The Use of 0.2% Chlorhexidine Spray as an Adjunct to Oral Hygiene and Gingival Health in Physically and Mentally Handicapped Adults

Abstract

Chlorhexidine has been used as an aid to or replacement for oral hygiene measures in special needs groups such as the handicapped. Previous studies have indicated that spray delivery of chlorhexidine is both effective and acceptable. This study evaluated twice daily use of a 0.2% chlorhexidine spray as an adjunct to toothbrushing in a group of physically and mentally handicapped adults attending a day training center. The study was a double-blind, placebo controlled, cross-over design involving two 31 days regimens separated by 30 days. Plaque, bleeding on probing, and pocketing were measured at the beginning and end of each regimen. There were clinically and statistically significantly lower plaque and bleeding scores at the end of the chlorhexidine compared to the placebo period. Pocketing was also significantly less after chlorhexidine, although in clinical terms the difference was small. The apparent acceptability and effectiveness of the regimen suggests that small doses of chlorhexidine delivered by sprays may be of considerable value as an aid to oral hygiene in handicapped individuals.

Duration of action of a single, early oral application of chlorhexidine on oral microbial flora in mechanically ventilated patients: a pilot study

“…Though comparison of spray versus swabbing CHG applications have not been previously tested in the critically ill, comparisons have been conducted in other populations and found of equal efficacy. 42,64,65 CHG spray was equally effective as a rinse after periodontal surgery. 66 It has also …”

“…38,42,64,65,67,68 Although this population is similar to the critically ill in their dependence on care providers for oral hygiene interventions, their normal oral flora is not similar to the gram-negative bacteria and potential respiratory pathogens that are found in the critically ill. Therefore, our findings may reflect the unique oral microbial environment in the critically ill population.…”

Comparison of the effectiveness of a commercially available herbal mouthrinse with chlorhexidine gluconate at the clinical and patient level

“…[2] There are also large groups of individuals, such as the handicapped and elderly, for whom maintaining adequate oral hygiene can be an insurmountable problem. [3] For these patients, a chemical plaque control approach is desirable to deal with the potential deficiencies of daily self-performed oral hygiene. Chlorhexidine Gluconate, a bisbiguanide, is considered to date the most effective anti-plaque agent,[4] but it is not a ‘Magic Bullet’ and it also comes with certain side-effects, notably tooth staining, taste disturbance, enhanced supragingival calculus formation and less commonly, desquamation of the oral mucosa.…”

The effect of 0.12% chlorhexidine dentifrice gel on plaque accumulation: a 3-day non-brushing model

“…Chlorhexidine can be applied in a number of ways: as a mouthwash (7–11), as a gel (12–18) and as a spray (13, 14, 19–24). Its efficacy has been extensively investigated.…”