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The effect of cetylpyridinium chloride on halitosis and periodontal disease-related parameters in dogs
Abstract
Periodontal disease is an oral disease common in middle-aged dogs and cats, with halitosis being the most common sign. There
are many commercial products containing chlorhexidine, cetylpyridinium chloride (CPC), zinc salts and essential oils for controlling
halitosis and periodontal disease. CPC is a quaternary ammonium compound and has a broad spectrum antimicrobial activity.
In this study, oral spray (OS) and gel (OG) containing CPC was applied to the dogs’ teeth twice daily for 3 weeks, and their
effect in controlling periodontal disease and halitosis was examined. In the 3-week study, OS and OG were significantly effective
in controlling plaque, calculus, and halitosis. Therefore, the OS and OG containing CPC were effective in controlling periodontal
disease and halitosis in dogs.
... Another chemical product described as effective in reducing calculus, dental plaque, halitosis, and gingivitis is cetylpyridinium chloride [25,48]. This compound is a cationic quaternary ammonium with broad spectrum activity that acts by disruption of the bacterial membrane [25]. ...
... There have been few studies investigating this molecule in dogs. However, Kim and collaborators (2008) showed that cetylpyridinium chloride was able to promote a reduction in dental plaque accumulation, calculus formation, and halitosis in dogs [48]. ...
Periodontal disease (PD) is one of the most prevalent oral inflammatory diseases in dogs. PD onset begins with the formation of a polymicrobial biofilm (dental plaque) on the surface of the teeth, followed by a local host inflammatory response. To manage this disease, several procedures focusing on the prevention and control of dental plaque establishment, as well as on the prevention of local and systemic PD-related consequences, are essential. The removal of dental plaque and the inhibition of its formation can be achieved by a combination of dental hygiene homecare procedures including tooth brushing, the application of different oral products and the use of specific diet and chew toys, and regular professional periodontal procedures. Additionally, in some cases, periodontal surgery may be required to reduce PD progression. Associated with these measures, host modulation therapy, antimicrobial therapy, and other innovative therapeutic options may be useful in PD management. Moreover, PD high prevalence and its relation with potential local and systemic consequences reinforce the need for investment in the development of new preventive measures, treatments, and oral procedures to improve the control of this disease in dogs. Knowledge on the specific guidelines and diversity of the available products and procedures are fundamental to apply the most adequate treatment to each dog with PD.
... Its method of action is by penetrating the cell membrane of oral bacteria, causing cell leakage and disruption of bacterial metabolism thus inhibiting cell growth. 70 This treatment is not without side effects, however, such as causing abnormal taste sensation and long-term use can result in reversible staining of teeth and mucosal surfaces. A study using a dog model indicated that cetylpyridinium chloride could be used to effectively control plaque and calculus, but these results should be interpreted with caution because human tolerance of chemicals may differ from that of animals. ...
... A study using a dog model indicated that cetylpyridinium chloride could be used to effectively control plaque and calculus, but these results should be interpreted with caution because human tolerance of chemicals may differ from that of animals. 70 Chlorhexidine and cetylpyridinium chloride are both compounds effective in reducing halitosis. A Cochrane review has found that mouthwashes with formulations of both compounds attained the best results in reducing the concentrations of VSCs found in expelled air and salivary bacterial counts. ...
Halitosis, an offensive breath odour, has multiple sources and negative impacts on people’s social interactions and quality of life. It is important for health care professionals, including general physicians and dental professionals, to understand its etiology and risk factors in order to diagnose and treat patients appropriately. In the study, we have reviewed the current literature on halitosis regarding its prevalence, classification, risk factors, sources, measurement, and treatment.
... Multiple methods for antimicrobial delivery, including dental hygiene chews, medications including antimicrobials such as clindamycin, and compounds such as chlorhexidine, cetylpyridinium chloride, and essential oils, have been used in studies of dogs. 7,8 Similar to results of studies in humans, professional dental cleaning to decrease biofilms and remove calculus has also been found to decrease halitosis in dogs. 9 The challenge is to maintain an acceptable amount of malodor for animals that do not have the ability to practice oral hygiene and that consume diets that could include a wide range of substances. ...
... Commercial antimicrobial products can be alcohol-based antiseptic mouth rinses that kill gram-negative microorganisms and hence reduce oral odor. 8 However, these can have harsh overall effects. Although chlorhexidine appears to be clinically effective, it is not an agent that should be used routinely or for long periods, especially considering that it can stain teeth. ...
Objective:
To evaluate the effectiveness of a topically applied gel containing essential oils (menthol and thymol) and polyphenolic antioxidants (phloretin and ferulic acid) for reducing halitosis in dogs.
Animals:
20 dogs.
Procedures:
A blinded crossover clinical trial was conducted. Dogs received a dental cleaning and examination (periodontal examination including periodontal probing and assessments of plaque, calculus, and gingivitis). Owners then applied a gel (active or placebo) to oral soft tissues twice daily for a 4-week period. Teeth of the dogs were cleaned again, and owners applied the other gel for a 4-week period. Clinicians scored halitosis immediately after the initial cleaning and at 4 and 8 weeks, and owners scored halitosis weekly.
Results:
Halitosis assessment by clinicians revealed that both groups had improvement in halitosis scores. Two dogs were removed because of owner noncompliance. In the active-to-placebo group (n = 9), halitosis was significantly reduced during application of the active gel but increased during application of the placebo. Seven of 9 owners reported increased halitosis when treatment was changed from the active gel to the placebo. In the placebo-to-active group (n = 9), halitosis decreased during application of the placebo and continued to decrease during application of the active gel. Seven of 9 owners reported a decrease in halitosis with the active gel.
Conclusions and clinical relevance:
An oral topically applied gel with essential oils and polyphenolic antioxidants applied daily after an initial professional dental cleaning decreased oral malodor in dogs.
... Additionally, zinc chloride has been shown to mitigate halitosis by eliminating oral anaerobic bacteria [17]. Chlorhexidine, which is frequently used as a disinfectant in dental clinics, kills bacteria when applied to tooth enamel or the salivary pellicle and is widely used as a disinfectant in patients with periodontitis and to minimize halitosis [18]. Unfortunately, these strategies are not specific to harmful oral microorganisms or have a short period of action, making lasting effects difficult to achieve [19]. ...
Background
Lactobacillus spp. have been researched worldwide and are used in probiotics, but due to difficulties with laboratory cultivation of and experimentation on oral microorganisms, there are few reports of Lactobacillus spp. being isolated from the oral cavity and tested against oral pathogens. This research sought to isolate and determine the safety and inhibitory capabilities of a Lactobacillus culture taken from the human body .
Results
One organism was isolated, named “ L. gasseri HHuMIN D”, and evaluated for safety. A 5% dilution of L. gasseri HHuMIN D culture supernatant exhibited 88.8% inhibition against halitosis-producing anaerobic microorganisms and the organism itself exhibited powerful inhibitory effects on the growth of 11 oral bacteria. Hydrogen peroxide production reached 802 μmol/L after 12 h and gradually diminished until 24 h, it efficiently aggregated with P. catoniae and S. sanguinis , and it completely suppressed S. mutans -manufactured artificial dental plaque. L. gasseri HHuMIN D’s KB cell adhesion capacity was 4.41 cells per cell, and the cell adhesion of F. nucleatum and S. mutans diminished strongly in protection and displacement assays.
Conclusion
These results suggest that L. gasseri HHuMIN D is a safe, bioactive, lactobacterial food ingredient, starter culture, and/or probiotic microorganism for human oral health.
... Topical (19)(20)(21)(22) or pill (5) administration of various antimicrobials reduced halitosis levels in dogs. ...
... That possibility could be investigated in studies of the effects on oral health of chlorhexidine (a well-known antimicrobial), which reportedly helps prevent plaque but not gingivitis, 17 thereby supporting the notion that the mechanical or chewing effect is more important than the chemical effect. In contrast, cetylpyridinium chloride, a quaternary ammonium compound, controls dental plaque and halitosis when applied to the mouths of dogs in gel or spray form twice a day, 40 demonstrating that a chemical effect is possible without a mechanical or chewing effect. ...
OBJECTIVE To determine whether consumption of a single dental treat with specific mechanical properties and active ingredients would provide a 24-hour effect on dental plaque bacteria and halitosis in dogs.
ANIMALS 10 dogs of various breeds from a privately owned colony that had received routine dental scaling and polishing 4 weeks before the study began.
PROCEDURES Dogs were randomly assigned to receive 1 placebo or dental treat first. A 4-week washout period was provided, and then dogs received the opposite treatment. Oral plaque and breath samples were collected before and 0.5, 3, 12, and 24 hours after treat consumption. Volatile sulfur compounds (VSCs) concentration was measured in breath samples. Total aerobic, total anaerobic, Porphyromonas gulae, Prevotella intermedia–like, Tannerella forsythia , and Fusobacterium nucleatum bacterial counts (measured via bacterial culture) and total live bacterial counts, total live and dead bacterial counts, and bacterial vitality (measured via quantitative real-time PCR assay) were assessed in plaque samples.
RESULTS Compared with placebo treat consumption, dental treat consumption resulted in a significant decrease in breath VSCs concentration and all plaque bacterial counts, without an effect on bacterial vitality. Effects of the dental treat versus the placebo treat persisted for 12 hours for several bacterial counts and for 24 hours for breath VSCs concentration.
CONCLUSIONS AND CLINICAL RELEVANCE Although clinical benefits should be investigated in larger scale, longer-term studies, results of this study suggested that feeding the evaluated dental treat may help to decrease oral bacterial growth in dogs for 12 hours and oral malodor for 24 hours. A feeding interval of 12 hours is therefore recommended.
Periodontal disease in dogs is common. Client compliance with oral hygiene and oral care for pets is low. The gold standard is annual dental prophylaxis under general anesthesia with imaging followed by home care including daily brushing. Clients should be offered methods to reduce calculus, plaque, gingivitis, and resulting halitosis that are time efficient, cost-effective, and easy to administer between annual preventative dental prophylaxis with the goal to move into maintenance phase of managing periodontal disease. This study aimed to evaluate the efficacy of a honeycomb-shaped dental chew in reducing hardened calculus, plaque, gingivitis, and malodor in client-owned dogs in their normal home environment including various breeds, skull types, ages, and weights. Calculus, plaque, and gingival scores with volatile sulfur compounds readings were performed under sedation and evaluated under general anesthesia after 60 consecutive days of receiving a daily honeycomb-shaped dental chew treat. There was an overall statistically significant percentage reduction of calculus (26.6%), plaque (14.2%), and malodor (46.71%). Gingival scores did not demonstrate statistically significant reduction (0.99%). Use of this honeycomb-shaped daily dental chew significantly reduced calculus, plaque, and associated malodor in dogs when fed consecutively for 60 days.
Background
Specific probiotic bacteria may have inhibitory effects against oral pathogens. Lactobacillus spp. have been researched worldwide and are used in probiotics, but due to difficulties with laboratory cultivation of and experimentation on oral microorganisms, there are few reports of Lactobacillus spp. being isolated from the oral cavity and tested against oral pathogens. This research aimed to determine the safety and inhibitory impacts of L. gasseri HHuMIN D as a potential oral probiotic with biotherapeutic capabilities against oral pathogens.
Results
The microbial and genetic characteristics of L. gasseri HHuMIN D were evaluated in this research. A 5% dilution of L. gasseri HHuMIN D culture supernatant exhibited 88.8% inhibition against halitosis-producing anaerobic microorganisms and L. gasseri HHuMIN D exhibited powerful inhibitory effects on the growth of every harmful oral bacterium tested. Unfortunately, other oral bacteria affected the growth of L. gasseri HHuMIN D, suggesting a poor proliferative response to most co-cultures. Hydrogen peroxide production by L. gasseri HHuMIN D reached 802 µmol/L after 12 hours and gradually diminished until 24 hours. It efficiently aggregated with P. catoniae and S. sanguinis, and completely supressed S. mutans-manufactured artificial dental plaque. L. gasseri HHuMIN D’s KB cell adhesion capacity was 4.41 cells per cell, and the cell adhesion of F. nucleatum and S. mutans diminished strongly in protection and displacement assays. L. gasseri HHuMIN D was evaluated for safety using ammonia and biogenic amine development, hemolytic property and mucin degradation testing, antibiotic susceptibility, and whole genome sequencing (WGS).
Conclusion
Our results suggest that L. gasseri HHuMIN D may be a safe, bioactive, lactobacterial food ingredient, starter culture, and/or probiotic microorganism for human oral health.
Dental disease is extremely prevalent among dogs and it is essential that it is prevented because it affects health and quality of life. Many factors including breed, genetics, age, weight and systemic diseases can increase the chances of getting dental disease. Owner compliance and a lack of education in dental disease is also a key factor contributing to poor oral health. However, educating owners on the importance of preventing dental disease is crucial to prevention and professional cleaning, daily tooth brushing, dental chews and dry food can all significantly improve dental health.
Současná moderní farmakoterapie sliznice ústní dutiny se zaměřuje na co nejcílenější léčbu a odstraňování vyvolávající příčiny onemocnění. Důležitou a nedílnou součástí velkého množství léčebných postupů však stále zůstává mírnění pro pacienta nepříjemných projevů spojených s propuknutím ústní choroby. Moderním tren-dem poslední doby je i vývoj nových lékových forem, jejichž cílem je zvyšování pacient compliance pomocí zlepšeného komfortu užívání, mír-nění nežádoucích účinků nebo zjednodušování aplikačního schématu (obrázek 1). Lokální antiseptika Jedná se o pomocná léčiva při terapii bak-teriálních zánětlivých onemocnění ústní sliznice a dásní. Dále se užívají k léčbě zánětlivých one-mocnění dýchacích cest, která jsou doprovázená bolestí v krku. Antiseptika ze skupiny tenzidů Řadu látek ze skupiny lokálních antiseptik lze zařadit mezi povrchově aktivní. Jejich účinek je podmíněn inhibicí růstu mikroorganizmů a také zásahem do autolytických mechanizmů buňky. Největší počet zástupců této skupiny patří me-zi tzv. kvarterní amoniové soli, které se obecně skládají z pozitivně nabité hydrofilní aminové skupiny a dlouhého hydrofóbního alkylového řetězce. Působí inhibičně na růst grampozitiv-ních i gramnegativních baktérií, dále na houby, kvasinky a také na některé prvoky. Mají schop-nost vázat se na proteiny a nukleové kyseliny, narušují integritu membrán a tím způsobují prosakování intrabuněčného obsahu. U někte-rých mikroorganizmů, které jsou schopné využí-vat tato léčiva jako jediný zdroj energie a uhlíku, se může vyvinout plazmidy zprostředkovaná rezistence (1, 2).
Virová onemocnění s projevy erozivního charakteru Infekce způsobené virem Herpes simplex V orofaciální oblasti se většinou uplatňuje podtyp 1 tohoto viru. Primární infekce nastává obvykle v dětském věku a nejčastěji se projevuje puchýřkovitými lézemi, vyskytujícími se kdekoliv v ústní dutině. Často dochází k jejich praskání za vzniku bolestivých, 1–2 mm širokých, ostře ohraničených vřídků se zarudlým okrajem, které mohou splývat a vytvářet tak rozsáhlé mapovité léze. Pro primární infekci je typická také gingi-vitida. K dalším projevům patří zvýšená teplota a malátnost, doprovázené bolestivým zduřením podčelistních uzlin. Léze obvykle samy ustoupí během jednoho až dvou týdnů. Asi třetina naka-žených jedinců je náchylná k rekurentním infek-cím, způsobeným virem přežívajícím v latentní formě v trigeminálním ganglionu. Nejčastější je v tomto případě postižení rtů nebo-li herpes labialis. V počátku se vyskytuje pálivá a bodavá bolest, následuje výsev puchýřků, které časem praskají a vytvářejí krustu. Spouštěčem může být nachlazení, vystavení slunci, menstruace nebo stres (1, 2, 3). Bez medikamentózního zásahu dochá-zí ke spontánnímu zahojení projevů obvykle v rozmezí jednoho až dvou týdnů. Orální projevy herpetické infekce se nejčastěji léčí symptoma-ticky antipyretiky a lokálními antiseptiky (genci-ánovou violetí). Cílená léčba spočívá v podávání virostatik v lokální formě, u imunodeficientních pacientů i celkově a v rámci prevence imuno-modulační léčba (1, 2, 3, 4). Plané neštovice (Varicella) a pásový opar (Herpes zoster) Obě choroby jsou vyvolávány virem Varicella zoster. Plané neštovice jsou vysoce in-fekční onemocnění vyskytující se u 90 % dětské populace. Onemocnění se projevuje výsevem svědících kožních puchýřků, přecházejících v ohniskové léze s krustou na povrchu v oblasti zad a hrudníku, výjimečněji i na obličeji, krku nebo v oblasti genitálií. V ústech se tvoří malé roztroušené nespecifické vřídky. Po prodělání akutní formy způsobuje virus latentní infek-ci, přetrvávající v neuronálních gangliích, kde může dojít k reaktivaci v podobě onemocnění označovaného jako Herpes zoster. Zvýšená incidence nastává nejčastěji od padesáti do sedm-desáti let. Ačkoliv se častěji projevuje na trupu, může k výsevu docházet i v orofaciální oblasti. Zprvu se objevuje jasně červená vyrážka, která se mění na puchýřky a poté na splasklé vřídky. Obvykle se vyskytuje pouze unilaterálně a je přesně ohraničená, což platí i pro výskyt přímo v dutině ústní. Fáze akutních projevů s ulcera-cemi trvá okolo týdne, ovšem problémem je častá přetrvávající silná bolestivost i po zhoje-ní viditelných projevů onemocnění, jež může u citlivých pacientů přejít až v postherpetickou neuralgii (2, 5, 6, 7). Léčba Herpes zoster probíhá pomocí der-matologik, analgetik a celkových antivirotik. V případě vzniku postherpetické neuralgie je léčba směřována k topické aplikaci přípravků s analgetickými účinky (lokální anestetika, kapsa-icin, nesteroidní antiflogistika atd.) a na zvládnutí neuralgické bolesti tricyklickými antidepresivy a antikonvulzivy, eventuálně i anodyny (5, 6).
To evaluate the efficacy of a novel toothpaste containing zinc ions and o-cymen-5-ol to reduce volatile sulfur compounds (VSCs) in in vitro models and to elucidate the mode of action for any activity observed.
Three models were employed, a chemical neutralisation model to evaluate the chemical reactivity of toothpaste slurries to VSCs, a biofilm perfusion model to measure activity in an orally-relevant biofilm and a planktonic bacterial model to measure antimicrobial effects.
The models showed that zinc ions were able to react chemically with hydrogen sulfide to remove this odorous component of halitotic breath. This activity was confirmed within a complex biofilm model, with over 90% of hydrogen sulfide removed from perfusate gas by a slurry of the test toothpaste.
This work provides a mode of action for the clinically observed reduction in VSCs seen for up to 12 hours post brushing with this novel toothpaste.
To evaluate the effects of two experimental cetylpyridinium chloride (CPC) mouthrinses containing 0.075% and 0.10% CPC on the development of gingivitis and plaque versus a placebo control over a period of 6 months.
This was a randomized, single center, parallel group, double blind, positive and placebo controlled clinical trial. A 0.12% chlorhexidine rinse served as the positive control for validation of the methodology. At the beginning of the trial, 366 subjects were balanced and randomly assigned to treatment groups. Subjects received a dental prophylaxis and began rinsing twice a day with 15 ml of their assigned mouthwash for 30 seconds after brushing their teeth. Subjects were assessed for gingivitis and gingival bleeding by the Löe-Silness Gingival Index method and plaque by the Turesky modification of Quigley Hein Plaque Index at baseline and after 3 and 6 months of product use. Oral soft tissue health was also assessed.
After 3 and 6 months, subjects rinsing with either 0.075% or 0.10% CPC had significantly (P< 0.0001) less gingivitis, gingival bleeding, and plaque, on average, than those on placebo. The 6-month mean reductions in gingivitis, gingival bleeding, and plaque for the 0.075% and 0.10% CPC rinses versus placebo were 23%, 30% and 17%, and 20%, 27% and 19%, respectively. There was no statistically significant difference in efficacy between the two CPC mouthrinses. Reductions at 3 months were similar to those seen at 6 months. Significant benefits were observed with chlorhexidine, thereby validating the study.
This study clearly demonstrates that CPC mouthrinses formulated to deliver therapeutic benefits when used twice daily can significantly prevent the development of gingivitis, gingival bleeding, and plaque over a 6-month period.
Forty-five mixed breed dogs were evaluated for the presence and extent of periodontal disease. Histopathology was performed on samples of lung, myocardium, liver, kidney, tonsil, spleen, submandibular lymph node and tracheobronchial lymph node. Mitral valves were evaluated grossly. Statistical analysis was used to deterimine if there was a relationship between the extent of periodontal disease and histopathologic changes in the tissues examined. In the forty-five dogs studied, an association was found between periodontal disease and histopathologic changes in kidney, myocardium (papillary muscle) and liver.
We investigated the effects ofFomitopsis pinicola extract on biological activity by examining the antioxidant and antitumor activityin vitro andin vivo. When theF. pinicola extract concentration was raised from 60 to 120 μg/mL, the DPPH scavenging rate increased from 50.3 to 88.2% and the superoxide
anion radical scavenging rate increased from 45.2 to 85.3% when theF. pinicola extract concentration was raised from 500 to 700 μg/mL. After incubatingF. pinicola extract for 12 h, the linoleic acid scavenging rate increased from 35.5 to 90.5%. A similar finding was observed for butylated
hydroxytoluene. The total phenolic content of theF. pinicola extracts were approximately 10- to 16-fold higher than what was observed in theP. nebrodensis andA. camphorate extracts. The glutathione production, using decoctions prepared fromF. pinicola, was 20.0 μM/g of liver, which corresponded to approximately 4.0-fold higher than the control. The glutathione peroxidase
activity was 8.3 U/mg of protein, which was approximately 2.8-fold higher than the activity level observed in the control
rat livers. The cell viability rates of all the human cancer cells, when 100 μg/mL of ethanol extract was used for the different
types of cancer cells, decreased with increasing extract concentrations in comparison to the hot water extract. In particular,
when HeLa and Hep3B cells were incubated with 1.000 μg/mL of methanol extract, the cell viability rates were 20 and 25%, respectively,
which was approximately 3.0-fold higher than what was observed for the hot water extract.
The objective of this study was to investigate the antitumor activity of suspension cultures of tea callus cells grown in
the presence of different concentrations of the growth regulator 2,4-dichlorophenoxy acetic acid (2,4-D) with or without light
irradiation. The methanol and ethanol extracts of precipitated cells (MEP, EEP) exhibited stronger inhibitory effects on the
growth of tumor cell lines than the water extract of precipitated cells (WEP) or the supernatant. Compared to culture under
dark conditions, exposure to light irradiation led to significantly higher antitumor activity. The MEP from light irradiated
cells at 250 μg/mL with 2.0 mg/L 2,4-D displayed more than 64% growth inhibition of HEP-2 cells, whereas normal cells showed
less than 25% growth inhibition. The some fractions of MEP obtained from Diaion HP-20 column chromatography displayed the
majority of inhibitory activity against the HEP-2 cell line. These results show that 2,4-D, and light stimulated the synthesis
of antitumor compounds.
The antioxidant activity of the extract ofErigeron annuus was assessed by means of two differentin vitro tests: bleaching of the stable 1,1-diphenyl-2-picrylhydrazyl radical (DPPH test) and the scavenging of authentic peroxynitrite
in company with peroxynitrite generation from 3-morpholinosydnonimine (SIN-1). In both tests, the 85% aq. MeOH andn-BuOH soluble fractions of the crude extract showed a significant scavenging effect on peroxynitrite and DPPH radical in comparison
to L-ascorbic acid. And bioassay-guided fractionation of then-BuOH soluble fraction led to the isolation of three compounds: Apigenin (1), quercetin-3-O-glucoside (2), and caffeic acid
(3). The structures of the isolated compounds were elucidated on the basis of their spectroscopic data and their antioxidant
activities were measured by determining their capacity to scavenge peroxynitrite and the DPPH radical.
Forty-five mixed breed dogs were evaluated for the presence and extent of periodontal disease. Histopathology was performed on samples of lung, myocardium, liver, kidney, tonsil, spleen, submandibular lymph node and tracheobronchial lymph node. Mitral valves were evaluated grossly. Statistical analysis was used to determine if there was a relationship between the extent of periodontal disease and histopathologic changes in the tissues examined. In the forty-five dogs studied, an association was found between periodontal disease and histopathologic changes in kidney, myocardium (papillary muscle), and liver.
A telephone questionnaire survey of owners of 51 dogs was conducted. All 51 dogs had had periodontal treatment at VHUP six months or more previously. At that time, they had received a tooth brush, dentifrice, instructions and a demonstrations of brushing. The owners were asked to brush the dogs' teeth once daily. At the time of survey, 53% of the clients were still brushing several times a week and 38% were no longer brushing at all.
In 28 dogs, oral malodor was assessed organoleptically (0-3 scale) and by measurement of volatile sulfur components (VSC), using two positions ('intraoral' and 'tooth surface') for sampling VSC. Significant correlations were found between: intraoral and tooth surface VSC collection positions (p < 0.0001) and between organoleptic and tooth surface VSC data (p < 0.0001). VSC measurement is a sensitive, repeatable and non-subjective method of assessing oral malodor in dogs.
Rarely is a chemical agent so effective with so few contra-indications as is chlorhexidine. It has many oral applications, the main ones being the control of plaque and gingivitis. Due to the constraints on oral hygiene in animals, its benefits and indications are especially appropriate to veterinary dental cases. Its full potential is not being realised.
The aim of this study was to evaluate the clinical and antibacterial properties of alcohol-free mouthrinses, an amine fluoride/stannous fluoride mouthrinse (ASF) and two triclosan solutions in comparison with a chlorhexidine and a placebo rinse.
In a double-blind, randomised 5-cell cross-over 4-day plaque regrowth study, 19 volunteers rinsed 2 x a day with 15 ml of each of the distributed solutions. Each test cycle was followed by a 10 days wash-out period. On day 0 of each test week, volunteers received a dental prophylaxis. Thereafter they refrained from all mechanical oral hygiene procedures for the next four days. Plaque regrowth was assessed daily by the plaque index and on day 4 by calculating the plaque area with a computer program after disclosure and photography of the front teeth. The vitality of the plaque was examined on days 1 to 4 by the vital fluorescence technique.
19 participants completed the study. Compared to the placebo the ASF solution showed 15.7% (p>0.5), 30.6% (p<0.001), 40.5% (p<0.001) and 44.7% (p<0.001) reductions on the consecutive days 14 in plaque index and a reduction of 61.9% in plaque area. The decrease of vitality of supragingival plaque was highly significant compared to placebo on every test day ranging between 30.9% and 36.6%. A reduction in plaque index from 19.4% (p<0.01) on day 2, 34.9% (p<0.001) on day 3 and 40.4% (p<0.001) on day 4 concommitant with a reduction in plaque area of 48.9% (p<0.001) was noted for alcohol-free chlorhexidine. Concerning the vitality chlorhexidine reduced the percentage of vital bacteria significantly on every day (16.0% to 24.9%). The reductions in mean plaque index for the 0.15% triclosan solution during the test period were 6.3%, 22.4%, 24.6% and 36% and in plaque area 41.8%. Vitality was significantly reduced at every day compared to placebo. Plaque Index reduction with the 0.02% triclosan increased from 15.3% (day 2) to 31.0% (day 4) and a reduction of 23.6% was seen in plaque area. A significant effect concerning the vitality of the plaque was only found at the first and the last day of the test cycle.
Alcohol-free mouthrinse solutions were shown to be effective in reducing both plaque accumulation and plaque biofilm vitality compared to a placebo solution.
Background:
Bad breath has a significant impact on our daily social life to those who suffer from it. The majority of bad breath originates within the oral cavity. However, it is also possible that it can come from other sources such as gastric-intestine imbalance. The term "oral malodor" is used to describe a foul or offensive odor emanating from the oral cavity, in which proteolysis, metabolic products of the desquamating cell, and bacterial putrefaction are involved. Recent evidence has demonstrated a link between oral malodor and adult periodontitis. The process of developing bad breath is similar to that noted in the progression of gingivitis/periodontitis. Oral malodor is mainly attributed to volatile sulfur compounds (VSC) such as hydrogen sulfide, methyl mercaptan and dimethyl sulfide. The primary causative microbes are gram-negative, anaerobic bacteria that are similar to the bacteria causing periodontitis. These bacteria produce the VSC by metabolizing different cells/tissues (i.e., epithelial cells, leukocytes, etc.) located in saliva, dental plaque, and gingival crevicular fluid. Tongue surface is composed of blood components, nutrients, large amounts of desquamated epithelial cells and bacteria, suggesting that it has the proteolytic and putrefactive capacity to produce VSC. One of the challenges in dealing with oral malodor is to identify a reliable test for detecting bad breath.
Aims:
The purposes of this review article were: (1) to correlate the relationship between oral malodor and adult periodontitis; (2) to analyze current malodor tests and discuss available treatment regimens.
Antimicrobial agents are commonly incorporated into hygiene products for the treatment and prevention of plaque and gingivitis. Recently, a new alcohol-free rinse containing 0.07% cetylpyridinium chloride (CPC) in a high bioavailable matrix (Crest ® Pro-Health Rinse) was introduced to provide antiplaque and antigingivitis benefits. This paper reviews results from an in vitro pre-clinical study and an in vivo clinical study evaluating the antibacterial and antiplaque benefits of this CPC rinse technology. In the in vitro experiment, a no-alcohol 0.065% high bioavailable CPC prototype rinse was evaluated for its hostility against a broad range of microorganisms commonly associated with plaque and gingivitis. The rinse demonstrated greater than 99% germ kill for all organisms tested individually as well as in whole saliva. The benefit of this antibacterial action on plaque inhibition was assessed in a clinical trial. A double-blinded, 3-period, 6-sequence crossover study was conducted evaluating the antiplaque effect of the novel 0.07% high bioavailable, alcohol-free CPC rinse versus a positive control (Listerine® Cool Mint containing essential oils) and a negative control (placebo CPC rinse). A modification of the Addy 4-day plaque model was used for this evaluation. Plaque was measured at baseline (Day 1) of each treatment period and at Day 4 using the Turesky modification of Quigley-Hein index. During the treatment period, subjects brushed only their lingual surfaces twice daily for up to 60 seconds. Following brushing, subjects used 20 mls of the mouthrinse product for 30 seconds in the morning and evening. Fifty-five subjects completed the study. For non-brushed sites, both the essential oils and CPC rinse exhibited a 25% reduction in plaque vs. placebo after four days of product usage, which was statistically significant (p < 0.0001). Both treatments also exhibited a statistically significant benefit versus placebo (p<0.0001) for brushed sites (>38% plaque reduction). These data support the antibacterial action of the high bioavailable, alcohol-free CPC rinse and demonstrate antiplaque effects for Crest Pro-Health Rinse that are “at least as good as” the leading essential oils antiseptic, making it well-suited for a broad range of patients, particularly those who are sensitive to products containing alcohol.
Citation
Witt J; Ramji N; Gibb R; Dunavent J; Flood J; Barnes J. Antibacterial and Antiplaque Effects of a Novel, Alcohol-Free Oral Rinse with Cetylpyridinium Chloride. J Contemp Dent Pract 2005 February; (6)1:001-009.
Successful treatment and prevention of periodontal disease in pet animals requires a multidimensional approach to identify and eliminate exacerbating factors, provide scheduled professional examinations and care, and plan and implement a dental homecare program. Over the years, many therapeutic and preventive interventions have been developed or advocated for periodontal disease, but evidence of efficacy or effectiveness is highly variable. Accordingly, the main objective of this systematic review is to identify and critically appraise the evidence supporting various aspects of homecare for prevention of canine and feline periodontal disease.
To evaluate the effects of a novel mouthrinse containing 0.07% high bioavailable cetylpyridinium chloride (Crest Pro-Health Rinse) on the development of gingivitis and plaque versus a placebo control over a period of 6 months.
This was a randomized, 6-month, placebo-controlled, parallel groups, double blind, single center clinical trial. One hundred thirty-nine generally healthy adults with mild-to-moderate gingivitis were enrolled in the study. Subjects were given Modified Gingival Index (MGI), Gingival Bleeding Index (GBI) and Modified Quigley-Hein Plaque Index (MQH) examinations followed by a dental prophylaxis. Subjects were then randomly assigned to either the cetylpyridinium chloride (CPC) rinse or placebo rinse and instructed to begin rinsing twice a day with 20 ml of their assigned mouthrinse for 30 seconds after brushing their teeth. Subjects were assessed for MGI, GBI and MQH scores after 3 and 6 months of product use. Oral hard and soft tissue examinations were also performed at all visits.
124 subjects were evaluable at Month 3 and 119 at Month 6. After 6 months, subjects rinsing with the CPC rinse showed 15.4% less gingival inflammation, 33.3% less gingival bleeding, and 15.8% less plaque relative to the placebo group. All reductions were highly statistically significantly different (P< 0.01). Results were similar at 3 months. Both treatments were well-tolerated.
This study demonstrates that the Crest Pro-Health 0.07% CPC mouthrinse provided significant antiplaque and antigingivitis benefits when used twice daily for 6 months as an adjunct to toothbrushing.
The objectives of this study were to assess intra-examiner (experienced examiner) and inter-examiner agreements (experienced versus non-experienced examiners) of scores assessed with the Logan & Boyce plaque index and to evaluate whether a modification of this index, where anatomical landmarks are used for horizontal division [mod L&B-AL] and dye references are used for assessing intensity of dye (plaque thickness) [mod L&B-DR], would improve repeatability. The Logan & Boyce index was found to be inaccurate when scoring plaque coverage as it underestimated the total crown surface. The contribution of the gingival part to the total tooth score was minimized by the Logan & Boyce index compared to the mod L&B-AL/DR. Precision of global plaque scorings was significantly improved by the mod L&B-AL/DR. Intra-examiner agreement of plaque thickness and plaque coverage scorings on the gingival part of the tooth was significantly improved by the mod L&B-AL/DR. Studies evaluating plaque accumulation in dogs should therefore use the mod L&B-AL/DR rather than the Logan & Boyce index.
(1) To determine the plaque inhibition properties of two formulations of alcohol-free mouthwash [0.1% w/w cetylpyridinium chloride (CPC) (B) and 0.05% w/w CPC (A)] versus a placebo mouthwash (C). (2) To compare the plaque-inhibiting activity between these two new CPC mouthwashes.
A double-blind, crossover study with three 1-week periods was used. Subjects were randomly assigned to one of the following groups. Group 1 (n=10) received the mouthwashes A, C and B in the periods 1, 2 and 3, respectively, group 2 (n=11) received the mouthwashes in the order B, A, C, while group 3 (n=11) received the mouthwashes in the order C, B, A. Mean plaque areas and Quigley & Hein plaque index scores were analysed using anova (analysis of variance). Measurements were made at the start of each period (baseline) and at 16, 24 and 40 h.
Mean plaque scores were similar across the groups at baseline. At all time points thereafter, volunteers using mouthwash A or B had significantly lower plaque areas and plaque index scores than those using mouthwash C (p<0.05), but there were no significant differences between the test formulations. At 16 h, the reduction in plaque area relative to mouthwash C was 22% for mouthwash A and 18% for mouthwash B; at 24 h, 11% for mouthwash A and 15% for mouthwash B; and at 40 h, 15% for mouthwash A and 16% for mouthwash B.
The use of both CPC mouthwashes resulted in less plaque accumulation compared with the control. There was no statistically significant difference in plaque accumulation between the two CPC mouthwashes.
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