Clinical controlled study on plaque and gingivitis reduction under long-term use of low-dose chlorhexidine solutions in a population exhibiting good oral hygiene

Abstract

The aim of this randomized, parallel-group, placebo-controlled, blind clinical study was to examine the dental plaque and the gingivitis inhibitory effects of two low-dose 0.06% chlorhexidine (CHX) preparations in comparison to a commercially available 0.1% CHX solution, an amine fluoride/stannous fluoride (ASF) solution and a water control as an adjunct to the daily mechanical oral-hygiene measures. After prophylaxis, 81 medical students performed their tooth cleaning and were asked to rinse for 30 s, according to the instructions given by the manufacturers with the assigned amount of the following solutions: once daily 10 ml ASF 250 ppm or twice daily each 10 ml CHX 0.06% with fluoride, 10 ml CHX 0.06% without fluoride, 15 ml CHX 0.1% or 100 ml tap water. The plaque index (PlI), the gingival index (GI) and the discoloration index (DI) were taken at day -14 and months (M) 0, 1, 2, 3 and 6. In this study group with good oral hygiene, all test products led to a reduction of the PlI scores when used as supplements to the usual mechanical hygiene measures. At M3 subjects using both the 0.1% as well as the 0.06% CHX showed significantly less plaque accumulation than those using ASF. In the GI a significant difference between the control and 0.1 % CHX was found at M3 and at M6. If a further decrease in the GI is wanted, a minimum concentration of 0.1% CHX for long-term use in association with habitual cleaning is needed, which, however, should be limited to special patients. If maintaining clinical health is the goal, the other solutions are a good alternative to 0.1% CHX because they exhibit less staining.

Antibacterial and anti-biofilm activity of mouthrinses containing cetylpyridinium chloride and sodium fluoride

“…The use of mouthrinses reportedly augments oral hygiene regimens based on regular brushing [ 12 ] and is believed to offer enhanced protection against dental caries, particularly when recommended oral healthcare regimens are not strictly adhered to [ 26 ]. The incorporation of sodium fluoride into antibacterial mouthwash formulations may further enhance caries control, especially post-brushing, when rinsing with water or a non-fluoridated mouthrinse can remove potentially beneficial residual fluoride [ 33 ].…”

The staining effect of different mouthwashes containing nanoparticles on dental enamel

“…Most evidence indicates that the likely cause of CHX-induced staining is the interaction or precipitation of anionic dietary chromogens with adsorbed cationic antiseptics ( 8 , 24 ). The severity of discoloration depends on the CHX concentration and its duration of application ( 18 , 25 ).…”

Efficacy of adjunctive therapies in patients with gingival inflammation: A systematic review and meta‐analysis

“…Soft tissue irritations were reported after the use of sanguinarine (Harper, Mueller, Fine, Gordon, & Laster, 1990;Kopczyk, Abrams, Brown, Matheny, & Kaplan, 1991), and tongue lesions and taste alterations were reported associated with CHX (Chaves et al, 1994;Stookey et al, 2005). A statistically significant increase in dental staining was associated with the use of alexidine (Spolsky & Forsythe, 1977), CHX (Charles, Mostler, Bartels, & Mankodi, 2004;Hase, Attstrîm, Edwardsson, Kelty, & Kisch, 1998;Hoffmann, Bruhn, Richter, Netuschil, & Brecx, 2001), CPC (Costa et al, 2013), delmopinol (Hase et al, 1998), EOs (Beiswanger TA B L E 5 Comparisons for plaque (%) between placebo and test groups for all antiseptics, according to vehicle (dentifrices and rinses), test product used and periodontal diagnosis (gingivitis, previously treated periodontitis, not reported-NR Abbreviations: n, number of studies; WMD, weighted mean difference; DL, random effect model; CI, confidence interval; I 2 , I squared; NR, not reported.…”

“…Circles represent the estimates from each study, sized according to the precision of each estimate. WMD, weighted mean differences et al Charles et al, 2004), tric_cop combined with Zinc_Citrate (Schaeken & van der Hoeven, 1993;Stephen, Saxton, Jones, Ritchie, & Morrison, 1990) or SnF (Beiswanger et al, 1997;Hoffmann et al, 2001;McClanahan et al, 1997;Paraskevas, Versteeg, Timmerman, Velden, & Weijden, 2005), when compared to control groups.…”