Evaluating the Effectiveness of Thyme Versus Chlorhexidine Mouthwash on Oral Health in Ventilated ICU Patients: A Randomized Controlled Study

OBJECTIVE: To compare the effectiveness of a formulated 5% thyme mouthwash with 0.2% aqueous chlorhexidine solution for improving oral health in ventilator-dependent intensive care unit (ICU) patients. METHODS: This prospective, triple-blinded, randomized controlled trial (RCT) allocated 46 mechanically ventilated patients to the thyme (n = 23) or 0.2% aqueous chlorhexidine solution (n = 23) groups. Oral health indices, including the Oral Health Assessment Tool (OHAT), were evaluated at baseline and re-evaluated 5 days (Day 5) after the intervention commenced. RESULTS: Baseline characteristics were comparable. Both mouthwashes significantly improved oral health indicators from baseline (p < 0.001). However, on Day 5, the thyme group showed a statistically greater improvement in key OHAT components compared to the 0.2% aqueous chlorhexidine solution group (e.g., Oral Hygiene score, p = 0.004). Importantly, no adverse reactions or tolerability issues were reported in either group. CONCLUSION: The 5% thyme mouthwash demonstrated comparable effectiveness to the 0.2% aqueous chlorhexidine solution by Day 5. This positions the thyme-based mouthwash as a viable, well-tolerated alternative to conventional 0.2% aqueous chlorhexidine solution for oral care in invasively ventilated ICU patients.