The effect of single morning and evening rinses of chlorhexidine on the development of tooth staining and plaque accumulation. A blind cross-over trial.
ABSTRACT A dietary aetiology for tooth staining associated with the use of chlorhexidine has been postulated. The time related activity of chlorhexidine would therefore suggest that evening rinsing would result in less staining than morning rinsing. This study measured tooth and tongue staining and plaque accumulation in a group of 18 volunteers, rinsing once at night or once in the morning with chlorhexidine in a blind cross-over design. Beverage intake during two 10-day periods was prescribed. Significantly more tooth staining, but not tongue staining, was seen with morning rinsing. Plaque accumulation showed a trend to more plaque with morning rinsing, which was not significant. The findings would be consistent with a dietary aetiology for tooth staining. However, these results emphasise the considerable duration of activity of chlorhexidine on surfaces in the oral cavity and the theory of progressive desorption of chlorhexidine from the tooth surface is questioned.
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ABSTRACT: Objetivos: el propósito de este estudio fue evaluar la posibilidad de reducir la caries de fisura en las caras oclusales de los primeros molares permanentes, a través de barnices antimicrobianos, en escolares con alta incidencia de caries. Se ha realizado un ensayo clínico aleatorio a doble ciego. Sujetos: 42 niños saludables con edades comprendidasentre los 6 y 8 años, con alto riesgo de caries, fueron seleccionados en un colegio de Madrid. Para ser incluidos en el estudio cada niño debería tener como mínimo dos primeros molares permanentes sanos, y presentar caries en dentina en sus molares temporales. Métodos: después de la profilaxis dental, el grupo de estudio se le aplicabaun barniz de clorhexidina 1% y timol 1% (Cervitec), y al grupo control un barniz deplacebo. El barniz era colocado sobre todos los dientes (dentición temporal y permanente) cada tres meses (al inicio a los 3, 6 y 9 meses) y el incremento de caries era comparado a los 12 meses. Resultados: al inicio del estudio no habían diferencias entre los grupos. Al año existia una diferencia significativa entre el grupo de estudio y el de control, en CAO-D P=0,000, CAO-S P=0,000 (en los primeros molares permanentes). Conclusión: la aplicación de Cetvitec cada 3 meses, es efectiva previniendo la caries en los primeros molares permanentes de escolares con alta actividad de caries.
Article: UNIVERSIDAD COMPLUTENSE DE MADRID
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ABSTRACT: The aim of this study was to determine the effect of pulsing chlorhexidine gluconate, at concentrations commonly used in mouthwashes, on Streptococcus sanguis biofilms and microcosm dental plaques in vitro. Biofilms were grown on bovine enamel and nutrients were supplied in the form of artificial saliva. Pulsing experiments were carried out on steady-state biofilms using 0.05 or 0.2% chlorhexidine solutions delivered twice daily for 1 min. In a separate study, the enamel discs on which the biofilms were formed were pre-treated with chlorhexidine and pulsed directly after inoculation and then at regular intervals. With both concentrations of chlorhexidine used, a c.2 log10 reduction in the viable counts of S. sanguis was achieved with the initial pulse, but as pulsing continued, the bacterial population recovered, albeit not to the previous level. A c.1 log10 reduction in the total viable counts of the microcosm plaques was seen after the first pulse with 0.2% chlorhexidine. The total count then recovered rapidly and, after the fifth pulse, the total viable counts were not significantly different from those before pulsing. The total counts then remained at a similar level throughout the course of the experimental runs. Pre-treatment of the enamel discs with 0.2% chlorhexidine before inoculation produced viable counts of c.10(5) cfu/mm2, a 1 log10 reduction compared with untreated discs. After pulsing with 0.2% chlorhexidine at 8 h, a 3 log10 reduction was seen in the total aerobic and anaerobic counts, but again the viable counts subsequently increased despite twice-daily chlorhexidine pulsing. Regardless of the nature of the biofilm, pulsing initially achieved substantial kills, but the viability of the biofilms subsequently increased despite continued pulsing. Chlorhexidine was effective at reducing the viability of microcosm plaques when it was applied to the substratum before exposure to bacteria and subsequently pulsed on to the biofilms.Journal of Antimicrobial Chemotherapy 11/1998; 42(4):453-9. · 5.34 Impact Factor