Can mouth washes containing chlorhexidine 0.12% be used as synonym of a water solution of chlorhexidine 0.12%?

Abstract

<p>Chlorhexidine digluconate (CHX) is a gold standard drug in dentistry and is widely used as a reference in both <italic>in vitro</italic> and <italic>in vivo</italic>experiments. Due to ease of access, mouth washes containing CHX 0.12% are used as a substitute for aqueous CHX 0.12% solution in laboratory experiments. Additionally, it is well known that for product flavor purposes, volatile compounds are added to mouth washes formulations. Volatiles added to CHX 0.12% may improve wash's antibacterial ability. Volatiles add potency to the mouth wash formulation. Compared with an aqueous CHX 0.12% solution, it is proposed that CHX solutions and Periogard<sup>®</sup> would have antimicrobial activity. Antimicrobial activity was assessed in the present study via disk diffusion assays against <italic>Streptococcus mutans</italic>, <italic>Streptococcus sanguinis</italic>and <italic>Escherichia coli</italic>. Periogard<sup>®</sup> showed a significantly higher antibacterial activity in relation to CHX 0.12% (p<0.05) and a similar activity in relation to CHX 1% (p>0.05). Periogard<sup>(r)</sup> volatiles were analyzed by gas-chromatography/mass spectrometry (GCMS) and the presence of antibacterial menthol, menthone, isomenthol, menthyl acetate, trans-anethol and eugenol was verified. Finally, the use of Periogard<sup>®</sup> as a synonym of CHX 0.12% must be avoided, because its antibacterial activity is closely related to CHX 1%.</p>

Mouthwash with Tagetes lucida Cav. for Control of Chronic Periodontitis in Older Adults

“…Finally, it is important to point out as limitations of the study: (i) the reduced sample size to measure the effect on all oxidative stress markers; (ii) the groups were not proportional by sex, consequently, the influence of this variable could not be evaluated; (iii) study follow-up was only once at 3 months, so the effectiveness over time cannot be guaranteed; (iv) the plaque index was not measured; and (v) a comparison group with a mouth rinse as the gold standard was not included, such as 0.12% chlorhexidine [51,52]. In this sense, it is advisable to carry out a longitudinal study with subsequent clinical evaluations considering the indicated limitations.…”