Abstract

The use of antiseptic mouthwash is widespread due to its oral health benefits. However, its impact on systemic physiological processes, particularly nitric oxide (NO) bioavailability and muscle contractility, is not fully understood.

PURPOSE To determine the effects of cetylpyridinium-based (antibacterial) versus sodium chloride (NaCl) -based (control) mouthwashes on salivary and breath NO markers and muscle contractile function in healthy young adults.

METHODS Twenty-six participants (n=13/group) completed a randomized, parallel-arm, blinded trial, comparing the effects of the two mouthwashes before and after 7 d of treatment. NO bioavailability was assessed via measurement of nitrate (NO3-), nitrite (NO2-), and cyclic guanyl monophosphate (cGMP) concentrations in saliva and the level of NO in breath. The contractile function of the knee extensor muscles was determined via isokinetic dynamometry.

RESULTS No significant changes in salivary NO3-, NO2-, or cGMP or in breath NO were observed in response to either treatment. However, cetylpyridinium-based mouthwash reduced the percentage of NO3- in saliva (16.9±10.5% vs. 24.9±13.4%; p=0.0036), supporting compliance with the intervention. Peak torque at velocities of 0-6.28 rad/s was unaffected by mouthwash use. Calculated maximal knee extensor velocity (Vmax) and power (Pmax) were therefore also unchanged.

CONCLUSION Cetylpyridinium-containing mouthwash inhibits reduction of NO3- to NO2- in the oral cavity but does not significantly diminish overall NO bioavailability or impair muscle contractile function in healthy young men and women.

ClinicalTrials.gov Registration Number NCT04095442 (registered 09/19/2019)

Competing Interest Statement

The authors have declared no competing interest.

Clinical Trial

NCT04095442

Funding Statement

EJG was supported by the Diversity Scholars Research Program of the Center for Research and Learning at Indiana University Indianapolis..

Author Declarations

I confirm all relevant ethical guidelines have been followed, and any necessary IRB and/or ethics committee approvals have been obtained.

Yes

The details of the IRB/oversight body that provided approval or exemption for the research described are given below:

Each provided written, informed consent, and the study protocol was approved by the Human Subjects Office at Indiana University.

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Yes

I understand that all clinical trials and any other prospective interventional studies must be registered with an ICMJE-approved registry, such as ClinicalTrials.gov. I confirm that any such study reported in the manuscript has been registered and the trial registration ID is provided (note: if posting a prospective study registered retrospectively, please provide a statement in the trial ID field explaining why the study was not registered in advance).

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I have followed all appropriate research reporting guidelines, such as any relevant EQUATOR Network research reporting checklist(s) and other pertinent material, if applicable.

Yes

Data Availability

All data produced in the present study are available upon reasonable request to the authors.

AbbreviationsANOVAAnalysis of varianceCa2+Divalent calciumcGMPCyclic guanyl monophosphateELISAEnzyme-linked immunosorbent assayNaClSodium chlorideNO3-NitrateNO2-NitriteNONitric oxidePAR-QPhysical Activity Readiness QuestionnairePmaxMaximal knee extensor powerVmaxMaximal knee extensor velocity