The effect of chlorhexidine on dental calculus formation: an in vitro study

Abstract

BackgroundChlorhexidine gluconate (CHG) has been proven to be effective in preventing and controlling biofilm formation. At the same time, an increase in calculus formation is known as one of considerable side effects. The purpose of this study was to investigate whether mineral deposition preceding a calculus formation would occur at an early stage after the use of CHG using an in vitro saliva-related biofilm model.MethodsBiofilms were developed on the MBEC™ device in brain heart infusion (BHI) broth containing 0.5% sucrose at 37 °C for 3 days under anaerobic conditions. Biofilms were periodically exposed to 1 min applications of 0.12% CHG every 12 h and incubated for up to 2 days in BHI containing a calcifying solution. Calcium and phosphate in the biofilm were measured using atomic absorption spectrophotometry and a phosphate assay kit, respectively. Morphological structure was observed using a scanning electron microscope (SEM), and chemical composition was analyzed with an electron probe microanalyzer (EPMA).ResultsThe concentrations of Ca and Pi following a single exposure to CHG increased significantly compared with the control. Repeatedly exposing biofilms to CHG dose-dependently increased Ca deposition, and the amount of Ca was five times as much as that of the control. Pi levels in CHG-treated biofilms were significantly higher than those from the control group (p < 0.05); however, the influence of the number of exposures was limited. Analyses using an SEM and EPMA showed many clusters containing calcium and phosphate complexes in CHG-treated biofilms. Upon composition analysis of the clusters, calcium was detected at a greater concentration than phosphate.ConclusionsFindings suggested that CHG may promote mineral uptake into the biofilm soon after its use. It is necessary to disrupt the biofilm prior to the start of a CHG mouthwash in order to reduce the side effects associated with this procedure. The management of patients is also important.

Effect of Hydrothermal Aging and Beverages on Color Stability of Lithium Disilicate and Zirconia Based Ceramics

“…The non-enzymatic browning and formation of pigmented metal sulfide are attributed to the discoloration of teeth and restorations [16]. In the protracted use of chlorhexidine, an increase in the formation of supragingival calculi is also observed [17]. Few researchers have reported that the discoloration is due to the precipitation of the dietary chromogens together with the locally adsorbed chlorhexidine.…”

Antifungal effect of silver nitrate on prosthodontic dentures

“…However, chlorhexidine has several drawbacks when used as denture cleaner. It has been shown that it can cause a change in taste, increase calculus formation, irritatemucosa and cause maculation of restorations 15 . At low concentrations, chlorhexidine accumulates on the cell surfaces of yeasts, causing cell membrane disorganization and leakage of cytoplasmic components, while higher concentrations produce coagulation of cytoplasmic constituents in those microorganisms 16 .…”

A Novel Small Molecule, LCG-N25, Inhibits Oral Streptococcal Biofilm

“…One of the major concerns on the topical use of broad-spectrum antimicrobials as anticaries measures is the possible cause of oral microbial dysbiosis ( Chen et al, 2020 ). CHX as a broad-spectrum antimicrobial agent can effectively inhibit most of oral microbes but with poor selectivity, which might impose adverse effects on the oral microbial ecology after long-term use ( Tokajuk et al, 2017 ; Sakaue et al, 2018 ). A multispecies biofilm model consisting of S. mutans , S. sanguinis , and S. gordonii was reported previously that could be used to evaluate the ecological impact of the tested compounds on oral biofilms ( Zhang et al, 2019 ; Yu et al, 2020 ).…”