Efficacy of saline or salt-based solution mouthrinse in improving periodontal health: a systematic review

Citra Jasmin Cangara; Sri Oktawati; Hasanuddin Thahir; Dian Setiawati; Sitti Raodah Juanita Ramadhan; Andi Nurul Ilmi Gunawan

doi:10.4322/bds.2026.e4934

Authors

Citra Jasmin Cangara Hasanuddin University, Department of Periodontology. Makassar Indonesia. https://orcid.org/0009-0001-0187-6595
Sri Oktawati Hasanuddin University, Department of Periodontology. Makassar Indonesia. https://orcid.org/0000-0002-9212-6641
Hasanuddin Thahir Hasanuddin University, Department of Periodontology. Makassar Indonesia. https://orcid.org/0000-0002-4526-6422
Dian Setiawati Hasanuddin University, Department of Periodontology. Makassar Indonesia. https://orcid.org/0000-0001-7187-1426
Sitti Raodah Juanita Ramadhan Hasanuddin University, Department of Periodontology. Makassar Indonesia. https://orcid.org/0000-0002-5861-4975
Andi Nurul Ilmi Gunawan Hasanuddin University, Department of Periodontology. Makassar Indonesia. https://orcid.org/0009-0001-3698-3526

DOI:

https://doi.org/10.4322/bds.2026.e4934

Keywords:

gingivitis, mouthrinse, periodontal health, plaque, saline, salt-based solution

Abstract

Saline and salt-based solution mouthrinses have emerged as potential alternatives to chemical antiseptics like chlorhexidine. Due to their osmotic, antimicrobial, and tissue-healing properties, these solutions may provide measurable benefits in managing periodontal inflammation. Objective: The study aims to systematically evaluate and synthesize effectiveness of saline or salt-based solution mouthrinse in improving periodontal health. Material and Methods: This systematic review followed PRISMA 2020 guidelines and applied a PICOS framework. Searches were conducted in PubMed, ScienceDirect, and the Cochrane Library using relevant MeSH terms and keywords. Eligible studies included randomized controlled trials, quasi-experimental studies, controlled clinical trials evaluating the use of saline or salt-based mouthrinses on periodontal parameters. Outcomes assessed included Plaque Index, Gingival Index, Bleeding on Probing and Pocket Depth. Seven studies met the inclusion criteria. Results: Most included studies reported that saline or salt-based solution mouthrinses were associated with reductions in plaque index, gingival index, bleeding on probing, and probing depth; however, one pilot study reported no significant additional benefit compared with mechanical oral hygiene alone. The findings suggest that Saline or salt-based solution offer a clinically viable adjunct or alternative to standard chemical rinses. Although slightly less potent than chlorhexidine in some metrics, their favorable safety profile, accessibility, and acceptability make them suitable for daily oral hygiene and public health use. Conclusion: Saline or salt-based solution mouthrinses are effective in improving periodontal health. While not a complete substitute for antiseptics like chlorhexidine, they provide a safe and low-cost alternative that merits broader clinical adoption, particularly where standard agents are contraindicated or unavailable.

KEYWORDS

Gingivitis; Mouthrinse; Periodontal health; Plaque; Salt-based solution.