salivary Streptococcus mutans levels will be evaluated using a culture-based method, with results expressed as log10 colony-forming units per millilitre. Compliance will be assessed using participant rinse logs and measurement of returned bottle weight.

Participants will not be blinded because of the differences in taste and sensory characteristics of the mouth rinses. Clinical outcome assessors and laboratory personnel will be blinded to treatment allocation. Statistical analysis will also be performed using blinded group assignments.

The study is intended primarily to assess feasibility and generate preliminary estimates of outcome variability and treatment effects rather than provide definitive evidence of comparative efficacy. These estimates may inform the design and sample-size planning of a future adequately powered randomized controlled trial.

02

Conditions studied

  • Plaque-Induced Gingivitis
  • Orthodontic Treatment

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Keywords

  • Clear aligners
  • Gingival inflammation
  • Orthodontic treatment
  • Plaque-induced gingivitis
  • Mouth rinse
  • Streptococcus mutans
03

In context

Gingivitis

609 studies on the registry are indexed under Gingivitis; 107 are open to participants now.

This study's enrollment of 30 is below the median of 63 across 494 interventional studies indexed under Gingivitis.

Browse Gingivitis studies →

Lead sponsor

Manav Rachna International Institute of Research and Studies is the lead sponsor of 2 studies on the registry; none are open to participants now.

Counted across the registry records on this site, refreshed daily.

04

Who can participate

Ages eligible
18 Years to 35 Years
Sexes eligible
All
Accepts healthy volunteers
No

Go through the criteria one by one — yes, no or not sure — and take the list to your doctor or the study team. Kept in this browser only.

Inclusion criteria

  • Adults aged 18-35 years.
  • Currently undergoing active clear aligner orthodontic treatment.
  • Clear aligner use for at least 4 weeks before enrolment.
  • Wearing clear aligners for approximately 20-22 hours per day.
  • Presence of mild to moderate plaque-induced gingivitis, defined as a Löe and Silness Gingival Index score of 1-2.
  • Presence of at least 20 natural teeth.
  • Willingness to comply with the study protocol and study instructions.
  • Ability and willingness to provide written informed consent.

Exclusion criteria

Exclusion Criteria:

  • Use of systemic antibiotics within the previous 3 months.
  • Use of antimicrobial mouth rinses within the previous 1 month.
  • History of periodontal pockets greater than 3 mm.
  • Systemic diseases that may affect periodontal health.
  • Current smoking or tobacco use.
  • Pregnancy or lactation.
  • Known allergy or hypersensitivity to any component of the study mouth rinses.
  • Current use of systemic medications that may affect salivary flow or gingival status.
05

Study design

Phase
Not applicable
Primary purpose
Treatment
Allocation
Randomized
Intervention model
Parallel assignment
Masking
Single (Outcomes assessor)
Enrollment
30 participants (actual)

Study arms

  • Experimental
    Alum Mouth Rinse

    Participants allocated to this arm will use a 0.02 M potassium aluminum sulfate (alum) mouth rinse. Participants will use 10 mL of the assigned mouth rinse twice daily, in the morning and evening after brushing, for 30 days. The mouth rinse will be swished for 60 seconds and then expectorated. Participants will continue their routine oral hygiene practices and prescribed clear aligner wear throughout the study.

    Drug: Alum Mouth Rinse

  • Experimental
    Triphala-based Herbal Mouth Rinse

    Participants allocated to this arm will use a commercially available Triphala-based herbal mouth rinse containing extracts of Terminalia chebula, Terminalia bellirica, and Emblica officinalis. Participants will use 10 mL of the assigned mouth rinse twice daily for 30 days. The mouth rinse will be swished for 60 seconds and then expectorated. Participants will continue their routine oral hygiene practices and prescribed clear aligner wear throughout the study.

    Drug: Triphala-based Herbal Mouth Rinse

  • Active comparator
    Chlorhexidine Mouth Rinse

    Participants allocated to this arm will use a 0.2% chlorhexidine gluconate mouth rinse. Participants will use 10 mL of the assigned mouth rinse twice daily, in the morning and evening after brushing, for 30 days. The mouth rinse will be swished for 60 seconds and then expectorated. Participants will continue their routine oral hygiene practices and prescribed clear aligner wear throughout the study.

    Drug: Chlorhexidine mouth rinse

Interventions

  • DrugAlum Mouth Rinse

    Drug pages: Aluminum sulfate · Aluminium sulfate

    0.02 M potassium aluminum sulfate solution; 10 mL used twice daily for 30 days, with 60-second rinsing followed by expectoration.

  • DrugTriphala-based Herbal Mouth Rinse

    Commercial Triphala-based herbal mouth rinse containing Terminalia chebula, Terminalia bellirica, and Emblica officinalis extracts; 10 mL used twice daily for 30 days, with 60-second rinsing followed by expectoration

  • 0.2% chlorhexidine gluconate mouth rinse; 10 mL used twice daily for 30 days, with 60-second rinsing followed by expectoration.

06

What researchers measure

Primary outcomes

  1. Change in Plaque Index(PI) and Gingival Index (GI)

    Change in Gingival Index (Löe and Silness) from baseline (T0) to 30 days (T2). Gingival inflammation will be assessed using the Löe and Silness Gingival Index on the specified index teeth by a calibrated outcome assessor blinded to intervention allocation.

    Time frame: Baseline (T0) to 30 days (T2)

07

Study locations

1 site
  • Faculty of Dental Sciences
    Faridabad, Haryana 121004, India
08

References and documents

Publications

  • Olmez A, Can H, Ayhan H, Okur H. Effect of an alum-containing mouthrinse in children for plaque and salivary levels of selected oral microflora. J Clin Pediatr Dent. 1998 Summer;22(4):335-40. PubMed 9796505 ↗
  • Mehta V, Mathur A, Tripathy S, Sa R, Sharma T. Effectiveness of herbal oral care products in reducing dental plaque and gingivitis: an overview of systematic reviews. Can J Dent Hyg. 2024 Jun 1;58(2):120-134. eCollection 2024 Jun. PubMed 38974822 ↗
  • Ahuja, D., Shetty, P., Giri, S., Mohammed, A., Kamath, V., Ravi, M. S. et al. Analysis of Streptococcus mutans level with the use of different mouth rinses during orthodontic treatment. J. Pharm. Negat. Results 13, 1967-1971 (2022).
  • Singaraju, A., Nuvvula, S., Rudravaram, V. R. K., Anchala, K., Venkata Saikiran, K. & Mallineni, S. K. Efficacy of Triphala and chlorhexidine mouthwashes on gingival inflammation and dental plaque in children: a systematic review. Oral 4, 567-577 (2024). https://doi.org/10.3390/oral4040044

Study documents

  • Protocol and informed consent form · Sep 24, 2026

Documents are hosted by the registry — open the source record to download them.

Individual participant data

Plan to share: No

09

Updates

1 registry update since Sep 25, 2026
Registered
First appeared on the registry. No changes since
Oct 8, 2026
Show all 1 update
  1. Oct 8, 2026
    First appeared on the registry

From the registry record's own update history. This site started tracking changes on Sep 25, 2026; for anything earlier, see the record history on ClinicalTrials.gov ↗

10

Registry details

Key details

Study ID
NCT07865416
Lead sponsor
Manav Rachna International Institute of Research and Studies
Responsible party
Sponsor
First posted
Oct 8, 2026
Start date
Dec 10, 2024
Primary completion
Dec 15, 2025
Completion
Dec 15, 2025
Last update
Oct 8, 2026

Oversight

Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No
View the source record on ClinicalTrials.gov ↗

Not currently enrolling

This study is completed, as verified in Oct 2026. You cannot join it, but the record below documents what was studied.

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Studies of the drugs tested here: Aluminum sulfate · Aluminium sulfate

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