A shared position to optimise the prevention of periodontal diseases

10/07/2026

International leaders have gathered at ISDH 2026, the International Symposium on Dental Hygiene, being held in Milan, to review two landmark oral health reports developed in Europe and the United States. Drawing on the same global scientific evidence, the reports jointly define the role of mouthwashes with clinically proven efficacy in the prevention of periodontal diseases.

Periodontal diseases affect more than 1 billion people worldwide and represent one of the leading global public health challenges.1 Although they are largely preventable, their burden continues to increase.1 At the International Symposium on Dental Hygiene (ISDH) in Milan, experts presented, during a session organised by Kenvue, two reports developed independently, one in Europe and the other in North America. Both reach remarkably similar conclusions on how prevention strategies should evolve and on the role of mouthwashes with clinically proven efficacy as an adjunct to mechanical oral hygiene.

The two documents are the American Dental Hygienists’ Association (ADHA) White Paper on redefining the management and prevention of periodontal disease,2 and the Principles for Oral Health report, promoted by the SEPA Foundation.3

Independent reports, one shared conclusion
Most importantly, both reports were developed independently, by different organisations and in different parts of the world; nevertheless, they draw on the same body of scientific evidence and reach broadly aligned conclusions. Both documents are based on a common scientific foundation, including the European Federation of Periodontology (EFP) S3-level clinical practice guidelines,4 as well as recommendations from the American Dental Association and the American Academy of Periodontology.

The conclusion is consistent across all sources. Although mechanical plaque control remains the cornerstone of prevention, the use of a mouthwash may be considered as a measure to control gingival inflammation within a personalised therapeutic approach for certain patients, with essential oil formulations supported by one of the highest levels of available scientific evidence.

Both reports position mouthwash as an adjunct to toothbrushing, never as a substitute, and recommend its use according to each patient’s individual risk.2,3

 

The voices behind the consensus
Four international experts took part in the briefing session and delivered a consistent, consensus-based message. Professor Luigi Nibali (King’s College London) presented the scientific basis explaining why a preventable disease continues to increase and why gingivitis should be regarded as a health problem requiring attention. Dr Ana Molina (SEPA), who presented the Principles for Oral Health report, explained how the evidence set out in clinical guidelines has been translated into practical recommendations that professionals can easily apply in their day-to-day clinical work. Dr JoAnn Gurenlian (ADHA) summarised the main conclusion of the White Paper, stressing that dental hygienists are on the front line of periodontal disease prevention and explaining why the profession itself drove this recommendation. Simone Ruzario, president-elect of the British Society of Dental Hygiene & Therapy, brought the discussion into everyday clinical practice, explaining how scientific evidence is changing the daily work of dental hygienists and dental therapists in practices around the world.

 

The role of mouthwash according to the reports
From the perspective of European scientific evidence, the European Federation of Periodontology (EFP) S3 clinical practice guidelines recognise certain antiseptics, including essential oil formulations, as being among the most effective options for use as a personalised adjunct to patients’ oral hygiene, helping to control gingival inflammation.4

The Principles for Oral Health report, meanwhile, concludes that the use of specific antiseptics as an adjunct to mechanical biofilm control is recommended for certain groups of patients in whom local or systemic factors make mechanical biofilm control insufficient to achieve and maintain periodontal health.3

In the United States, the American Dental Hygienists’ Association (ADHA) White Paper states that a mouthwash containing a fixed combination of four essential oils, used alongside toothbrushing and interdental cleaning with dental floss, significantly reduces whole-mouth plaque, gingivitis and gingival bleeding compared with toothbrushing alone. It also considers antiseptic mouthwash to be a simple, affordable and widely accessible adjunct to daily at-home oral hygiene.2

 

When and how to recommend it
The practical message for oral health professionals is fully aligned in both reports.

  • Brushing twice a day with a fluoride toothpaste and cleaning the interdental spaces daily remain the foundation of oral care.
  • As an adjunct, and never as a substitute for mechanical oral hygiene, daily use of an antiseptic mouthwash is recommended for patients for whom mechanical control alone is unlikely to be sufficient.
  • These include patients with persistent gingival inflammation; people with biofilm-retentive factors (such as dental crowding, restorations, implants or orthodontic appliances); and patients whose general circumstances, reduced manual dexterity, frailty or conditions such as diabetes make effective control of bacterial plaque and gingival inflammation more difficult.
  • The recommendation should be tailored to each patient, explained in clear language and reviewed at every visit, taking factors such as flavour or mouthwash intensity into account to support treatment adherence.2,3 2,3

 

As Dr Ana Molina , vice president of SEPA,commented, “The scientific evidence is sufficiently robust and consistent for clinical guidelines and reports developed in different regions of the world to include the use of a mouthwash with clinically proven efficacy for certain patients. Although toothbrushing and interdental cleaning remain essential, the number of people with periodontal diseases continues to grow, and the evidence supports the use of mouthwash as an adjunctive treatment to help maintain gingival health in specific patients.”

Dr Simon Arnold, Medical Affairs Lead for EMEA at Kenvue, highlighted another crucial aspect. “It is unusual for organisations working in different healthcare systems and professional settings to review the scientific evidence independently and reach such similar conclusions. This degree of alignment gives clinicians greater confidence that the recommendations are underpinned by a solid and coherent scientific basis.”

 

Further information
Principles for Oral Health is an international consensus report promoted by SEPA. The American Dental Hygienists’ Association (ADHA) White Paper, Redefining the Management and Prevention of Periodontal Disease, was developed with support from Kenvue.

Listerine is the world’s number-one mouthwash (Euromonitor International Limited; Beauty and Personal Care 2026 edition, based on the Mouthwashes/Dental Rinses category definition, retail sales value (RSP), 2025 data).

Oral health professionals can consult the scientific evidence and practical recommendations supporting these findings at kenvuepro.com. To access the full reports, they can consult Principles for Oral Health at principlesfororalhealth.com or the American Dental Hygienists’ Association (ADHA) White Paper, Redefining the Management and Prevention of Periodontal Disease, available at adha.org.

 

 

References

  1. Hu M, Zhang R, Wang R, Wang Y, Guo J. Global, regional, and national burden of periodontal diseases from 1990 to 2021 and predictions to 2040: an analysis of the Global Burden of Disease Study 2021. Front Oral Health. 2025; 6: 1627746. doi:10.3389/froh.2025.1627746
  2. American Dental Hygienists’ Association. Redefining the Management and Prevention of Periodontal Disease: Practical Guidance for the Practicing Hygienist in Navigating Clinical Decision-Making and Patient Engagement [White Paper]. 2026. Available at: https://www.adha.org/wp-content/uploads/2026/03/ADHA-White-Paper_Final_25Mar26.pdf. Accessed 24 June 2026
  3. SEPA. Principles for Oral Health Report. Sponsored by LISTERINE®. 2025. Available at: https://principlesfororalhealth.com/wp-content/uploads/2025/01/PRINCIPLES-CONSENSUS.v2.pdf. Accessed 24 June 2026
  4. Sanz M, Herrera D, Kebschull M, et al. Treatment of stage I–III periodontitis—The EFP S3 level clinical practice guideline. J Clin Periodontol. 2020; 47(Suppl 22): 4-60. doi:10.1111/jcpe.13290

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