Efficacy of 0.2% tempered chlorhexidine as a pre-procedural mouth rinse: A clinical study

Abstract

Objective:Our objective was to determine the efficacy of pre-procedural rinsing with chlorhexidine in reducing bacterial aerosol contamination during use of ultrasonic scaler and comparing the efficacy of water, non-tempered chlorhexidine and tempered chlorhexidine in reducing bacterial count in aerosols when used as a pre-procedural rinse.Materials and Methods:The study was designed to include 30 systemically healthy patients in different age groups. The patients were divided randomly into 3 groups (I, II, III) of 10 patients each to be administered with sterile water, non tempered chlorhexidine and tempered chlorhexidine, respectively, as a pre-procedural rinse. The aerosol produced by the ultrasonic unit was collected at 3° clock, 6° clock and 12° clock positions on blood agar plates within a range of 4 feet in all the three groups. The blood agar plates were incubated for 48 hours and the total number of colony forming units (CFUs) were counted and statistically analyzed.Results:The results showed that CFU in group III and group II were significantly reduced when compared to group I with F=1084.92, P<0.001 (ANOVA). Also, CFU in group III was significantly reduced when compared to group II with P<0.001.Conclusions:Pre-procedural rinse can significantly reduce the viable microbial content of dental aerosols and tempered chlorhexidine was more effective than non-tempered chlorhexidine.

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

“…Recent systematic review has demonstrated moderate evidence that pre-procedural mouth rinsing with antiseptics can reduce dentally generated aerosolisation of viable microbes [ 109 ]. This includes 0.2% CHX reducing the number of colony forming units (CFUs) of bacteria produced (approximately 70%) in response to ultrasonic scaling, as measured on an agar plate placed within the dental surgery [ [110] , [111] , [112] ]. Randomised controlled trials have also shown that compared to pre-rinsing with 0.2% CHX, herbal mouth rinses are less effective - in the region of 30% [ 111 ].…”

Antiviral mouthwashes: possible benefit for COVID-19 with evidence-based approach

“…This mouthwash has a wide range of antimicrobial effects. Previous studies have shown that CHX has the greatest effect on a variety of gram-positive and gram-negative, aerobic and non-aerobic bacteria, which is superior and more effective than other mouthwashes in this regard [ 23 , 30 – 32 ].…”

“…Prescribing CHX before dental procedures is a routine procedure that reduces the level of oral microorganisms in the aerosols generated during dental procedures [ 15 , 18 , 32 , 33 ].…”

Minimizing the aerosol-generating procedures in orthodontics in the era of a pandemic: Current evidence on the reduction of hazardous effects for the treatment team and patients

“…Use of preprocedural mouthrinse with CHX of either 0.12% or 0.2% concentration has been identified by individual studies as an important decontaminating agent contributing to identification of decreased bacterial amounts of infected aerosol; latest data coming from an endorsement to compare all direct and indirect evidence from examined interventions (mouth rinses, evacuators, decontamination of DUWLs, and others) across studies and within dental settings, has revealed this supremacy of preprocedural chlorhexidine mouthrinse over other measures for 30 s to 1 min, but also with documented prevailing of tempered (47°C) CHX 0.2%. 27 , 29 , 30 , 35 , 36 , 41 , 42 Tempered CHX solution at 47°C, has been reported to offer increased anti-microbiologic action against bacteria of the human dental plaque, while also preserving adverse effects on tooth and pulp vitality to the minimum. 43 The increase in bacterial kill rate has been determined to reach as high as 25% surplus, while to avoid storage contamination with toxic compounds such as p-chloroaniline, freshly made CHX solutions should undergo heating.…”