The anti-plaque efficacy of a chlorhexidine mouthrinse used in combination with toothbrushing with dentifrice

Assessment of antiplaque effectiveness of chlorhexidine-soaked gauze compared to chlorhexidine mouth rinse: Randomized clinical trial

AIM

The aim of the present study was to compare the efficacy of a disposable gauze soaked with chlorhexidine and rolled up on the finger vs chlorhexidine mouth rinse (CM) to maintain oral hygiene.

METHODS

In this single-blind, randomized trial, both groups were instructed to brush their teeth and use the 0.12% chlorhexidine intervention twice per day (experimental group: toothbrushing + chlorhexidine-soaked gauze; control group: toothbrushing + mouth rinse). The main outcome was the change in full mouth plaque index scores from baseline to 2 weeks. Secondary outcomes were the patient's appreciation (visual analog scale) and the bleeding index.

RESULTS

The final sample consisted of 60 young patients: 31 in the experimental group and 29 in the control group. After 2 weeks, both interventions were effective in reducing plaque index. The percentage of score reduction was 33% in the experimental group and 30% for the controls, with no significant difference between groups. Both interventions reduced the bleeding index, but this reduction was significant only in the experimental group (P < .001).

CONCLUSIONS

There is no difference between chlorhexidine-soaked gauze and CM regarding plaque control. In addition, gauze soaked with chlorhexidine was significantly more effective in reducing the bleeding index score and was appreciated by the patients.

Socioeconomic and sociodemographic variables associated with oral hygiene status in Mexican schoolchildren aged 6 to 12 years

BACKGROUND

The purpose of this study was to identify the socioeconomic and sociodemographic variables associated with oral hygiene status in schoolchildren aged 6 to 12 years in Navolato, Sinaloa, Mexico.

METHODS

A cross-sectional study was carried out in 3,048 schoolchildren. A questionnaire was used to determine socioeconomic and sociodemographic variables, and a clinical oral examination was carried out to establish oral hygiene status. The "plaque" component of the simplified oral hygiene index (S-OHI) was the criterion used to determine oral hygiene status in children. Using principal component analysis, five socioeconomic factors were streamlined to one principal component to determine the individual socioeconomic level. Data were analyzed with non-parametric tests and multivariable logistic regression.

RESULTS

The population included 1,456 boys and 1,592 girls. The mean value for S-OHI was 1.10 +/- 0.34. The largest percentage (50.8%) of the S-OHI scores ranged between 0 and 1. In the multivariate model, younger age, male gender, and lower toothbrushing frequency (P <0.05) were associated with poor oral hygiene. Children with better socioeconomic status had better oral hygiene (P <0.05).

CONCLUSIONS

Most children ( approximately 60%) had an acceptable level of oral hygiene. Diverse variables were associated with oral hygiene in these Mexican children, highlighting a gradient distribution throughout the socioeconomic spectrum. It is necessary to implement strategies that would help to diminish the disparities observed across diverse socioeconomic groups.

The antimicrobial effect of a triclosan/copolymer dentifrice on oral microorganisms in vivo

BACKGROUND

The authors compared the in vivo antimicrobial effects on microorganisms from dental plaque, saliva and the tongue in subjects who used a triclosan/copolymer dentifrice and a fluoride dentifrice (control).

METHODS

The authors assigned 15 subjects randomly to the control dentifrice or the triclosan/copolymer dentifrice for twice-daily use for one week. They collected samples of plaque, saliva and tongue scrapings six and 12 hours after the final brushing. They analyzed colony-forming units of Veillonella species, Fusobacteria species, total cultivable anaerobes and hydrogen sulfide (H(2)S)-producing bacteria. A one-week washout followed. The authors repeated the protocol with the second dentifrice.

RESULTS

The results showed no differences at baseline. Significant reductions (88 to 96 percent) in oral anaerobic bacteria were observed in the triclosan/copolymer group six and 12 hours after brushing compared with the control group (P = .001). Fusobacteria decreased by 77 to 92 percent and Veillonella decreased by 84 to 89 percent six and 12 hours after brushing in the triclosan/copolymer group versus the control group. The triclosan/copolymer group also demonstrated a significant decrease in H(2)S-producing bacteria six and 12 hours after brushing (74 to 85 percent) (P = .001).

CONCLUSIONS

Brushing with the triclosan/copolymer dentifrice resulted in significant reductions in microorganisms from the three sites compared with the control dentifrice.

CLINICAL IMPLICATIONS

The triclosan/copolymer dentifrice produced sustained effects on oral bacteria for 12 hours.

Short-term side effects of 0.2% alcohol-free chlorhexidine mouthrinse used as an adjunct to non-surgical periodontal treatment: a double-blind clinical study

BACKGROUND

The aims of this clinical study were to evaluate the short-term subjective (by means of questionnaire) and objective (by means of clinical examination) side effects of 0.2% chlorhexidine (CHX) mouthrinse without alcohol used as an adjunct to non-surgical periodontal treatment and to elucidate the relationship between the subjective and objective evaluations.

METHODS

This was a randomized, double-blind, placebo-controlled clinical trial with two groups: 1) the test group, rinsing with the test product (0.2% CHX without alcohol) twice per day for 1 week, and 2) the control (placebo) group, rinsing with a placebo solution twice per day for 1 week. Following the start of rinsing, patients were subjectively and objectively evaluated for the presence and severity of side effects (pain, burning sensation, pruritus, dryness of mouth, taste disturbance, mucosal irritations, and discoloration of tooth and tongue surfaces) at days 1, 3, and 7 of the rinsing period. The presence of subjective and objective side effects of the groups was compared via use of chi2 and Fisher exact tests. Analysis of the subjective and objective side effects within the evaluation periods was done by McNemar test. Spearman correlation analysis was used to assess the relationships between the subjective and objective side effects.

RESULTS

None of the patients in either group complained of dryness of the mouth. The most commonly reported side effect was the change in color of the labial and buccal mucosa, particularly of the gingiva, after day 3 of rinsing. There were significant (r=0.308 to 0.835; P<0.05) correlations between the discolorations of tongue and tooth surfaces reported by the patients and clinically detected at all evaluation periods. There was a significant and positive relationship between the subjective side effects and the soft tissue irritations when the duration of rinsing increased.

CONCLUSION

Within the limits of this clinical evaluation, rinsing with 0.2% alcohol-free CHX for 1 week caused more irritation to oral mucosa, greater burning sensation, and increased altered taste perception compared to the placebo rinse.

Chlorhexidine mouthrinse in combination with an SLS-containing dentifrice and a dentifrice slurry

OBJECTIVES

The aim of the present study was to compare the plaque-inhibitory effect of a 0.2% chlorhexidine digluconate (CHX) rinse when preceded by ordinary toothbrushing with a 1.5% sodium lauryl sulphate (SLS)-containing dentifrice to the effect of the same rinse when used alone, or when preceded by rinsing with an SLS-containing slurry.

METHODS

The study was an examiner blinded, randomized three-arm, parallel design. It used a 4-day plaque accumulation model to compare three different oral hygiene regimens, which were performed under supervision. One hundred and twenty healthy volunteers were enrolled in the study and were randomly assigned to one of each group. At the beginning of each test period, they received a thorough dental prophylaxis. The experiment was performed in one randomly assigned (upper or lower) jaw, called the study jaw. The opposite jaw, referred to as the dentifrice jaw, served only to introduce the influence of toothbrushing with a dentifrice on the anti-plaque efficacy of the CHX in the study jaw of the same mouth. At the end of the 4-day test period, plaque and gingival bleeding were scored in the study jaw. In all the regimens, the oral hygiene procedure was finalized by rinsing with a CHX 0.2% solution for 1 min. The study jaw was not brushed during the experiment. Regimen A (positive control) consisted of rinsing with CHX alone. In regimen B, rinsing with CHX was preceded by rinsing with an SLS-containing slurry, while in regimen C rinsing with CHX was preceded by toothbrushing with an SLS-containing dentifrice in the dentifrice jaw. No other oral hygiene measures were allowed. After 4 days of undisturbed plaque accumulation, the amount of plaque and level of gingival health were evaluated.

RESULTS

The overall plaque index for regimens A, B and C was 1.17, 1.62, and 1.14, respectively. There was no significant difference in plaque accumulation between the CHX alone regimen (A) and the SLS-dentifrice-CHX regimen (C). Regimen B differed significantly from regimens A and C. The overall bleeding index for regimens A, B and C was 0.24, 0.18, and 0.20, respectively. There was no significant difference between the three regimens.

CONCLUSIONS

The present study shows that the anti-plaque efficacy of a 0.2% CHX rinse was not reduced when preceded by everyday toothbrushing with a SLS-containing dentifrice. However, when preceded by rinsing with an SLS-containing slurry, the anti-plaque efficacy of a 0.2% CHX rinse was reduced.