Clinical Science Effects of Highly Concentrated Stannous Fluoride and Chlorhexidine Regimes on Human Dental Plaque Flora

Abstract

The aim of this study was to determine the effect of an intensive antimicrobial treatment on the number of Streptococcus mutans, Streptococcus sanguis, Actinomyces viscosus/Actinomyces naeslundii, and the total Colony-forming Units (CFU) in plaque. The dentition of human volunteers was treated in a dental office with either chlorhexidine (5%) or stannous fluoride (8%). Following the office treatment with chlorhexidine, selected volunteers rinsed daily at home for seven or 49 days with chlorhexidine solution (0.2%), while another group flossed daily at home for seven days with dental floss impregnated with chlorhexidine. On days one, seven, 21, 35, and 49 after the local applications, we took saliva samples and plaque samples from fissures, smooth surfaces, and approximal areas. Chlorhexidine and stannous fluoride suppressed S. mutans and the Actinomyces species on all surfaces and in saliva. S. mutans on tooth surfaces was suppressed for approximately seven days and returned to the baseline level at day 21. A. viscosus/naeslundii was suppressed for more than seven days on the teeth. S. sanguis and the total CFU returned to the baseline level within seven days on all surfaces and in saliva. Rinsing or flossing with chlorhexidine suppressed S. mutans during the period of time that these supplements were used. Brushing for seven days with chlorhexidine gel (1%) without a preceding intensive chlorhexidine treatment had virtually no effect on S. mutans in approximal areas and in saliva, but suppressed S. mutans in fissures and on smooth surfaces.

Levels of infection and colonization of some oral bacteria after use of naf, chlorhexidine and a combined chlorhexidine with naf mouthrinses

“…Bacterial recolonization is observed after some days (26,29) or months based on adopted treatment, infection levels, sucrose ingestion or dental restorations. In this study the recolonization of mutans streptococci did not occur 30 days after treatment, probably due to combined action of both products and because infection level at baseline was high.…”

Chlorhexidine Efficacy in Preventing Lesion Formation in Enamel and Dentine

“…This, however, gives no information about the plaque viability or the cariogenic challenge exerted by this plaque. Although the suppression of cariogenic microorganisms like mutans streptococci by chlorhexidine is well documented [Schaeken et al, 1986;Järvinen et al, 1995], it is not clear whether this suppression results in protection against demineralization of enamel and dentine [van Strijp et al, 2003a]. Other cariogenic microorganisms that are less susceptible to the antibacterial action of chlorhexidine could maintain the caries process [Beighton, 2005].…”

Effect of Chlorhexidine Gel Treatment Supplemented with Chlorhexidine Varnish and Resin on Mutans Streptococci and Actinomyces on Root Surfaces

“…Mutans streptococci have been implicated in the etiology of human root surface caries, whereas there is no evidence of Actinomyces playing a significant role [Ellen et al, 1985;Brown et al, 1986;Keltjens et al, 1987;Fure et al, 1987;Emilson et al, 1988], Treat ment with chlorhexidine gel considerably reduces the number of mutans streptococci in plaque and saliva in subjects with high levels of these microorganisms [Emilson 1977a[Emilson , 1981Maltz et al, 1981;Schaeken et al, 1984Schaeken et al, , 1986. In most cases, however, the micro organisms reappear and reach pretreatment levels within 2-5 months.…”

“…Supplementing the chlorhexidine gel treatment with fluoride applications has delayed the recolonization of mutans streptococci [Zickert et al, 1987] and, in studies using a chlorhexidine var nish, a long-term elimination of mutans streptococci has been obtained [Sandham et al, 1988]. A selective reduction in the proportion of Actinomyces has been observed after the topical application of a chlorhexi dine solution in primates and humans [Schaeken et al, 1986], The aim of this study was to determine whether chlorhexidine varnish and resin can prolong the period for the recolonization of root surfaces by mutans streptococci and Actinomyces spp. after chlorhexidine gel treatment.…”