The effects of a 0.12% chlorhexidine gluconate mouthrinse on orthodontic patients aged 11 through 17 with established gingivitis

The purpose of this study was to assess the effectiveness of a 0.12% chlorhexidine gluconate (CH) mouthrinse, Peridex, on orthodontic patients 11 through 17 years of age with established gingivitis. Thirty-four subjects were divided into two groups (CH and placebo) of 17 subjects each on the basis of gender, and they were evaluated at baseline, at 6 weeks, and at 12 weeks in a double-blinded manner. The gingival index (GI) of L?e and Silness, the plaque index (PI) of Silness and L?e, the Eastman Interproximal Bleeding Index, and the CWRU staining index were recorded for each subject. The subjects in the CH group, as compared with the placebo group, had statistically significant reductions, expressed as percent reductions against baseline, at the conclusion of this 3-month period: PI = 64.9%, GI = 60.0%, and gingival bleeding = 77.2%. Staining was in the moderate range, and it was concentrated on the mandibular lingual surfaces. Peridex, in combination with mechanical plaque removal, proved to be an important therapeutic agent in controlling gingival inflammation, bleeding, and plaque accumulation in orthodontic patients 11 through 17 years of age with established gingivitis.     

Six-month effects of a sanguinarine dentifrice on plaque and gingivitis

A six-month, double-blind clinical trial was conducted to determine the effectiveness of a sanguinarine-containing dentifrice in reducing plaque and gingival inflammation. One hundred twenty adult volunteers were randomly assigned to a control or experimental group. The test dentifrice contained 750 mcg/g of sanguinaria extract. A dentifrice of similar composition without sanguinarine was used as the placebo. Plaque and gingival inflammation scores were recorded for four surfaces on each of 12 index teeth at baseline, one-, three, and six-months. Matched pair t-test analyses showed no significant differences between experimental and control groups for mean six-month changes in plaque and gingival inflammation scores in analyses using all 48 sites per subject or in analyses of only the 24 interproximal sites. No long-term reduction was demonstrated in plaque or gingival inflammation with the use of a sanguinarine-containing dentifrice.     

Some effects of a Sanguinarine-containing mouthrinse on developing plaque and gingivitis

The present clinical trial was performed to assess the effect of a Sanguinarine-containing mouthrinse on developing plaque and gingivitis in man. The trial was designed as a blind cross-over study. The active mouthrinse consisted of a 0.03% aqueous solution of Sanguinaria extract; an aqueous solution with similar color and taste as the active rinse was used as the placebo preparation. 14 dental students participated in the trial. At the start of each of 2 test phases, their gingival conditions were normal and their tooth surfaces free from dental plaque. Following a baseline examination, the participants refrained from mechanical tooth cleaning measures for 2 weeks. They rinsed twice daily with either the active or the placebo mouthrinse. Clinical examinations of plaque and gingivitis were repeated after 4, 7 and 14 days use of the mouthrinse preparation. During the second test phase of no mechanical tooth cleaning, the subjects who previously had rinsed with the placebo solution now used the active compound and vice versa. The results demonstrated that the Sanguinarine-containing mouthrinse was effective in reducing plaque formation and retarding the development of gingivitis.     

Therapeutic effects of supervised chlorhexidine mouthrinses on untreated gingivitis

AIM: The aim of the present study was to test the presumptive therapeutic effect of chlorhexidine digluconate in a population with untreated gingivitis and presence of abundant calculus. SETTING AND STUDY DESIGN: Sixty subjects (? mean age of 23.4) were recruited from a knitting factory in the Province of Guangdong, People's Republic of China. By applying a double-blind clinical trial design the participants were divided into two groups (Test and Control) and matched according to their mean GI scores. The Test group (n= 20) was assigned to two daily mouth-rinses for 6 days per week using 0.12% chlorhexidine digluconate (Peridex®). The Control group (n= 40) rinsed twice daily with a placebo solution. All the rinsings were supervised and timed for 45 S. No attempt was made to influence the oral hygiene habits of the participantS. Prior to and after 3 months of the supervised rinsing, plaque was scored using the Plaque Index system (PIl), and gingivitis was assessed using the criteria of the Gingival Index system (GI).Calculus was scored according to the Calculus Surface Severity Index system (CSSI), and stain was also graded by the Discoloration Index system (DI). RESULTS: After 3 months, the Test group (n= 13) showed significant reduction in mean PIl, GI and percentage of gingivial bleeding (GB%), while significant increases in mean DI were observed. The improvement in gingival health was observed at all regions with marked reduction in mean GI (from GI = 1.40 to 1.08) and GB% reduction by 24–52%. The proportion of GI = 2 was also reduced significantly from 50-36%. The Control group (n= 23) also showed a decrease in mean PIl but significant increases in the mean GI and GB%. Intergroup comparison showed statistically significant differences between mean GI, percentage of gingival bleeding (GB%) and mean DI for the test and control groups after 3 months of supervised rinsing. However, there were no significant intergroup differences for mean PIl. CONCLUSION: In conclusion, there was a significant effect of chlorhexidine on gingivitis, although the effect may be too limited to assure prognostic benefits in the prevention of future disease progression.     

含精油漱口液对成人牙菌斑和牙龈炎的抑制效果

目的:探讨含精油漱口液作为机械性控制菌斑的辅助措施,对成年人减少菌斑积聚和预防牙龈炎的效果.方法:82名年龄在18～70岁的健康志愿者纳人为期6个月的随机、双盲、对照临床研究.对试验对象进行洁治和牙面抛光后,随机分为试验组和对照组,分别发给含精油的漱口液和不含精油的安慰剂漱口液.所有试验对象每天使用分发的漱口液漱口2次,每次20mL.除使用检查者统一提供的牙膏和牙刷早晚刷牙外,不进行其他口腔保健措施.分别于基线、3个月和6个月时检查受试对象的菌斑指数和牙龈指数的变化情况.采用SPSS13.0软件包对数据进行t检验.结果:3个月检查时,使用含精油成分漱口液的试验组与对照组相比,菌斑指数和龈炎指数分别降低9.02%与11.88%;6个月检查时,试验组菌斑指数和龈炎指数分别较对照组降低16.98%和21.47%.两组比较均有统计学差异(P＜0.05).结论:含精油的漱口液与安慰剂漱口液相比,具有控制牙菌斑、降低牙龈指数、改善牙龈健康的作用.     

Influence of a SLS-containing dentifrice on the anti-plaque efficacy of a chlorhexidine mouthrinse

Background: Chlorhexidine (CHX) and sodium lauryl sulphate (SLS), the most widely used detergent in dentifrice, may counteract. Consequently, studies about this interaction suggested that care is required when combining both these compounds, even when they are introduced separately into the oral cavity. The purpose of the present study was to investigate the effect of toothbrushing with a SLS-containing dentifrice in one jaw, on the plaque inhibition of a CHX mouthrinse in the opposite jaw during a 4-day study period. Methods: The study was an examiner-blind, randomised two-cell, crossover design. It used a 4-day plaque accumulation model to compare two different oral hygiene regimens with a washout period of 17 days. Sixteen healthy volunteers were enrolled in the study and received a thorough dental prophylaxis at the beginning of each 4-day test period. One jaw (upper or lower) was randomly assigned as the “study” jaw. The opposite jaw was assigned as the “dentifrice” jaw and served only to introduce the effect of brushing with a dentifrice in the study model. Two oral hygiene regimens were evaluated. During one randomly assigned test period, the “dentifrice” jaw was treated by toothbrushing with a 1.5% SLS-containing dentifrice and rinsed together with the “study” jaw with 0.2% CHX, thus forming regimen 1. As a control during the other test period, both the “dentifrice” jaw and “study” jaw were only rinsed with 0.2% CHX, forming regimen 2. No other oral hygiene methods were allowed. After 4 days of undisturbed plaque accumulation, the amount of plaque was evaluated ( Silness & Löe 1964 ). The “study” jaw was used to study the effect of the two regimens on the level of plaque accumulation at the end of the 4-day period. Results: The overall plaque index was 0.36 for regimen 1 and 0.34 for regimen 2. There was no significant difference in plaque accumulation between the two regimens. Conclusions: Within the limitations of the present study design, it can be concluded that ordinary brushing with a 1.5% SLS-containing dentifrice (Colgate Bi-Fluor), followed by rinsing with water does not appear to reduce the level of plaque inhibition offered by a post-brushing CHX rinse.     

Comparison of a 0.12% chlorhexidine mouthrinse and an essential oil mouthrinse on oral health in institutionalized, mentally handicapped adults: one-year results.

The purpose of this study was to compare the efficacy of a 0.12% chlorhexidine mouthrinse and an essential oil mouthrinse on plaque accumulation and gingivitis in mentally handicapped adults over a one-year period. Twenty-seven institutionalized mentally handicapped adults participated. Gingival index (GI), plaque index (PI), and probing depths (PD) were recorded and an ultrasonic scaling was performed (Baseline 1). GI, PI, and PD were again recorded after 2 weeks (Baseline 2). Patients were then assigned to either the chlorhexidine or essential oil mouthrinse group. The patients rinsed twice daily under supervision with their assigned mouthrinse while maintaining their attempts at daily brushing. GI and PI were recorded at monthly intervals for 12 months, while the PD was recorded only at Baseline 1 and 2 and at 12 months. A paired t-test was used to compare differences between the parameters at Baseline 1 and Baseline 2. A 2-factor repeated measure ANOVA was performed on each parameter after the Baseline 2 evaluation. A statistically significant decrease in the probing depth occurred as a result of ultrasonic scaling; however, no significant changes in the PI or GI occurred. Both mouthrinses produced a significant improvement in the GI after one month. Despite the improvement, the GI was still indicative of disease. Over the 12 months no further significant improvement in the GI occurred. A statistically significant improvement in the PI occurred in the chlorhexidine group at month 1, but returned to Baseline 2 levels over the 12 months. No improvement in the PI occurred in the essential oil group. The probing depths remained the same over the 12 months.(ABSTRACT TRUNCATED AT 250 WORDS)     

Effect of chlorhexidine gluconate mouthrinse on plaque bacteria

The antimicrobial effect of a 0.12% chlorhexidine gluconate mouthrinse on plaque bacteria was compared to that of a placebo mouthrinse without chlorhexidine gluconate. Forty subjects in each treatment group rinsed twice daily with 15 ml mouthwash for six months. They were instructed to continue their usual oral hygiene practices. After six months, the subjects stopped using the mouthrinse. Supragingival plaque was collected from each subject and assayed for eight representative microbial populations at baseline, after three and six months of treatment, and after a three-month post-treatment period.
During the six months of mouthrinse use, significant reductions in the numbers of total aerobes. total anaerobes, streptococci, and actinomyces were observed in plaque samples taken from subjects using the chlorhexidine mouthrinse. The effect of chlorhexidine on actinomyces accumulation was especially pronounced with reductions ranging from 85–97%. This was considered to be particularly significant since actinomyces is one of the bacteria known to be periodontopathic in both experimental animals and in humans. Although chlorhexidine treatment reduced the number of microbes on teeth, it did not produce a detectable shift in microbial populations.
At the end of the three-month post-treatment period, the microbial profile was similar to the pre-treatment profile for both groups. Therefore, no residual effects of chlorhexidine on plaque bacteria were observed after cessation of rinsing.     

Antimicrobial effectiveness of an herbal mouthrinse compared with an essential oil and a chlorhexidine mouthrinse

BACKGROUND: The authors investigated mouthrinses' antimicrobial effectiveness against predominant oral bacteria, as determined by the minimum inhibitory concentration (MIC). Specifically, they evaluated an herbal mouthrinse, an essential oil rinse and a 0.12 percent chlorhexidine gluconate rinse. METHODS: The authors assessed the inhibitory effects of the three test agents against 40 oral bacteria at concentrations of 1, 2, 4, 8, 16, 32, 64, 128, 256 and 512 micrograms per millliter. They inoculated plates containing basal medium and the test agents with suspensions of the test species and incubated them anaerobically at 35 degrees C. The authors interpreted the MIC as the lowest concentration of the agent that completely inhibited the growth of the test species. RESULTS: The herbal mouthrinse inhibited the growth of most of the 40 test species. Compared with the essential oil mouthrinse, the herbal mouthrinse exhibited significantly lower MICs for Actinomyces species, periodontal pathogens Eubacterium nodatum, Tannerella forsythia and Prevotella species, as well as the cariogenic pathogen Streptococcus mutans. The chlorhexidine gluconate rinse had the lowest MICs compared with the essential oil rinse and the herbal rinse for all test species examined. CONCLUSIONS: Although less potent than the chlorhexidine gluconate rinse, the herbal rinse was more effective than the essential oil rinse in inhibiting the growth of oral bacteria in vitro. CLINICAL IMPLICATIONS: The data suggest that the herbal mouthrinse may provide oral health benefits by inhibiting the growth of periodontal and cariogenic pathogens. In vivo clinical testing is essential to confirm in vitro results.     

The effects of a chlorhexidine toothpaste on the development of plaque, gingivitis and tooth staining

Abstract Chlorhexidine has found many uses in clinical dentistry as an antiplaque agent. To date, effective chlorhexidine-containing toothpastes have not been made available. This study was the first phase in the evaluation of a 1% chlorhexidine toothpaste, formulated to ensure a high availability of the contained antiseptic. The study was a 19-day, randomised double-blind placebo-controlled, crossover experimental gingivitis clinical trial employing 14 healthy human volunteers. From a zero plaque and low gingivitis baseline, the development of plaque, gingivitis and dental staining was measured on days 12 and 19 of the 2 study periods. The toothpaste was used 2 × a day as a slurry rinse with no other form of oral hygiene. The washout period was 21 days. The development of plaque and gingivitis was statistically and clinically highly significantly reduced during the use of the active compared to the placebo product. Conversely, dental staining was statistically and clinically significantly increased. The product deserves further evaluation for potential clinical use.     

The effect of chlorhexidine mouthrinse on healing after gingivectomy

abstract – The purpose of this investigation was to evaluate the effect of 0.2 % chlorhexidine gluconate mouthrinse following gingivectomy on plaque under the dressing and on healing. Twenty-eight patients with indications for gingivectomy were selected. Coe-Pak® was used as surgical dressing. In addition to usual home care, the patients rinsed twice daily with chlorhexidine or placebo for 21 d after surgery. The study followed a cross-over, double-blind design. Gingival exudate was assessed and P1 I and G I were registered at 7, 14, and 21 d postsurgically. The study indicated that chlorhexidine did not influence the amount of plaque under the dressing, and it was uncertain whether chlorhexidine had any effect on the healing process when the surgical area was covered by Coe-Pak. However, (1) after the surgical dressing was removed, the chlorhexidine maintained plaque scores at the same low level as under the dressing, (2) healing was promoted when chlorhexidine was used, and (3) the presence of a dressing in one side of the mouth did not prevent the patient from maintaining good oral hygiene.     

Effects of octenidine mouthrinse on plaque formation and gingivitis in humans

Octenidine, a new bispyridine mouthrinse, has been shown to prevent plaque formation in humans over a seven-day period. The purpose of the present study was to determine the effects of octenidine on plaque and gingivitis development in humans using a 21-day experimental gingivitis model. Eighty-eight subjects with a Plaque Index (PII) and Gingival Index (GI) ≤ 0.4 were randomly assigned to 4 coded formulations: 1) 0.1% octenidine in mouthwash vehicle used 3 times a day (TID), 2) 0.1% octenidine in mouthwash vehicle used twice a day (BID), placebo rinse once a day, 3) 0.1% octenidine in water used 3 times a day, and 4) mouthwash vehicle alone used 3 times a day (VEH). Each subject refrained from all mechanical plaque control and rinsed morning, noon, and evening under supervision with 15 ml of assigned formulation for 60 s. At 0, 7, 14, and 21 days, Pit, GI, and mucosal tolerance were assessed. Tooth stain was measured at day 0 and twice at day 21 (prior to and immediately following a single toothbrushing). By day seven of the rinse phase, significant mucosal irritation had occurred in several subjects in the octenidine in water group. Therefore, that group was discontinued from the study and the remaining 66 subjects continued. The mean PII increased in the VEH group from a mean of 0.13 at day 0 to 1.08, 1.39, and 1.69 at days 7, 14, and 21, respectively. In contrast, the mean PII of the TID and BID groups did not increase over the 21 day period (0.14 and 0.10, 0.18 and 0.22, 0.15 and 0.16, 0.12 and 0.16 at day 0, 7, 14, and 21 for TID and BID, respectively). Although the TID and BID groups did not statistically differ at any point, both groups demonstrated significantly less plaque accumulation than the VEH group at days 7, 14, and 21 (p < 0.000001). Gingivitis, as measured by GI, increased significantly in the VEH group from a mean of 0.14 at day 0, to 0.58, 0.84 and 0.98 at day 7, 14, and 21. Both the TID and BID groups demonstrated a small increase in mean GI, rising from 0.12 and 0.16 at day 0 to 0.21 and 0.24, 0.29 and 0.27, and 0.32 and 0.31 at days 7, 14, and 21 for TID and BID, respectively. Again, the TID and BID groups were not different while both had significantly less gingivitis than the VEH group at days 7, 14, and 21 (p 0.000002). Stain, observed in 26 subjects in the TID and BID groups at day 21, was removed by a single toothbrushing in all but 5 subjects. No significant adverse reactions were observed in the remaining subjects. These results demonstrate that octenidine, when used as the only means of oral hygiene for 21 days, will significantly inhibit the development of plaque and gingivitis.     

Effect of Peroxyl mouthrinse on chlorhexidine staining of teeth.

The efficacy of Peroxyl mouthrinse in reducing the extrinsic stain produced by Peridex, a chlorhexidine mouthrinse, was evaluated in a double-blind, three-month clinical study. Intraoral safety, extrinsic tooth stain and plaque accumulation scores were determined on 119 healthy adult subjects at baseline and at 30-, 60- and 90-day intervals following use of Peroxyl or placebo formulations in combination with the Peridex product. Subjects were randomly assigned to two groups. The test group used the chlorhexidine mouthrinse plus Peroxyl mouthrinse, while the control group used the chlorhexidine mouthrinse plus a placebo mouthrinse. All participants were given an oral prophylaxis prior to use of the mouthrinses. The assigned mouthrinse combinations were used by 58 test and 61 control subjects, who followed specific toothbrushing and mouthrinse regimens throughout the three-month period. Both the examiner and the subjects were unaware of the identities of the products tested. Use of Peroxyl mouthrinse significantly reduced extrinsic tooth stain produced by chlorhexidine rinsing. The mean stain scores for all teeth were significantly lower for the Peroxyl/chlorhexidine group, at 60 and 90 days of use, compared to the placebo/chlorhexidine group. At all three time points, the mean stain scores of the anterior teeth of the individuals using Peroxyl/chlorhexidine rinses had significantly less stain compared to the placebo/chlorhexidine rinse group means. No intraoral soft tissue side effects, attributed to product use, were observed or reported throughout the study.     

Effect of a combined chlorhexidine and NaF mouthrinse: an in vivo human caries model study

Chlorhexidine (CHX) is probably the most widely used and the most potent chemical plaque inhibitory agent, whereas fluoride (F⁻) is the only truly accepted anticaries agent available at present. As they have discrete mechanisms of action, a combination effect of these agents on human dental caries may exist. The inhibitory effect of CHX on the formation of, and acid production in, plaque may reduce a relatively extreme cariogenic challenge sufficiently for it to be overcome by the local F⁻ concentrations achieved by brushing or rinses. The aim of this study was to evaluate the possible caries inhibitory effect of combining 2.2 mM CHX mouthrinses used twice daily with daily 11.9 mM NaF rinses in an in vivo human caries model using plaque-retaining bands on premolars scheduled for extraction. Nine subjects (a total of 28 teeth) were fitted with the bands for 4 wk. Saliva and plaque samples were collected before and after the study period for bacterial cultures, and the tooth surfaces were analyzed by microradiography after careful tooth extractions. The combination of CHX and F⁻ rinses resulted in enamel mineral loss only slightly higher than that observed in "sound" enamel and clearly less than with F⁻ rinses alone. Both total plaque bacteria and Streptococcus mutans were reduced by CHX rinses, confirming the discrete mechanisms of action.     

The influence of a 0.2% chlorhexidine mouthrinse on plaque regrowth in orthodontic patients

In a prospective plaque regrowth study focusing on oral hygiene during fixed appliance therapy 12 adolescent patients (mean age 14.1 +/- 1.5 years) were evaluated twice over 2-day test periods. In the randomized, double-blind study the influence of a 0.2% chlorhexidine (CHX) mouthrinse (Corsodyl) and a commercially available dentifrice supplementing fluoride (Odol-med-3) were compared intra- and interindividually in a crossover design with regard to plaque and gingivitis. Before starting the first test phase there was a 14-day preliminary phase for upgrading the oral hygiene. Between the 2 test phases was a 5-day "washout". On the last day of the second test phase the patients were asked to fill in a questionnaire concerning their experiences during the study. The 0.2% Corsodyl reduced the plaque index scores significantly (p < 0.001). The gingival index revealed a similar reduction (2nd day of test: p = 0.03). Until the 5th day of washout a clear-cut carryover effect of the chlorhexidine rinse on the gingival index was observed. Both the lower mean values of the 2 clinical parameters at the beginning of the test phases as compared with those at the beginning of the preliminary phase and the evaluation of the questionnaires indicated a possible Hawthorne effect. 0.2% Corsodyl may be employed as an adjunct to other preventive measures such as professional care and patient-oriented instruction on an intermittent basis in order to reduce the plaque-induced iatrogenic side effects and to enhance the efficacy of oral hygiene measures in connection with orthodontic therapy with fixed appliances.