The Role of Chlorhexidine in Caries Prevention

Abstract

SUMMARYThe use of chlorhexidine for caries prevention has been a controversial topic among dental educators and clinicians. In several reviews, it has been concluded that the most persistent reduction of mutans streptococci have been achieved by chlorhexidine varnishes, followed by gels and, lastly, mouth rinses. Also, the evidence for using different chlorhexidine modes or a combination of chlorhexidine-fluoride therapy for caries prevention has been "suggestive but incomplete." Variable study designs and lack of data in highrisk children and adults support the need to continue conducting randomized, well-controlled clinical trials and to search for a practical, effective mode of antimicrobial treatment that augments the known effect of fluoride treatments.Currently, the only chlorhexidine-containing products marketed in the United States (US) are mouthrinses containing 0.12 percent chlorhexidine. Based on the available reviews, chlorhexidine rinses have not been highly effective in preventing caries, or at least the clinical data are not convincing. Due to the current lack of long-term clinical evidence for caries prevention and reported side effects, chlorhexidine rinses should not be recommended for caries prevention. Due to the inconclusive literature and sparse clinical data on gels and varnishes, their use for caries prevention should also be studied further to develop evidence-based recommendations for their clinical role in caries prevention.Since dental caries is a disease with a multifactoral etiology, it is currently more appropriate to use other established, evidence-based prevention methods, such as fluoride applications, diet modifications and good oral hygiene practices. Recent findings also indicate that the effect of an antimicrobial agent for reducing the levels of mutans streptococci or plaque reduction may not always correlate with eventual caries reduction. The clinically important outcome is proven reductions in caries.Many advances in the treatment and prevention of dental caries have been introduced over the past century. The use of chlorhexidine in caries prevention has been referred to as a nonsurgical management of dental caries and has represented the modern medical model of caries treatment. However, there is a lack of consensus on evidence-based treatment protocols and controversy regarding the role of chlorhexidine in caries prevention among dental educators and The Role of Chlorhexidine in Caries PreventionJ Autio-Gold Clinical RelevanceChlorhexidine rinses should not be recommended for use in caries prevention due to the current lack of evidence for their effectiveness.*Jaana Autio-Gold, DDS, PhD This paper reviewed the literature on the effectiveness of different modes of chlorhexidine delivery for caries prevention and provides guidelines for chlorhexidine use in caries management. A literature search was conducted using the PubMed and Evidence-Based Medicine Reviews databases and the keywords "chlorhexidine" and "caries," limiting the search to "humans, "reviews" and "English...

Effect of Chlorhexidine Gel in Mentally Handicapped Children highly Infected with Streptococcus Mutans

“…The permanence of this microorganism in the oral cavity can be explained by the presence of reservoirs and / or retentive areas in the teeth slightly affected or not affected by the antimicrobial agent, from which SM start re-colonization after removal of the antimicrobial pressure [20] In the other saliva collections performed after CHX gel treatment, it was observed a gradual reappearance of SM over time. However, 120 days after the treatment period, the levels of these microorganisms showed statistically significant differences from the initial levels (baseline).…”

Antimicrobial activity of silver nanoparticles in treating dental caries

“…Chlorhexidine is a chemical antiseptic, antifungal, and bactericidal capable of eliminating both gram--positive as gram-negative bacteria. Also it has bacteriostatic action, inhibiting bacterial proliferation by disrupting the cell membrane, and not by inactivating ATPase, as imagined before 17 .…”

“…To assure consistency of the MIC value microdilution was performed in triplicate. However, systematic reviews indicate that chlorhexidine does not have enough scientific evidence to be used as a preventive agent for dental caries 17 . However, substances containing silver have been used in Dentistry, such as SDF, with high clinical efficacy 13 .…”

The Importance and Possibilities of Proper Oral Hygiene in Orthodontic Patients

“…Based on the available reviews, chlorhexidine rinses have not been highly effective in preventing caries or at least the clinical data are not convincing (Autio-Gold, 2008). Due to the current lack of long term clinical evidence for caries prevention and reported side effect, CHX rinses should not really be recommended for caries prevention.…”