Should chlorhexidine mouthwash be a concern for blood pressure in dental patients?

A COMMENTARY ON: Toonen LSJ, et al. The Effect of Chlorhexidine Mouthwash on Blood Pressure: A Systematic Review and Meta-Analysis. Int J Dent Hyg. 2026. https://doi.org/10.1111/idh.70035 .

OBJECTIVE

To evaluate whether current clinical evidence supports an association between chlorhexidine mouthwash (CHX-MW) use and changes in blood pressure in human populations.

DATA SOURCES: Evidence was derived from a systematic review and meta-analysis of studies identified through PubMed/MEDLINE and Cochrane CENTRAL up to December 2024.

STUDY SELECTION: Randomised, controlled, and observational studies evaluating blood pressure following chlorhexidine mouthwash use were included.

METHODS

Evidence was synthesised through narrative review and meta-analysis, with methodological quality and risk of bias assessed using established appraisal frameworks.

RESULTS

Five studies met the inclusion criteria. Although two studies reported small increases in blood pressure, the pooled analysis found no statistically or clinically significant effect of chlorhexidine mouthwash on systolic or diastolic blood pressure.

CONCLUSIONS

Current evidence does not demonstrate a clinically meaningful effect of chlorhexidine mouthwash on blood pressure, but certainty remains low due to methodological limitations and indirectness of study populations.