Dose response of chlorhexidine against plaque and comparison with triclosan

Abstract

The optimum dose of chlorhexidine delivered by mouthrinse, which balances efficacy against local side-effects, is generally considered to be in the region of 20 mg 2 x daily. Unfortunately, there have been few dose-response studies for chlorhexidine mouthrinses and for these, only limited details are published. The aims of this study were to determine the dose response of chlorhexidine to plaque inhibition and position a 0.1% triclosan rinse within this model. 28 subjects took part in this 7-treatment, double-blind, randomised cross-over 4-day plaque regrowth study. The rinses were 0.01%, 0.05%, 0.1% and 0.2% chlorhexidine, 0.1% triclosan and minus active controls for chlorhexidine and triclosan. On day 1 from a zero plaque baseline, volunteers suspended tooth-cleaning and commenced supervised 2 x daily rinsing with 10 ml volumes of the allocated rinses. On Day 5, plaque was scored by index and area. Treatment differences between the 7 rinses were highly significant. A clear dose-response pattern was seen for chlorhexidine with mean plaque scores decreasing with increasing dose. Even at 0.01%, chlorhexidine showed considerable and significant plaque inhibition compared to control. Triclosan at 0.1% showed limited plaque inhibition and less than 0.01% chlorhexidine. The findings of this study suggest that consideration could be given to low concentration chlorhexidine rinses as adjuncts to oral hygiene.

An in vitro Oral Biofilm Model for Comparing the Efficacy of Antimicrobial Mouthrinses

“…A 4-day dose-response study demonstrated a small but significant reduction in plaque for a 0.20% CHX mouthrinse compared to a 0.10% CHX mouthrinse [Jenkins et al, 1994]. When used as an adjunct to regular mechanical oral hygiene procedures during 4 weeks mouthrinses with 0.20% CHX reduced plaque accumulation slightly but not significantly better than 0.10% CHX mouthrinses [Flötra et al, 1972].…”

A Comparative Study of Fluoride Containing Chlorhexidine and Non-Chlorhexidine Mouthrinses in a Teenage Group

“…The experimental gingivitis and dental plaque accumulation models are acknowledged as the best design to prove both plaque accumulation and gingival health effects of active components in mouthrinse preparations, as shown in numerous clinical studies (13,18,19).…”

“…In the absence of mechanical oral hygiene procedures, the 6-day (short-term) plaque re-growth study is conducted. Similarly, in several studies, a short-term plaque regrowth model was used to assess the chemotherapeutic plaque inhibitory activity of different formulations (1,8,9,13,18).…”

Effects of a Novel Mouthwash on Plaque Presence and Gingival Health

“…In order to further overcome any potential effects of the sequential crossover design of this study, the sequence of mouthwash usage was randomized so that 3 subjects used the test mouthwash first, 3 subjects used the control mouthwash first, and 4 subjects used no mouthwash at all first [28]. Overall, during the 8-week study period, oral health improved in both groups using the mouthwash [29][30][31][32][33][34][35].…”