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PubMed1989

Hemostatic effect of tranexamic acid mouthwash in anticoagulant-treated patients undergoing oral surgery.

We carried out a placebo-controlled, double-blind, randomized study of the hemostatic effect of tranexamic acid mouthwash after oral surgery in 39 patients receiving anticoagulant agents because of the presence of cardiac valvular stenosis, a prosthetic cardiac valve, or a vascular prosthesis. Surgery was performed with no change in the level of anticoagulant therapy, and treatment with the anticoagulant agent was continued after surgery. Before it was sutured, the operative field was irrigated in 19 patients with 10 ml of a 4.8 percent aqueous solution of tranexamic acid (an inhibitor of fibrinolysis) and in 20 patients with a placebo solution. For seven days thereafter, patients were instructed to rinse their mouths with 10 ml of the assigned solution for two minutes four times a day. There were no significant differences between the two treatment groups in base-line variables, including the level of anticoagulation at the time of surgery. Eight patients in the placebo group had a total of 10 postoperative bleeding episodes, whereas only 1 patient in the tranexamic acid group had a bleeding episode (P = 0.01). There were no systemic side effects. We conclude that local antifibrinolytic therapy is effective in preventing bleeding after oral surgery in patients who are being treated with anticoagulants.

Adult↗
PubMed1997

Detection of HTLV type I provirus by in situ polymerase chain reaction in mouthwash mononuclear cells of HAM/TSP patients and HTLV type I carriers.

Molecular studies have revealed the presence of HTLV-I provirus DNA in saliva of HTLV-I-infected subjects. However, cellular localization has not been determined. In the present study, we have used in situ PCR technique to study saliva-associated cells for localization of HTLV-I proviral DNA. We found that HTLV-I proviral DNA was present in the nuclei and cytoplasm of salivary lymphocytes in five (71%) of seven HTLV-I-seropositive subjects. The percentage of infected cells in positive mouthwash samples ranged from 0.5 to 2%. None of the HTLV-I-negative patients had HTLV-I provirus in saliva. The localization of HTLV-I provirus DNA suggests that salivary lymphocytes can serve as vector for HTLV-I infection through saliva.

Carrier State↗
PubMed1984

Folate mouthwash: effects on established gingivitis in periodontal patients.

A double blind study was designed to determine the effects of folate mouthwash (MW) on established gingivitis in non-pregnant adults. 60 subjects who had greater than 20 teeth, visible gingival inflammation around greater than 6 teeth, no complicated medical history, currently not receiving periodontal treatment or medication, and not wearing dentures, were randomly assigned to control or experimental groups. Full mouth assessment included plaque scores, gingival colour changes, bleeding tendency around every tooth and experience of disease and local factors. Subjects used 5 ml of MW twice daily for 4 weeks, rinsing for 1 min before expectorating. Experimental MW contained 5 mg folate per 5 ml. The control group used a placebo MW. A detailed 3-day diet record was kept by each subject. The oral examination was repeated after 4 weeks. Initially, groups were similar except that the experimental group exhibited more bleeding sites at the outset, but after 4 weeks, the experimental group showed a significant decrease in mean number of colour change sites (from 70.17 +/- 12.89 to 56.62 +/- 17.42) and in bleeding sites (from 48.59 +/- 24.28 to 29.28 +/- 19.64) compared with control group (colour: from 66.93 +/- 15.27 to 66.20 +/- 18.83; bleeding: from 36.93 +/- 16.96 to 39.47 +/- 16.67) p less than 0.001. Dietary analysis showed that few subjects ate greater than 200 micrograms folate daily. However, the level of dietary folate did not correlate with changes in inflammation in experimental subjects, r = 0.097. Folate MW appears to have an influence on gingival health through local rather than systemic influence.

Adult↗
PubMed1986

Effects of folate mouthwash on experimental gingivitis in man.

Although the experimental gingivitis model has been used extensively since 1965, some doubts exist concerning the nature of the tissue response in this model. Accordingly, the present study was designed to determine whether or not experimental gingivitis responded to 0.1% folate mouthwash (MW) in a similar manner to that already reported for established gingivitis. 20 male dental students took part in a double blind cross-over study which involved two 3-week experimental periods with random allocation to folate or placebo MW. The experimental site was the lower anterior area and 24 points of gingival examination were made at baseline and weeks 1, 2 and 3. Inflammation was assessed by presence or absence of colour change, and bleeding being slight, profuse or absent when gingivae were stroked with a blunt probe. A plaque sample was evaluated using dark field microscopy, and dry weight of accumulated plaque was measured at the end of each experimental period. Folate MW did not appear to have any statistically significant effects on accumulated plaque, or clinical signs of experimental gingivitis in this study. The different response of experimental gingivitis to folate MW, compared with the response of established gingivitis already reported, further suggests that experimental gingivitis may not represent an authentic replica of the cellular and immunological responses occurring in established gingivitis.

Adult↗
PubMed1987

The effect on early plaque formation, gingivitis and salivary bacterial counts of mouthwashes containing hexetidine/zinc, aminefluoride/tin or chlorhexidine.

This study was designed to investigate the effectiveness of mouthwashes containing hexetidine/zinc (HZA) or tin (ASF) in inhibiting plaque formation and gingivitis in humans. 24 dental students and assistants participated in the study (latin square design) with 7-day test periods. They rinsed twice daily for 1 min with one of the following formulations: HZA = 750 ppm hexetidine/750 ppm zinc acetate, ASF = 100 ppm aminefluorid/310 ppm stannous fluoride, CHX = 0.1% chlorhexidine and M = negative control. Plaque accumulation was determined planimetrically and gravimetrically. Gingivitis was evaluated with the papillary bleeding index. Total colony forming units and S. mutans counts were estimated from saliva samples. The results showed that HZA and CHX almost completely inhibited plaque accumulation and gingivitis. ASF was less effective than HZA and CHX but still reduced plaque significantly compared to the negative control. Furthermore, CHX reduced salivary S. mutans counts.

Amines↗
PubMed1991

Effect of antiseptic mouthwashes on some clinical and microbiological findings in the mouths of lymphoma patients receiving cytostatic drugs.

51 patients suffering from Hodgkin's disease or non-Hodgkin's lymphoma participated in this double-blind, cross-over study in which 2 antiseptic mouthwashes were tested for their effects on various periodontal index scores and salivary microbial counts. All patients were receiving combination cytostatic treatment based on methotrexate and doxorubicin. The patients (49 +/- 14 years old, 28 men, 23 women) were allotted at random to 2 groups. One rinsed with a 0.12% chlorhexidine gluconate (CHX) solution, the other with a 0.025% amine-stannous fluoride (AmF + SnF) solution 2x daily for 2 weeks. Both groups then continued rinsing with a 0.05% sodium fluoride (F) solution for 2 weeks, before switching over to AmF + SnF or CHX, respectively. All solutions had been prepared in such a way that they had the same colour and taste. Visible plaque index and gingival bleeding index scores were significantly reduced after periods of rinsing with CHX solution (P less than 0.001) and AmF + SnF solution (P less than 0.05). Microbiological cultivations of saliva specimens revealed significant reductions in mutans streptococci immediately after commencing rinsing, while lactobacilli and yeast counts were not affected.

Amines↗
PubMed1995

A 6-month home-usage trial of 0.1% and 0.2% delmopinol mouthwashes (II). Effects on the plaque microflora.

The effects of 0.1% and 0.2% delmopinol mouthwashes on supragingival plaque flora were investigated in a 6-month home-use study. 141 subjects were studied from whom plaque was collected at baseline, 12, 24, and 36 weeks. Overall, there were no consistent effects on microscopic or total counts. However, there was a significant reduction in the proportion of dextran-producing streptococci in the active groups compared to the control group throughout treatment. There was no colonisation by Candida or Gram-negative aerobic bacilli in the active groups nor was there any decrease in susceptibility to delmopinol. Delmopinol appears to mediate its anti-plaque effect without causing a major shift in bacterial populations, although dextran-producing bacteria appear to be affected, which may have relevance to this agent's mode of action.

Adolescent↗
PubMed1996

A 6-month home-usage trial of 0.1% and 0.2% delmopinol mouthwashes (I). Effects on plaque, gingivitis, supragingival calculus and tooth staining.

Delmopinol is a morpholinoethanol derivative which, in mouthrinses used in the absence of normal oral hygiene, has been shown effective in the inhibition of plaque and gingivitis. The aim of this study was to determine the adjunctive oral hygiene benefits and safety of delmopinol rinses when used alongside normal toothcleaning. This 6-month home use study was a placebo-controlled, double-blind, randomised parallel design evaluating 0.1% and 0.2% delmopinol rinses and structured to conform with the ADA Council of Dental Therapeutics guidelines. A total of 450 dentate male and female subjects were recruited who had no relevant medical or pharmacotherapy histories determined from a full medical examination, including haematological and biochemical tests. Subjects had moderate levels of plaque and gingivitis. At baseline, 3 and 6 months subjects were scored for plaque, gingivitis, tooth stain and supragingival calculus, with plaque sampled for microbiological analysis. Additionally, oral mucosal examinations were performed and subjects questioned for adverse symptoms. Baseline special tests were repeated at the end of the study. After baseline examinations, the subjects received a professional prophylaxis, provided with the allocated mouthwash and instructed to use 10-ml volumes for 60 s 2 x daily and where appropriate after toothbrushing and meals. Demographic features of the 3 groups were similar and losses to trial were small. Adverse signs and symptoms included transitory numbness of the tongue, tooth and tongue staining, taste disturbance and rarely mucosal soreness and erosion. All local side-effects were less commonly reported at 6 compared to 3 months and only 6 subjects were withdrawn because of adverse event. No systemic effects attributable to the agent were observed and no significant shifts in haematological or biochemical parameters occurred. All groups showed considerable improvements in oral hygiene and gingival health with some significant differences in favour of 0.2% delmopinol compared to placebo for gingivitis and more particularly plaque. Staining was also significantly increased in the delmopinol groups but not calculus. In the present study, a considerable Hawthorne effect occurred, which must in part explain why only a modestly significant effect was achieved.

Adult↗
PubMed2004

Chlorhexidine spray versus mouthwash in the control of dental plaque after implant surgery.

BACKGROUND/PURPOSE: This randomized clinical trial was aimed at comparing two different means of delivering chlorhexidine digluconate (CHX) for plaque control during the 2 weeks following implant surgery. MATERIALS AND METHODS: Twenty patients selected for implant therapy were randomly divided into two groups: 10 subjects used 15 ml of 0.12% CHX mouthrinse (control group) and 10 used 0.2% CHX spray (test group). Professional oral hygiene was carried out immediately before surgery. During the 14 days following surgery mechanical oral hygiene was performed only at the teeth not surgically involved. Plaque index (PI), stain index (SI), modified gingival index and taste alteration were assessed on the 7th and 14th day after surgery. The clinical parameters were evaluated at four tooth surfaces by a single examiner. Teeth proximal to surgical site and teeth not involved were statistically compared. RESULTS: In both groups, the PI increased similarly, with respect to the baseline, at days 7 and 14. There was no significant difference between the two groups at either time point. On the contrary, in the control group, the SI increased significantly when compared with baseline over the 14 days both at teeth nearest to surgical sites and at not-involved sites. In the test group pigmentation was consistent only at teeth proximal to the surgical site. When considering not-involved sites, tooth staining was significantly lower in the test with respect to the control group. CONCLUSIONS: The present study indicates that the efficacy of CHX spray in the post-surgical control of dental plaque is similar to that of CHX mouthwash. Tooth staining, however, is significantly lower in the spray group at sites not surgically involved. These effects might be related to the route of CHX delivery, as well as the total dose administered that was significantly lower in the spray group with respect to the rinse group.

Adult↗
PubMed1985

Effectiveness of Veadent as a plaque-inhibiting mouthwash.

The aim of this study was to compare the effect of the commercially available Veadent mouthwash and chlorhexidine on plaque formation. Plaque accumulating during two 5-day periods was recorded in a group of 10 students. During the experimental periods, the test subjects abstained from mechanical cleaning of the teeth, and chewed sucrose-containing chewing gum every 4th h in order to enhance plaque formation. They also rinsed with either chlorhexidine or Veadent twice a day according to the manufacturer's recommendations. Chlorhexidine mouthrinses resulted in significantly lower plaque scores than did Veadent in the present short-term model study.

Adult↗
PubMed1994

Triclosan-containing mouthwashes--does the nature of the solvent influence their clinical effect?

The effect of triclosan on plaque inhibition was studied with various solvents. Eight subjects used the solutions as mouthwashes twice daily for 4 days while refraining from any other form of oral hygiene. Bacteriologic tests were also done with the same solutions. The study showed that the nature of the substance used to dissolve triclosan may be of clinical significance. Solutions of triclosan in polyethylene glycol, glycerol, or 3% sodium lauryl sulfate (SLS) alone showed marked antiplaque effect. (The first two solutions both contained 1.5% SLS). However, triclosan dissolved in Tween 80 had only a negligible clinical effect. In vitro experiment showed that antibacterial tests did not correlate well with clinical data. It is proposed that the nature of the micelles of the detergents which are used to dissolve triclosan is of significant importance. Strongly charged micelles such as SLS show clinical effect, whereas less charged micelles of SLS/Tween 80 or uncharged micelles of Tween 80 alone appear not to have this effect.

Adult↗
PubMed2003

Effects of a chlorhexidine gluconate-containing mouthwash on the vitality and antimicrobial susceptibility of in vitro oral bacterial ecosystems.

Oral bacterial microcosms, established using saliva inocula from three individuals, were maintained under a feast-famine regime within constant-depth film fermenters. Steady-state communities were exposed four times daily, postfeeding, to a chlorhexidine (CHX) gluconate-containing mouthwash (CHXM) diluted to 0.06% (wt/vol) antimicrobial content. The microcosms were characterized by heterotrophic plate counts and PCR-denaturing gradient gel electrophoresis (DGGE). CHXM caused significant decreases in both total anaerobe and total aerobe/facultative anaerobe counts (P < 0.05), together with lesser decreases in gram-negative anaerobes. The degree of streptococcal and actinomycete inhibition varied considerably among individuals. DGGE showed that CHXM exposure caused considerable decreases in microbial diversity, including marked reductions in Prevotella sp. and Selenomonas infelix. Pure-culture studies of 10 oral bacteria (eight genera) showed that Actinomyces naeslundii, Veillonella dispar, Prevotella nigrescens, and the streptococci were highly susceptible to CHX, while Lactobacillus rhamnosus, Fusobacterium nucleatum, and Neisseria subflava were the least susceptible. Determination of the MICs of triclosan, CHX, erythromycin, penicillin V, vancomycin, and metronidazole for microcosm isolates, before and after 5 days of CHXM exposure, showed that CHXM exposure altered the distribution of isolates toward those that were less susceptible to CHX (P < 0.05). Changes in susceptibility distributions for the other test agents were not statistically significant. In conclusion, population changes in plaque microcosms following repeated exposure to CHXM represented an inhibition of the most susceptible flora with a clonal expansion of less susceptible species.

Bacteria↗
PubMed1994

Effect of mouthwashes of variable NaF concentration but constant NaF content on oral fluoride retention.

Previous work showed that oral fluoride levels increased with increasing applied F dose for both mouthwashes and dentifrices. This study aimed to determine whether the above dependence was related to applied fluoride concentration or applied fluoride amount. Ten adults mouthrinsed with aqueous NaF solutions of 1-10 ml, each of which contained 2.5 mg F, i.e. in the concentration range 250-2,500 ppm F. Subjects rinsed for 1 min and then spat out. Samples of mixed saliva were collected for 3 h afterwards, which were analysed for fluoride. Salivary fluoride clearance curves were obtained which could be fitted to a pharmacokinetic model involving processes ascribed to loss of fluoride from saliva by swallowing and to exchange of fluoride between saliva and an oral reservoir. Mean salivary fluoride concentrations increased significantly with increasing applied F concentration both within the first 3 h after single use and up to at least 18 h after regular daily use. These findings suggest that applied F concentration is a more important factor than applied F amount per se in determining the elevation of oral fluoride levels following topical fluoride use. This implies that application of a given F dose, in a smaller volume at higher concentration than the current norm, may increase efficacy without increasing the risk of adverse effects.

Adult↗
PubMed1977

Effects of alexidine.2HCL mouthwash on plaque and gingivitis after six months.

Two-hundred and fourteen subjects ranging in age from 22 to 63 years used either a mouthwash that contained 0.035% w/v alexidine.2HCL (2-ethylhexyl bisbiguanidine dihydrochloride) or a placebo twice daily on a doubleblind basis for six months in conjunction with routine oral hygiene procedures. The results indicated that alexidine.2HCL was safe and was statistically more effective in producing a clinically significant reduction in gingivitis than was the placebo.

Adult↗
PubMed1978

Effects of an antiseptic mouthwash on odorigenic microbes in the human gingival crevice.

Odorigenic gram-negative anaerobes in human gingival crevices were significantly decreased for up to 120 minutes after rinsing with an antiseptic mouthwash. This observation parallels clinical measurements of the antiseptic effect on oral malodor and suggests that its odor-decreasing properties are related to its antimicrobial action in the mouth.

Adult↗
PubMed2003

An attenuated adenovirus, ONYX-015, as mouthwash therapy for premalignant oral dysplasia.

PURPOSE: Dysplastic lesions of the oral epithelium are known precursors of oral cancer. A significant proportion of oral dysplastic lesions have functional defects in p53 response pathways. The ONYX-015 adenovirus is selectively cytotoxic to cells carrying defects in p53-dependent signaling pathways. The current study sought to establish the feasibility and activity of ONYX-015 administered topically as a mouthwash to patients with clinically apparent and histologically dysplastic lesions of the oral mucosa. PATIENTS AND METHODS: A total of 22 patients (19 assessable patients) were enrolled onto the study. ONYX-015 was administered on three different schedules to consecutive cohorts. Biopsies of the involved mucosa were performed to evaluate histologic response and changes in expression of putative markers of malignant potential, including p53, cyclin D1, and Ki-67. Serology was performed to measure antiadenoviral titers. RESULTS: Histologic resolution of dysplasia was seen in seven (37%) of 19 patients, and the grade of dysplasia improved in one additional patient. The majority of responses were transient. No toxicity greater than grade 2 (febrile episode in one patient) was observed. Only one of seven patients demonstrated an increase in circulating antiadenoviral antibody titer while on therapy. Although responding and resistant lesions had similar mean p53 staining at baseline, histologic response correlated with a decrease in p53 positivity over time. Significant changes in cyclin D1 or Ki-67 were not observed. Viral replication was confirmed in two of three lesions examined. CONCLUSION: This novel approach to cancer prevention is tolerable, feasible, and has demonstrable activity.

Adenoviridae↗