The effect of delmopinol rinsing on dental plaque formation and gingivitis healing

The aim of this study was to investigate a possible dose-response effect of delmopinol hydrochloride, on the development of plaque and on the healing of gingivitis. 64 healthy male volunteers, aged 18-40 years with healthy gingivae and clean teeth, participated. During a 2-week period, the participants refrained from all oral hygiene and rinsed 2x daily with a placebo solution. On day 14 of the study, they received professional toothcleaning, and were randomly assigned to 4 groups. For the following 2 weeks, they rinsed 2x daily for 1 min with 10 ml of 0.05% (15 subjects), 0.1% (17) or 0.2% (16) delmopinol, respectively. 16 subjects rinsed with 0.2% chlorhexidine. No oral hygiene procedures were performed during the test period. On days 0, 14 and 28, gingival bleeding index and the presence of stainable plaque were determined. Periodic identical photographs were used for planimetric determination of buccal plaque extension. No significant difference for the reduction in gingival bleeding index was found between 0.2% delmopinol and chlorhexidine rinsing. The mean plaque index showed its most significant reduction on lingual surfaces of both upper and lower jaws when rinsing with 0.2% delmopinol. Mean plaque extension was reduced by 23% for 0.05%, 39% for 0.1% and 55% for 0.2% delmopinol. A significant dose-response effect for 0.05%, 0.1% and 0.2% delmopinol was found for gingival bleeding index, plaque index and plaque extension. The results show that delmopinol favors the healing of gingivitis and reduces plaque formation.     

Development of plaque and gingivitis after mouthrinsing with 0.2% delmopinol hydrochloride

A double-blind, randomized, 2-wk experimental gingivitis clinical trial with cross-over design in 14 dental students was conducted in order to study the efficacy and safety of delmopinol hydrochloride solution (2 rug/ml), used with no other oral hygiene procedures, in comparison with placebo. Plaque formation was measured by the Q uigley & H ein Plaque Index and gingivitis was assessed by bleeding on probing according to M ühlemann & S on . Rinsing with delmopinol resulted in lower plaque scores compared to placebo. The development of gingivitis was weak during the 2-wk test periods, and thus no conclusive results were obtained. As in previous studies, the most frequent adverse event when rinsing with delmopinol was a transient anaesthetic sensation in the oral mucosa. The results showed that rinsing with delmopinol hydrochloride solution (2 mg/ml) for 60 s twice daily with no other oral hygiene procedures led to less plaque formation than rinsing with placebo. This study also showed good tolerance and acceptability of mouthrinsing with delmopinol.     

Predominant cultivable supragingival plaque in Chinese "rapid" and "slow" plaque formers

Abstract The aim of this study was to compare the predominant cultivable bacterial flora in supragingival plaque samples of Chinese “rapid” and “slow” plaque formers, using the experimental gingivitis model. 11 Chinese subjects (5 “rapid” and 6 “slow” plaque formers) were selected from 49 healthy young adults. The selection was based on the plaque index on the buccal surfaces of all the canines, premolars and 1st molars after 3-days without plaque control. The 11 subjects began a 14-day no oral hygiene period after prophylaxis. Plaque samples were collected on day 1. day 3, day 7 and day 14 from the buccal surface of upper right canine. 2nd premolar. 1st premolar and 1st molar, respectively. The samples were then dispensed into a tryptic soy broth, and cultured anaerobically to obtain pure isolates which were then identified by conventional means. Results showed similar trends in plaque development in the two groups; gram-positive bacteria were the predominant cultivable species (“rapid”: 71–37%; “slow”: 53–63%) and gram-negative species increased in proportion to the plaque age (“rapid”: 9–47%. “slow”: 13–28%). “Rapid” plaque formers showed a statistically significant higher percentage of gram-negative rods (38%) than the “slow” group (17%) in the 14-day samples. The difference in the proportions of other groups of bacteria between the “rapid” and “slow” plaque formers were also found to be statistically significant using the MANOVA test (p=0.0162). Most of the cultivable gram-negative rods belonged to Fusobacterium and Capnocytophaga species. Besides the quantitative difference observed clinically, there seems to be a qualitative difference in the cultivable flora between subjects with different rates of plaque formation.     

6-month use of 0.2% delmopinol hydrochloride in comparison with 0.2% chlorhexidine digluconate and placebo

Abstract. A double-blind, randomized, 6-mónth clinical trial with parallel group design in 149 patients with gingivitis was conducted to study the efficacy and safety of delmopinol hydrochloride 2 mg/ml (0.2% w/v. Decapinol Mouthwash) used for partly supervised mouthrinsing in comparison with chlorhexidine digluconate 2 mg/ml (0.2% w/v. Hibitane Dental®, ICI Pharmaceuticals. UK) and placebo as an addition to normal oral hygiene. Assessments of efficacy were performed using the plaque index and bleeding on probing (BOP). Delmopinol showed 22% lower plaque index scores than placebo after 3 months ( p <0.01) and 13% lower scores after 6 months. The corresponding figures for chlorhexidine were 38% ( p <0.001) and 38% ( p <0.001) after 3 and 6 months, respectively. Bleeding on probing was reduced for delmopinol in comparison with placebo by 11% after 3 months and by 18% ( p <0.05) after 6 months. For chlorhexidine the corresponding figures were 18% ( p <0.01) and 22% ( p <0.01) after 3 and 6 months, respectively. While chlorhexidine showed greater plaque reduction than delmopinol ( p <0.01 at 6 months), no statistically significant difference was reached between these two solutions regarding BOP Both active solutions showed an increased amount of dental calculus in comparison with placebo. A transient anaesthetic sensation in the oral mucosa and taste affection were commonly reported adverse events in both the delmopinol and the chlorhexidine groups. The number of patients withdrawn from treatment due to adverse events or lack of cooperation was 7 in the chlorhexidine group. 4 in the placebo group and 1 in the delmopinol group. The results showed that rinsing with either 0.2% delmopinol hydrochloride or 0.2% chlorhexidine digluconate twice daily for 60 sees for 6 months results in less plaque formation and gingivitis than rinsing with placebo. Mouthrinsing with the 0.2% delmopinol hydrochloride solution was well accepted in this study.     

Short-term effect of topical application of delmopinol on salivary microbiology, plaque, and gingivitis

The aim of this study was to test a possible dose-response effect of topical application of delmopinol HC1 on the salivary microbiology, the healing of a pre-established experimental gingivitis, plaque development, and supragingival plaque composition. Forty-eight healthy subjects were enrolled in an oral hygiene program for 2 wk to upgrade their oral health. After professional tooth cleaning, they abstained from all oral hygiene, but applied 2 ml of a placebo with a soft paintbrush onto their teeth twice daily for 2 wk. At the end of this period, the subjects received tooth cleaning and were then assigned to three treatment groups of 16 individuals each. They applied 2 ml of 0.1%, 0.5%, and 1% delmopinol HC1, respectively, twice daily for the next 2 wk and refrained from all other oral hygiene procedures. At the end of the placebo and delmopinol HC1 treatment periods, (1) saliva samples were obtained and cultivated on a series of media, (2) the degree of gingivitis was measured with gingival crevicular fluid (GCF) and gingivitis index (GI), (3) the stainable buccal plaque extension was analyzed planimetrically, and (4) the bacterial morphotypes of plaque adjacent to the gingival margin were analyzed. No changes in the salivary microbiologic counts were detected. The amounts of GCF and GI were reduced in all delmopinol groups, as compared with placebo. Mean plaque extension was reduced by 16% for the 0.1%, 56% for the 0.5%, and 58% for the 1% delmopinol group. Cocci appeared to predominate in bacterial dental plaque when 0.5% and 1% delmopinol were used. The results indicate that short-term use of delmopinol promotes the healing of pre-established gingivitis, reduces plaque formation, and delays plaque maturation without detectable changes in the salivary microflora.     

一种香精油漱口水抑制菌斑和牙龈炎症作用的研究

目的评价一种香精油漱口水抑制菌斑和牙龈炎症的作用。方法将67名改良牙龈指数(MGI)≥1.5且改良菌斑指数(MPI)≥2.0的受试者纳入试验,指导其在每天早晚刷牙后含漱20ml香精油漱口水30s,持续13周之后,检查受试者的MGI、MPI和牙龈出血指数(GBI),与基线值进行比较。结果使用香精油漱口水13周之后,与基线值相比,受试者的MGI下降了26.52%,MPI下降了61%,GBI下降了30.65%,差异均有显著性(P<0.01)。结论在日常刷牙的同时,配合使用香精油漱口水能够抑制菌斑和牙龈炎症。     

The effect of herbal extracts in an experimental mouthrinse on established plaque and gingivitis

Abstract. The purpose of the present study was to establish in vitro the inhibiting effect of a herbal extract mixture on a selected number of micro-organisms and to test in vivo the effect of a mouthwash containing 6.3 mg/ml herbal extract mixture on plaque and gingivitis as compared to a minus active control mouthrinse. The herbal extract was a mixture of: Juniperus communis (juniper), Urtica dioca (nettle), Achillaea millefolium (yarrow); 1:1:1. In the study, in-vitro, the effect of pure herbal extract mixture on acid production of Streptococcus mutans was tested and the minimum inhibitory concentrations (MIC) of the following micro-organisms were tested: Streptococcus mutans, Streptococcus mitis, Actynomyces viscosus, Actynomyces naeslundii, Actinobacillus actinomycetemcomitans, Prevotella intermedia, Campylobacter rectus, Fusobacterium nucleatum, Veillonella parvula. The MIC-values for A. viscosus and P. gingivalis were 100 mg/ml. The MIC-values for A. naeslundii and A. actinomycetemcomitans were considerably lower (10 mg/ml). S. mitis was the most susceptible of the tested organisms to the extract with a MIC value of 1 mg/ml. S. mutans, C. rectus, V. parvula, and F. nucleatum were not influenced by the extracts. No inhibitory effect of the 6.3 mg/ml herbal extract mixture was observed on the acid production of S. mutans. For the study in-vivo, 45 volunteers were selected on the basis of having moderate gingival inflammation. As efficacy parameters the plaque index, modified gingival index and angulated bleeding index were assessed. The subjects were randomly divided among 3 experimental groups (2× test and 1‘minus active’control). The participants were requested to rinse with 10 ml of mouthwash twice a day for a period of three months. After 6 weeks and 3 months, the same clinical indices as at baseline were recorded. The results show no difference between the two test groups and the control group. In conclusion, the results of the present study have shown that the mixture of the 3 herbal extracts, Juniperus communis, Urtica dioca and Achillaea millefolium when used in a mouthrinse has no effect on plaque growth and gingival health.     

Effect of local application of delmopinol hydrochloride on developing and early established supragingival plaque in humans

Abstract The aim of the study was to investigate the effect of delmopinol hydro-chloride on the development of dental plaque and on newly established plaque. In addition, the influence of this compound on the composition of the microbiota colonizing the gingival mucous membrane was studied. 14 healthy male volunteers took part. After a 3 week pre-experimental period of intense oral hygiene, the participants refrained from all oral hygiene for 14 days. The buccal surfaces of cuspids and bicuspids on one side of the jaws were treated with a 1% aqueous solution of delmopinol hydrochloride (applied with a paint brush) 2 × a day for 7 days, while the contralateral side received placebo solution. On day 7, the application procedures were changed m that the test compound was applied on the teeth previously treated with placebo and vice versa. Plaque development was assessed clinically and by photo-based planimetric determination. The clinical recordings revealed that 89.3% of the placebo-treated surfaces displayed visible plaque on day 7, compared to 6.0% of the delmopinol hydrochloride treated surfaces. Delmopinol hydrochloride treatment of the previously placebo-treated surfaces resulted in a decrease in the number of surfaces with visible plaque from 89.3% on day 7 to 6% on day 14. These results were confirmed by the planimetric data. No significant change in the composition of the mucosal flora was observed during the experimental period. The present results indicate that delmopinol hydrochloride markedly reduces the formation of dental plaque on a clean tooth surface exposed to conditions which favour bacterial colonization. Furthermore, the substance appears to possess plaque-dissolving properties.     

6-month use of 0.2% delmopinol hydrochloride in comparison with 0.2% chlorhexidine digluconate and placebo (II). Effect on plaque and salivary microflora

Abstract. This double-blind, randomised, 6-month clinical trial with parallel group design in 68 subjects with gingivitis was conducted to study the effects on the oral flora of delmopinol hydrochloride 2 mg/ml (0.2% w/v, Decapinol Mouthwash), when used for partly supervised mouthrinsing in comparison with placebo and chlorhexidine digluconate 2 mg/ml (0.2% w/v, Hibitane Dental, ICI Pharmaceuticals, UK). Apart from estimating the total cultivable microbial dental plaque flora and salivary flora, analyses were focused on bacterial groups associated with gingivitis/periodontitis and dental caries. Furthermore, the presence of staphylococci, Gram-negative enteric bacteria and yeasts in saliva were evaluated. The minimal inhibitory concentration (MIC) was determined for isolates belonging to the predominating micro-organisms in samples of both dental plaque and saliva. In relation to the findings in the placebo group, the use of delmopinol during the rinsing period did not produce an undesirable shift in the bacterial populations considered to be related to dental caries or periodontal diseases. These groups remained virtually unchanged during the study. In relation to the observations in the placebo group, slight reductions in the total cultivable plaque and salivary flora were observed during the study and no change was found in the ratio total anaerobically/aerobically cultivable microbial flora. Furthermore, no increased growth in staphylococci, enteric bacteria or yeasts was observed in the saliva samples. The pattern of changes taking place in the composition of the plaque and salivary microbial flora in samples from the participants rinsing with chlorhexidine were in most aspects similar to that observed in the delmopinol group. In the delmopinol group, no microbiologically significant changes were observed over time in the MIC-values for the isolates, neither in the plaque nor in the saliva samples, which indicates that no adaptation to delmopinol had taken place during the rinsing period. Similar observations were made for the plaque isolates in samples from the participants in the chlorhexidine group. On the other hand, when Gram-positive and catalase-negative cocci from the saliva samples of the latter group were tested against chlorhexidine, 4–6 times higher MIC-values were obtained at 3 and 6 months both when compared to baseline and in comparison with the other two rinsing groups (p<0.01 or p<0.05). Neither delmopinol nor chlorhexidine showed any residual effect on the studied microbial groups in the plaque and the saliva samples 3 months after the end of treatment. In conclusion, delmopinol was accompanied by a composition of the plaque and salivary flora associated with healthy conditions in the oral cavity.     

Microbiology of early supragingival plaque development after delmopinol treatment

The aim of this double blind, cross-over, microbiological study was to compare the effect of topical application of the plaque control agent 0.5% delmopinol HCl with placebo on early supragingival plaque formation. Six subjects underwent 7 periods (0.5, 1, 2, 8 and 24 h and 3 and 7 days) of placebo and delmopinol application, respectively. At the start of each study period the teeth were professionally cleaned and 2 ml of placebo and delmopinol 0.5%, respectively, were applied on all teeth (twice daily for periods lasting 24 h or more). At the end of each period, supragingival plaque samples of one upper and one lower buccal tooth surface were collected separately and cultured on anaerobically incubated Brucella blood agar, on aerobically incubated blood agar and on selective media for the enumeration of Streptococcus spp., Haemophilus spp., Actinomyces spp., Veillonella spp., Neisseria spp. and Fusobacterium spp. The total anaerobic cultivable microflora after delmopinol use was 10–100 times lower than after placebo use. Compared with placebo, the proportion of cultivable aerobes (61.3%), Streptococcus spp. (104.8%) and Haemophilus spp. (82.3%) increased and the proportion of Actinomyces spp. (86.1%), Veillonella spp. (60.5%), Neisseria spp. (96.9%) and Fusobacterium spp. (60.6%) decreased after 7 days. Short-term application of 0.5% delmopinol HCl on supragingival dental plaque regrowth resulted in a reduction of the number of cultivable microorganisms in the plaque and produced a shift in the cultivable plaque composition.     

Effect of Listerine® on dental plaque and gingivitis

abstract — The present study was performed in 10 adults in order to evaluate the effect of an antiseptic mouthrinse (Listerine®) on the rate of dental plaque formation and gingivitis development during a 2-week period when all efforts towards active mechanical oral hygiene were withdrawn. The study was performed as a crossover study and was carried out during four consecutive 2-week periods. During the first and third periods (preparatory periods) the participants were subjected to repeated professional tooth cleanings in order to establish plaque- and gingivitis-free dentitions. During the second and fourth periods (test and control periods) the participants were not allowed to brush their teeth but rinsed their mouths three times a day with Listerine or a placebo mouthwash. Plaque Index, Gingival Index, gingival fluid flow, and crevicular leukocytes were assessed on d 0, 2, 4, 7, and 14. On d 7 and 14, dental plaque was removed from the right and left jaws respectively and the wet weights determined. The chemotactic activity elaborated by the plaques was studied in Boyden chambers. During the Listerine test period, significantly lower Plaque and Gingival Index values were scored and lower amounts of plaque could be sampled in comparison to the control period.     

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.     

Scanning electron microscopic observations of early plaque formation in vivo on enamel specimens treated with delmopinol

Abstract The aim of this double blind, cross-over, scanning electron microscopic (SEM) study was to compare the effect of topical application of 0.5% delmopinol HCl (aqueous solution) with placebo on early supragingival plaque formation on enamel specimens attached to a maxillary premolar. 3 subjects underwent 2 × (placebo and delmopinol treatment, respectively) 7 treatment periods (1/2, 1, 2, 8, 24 hours; 3, 7 days) of undisturbed dental plaque accumulation, during which 2 ml of placebo and delmopinol HCl 0.5%, respectively, were applied topically to all teeth 2 × daily. At the end of each period, the specimen was retrieved and processed for SEM. For the specimens obtained after 24 h or less, the number of visible micro-organisms was estimated. For the 3- and 7-day specimens, the area covered by plaque was calculated planimetrically. Large inter-individual differences were observed in the number of bacteria attaching during the first 24 h, with apparently no major differences between delmopinol and placebo. 1 subject showed a bacterial colonization predominated by curved rods throughout the first 8 h. Compared to placebo, the area of the specimens covered by plaque was reduced after 3 and 7 days of delmopinol use, with coccoid cells as the predominant morphotype. Plaque maturity, characterized by the appearance of corncob formations and high numbers of different morphotypes, was not observed on the delmopinol specimens, in contrast to the placebo specimens. The study shows that topical application of 0.5% delmopinol HCl delays and interferes with dental plaque maturation.     

Effect of delmopinol on in vitro dental plaque formation, bacterial acid production and the number of microorganisms in human saliva

This study investigated the effect of a surface active compound, delmopinol, on plaque formation and established plaque in vitro, on the bacterial acid production from glucose and on the total viable bacterial counts in saliva. The antimicrobial effect was compared with that of chlorhexidine. The plaque-inhibiting effect was evaluated in an artificial mouth system, and the effect on bacterial acid production was registered as a decrease of pH in bacterial suspensions with various concentrations of delmopinol. It was shown that delmopinol is able to prevent plaque formation, to dissolve established plaque in vitro, and that it has 5-125 times higher minimum inhibitory concentrations than chlorhexidine. Saliva samples collected 1 min after rinsing with delmopinol showed on differences in the total number of bacteria in saliva as compared with controls. It was also shown that the bacterial acid production from glucose was reduced successively with increasing concentrations of delmopinol. The results indicate that delmopinol might be as effective as chlorhexidine against plaque formation and that delmopinol is capable of penetrating established plaque, thus promoting a more effective mechanical cleansing.     

Plaque formation and gingivitis after supervised mouthrinsing with 0.2% delmopinol hydrochloride, 0.2% chlorhexidine digluconate and placebo for 6 months

OBJECTIVES AND METHODS: A double-blind, randomized, 6-month clinical trial with parallel group design in 162 patients with gingivitis divided into three rinsing groups was conducted in order to study the efficacy and safety of a flavoured solution of delmopinol hydrochloride 2 mg ml“‘ (0.2% w/v, Decapinol Mouthwash”^®) used for supervised mouthrinsing in one rinsing group, in comparison with chlorhexidine digluconate 2 mg ml^-1 (0.2% w/v, Hibitane Dental’^{a, b}) in a second rinsing group, and placebo in the third group. The criteria of the Plaque Index (PI) were used to assess plaque formation. Bleeding on probing (BOP) to the bottom of the pocket with a standard pressure was used as the primary gingivitis assessment. The occurrence of supragingival dental calculus and extrinsic tooth staining were also assessed. In addition, patients were asked to report adverse events at each visit. RESULTS: Delmopinol and chlorhexidine exhibited lower scores of the mean PI and the BOP percentage than placebo, both at the 3-month and 6-month examinations. Furthermore, both active solutions showed a higher extent of staining of the teeth than placebo during these two observation periods. Rinsing with chlorhexidine resulted in more dental calculus than placebo after 6 months. Chlorhexidine showed lower scores for plaque formation and gingivitis development but higher scores of supragingival dental calculus (after 6 months) and tooth staining than did delmopinol. Both active solutions were reported by the patients–approximately to the same extent but more frequently than placebo–to induce taste alterations and a transient anaesthetic sensation of the oral mucosa. However, subjective staining of the teeth and tongue was reported by 16% of the delmopinol patients, but by 86% of the patients rinsing with chlorhexidine for 6 months. Furthermore, 24% of the patients in the chlorhexidine group, 9% in the delmopinol group and 4% in the placebo group wished to withdraw from treatment. CONCLUSIONS: The results from this clinical trial indicate that supervised rinsing with 0.2% delmopinol hydrochloride or with 0.2% chlorhexidine digluconate twice daily for 60 s as a supplement to normal mechanical oral hygiene procedures resulted in less plaque formation and gingivitis than rinsing with placebo. Although chlorhexidine was more effective than delmopinol regarding plaque formation and gingivitis, it was considered by the patients as less tolerable.     

The effect of 3 mouthrinses on plaque and gingivitis development.

The aim of this study was to evaluate the effect of 3 mouthrinses, Listerine Antiseptic (thymol), Peridex (chlorhexidine), Perimed (povidone iodine and hydrogen peroxide), and a placebo (water) on the development of dental plaque and gingivitis, when used as the only oral hygiene procedure for 14 days. 71 subjects were entered into a randomized, double-blind study. At the baseline examination, papillary bleeding score (PBS), and plaque index (PI) were registered, after which subjects received supragingival prophylaxis and were assigned to 1 of 4 study cells. Subjects were asked to refrain from all oral hygiene procedures except for the supervised 14-day 2 x daily rinsing with the assigned preparation. At day 14, the same clinical parameters were again registered. Statistical analysis was performed by a one-way analysis of variance (ANOVA) to compare the 4 groups, followed by Duncan's multiple range test to determine specific group differences. At baseline, average PBS and PI scores were similar for all 4 groups. After 14 days, the average PBS for Peridex and Perimed was significantly lower than for Listerine Antiseptic and water. The frequency of interdental units with a PBS greater than 2 was significantly lower for Peridex and Perimed than for Listerine Antiseptic and water. We concluded that both Peridex and Perimed were effective in reducing plaque and gingivitis when used as a 2 x daily mouthrinse by subjects refraining from other oral hygiene procedures. In vitro, a synergistic effect was assumed when inhibition was achieved with Perimed at the same or greater dilution than was achieved with povidone-iodine alone.     

A comparison of delmopinol and chlorhexidine on plaque regrowth over a 4-day period and salivary bacterial counts

Delmopinol has been considered as a potential agent for the chemical control of plaque. The aims of these studies were to measure the effects of a 0.2% delmopinol hydrochloride mouthrinse on (1) plaque reformation and (2) salivary bacterial counts. Comparisons were made with a 0.2% chlorhexidine rinse and a placebo rinse. A group of 12 male volunteers took part in the plaque study which was of a double blind, randomised, 3 cell, cross-over design. From a zero plaque baseline subjects rinsed, 2x a day, under supervision, for 1 min with 10-ml volumes of the allocated rinse. After 4 days, during which no other form of oral hygiene was performed, plaque was scored by area and index. Plaque results were significantly lower with chlorhexidine and delmopinol compared with control, and with chlorhexidine compared to delmopinol. Side-effects with delmopinol were transient tingling and numbness of the tongue in some subjects. A 2nd group of 12 male volunteers received single, 1-min rinses of the 3 formulations. Salivary bacterial counts were determined immediately before and up to 420 min after rinsing. Compared to the control rinse, chlorhexidine significantly reduced bacterial counts of 420 min. Delmopinol produced a small reduction in bacterial counts which was only significantly different from control at one time point. Delmopinol deserves further evaluation as a chemical plaque inhibitor, particularly when used as an adjunct to normal toothcleaning.     

Effect of two new chlorhexidine mouthrinses on the development of dental plaque, gingivitis, and discolouration. A randomized, investigator-blind, placebo-controlled, 3-week experimental gingivitis study

OBJECTIVE: The aim of this experimental gingivitis study was to assess the efficacy and safety of two new chlorhexidine (CHX) mouthrinses. MATERIAL AND METHODS: Ninety volunteers participated in this investigator-blind, randomized, clinical-controlled trial in parallel groups. During the treatment period, no oral hygiene measures except rinsing with non-alcoholic 0.2% CHX or 0.2% CHX/0.055% sodium fluoride mouthrinses, a positive control, or a negative control were permitted. The primary parameter was the gingival index; the secondary parameters were plaque index, discolouration index, and bleeding on probing. Clinical examinations were conducted 14 days before the start of the study, at baseline, and after 7, 14, and 21 days. The two sample t-test, anova, and ancova were used for the statistical analysis. RESULTS: No difference in efficacy was found between the two new CHX formulations and the positive control. On day 21, statistically significantly less gingival inflammation and plaque accumulation compared with placebo were observed. Besides discolouration and taste irritations, no adverse events were recorded. CONCLUSION: The two new CHX mouthrinses were able to inhibit plaque re-growth and gingivitis. Neither the omission of alcohol nor the supplementation with sodium fluoride had weakened the clinical efficacy of CHX with respect to the analysed clinical parameters.