Current uses of chlorhexidine for management of oral disease: a narrative review

Abstract

Objectives Chlorhexidine (CHX) is a commonly used antiseptic mouthwash, used by dental practitioners and the public, due to its antimicrobial effects. The aim of this article was to provide a narrative review of current antimicrobial uses of CHX relevant to dentistry in the context of oral diseases, highlighting need for further studies to support its safe and appropriate use. Study selection, data and sources Randomised controlled trials, systematic reviews and national (UK and US) guidelines were consulted where available, with search terms for each subject category entered into MEDLINE, PubMed, Google Scholar and the Cochrane database. Results Some evidence existed to support adjunctive short-term use of CHX to manage dental plaque, and reduce clinical symptoms of gingivitis, dry socket, as well as reduce aerosolisation of bacteria. However, use must be weighed alongside the less desirable effects of CHX, including extrinsic staining of teeth, antimicrobial resistance to antiseptic agents and the rare, but fatal, allergic reactions to CHX. Conversely, evidence for the effectiveness of chlorhexidine to manage or prevent periodontitis, dental caries, necrotising periodontal diseases, peri-implantitis, and infections associated with extraction and aerosolised viruses remains less certain. Conclusions The use of CHX in dentistry and oral healthcare continues to be widespread and thus it is important that dental practitioners understand that, based on its differential mechanisms of action on different microbes, appropriate clinical and dental use of CHX should be oral disease specific. However, further scientific and clinical research is required before full recommendations can be made.

Antiviral Essential Oil Components Against SARS-CoV-2 in Pre-procedural Mouth Rinses for Dental Settings During COVID-19: A Computational Study

“…The use of PVP-I has been contraindicated in patients with an allergy to iodine, thyroid disease, and pregnancy. Chlorhexidine (CHX) is a broadspectrum antiseptic that has long been known to be effective against herpes simplex virus (HSV), human immunodeficiency virus (HIV), and hepatitis B virus (HBV) (Brookes et al, 2020 (Alshehri, 2018). The activity of these components has been well established by several studies against a wide array of microbes, including viruses.…”

Antibacterial and Antimicrobial Effects of Xanthorrhizol in the Prevention of Dental Caries: A Systematic Review

“… 55–60 Chlorhexidine, which is commonly found in mouthwash has faced limitations due to restricted does and possible side effects. 61 In contrast, studies involving xanthorrhizol have shown no toxicity in addition to effective antimicrobial and antibacterial activities even at low concentrations. While the MIC of xanthorrhizol is comparable to chlorhexidine, it also suffers from the challenge of not been selective for cariogenic bacterial species.…”

Pregnancy and Dentistry: A Literature Review on Risk Management during Dental Surgical Procedures

“…Chlorhexidine (in concentrations 0.05–0.2%) is an antiseptic active ingredient present in many types of mouthwash. It belongs to the FDA category B since animal studies have not shown teratogenicity at high doses, but there are no controlled data obtained from human pregnancies and, therefore, its use in pregnancy is recommended only in case of need [ 99 ]. In addition, all products that contain alcohol should be avoided during pregnancy [ 99 ].…”