Effect of Immediate Versus Delayed Chlorhexidine Rinse on Post-Extraction Pain: A Randomized Clinical Study
DOI:
https://doi.org/10.48165/ajm.2026.9.01.12Keywords:
Tooth extraction, chlorhexidine mouth rinse, postoperative pain, timing, oral surgeryAbstract
Background: Chlorhexidine mouth rinse is routinely prescribed after tooth extraction to reduce microbial load. However, the optimal timing of its use remains unclear and may influence postoperative pain. Aim: To compare the effect of immediate versus delayed chlorhexidine mouth rinse on post extraction pain following simple tooth extraction. Materials and Methods: Sixty systemically healthy patients undergoing simple tooth extraction were randomly allocated into two groups. Group I used 0.12% chlorhexidine mouth rinse immediately after extraction, while Group II initiated the rinse 24 hours post-extraction. Postoperative pain was evaluated using a Visual Analog Scale (VAS) on postoperative day 1 and day 3. Statistical analysis was performed using the independent t-test with significance set at p < 0.05. Results: Patients in the immediate rinse group reported significantly higher pain scores on postoperative day 1 compared to the delayed rinse group (p < 0.05). By postoperative day 3, pain scores decreased in both groups, with no statistically significant difference observed. Conclusion: Delaying the use of chlorhexidine mouth rinse for 24 hours after tooth extraction reduces early postoperative pain. Avoidance of immediate rinsing may help preserve the blood clot and enhance patient comfort during the initial healing period.References
Jafarian M, Etebarian A. Reasons for extraction of permanent teeth in general dental practices in Tehran, Iran. Med Princ Pract. 2013;22(3):239-44.
Alesia K, Khalil HS. Reasons for and patterns relating to the extraction of permanent teeth in a subset of the Saudi population. Clin Cosmet Investig Dent. 2013;5:51-6.
Rakhshan V. Common risk factors for postoperative pain following the extraction of wisdom teeth. J Korean Assoc Oral Maxillofac Surg. 2015 Apr;41(2):59-65.
Calhoun NR. Dry socket and other postoperative complications. Dent Clin North Am. 1971;15:337-48.
Muhonen A, Ventä I, Ylipaavalniemi P. Factors predisposing to postoperative complications related to wisdom tooth surgery among university students. J Am Coll Health. 1997;46:39-42.
Brookes ZLS, Bescos R, Belfield LA, Ali K, Roberts A. Current uses of chlorhexidine for management of oral disease: a narrative review. J Dent. 2020 Dec;103:103497.
Poppolo Deus F, Ouanounou A. Chlorhexidine in dentistry: pharmacology, uses, and adverse effects. Int Dent J. 2022 Jun;72(3):269-77.
Park WJ, Park IK, Shin KS, Choi EJ. Post-extraction pain in the adjacent tooth after surgical extraction of the mandibular third molar. J Dent Anesth Pain Med. 2019;19:201-8.
Sirintawat N, Sawang K, Chaiyasamut T, Wongsirichat N. Pain measurement in oral and maxillofacial surgery. J Dent Anesth Pain Med. 2017;17:253-63.
Wang CH, Yang SH, Jen HJ, Tsai JC, Lin HK, Loh EW. Preventing alveolar osteitis after molar extraction using chlorhexidine rinse and gel: a meta-analysis of randomized controlled trials. J Nurs Res. 2020 Sep 21;29(1):e137.
Haraji A, Rakhshan V. Single-dose intra-alveolar chlorhexidine gel application, easier surgeries, and younger ages are associated with reduced dry socket risk. J Oral Maxillofac Surg. 2014;72(2):259-65.
Hermesch CB, Hilton TJ, Biesbrock AR, Baker RA, Cain-Hamlin J, McClanahan SF, et al. Perioperative use of 0.12% chlorhexidine gluconate for the prevention of alveolar osteitis: efficacy and risk factor analysis. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 1998;85(4):381-7.
Hita-Iglesias P, Torres-Lagares D, Flores-Ruiz R, Magallanes-Abad N, Basallote-Gonzalez M, Gutierrez-Perez JL. Effectiveness of chlorhexidine gel versus chlorhexidine rinse in reducing alveolar osteitis in mandibular third molar surgery. J Oral Maxillofac Surg. 2008;66(3):441-5.
