Effect of Repeated Treatment with Sustained-Release Chlorhexidine Mouth Guards on Salivary Levels of Mutans Streptococci

Abstract

The effect of multiple treatments with chlorhexidine mouth guards on salivary levels of mutans streptococci (MS) was studied. Eleven subjects with salivary MS ≥ 10⁵ CFU/ml were randomly assigned to an experimental or control group. Complete-arch mouth guards were coated internally with one of two ethylcellulose varnishes, one containing 30% dry w/w chlorhexidine and one containing no chlorhexidine. Subjects wore the mouth guards up to four times, each time for 7 consecutive nights while sleeping, with at least a 1-week break between treatment weeks. Subjects in the control group subsequently crossed over and also wore the chlorhexidine-containing mouth guards. Each of the week-long mouth guard sessions resulted in a reduction in mean salivary MS levels as follows (log₁₀ CFU/ml): for the experimental group, ––1.0, ––0.9, ––1.0 and ––1.2, and for the crossover group, ––1.7, ––0.6, ––0.5 and ––0.6. Salivary MS levels were (mean ± SD) 6.4 ± 0.5 at baseline and 3.8 ± 0.5 after the last mouth guard session for the experimental group and 6.0 ± 0.5 and 4.3 ± 0.7, respectively, for the crossover group. For the control group, there was no significant change in MS levels.

Effects of chlorhexidine (gel) application on bacterial levels and orthodontic brackets during orthodontic treatment

“…Although 3DS has been well established in the literature as an effective method of application of CHX gel in patients with high risk of caries (32)(33)(34)(35)(36), no clinical studies have examined the efficacy of using 3DS in orthodontic patients.…”

Study of the clinical usefulness of a dental drug system for selective reduction of mutans streptococci using a case series

“…Long-term suppression of mutans streptococci is achieved by repeated application of CHX. However, repeated applications, even using individual trays, are sometimes accompanied by adverse effects such as a burning sensation in the oral mucosa and a change in the taste of food (22). The absence of any side effects of the 3DS in this study may be explained by the minimum contact between CHX and the oral mucosa.…”

“…In the present study, we examined the clinical efficacy of 0.2% CHX delivered by a dental drug delivery system (drug retainer) in reducing mutans streptococci on tooth surfaces in adults. The drug retainer was an apparatus that has been used in previous experiments for bacterial elimination (20)(21)(22)(23)(24). Randomized control trials demonstrated that individual trays were more effective than other application methods such as polishing the tooth surfaces with gel containing CHX (24) or brushing with a dentifrice containing CHX (20).…”

Effect of storage time and chlorhexidine addition on the mechanical properties of glass ionomer cements

“…The GICs indicated for ART have shown reduced antimicrobial activity 5,6,14,15 , and for this reason, the incorporation of antimicrobial agents (chlorhexidine and antibiotics) to the cement has been suggested in several investigations 1,6,[14][15][16][17][18] , in order to increase the effect of these materials against residual microorganisms on cavities after partial caries removal. Chlorhexidine is the antimicrobial agent commonly used in Dentistry due its safety and broad-spectrum bactericidal effect, affecting the growth of gram-positive bacteria especially oral streptococci 19 , gram-negative bacteria, fungi and yeasts, facultative aerobic and anaerobic species 20 . Conflicting results about the influence of the incorporation of chlorhexidine on the physical-mechanical properties of GICs are still present in the literature.…”