Chlorhexidine and Preservation of Sound Tooth Structure in Older Adults

Wyatt, Chris; Maupomé, Gerardo; Hujoel, Philippe P.; MacEntee, Michael I.; Persson, G. Rutger; Persson, Rutger; Kiyak, H. Asuman

doi:10.1159/000098041

Cited by 32 publications

(24 citation statements)

References 44 publications

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“…Analyses could not be performed for varnish containing 22,500 ppm F -(Duraphat), since these studies used Duraphat as a control group without having a second (negative) control group (Ravald and Birkhed 1992;Fure and Lingstrom 2009) or the results were presented according to different indices (DMFRS or texture) and did not report all information required for recalculation (Schaeken et al 1991;Tan et al 2010). For CHX mouth rinses (Powell et al 1999;Wyatt and MacEntee 2004;Wyatt et al 2007) and ozone treatment (Holmes 2003;Baysan and Lynch 2007), recalculation was not possible owing to insufficient data presentation. Thus, meta-analyses were performed only for dentifrice containing 5,000 ppm F -or 1.5% arginine plus 1,450 ppm F -, rinse containing 0.05% to 0.2% NaF (225 to 900 ppm F -), varnish containing SDF or CHX and combined use of dentifrice (1,500 ppm F -), and a rinse containing AmF/SnF 2 (250 ppm F -).…”

Section: Resultsmentioning

confidence: 99%

Systematic Review on Noninvasive Treatment of Root Caries Lesions

2014

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The present systematic review critically summarizes results of clinical studies investigating chemical agents to reduce initiation or inactivation of root caries lesions (RCLs). Outcomes were DMFRS/DFRS (decayed, missing, filled root surfaces), surface texture (hard/soft), and/or RCI (root caries index). Three electronic databases were screened for studies from 1947 to 2014. Cross-referencing was used to further identify articles. Article selection and data abstraction were done in duplicate. Languages were restricted to English and German. Mean differences (MD) were calculated for changes in DMFRS/DFRS. Risk ratios (RR) were calculated for changes in surface texture and RCI in a random effects model. Thirty-four articles with 1 or more agents were included; they reported 30 studies with 10,136 patients who were 20 to 101 y old; and they analyzed 28 chemical agents (alone or in combination). Eleven studies investigated dentifrices, 10 rinses, 8 varnishes, 3 solutions, 3 gels, and 2 ozone applications. Meta-analyses revealed that dentifrices containing 5,000 ppm Regular use of dentifrices containing 5,000 ppm F -and quarterly professionally applied CHX or SDF varnishes seem to be efficacious to decrease progression and initiation of root caries, respectively. However, this conclusion is based on only very few well-conducted randomized controlled trials.

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Section: Resultsmentioning

confidence: 99%

Systematic Review on Noninvasive Treatment of Root Caries Lesions

2014

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“…The investigators concluded that the daily rinse with 0.25% NaF solution was significantly better than with 0.12% chlorhexidine rinse. A double-blind clinical trial by Wyatt and others 12 also tested the impact of regular rinsing with a 0.12% chlorhexidine solution on caries in low-income elders in Seattle, WA, USA and Vancouver, Canada. The subjects alternated between daily rinsing for one month, followed by weekly rinsing for five months.…”

Section: Mouthrinsesmentioning

confidence: 99%

The Role of Chlorhexidine in Caries Prevention

Autio-Gold¹

2008

Operative Dentistry

170

107

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SUMMARYThe use of chlorhexidine for caries prevention has been a controversial topic among dental educators and clinicians. In several reviews, it has been concluded that the most persistent reduction of mutans streptococci have been achieved by chlorhexidine varnishes, followed by gels and, lastly, mouth rinses. Also, the evidence for using different chlorhexidine modes or a combination of chlorhexidine-fluoride therapy for caries prevention has been "suggestive but incomplete." Variable study designs and lack of data in highrisk children and adults support the need to continue conducting randomized, well-controlled clinical trials and to search for a practical, effective mode of antimicrobial treatment that augments the known effect of fluoride treatments.Currently, the only chlorhexidine-containing products marketed in the United States (US) are mouthrinses containing 0.12 percent chlorhexidine. Based on the available reviews, chlorhexidine rinses have not been highly effective in preventing caries, or at least the clinical data are not convincing. Due to the current lack of long-term clinical evidence for caries prevention and reported side effects, chlorhexidine rinses should not be recommended for caries prevention. Due to the inconclusive literature and sparse clinical data on gels and varnishes, their use for caries prevention should also be studied further to develop evidence-based recommendations for their clinical role in caries prevention.Since dental caries is a disease with a multifactoral etiology, it is currently more appropriate to use other established, evidence-based prevention methods, such as fluoride applications, diet modifications and good oral hygiene practices. Recent findings also indicate that the effect of an antimicrobial agent for reducing the levels of mutans streptococci or plaque reduction may not always correlate with eventual caries reduction. The clinically important outcome is proven reductions in caries.Many advances in the treatment and prevention of dental caries have been introduced over the past century. The use of chlorhexidine in caries prevention has been referred to as a nonsurgical management of dental caries and has represented the modern medical model of caries treatment. However, there is a lack of consensus on evidence-based treatment protocols and controversy regarding the role of chlorhexidine in caries prevention among dental educators and The Role of Chlorhexidine in Caries PreventionJ Autio-Gold Clinical RelevanceChlorhexidine rinses should not be recommended for use in caries prevention due to the current lack of evidence for their effectiveness.*Jaana Autio-Gold, DDS, PhD This paper reviewed the literature on the effectiveness of different modes of chlorhexidine delivery for caries prevention and provides guidelines for chlorhexidine use in caries management. A literature search was conducted using the PubMed and Evidence-Based Medicine Reviews databases and the keywords "chlorhexidine" and "caries," limiting the search to "humans, "reviews" and "English...

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“…Wyatt et al 21 tested the impact of regularly chewing a solution of chlorhexidine 0.12% among 550 elderly persons. All dental and crown surfaces were monitored for five years.…”

Section: Root Cariesmentioning

confidence: 99%

Approach to the most prevalent oral disorders among the elderly: an integrative review focusing on primary health care

Silva

Koppe

Brew

et al. 2017

Rev. bras. geriatr. gerontol.

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Objective: an integrative review of the treatment of oral candidiasis, root caries and xerostomia among the elderly population, focusing on Primary Health Care, was carried out. Method: scientific articles were collected from the MEDLINE/PUBMED database using the keywords "Geriatric dentistry" and "Oral health", crossed with corresponding descriptors, together with specific terms for the pathologies studied, and with "the clinical trial" filter activated. The abstracts of the articles were read by three researchers. Result: oral candidiasis: six randomized clinical trials and one quasi-experimental design study, on the treatment of prosthetic stomatitis by medication and/or the disinfection of dentures by different techniques, were identified; root caries: three randomized clinical trials were included, which tested the use of mouthwash with chlorhexidine solution and oral hygiene instruction associated or otherwise with other drugs; and xerostomia: two articles were analyzed using various medications, and the functional massage of the salivary glands and associated muscles. Conclusion: The results demonstrate a variety of treatment options for the studied clinical situations, although these should be adapted to the characteristics of the services and the population, as standard treatment in Primary Health Care has not been established. Strategies based on soft technologies, such as health education, seem to provide good results. The present study provides additional knowledge for health professionals in search of more resolutive and qualified dental care for the elderly in primary health care.

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Chlorhexidine and Preservation of Sound Tooth Structure in Older Adults

Cited by 32 publications

References 44 publications

Systematic Review on Noninvasive Treatment of Root Caries Lesions

Systematic Review on Noninvasive Treatment of Root Caries Lesions

The Role of Chlorhexidine in Caries Prevention

Approach to the most prevalent oral disorders among the elderly: an integrative review focusing on primary health care

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