Effect of Slow-Release Chlorhexidine Mouthguards on the Levels of Selected Salivary Bacteria

Abstract

This study evaluated the effect of an alternate delivery system for chlorhexidine on salivary levels of mutans streptococci (MS) and other selected oral bacteria. On the basis of salivary MS levels ≥10⁴ CFU/ml, 22 subjects were enrolled. All caries lesions were restored prior to treatment. Two pretreatment paraffin-stimulated saliva samples were obtained for culturing at least 1 week apart. Complete-arch vacuum-adapted mouthguards were individually fabricated and coated internally with a 3% w/v chlorhexidine varnish. Mouthguards were worn for an average of 7 h/night for 7 nights. Saliva samples were obtained immediately after treatment and 1 and 3 months later. There was no significant change in levels of any of the monitored bacteria between the two pretreatment samples. A significant and specific reduction in salivary MS levels was observed in the three after-treatment samples as compared with baseline values (p < 0.001, p < 0.001, p < 0.05, respectively). The levels of Actinomyces viscosus were also measured, and there was a significant reduction immediately after treatment (p < 0.05), a return to baseline values at 1 month, and a significant increase above baseline values at 3 months, (p < 0.001). There was no significant change in saliva volume, in total numbers of facultatively anaerobic bacteria, or in levels of lactobacilli or Streptococcus sanguis. This treatment system is capable of significant and specific suppression of MS levels for up to 3 months without retreatment.

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

“…Daily mouthrinses with chlorhexidine alone reduced levels of infection by mutans streptococci immediately after treatment (T 0 ), afterwards they returned to baseline levels. Despite of some other studies had observed that this reduction had been more prolonged (4,5,11), in our study this fact was not observed probably due to low concentration used. Toxic effects of chlorhexidine on mutans streptococci is due to affect the hydrofobicity (13).…”

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.…”

Chlorhexidine Inhibits the Proteolytic Activity of Root and Coronal Carious Dentin in vitro

“…As an antimicrobial agent [Huizinga et al, 1990;Schaeken et al, 1991;Hildebrandt et al, 1992] CHX is thought to act by binding to the cell walls of microorganisms, destabilizing their osmotic balance. It is considered to be bacteriostatic at low concentrations and bactericidic at high concentrations [Silla et al, 2008].…”

“…Because of its antimicrobial function [Hildebrandt et al, 1992] CHX has been thought to be effective in controlling caries progression by inhibiting the activity of cariogenic bacteria [Huizinga et al, 1990;Schaeken et al, 1991, Hildebrandt et al, 1992. Moreover, recent studies have demonstrated that CHX is also a potent antiproteolytic agent [Gendron et al, 1999;Dabrowska et al, 2006] with the ability to significantly reduce the host-derived proteolytic activity of sound dentin [Pashley et al, 2004].…”