Synopsis

Source of validity: Scientific
Rating (out of 5): 2

L-Acetyl n-Cysteine (NAC) is an acetylated form of the amino acid cysteine, commonly used as a mucolytic agent and an antioxidant. Its application in gingivitis is supported by some emerging scientific evidence, though not yet robust or widespread. The rationale for NAC in oral health, particularly gingivitis, stems from its antioxidant and anti-inflammatory properties. Gingivitis is characterized by inflammation of the gums primarily due to bacterial biofilm (plaque) accumulation, leading to oxidative stress and inflammatory responses in the gingival tissues.

Several small clinical studies and in vitro investigations have suggested that NAC can inhibit the formation of oral biofilms by common periodontal pathogens and reduce inflammatory markers in gingival tissues. For example, studies have demonstrated that NAC, when used as a mouthwash or gel adjunctive to scaling and root planing, may reduce gingival index scores and markers of oxidative stress compared to placebo. However, these studies are generally limited by small sample sizes, short durations, and lack of long-term follow-up.

Systematic reviews and larger randomized controlled trials are lacking, making the overall level of evidence moderate to low. As such, while there is some scientific rationale and preliminary data supporting NAC's use for gingivitis, it is not currently a mainstream or guideline-endorsed therapy. Further high-quality research is needed to confirm its efficacy and safety for this indication.

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