CHLORHEXIDINE
RINSE
One of the
earliest signs of periodontal disease is red or
bleeding gum tissue.
If this
condition is allowed to continue it will
develop into periodontitis which will cause loss of bone and supportive
structures around your teeth. Most adult teeth are lost because of
periodontal disease.
To help prevent this
breakdown of the gum tissue you need to brush
and floss 2 times day. If any bleeding is
noticed it means you need to brush and floss more often or more thoroughly and
that you need your teeth professionally cleaned.
Carefully cleaning every
day and professional cleaning every six months is
needed to remove the hard deposit called calculus
that builds up on your
teeth.
Calculus acts like a piece of sandpaper that is wrapped around your
teeth causing irritation because of its roughness. This roughness and
irregularity leads to bacteria growth and infection in the gum tissue.
There is
no place for alcohol based mouthrinse.
Since gum disease is a
protein based disease (as opposed to decay which is
carbohydrate) the more drying that occurs in the mouth the more
tissue sloughs and the more protein is available for metabolism
which supports the progression of gum disease.
IDF Dr Light 5/15/05
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The
goal is to have smooth teeth so plaque and tartar can not cling to your teeth
thus limiting bacteria growth. It is, however, impossible for you to
remove this calculus, it must be removed by your dentist or a hygienist.
For this persistent
cause of bleeding a mouth rinse called Periogard can be professional prescribed
for you . It is the most effective mouthrinse for removing plaque and fighting
gingivitis. It has a solution of Chlorhexidine that controls the growth and
kills the bacteria that is causing your gum disease.
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It has a few
side effects:
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If you are allergic to Chlorhexidine you
will not be able to use this product.
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It may cause staining of teeth, restorations
and your tongue. Not everyone will experience this. This stain
can be removed by having your teeth professional cleaned.
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Increase in calculus formation above the
gumline may develop. We will monitor your condition for these
deposits.
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Lingering after taste that may change taste
perception. You will adjust to time to this effect with no permanent change
to your taste perception.
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This drug should
not be used if you are pregnant or nursing. |
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Chlorhexidine
rinses must be used daily for two weeks straight to be
effective. Occasional or "scattershot" use will not
work. After a two-week regimen of
rinse use, harmful bacteria will not regrow into colonies for
four to six weeks.
How to
use:
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Use 1/2 fl. oz. of undiluted
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| Swish in mouth for 30 seconds
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After rinsing for 30 seconds be sure to
spit out all the rinse, do NOT swallow any of the rinse.
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| To minimize medicinal taste, DO NOT rinse
with water immediately after use.
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In the morning brush
and floss for 2 minutes and than rinse with chlorhexidine for 30
seconds
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In the evening brush and floss and
rinse again for 30 seconds.
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Take any missed dose as soon as possible
but not if it is almost time for the next dose. If it is
time for the next dose, skip the missed dose and resume
your regular schedule. Do not "double-up" the
dose. Store at room temperature
below 77 degrees. Do not freeze.
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To minimize
the staining apply Chlorhexidine with the
hollow cup brush tip of the Rota-dent perio
tool to only the gum tissue, especially
focus on the areas with pockets depths over
4mm. You may also alternate CHX with
custom bleaching trays at home.
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 0.12%
Chlorhexidine Oral Rinse
| Exceptional flavor
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| Chlorhexidine Gluconate 0.12%
is the leading prescription oral
rinse to fight gingivitis. |
| Significantly reduces gingival
inflammation and bleeding due to
gingivitis.
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| Safe, clinically proven
formula.
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| Convenient 16-oz. bottle comes
with unit dose cup. |
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To
insure successful results following periodontal treatments, your cooperation in maintaining excellent oral hygiene is essential.
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News Updates on
Chlorhexidine
This is why we use
Chlorhexidine AND fluoride rinse with our patients:
The effect of a mouthrinse containing chlorhexidine and fluoride on plaque and gingival bleeding.
The aim of this study was to test the effect of a rinse with 0.05% sodium fluoride and 0.05% chlorhexidine on plaque and gingival inflammation
compared with a placebo without these agents. I Subjects were asked to rinse for 30 s with 10 ml of the respective test or placebo rinse after
normal oral hygiene for 8 weeks. 39 subjects completed the study. There was no significant difference in the 2 groups at baseline with respect to
either plaque or bleeding scores. After scaling and 8 weeks use of the test rinse, there were significant reductions (p < 0.001) in both plaque
and bleeding. The control group showed no significant reduction in plaque scores after 8 weeks, but a significant (p < 0.05) reduction in bleeding.
However, this reduction was significantly greater (p < 0.001) in the test group than in the control. The test group had a significantly greater (p
< 0.05) stain score than the control at baseline. After scaling and rinsing for 8 weeks, stain scores were lower for both groups compared to
baseline but reached significance (p < 0.05) only for the control group. It is concluded that, as an adjunct to normal oral hygiene, the
chlorhexidine/fluoride rinse had a significant inhibitory effect on plaque and bleeding but its effect on staining is uncertain.
Joyston-Bechal S, Hernaman N. Department of Oral Medicine and Periodontology, London Hospital Medical College, UK. PMID: 8421116 [PubMed - indexed for MEDLINE
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Alcohol-Free Chlorhexidine Rinse
as Effective as One with Alcohol
Researchers in Spain compared the effectiveness of
an 11% alcohol- chlorhexidine rinse to an
alcohol-free formulation. Both rinses
contained 0.12% chlorhexidine and 0.05% sodium
fluoride. A placebo rinse was used for the
control group.
The 97 study subjects were between 25 and 50 years
of age, with a minimum of 22 teeth.
Participants were asked to use their assigned rinse
once daily for 30 seconds for the 28-day study.
They were also instructed to brush 3-times/daily at
least 30 minutes before rinsing. Plaque and bleeding
scores were recorded at baseline, 2-weeks and 4-
weeks. No significant changes were observed in the
placebo group. Both chlorhexidine rinse
groups showed reductions in bleeding and plaque
levels. No differences were seen between the
alcohol rinse and the alcohol-free rinse.
Leyes Borrajo, J., Garcia Varela, L., Lopez Castro,
G., Rodriguez-Nunez, M., Barcia Figueroa, M .,
Gallas Torreira, M.: Efficacy of Chlorhexidine
Mouthrinses with and without Alcohol: A
Clinical Study. J of Perio 73: 317-321, 2002.
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Chlorhexidine & S. mutans
Chlorhexidine has been proposed as a potent
chemotherapeutic agent against oral bacteria. The purpose of
this study was to investigate the effectiveness of combining
oral rinses to reduce S. mutans levels in human saliva.
Sixteen healthy adult subjects were randomly assigned to one of
fourrinse groups using a 4-cell crossover design. The groups
rinsed twicea day for 7 days with one of the following: 0.12%
chlorhexidine (PerioGard®), 1.5% hydrogen peroxide (Peroxyl®), a
combined chlorhexidine + hydrogen peroxide, or water (control).
No significant differences were seen in S. mutans levels
among the groups; however, the levels of total streptococci on
day 7 samples were significantly lower in the chlorhexidine and
chlorhexidine + hydrogen peroxide groups than in the hydrogen
peroxide and control groups. There was no additional
decrease seen in S. mutans or total streptococci levels in the
group receiving chlorhexidine + hydrogen peroxide compared to
chlorhexidine alone. Adding hydrogen peroxide to the
chlorhexidine mouthrinse did not result in a further
decrease in S. mutans levels.
[Menendez A Comparative analysis of
the antibacterial effects of combined mouthrinses on
Streptococcus mutans Oral Microbiology and
Immunology 2005;20(1):31.]
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Mouthwashes
As
Adjuncts
To Oral
Hygiene
There is a range of
mouthwashes available to the consumer. Some of these are purely
cosmetic, while others have been clinically proven to improve
oral hygiene and reduce plaque, a major cause of periodontal
diseases. The efficacy of cetylpyridinium chloride as a
mouthwash prior to toothbrushing does little to reduce plaque
levels or improve oral health. Solely using mouthrinses as
the only method of oral hygiene will be detrimental to their
periodontal health.1: Chlorhexidine preparations have
the slight advantage over essential oils with respect to plaque
reduction. Unlike essential oil mouthwashes chlorhexidine
preparations can stain teeth, are generally indicated for
shorter-term use and can alter taste perceptions for up to
several hours post rinsing. The percentage reduction from
control of EO mouthwash and chlorhexidine groups after twice
daily rinsing for six weeks 2: Overall plaque index at six
weeks Chlorhexidine 0.1 percent was 54 percent and
Chlorhexidine 0.2% was 77 percent. Both agents have a range of
uses in the management of oral conditions where plaque levels
could be problematic. Mouthwash can be used after
mechanical methods to further reduce plaque levels because
mechanical plaque removal alone may not achieve these low
scores on a regular basis.
Another
significant
use of
mouthwashes
is to
reduce
malodour.
Oral
malodour
is
multifactorial
in its
origins
but a main
cause is
metabolic
products
from
bacteria
residing
in
bacterial
plaque, on
the tongue
or present
in saliva.
Mouthwash
containing
chlorhexidine
is
beneficial
in the
management
of oral
malodour
and reduce
levels of
odourgenic
bacteria.
Chlorhexidine
has been
used
successfully
to ensure
maintenance
of
gingival
health
around
dental
implants
and reduce
bacteria.
References
1 Seymour
RA,
Heasman
PA.
Pharmacological
control of
periodontal
disease.
II.
Antimicrobial
agents. J
Dent. 1995
Feb;23(1):5-14.
2 Axelsson
P &
Lindhe J.
Efficacy
of
mouthrinses
in
inhibiting
dental
plaque and
gingivitis
in man. J.
Clin
Periodontol
1987; 14:
205-212. 3
Ramfjord
SP:
Maintenance
care for
treated
periodontitis
patients.
J. Clin
Periodontol
1987; 14:
433-437.6/04
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Evidence-based control of plaque and
gingivitis Most adults brush and floss inadequately, and
constant education and /or reinforcement is often required.
Bacteria are usually left behind with mechanical oral health
routines, and chemotherapeutic agents may have a key role as
adjuncts to daily home-care. To date, two antiseptic mouthwashes
have received the ADA seal of acceptance: Peridex, Zila
Pharmaceuticals chlorexidine (CHX), essential
oil (EO) mouthwash. CHX has a strong affinity for tooth
and tissue surfaces, but can cause brown staining on the teeth
and tongue. Patients must also wait until all traces of
toothpaste are removed before rising with CHX. Long-term use of
an EO mouthwash is microbiologically safe, with no changes
observed n the bacterial composition of supragingival plaque,
and no evidence of antimicrobial resistance. A number of trails
have demonstrated the long-term plaque and gingivitis-reducing
properties of both CHX and EO mouthwashes. These studies clearly
demonstrate that these agents have lasting efficacy and can
access hard-to-reach areas. [A Santos Evidence-based control
of plaque and gingivitis J Esthet Restor Dent
2003;15(1):25-30.]
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February 06, 2008
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