The effect of single morning and evening rinses of chlorhexidine on the development of tooth staining and plaque accumulation. A blind cross-over trial

Departments of Periodontology, Dental School, Welsh National School of Medicine, Heath Park, Cardiff, South Wales and the University of Bristol Dental School, Lower Maudlin Street, Bristol, England
Journal Of Clinical Periodontology (Impact Factor: 4.01). 04/1982; 9(2):134-40. DOI: 10.1111/j.1600-051X.1982.tb01229.x
Source: PubMed


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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    • "Controlled-release antimicrobial delivery systems have also been tested as monotherapies, independent of scaling and root planing (SRP) [12,14,18–21] or in combination with mechanical debridement as adjunctive therapies [9–11,13,15,19,22–25]. Chlorhexidine is an effective antiplaque agent [26] though a drawback of chlorhexidine is pigmentation of teeth and oral tissues [27] [28] Some clinical trials have shown that the application of chlorhexidine has not significantly improved periodontal parameters [29] [30], but PD has been significantly reduced by subgingival irrigation with 1% CG [31] [32] [33], which may have a role in the management of persistent pockets during chronic periodontitis. The effects of a single intrasulcular injection of 2% CG on the treatment of gingivitis in orthodontic patients wearing fixed appliances have not been evaluated. "
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    ABSTRACT: Objectives The purpose of this study was to compare the short-term clinical effects of a single intrasulcular injection of 2% chlorhexidine gluconate gel (CG) and placebo gel (PG) in orthodontic patients with fixed appliances and established gingivitis aged from 12 to 20 years.Methods and materials50 patients (31 females and 19 males) as subjects were divided into two groups (CG and PG). This study was single-blind randomized split mouth clinical trial. As randomly assigned by coin toss, the first permanent molars on the right or left side of the mouth received either CG or PG. Probing depth (PD) was measured with a Michigan 0 probe. The gingival index (GI) of Löe and Silness and papilla bleeding index (PBI) of Mühlemann were recorded on the first permanent molars. These indices were measured at baseline, and in treatment on 2nd, 4th, 8th, and the 12th weeks. t-Test and Chi-square test were used to analyze the data.Resultst-Test showed that PD was reduced in experimental group in comparison with the control group in the 4th week and following intervals (p < 0.001). Chi-square showed that PBI was improved in experimental group in comparison with the control group in the 2nd week and following intervals (p < 0.001). The same test showed that GI was improved in experimental group in the 2nd week and following intervals (p < 0.001).Conclusion The data indicate that the use of a single application of 2% CG was effective in reducing gingivitis related to banded first permanent premolars in adolescents undergoing orthodontic treatment in short time.
    Orthodontic Waves 12/2008; 67(4):162-166. DOI:10.1016/j.odw.2008.07.001
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