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PubMed1991

The effect of some chlorhexidine-containing mouthrinses on salivary bacterial counts.

A number of chlorhexidine mouthwashes are available commercially which differ in formulation and regimen of use. As a comparative measure of antimicrobial persistence, this study evaluated the effect of 4 chlorhexidine mouthwash formulations on salivary bacterial counts after a single rinse. The study was a randomised single-examiner blind 5-way crossover investigation employing a panel of 10 young healthy human volunteers. The 0.12% and 0.2% commercial formulations when rinsed according to the respective manufacturers instructions produced similar large and prolonged reductions in salivary bacterial counts during the 7-h period. A 0.1% formulation also commercially available produced minimal effects on salivary bacterial counts and was little different to the saline rinse. A reformulated 0.1% rinse, not commercially available at the time of the study, produced significant salivary bacterial count reductions over the 7-h period albeit to a lesser degree of magnitude than to the 0.2% and 0.12% rinses. The results were consistent with comparative plaque inhibitory studies of the formulations and suggest that the method is a quick and simple way of screening products for antimicrobial and antiplaque potential.

Adult↗

PubMed1992

Efficacy of Listerine, Meridol and chlorhexidine mouthrinses as supplements to regular tooth cleaning measures.

The anti-plaque, anti-gingivitis and anti-microbial efficacies of a phenolic compound (Listerine) and 2 different amine/stannous fluoride mouthwashes (Meridol I, II) were compared when these solutions were used in addition to usual tooth cleaning. A placebo preparation was utilized as a negative control and a chlorhexidine solution as a positive control in this double-blind study. After professional tooth cleaning, 49 volunteers continued their habitual, self-performed and non-supervised oral hygiene for a period of 2 weeks, in order to have a more standard baseline. At day 0, they began to rinse twice daily with 1 of the 5 mouthwashes. After 3 weeks of rinsing, plaque indices remained the lowest in the chlorhexidine and the Meridol I groups, while subjects using Listerine or Meridol II demonstrated similar indices significantly lower than that of individuals rinsing with the placebo solution. Through this period, the gingival index scores were similar in the Meridol, Listerine and chlorhexidine groups. At day 21, the mean GI scores in the chlorhexidine group were significantly lower than the scores in the placebo group. The plaque vitality scores showed a bacterial effect in vivo of chlorhexidine and, to a lesser extent, of the Meridol solutions. No substantial evidence of an antibacterial effect in vivo was found for Listerine. This study has demonstrated that when mouthrinses are used to supplement habitual mechanical oral hygiene, chlorhexidine remains the most powerful solution. Furthermore, it was also shown that a combination of habitual self-performed and non-supervised oral hygiene with Meridol or Listerine is more beneficial for plaque control than the use of mechanical oral hygiene alone.

Adult↗

PubMed1992

A model for studying the effects of mouthrinses on de novo plaque formation.

The aim of the present study was to describe a 4-day no oral hygiene model to assess the pattern of de novo plaque formation and to use this model to appraise the potential of some mouthwash preparations to retard or inhibit plaque formation in the human dentition. 10 subjects were recruited for the trial. During a preparatory period, the participants were exposed to repeated professional plaque control and given oral hygiene instruction to eliminate signs of gingivitis. At the end of the preparatory period, each participant received a final professional tooth cleaning and was subsequently told to abstain from mechanical plaque control efforts for the next 4 days. They were asked to rinse twice daily for 60 s with 10 ml varying test solutions. On Day 4, the volunteers were exposed to a new clinical examination and the presence and amount of plaque were examined by the use of the plaque index system (P1I). The participants were subsequently given a professional tooth cleaning and asked to exercise proper self performed plaque control during the next 10 days. A new test period was then initiated. 6 different mouthwash preparations were tested in each subject namely, (1) placebo (a negative control rinse), (2) Veadent mouthrinse, (3) Listerine mouthrinse, (4) 0.06% triclosan + polyvinyl phosphonic acid (PVPA), (5) 0.06% triclosan + phenolic flavor and (6) 0.12% chlorhexidine digluconate (a positive control rinse). The results from the study revealed that the mean P1I values for individuals, groups of teeth and tooth surfaces provide an adequate but gross overall estimation of the potential of a given mouthrinse to retard/inhibit plaque build up. More detailed information on the effects of the test rinses could be obtained by data describing the % distribution of different P1I score categories; a high frequency of score 0 describes the potential of a mouthrinse to maintain tooth surfaces free from plaque while a low frequency of score 2/3 describes the ability of a treatment to retard/prevent gross plaque formation. The plaque pattern displays finally allowed assessment of the magnitude of plaque prevention, in comparison to the positive and negative controls, that could be achieved by a given compound in various parts and surfaces of the dentition. In this model, all test rinses (i) were significantly more effective than the placebo rinse in retarding de novo plaque build up and (ii) had a minor effects on plaque build up in the maxillary molars and at the approximal surfaces.(ABSTRACT TRUNCATED AT 400 WORDS)

Adult↗

PubMed1996

Some effects of mouthrinses containing salifluor on de novo plaque formation and developing gingivitis.

Three clinical trials were carried out to evaluate the effects of mouthrinses containing 5n-octanoyl-3'-trifluormethylsalicylanilide (salifluor) on plaque and gingivitis. Each trial was performed as a double-blind, randomised and cross-over designed study (studies 1, 2 and 3). In each study, 10 young individuals with healthy gingiva abolished all means of mechanical plaque control during the course of the experimental period including 6 x 4 days (study 1), 3 x 18 days (study 2) and 3 x 14 days (study 3). They rinsed, 2 x daily, with various mouthwash preparations for 4 days (study 1), for the last 4 days of a 18 day period (study 2) or for 14 days (study 3). 6 (control, vehicle control, 0.08%, 0.12% and 0.2% salifluor and 0.12% chlorhexidine), 3 (control, 0.12% salifluor and 0.12% chlorhexidine) and 3 (control, 0.12% salifluor and 0.12% chlorhexidine) mouthwash preparations were tested in studies 1, 2 and 3, respectively. The findings of study 1 indicated that (i) mouthrinses containing salifluor were significantly more effective than control rinses and that (ii) the salifluor mouthrinses were equally effective as the 0.12% chlorhexidine mouthrinse, in retarding 4-day de novo plaque formation. The findings of study 2 indicated that (i) the mouthrinse containing 0.12% salifluor retarded de novo plaque formation to the same extent as the 0.12% chlorhexidine mouthrinse at healthy as well as at inflamed sites but that (ii) the anti-plaque effects of the salifluor and chlorhexidine mouthrinses were significantly smaller at sites with inflamed than with healthy gingiva. In study 3, it was observed that there was no significant difference between the 0.12% salifluor and 0.12% chlorhexidine mouthrinses in retarding de novo plaque formation and the development of gingivitis during a 14-day period of no mechanical plaque control. Thus, the results of the 3 clinical trials demonstrated the potential of salifluor as an effective anti-plaque and anti-inflammatory agent.

Adult↗

PubMed1998

The effect of herbal extracts in an experimental mouthrinse on established plaque and gingivitis.

The purpose of the present study was to establish in vitro the inhibiting effect of a herbal extract mixture on a selected number of micro-organisms and to test in vivo the effect of a mouthwash containing 6.3 mg/ml herbal extract mixture on plaque and gingivitis as compared to a minus active control mouthrinse. The herbal extract was a mixture of: Juniperus communis (juniper), Urtica dioca (nettle), Achillaea millefolium (yarrow); 1:1:1. In the study, in-vitro, the effect of pure herbal extract mixture on acid production of Streptococcus mutans was tested and the minimum inhibitory concentrations (MIC) of the following micro-organisms were tested: Streptococcus mutans, Streptococcus mitis, Actynomyces viscosus, Actynomyces naeslundii, Actinobacillus actinomycetemcomitans, Prevotella intermedia, Campylobacter rectus, Fusobacterium nucleatum, Veillonella parvula. The MIC-values for A. viscosus and P. gingivalis were 100 mg/ml. The MIC-values for A. naeslundii and A. actinomycetemcomitans were considerably lower (10 mg/ml). S. mitis was the most susceptible of the tested organisms to the extract with a MIC value of 1 mg/ml. S. mutans, C. rectus, V. parvula, and F. nucleatum were not influenced by the extracts. No inhibitory effect of the 6.3 mg/ml herbal extract mixture was observed on the acid production of S. mutans. For the study in-vivo, 45 volunteers were selected on the basis of having moderate gingival inflammation. As efficacy parameters the plaque index, modified gingival index and angulated bleeding index were assessed. The subjects were randomly divided among 3 experimental groups (2x test and 1 'minus active' control). The participants were requested to rinse with 10 ml of mouthwash twice a day for a period of three months. After 6 weeks and 3 months, the same clinical indices as at baseline were recorded. The results show no difference between the two test groups and the control group. In conclusion, the results of the present study have shown that the mixture of the 3 herbal extracts, Juniperus communis, Urtica dioca and Achillaea millefolium when used in a mouthrinse has no effect on plaque growth and gingival health.

Actinomyces↗

PubMed2006

Meta-analyses of studies of 0.2% delmopinol mouth rinse as an adjunct to gingival health and plaque control measures.

BACKGROUND: Delmopinol is a third-generation anti-plaque agent used as a mouthwash to reduce plaque and alleviate gingivitis. OBJECTIVE: To create an overview of the anti-plaque efficacy of 0.2% delmopinol as an adjunct to normal oral hygiene measures by meta-analysis of completed clinical trials. MATERIALS AND METHODS: Eight double-blind, parallel-group studies were identified. Study durations ranged from 8 to 24 weeks. Five studies (n=913) involved supervised rinsing; three studies (n=467) involved unsupervised rinsing. These sets of trials were analysed separately and in combination. Efficacy outcomes comprised modified plaque index, modified gingival index (MGI) and gingival bleeding on probing (BOP). RESULTS: Delmopinol 0.2% was superior to placebo for the reduction of plaque scores in both sets of studies. Effects on MGI and BOP were also better with delmopinol 0.2% than with placebo. In most instances, 95% confidence intervals were wholly in favour of delmopinol. Pooled analysis of all eight studies confirmed statistically significant effects of delmopinol 0.2% compared with placebo (p<0.00001). Delmopinol met the efficacy criteria of the American Dental Association in studies of extended duration. CONCLUSION: Delmopinol 0.2% mouthwash is effective as an adjunct measure for reducing plaque burden and indices of gingivitis, whether or not it is used under supervision.

Dental Plaque↗

PubMed1999

Fluorosis risk in grade 2 students residing in a rural area with widely varying natural fluoride.

OBJECTIVES: This pilot study was performed to determine the prevalence of dental fluorosis and the association between fluorosis and a number of risk factors in a group of second grade students in a rural, non-fluoridated area of Ontario, Canada. METHODS: Of 1739 students screened during routine health surveillance, 1367 had erupted maxillary central incisors. Fluorosis was scored on these children using the Tooth Surface Index of Fluorosis (TSIF). A fluoride exposure questionnaire and water sample vial was sent home from school with each child. RESULTS: Valid responses were obtained for 752 children (55%). The prevalence of fluorosis in respondents was 23.3%, with 4.9% scoring TSIF of 2 or more. In bivariate analysis, several variables were significantly associated with the prevalence and/or severity of fluorosis. These included: water fluoride concentration, breast-feeding duration, professionally applied topical fluoride, fluoride supplement use, bottle-feeding, fluoridated mouthwash use, and early parental toothbrushing with toothpaste. In logistic regression analysis limited to children living at the current residence for 4 years or more, only four variables had significant independent effects. These were water fluoride concentration, breast-feeding duration, fluoride supplement use, and fluoridated mouthwash use. CONCLUSIONS: These findings indicate that fluorosis is an important concern in non-fluoridated areas. Fluoride supplements should not be recommended unless an independent home water test is performed. Breast-feeding for 6 months or more may protect children from developing dental fluorosis in the permanent incisors.

Analysis of Variance↗

PubMed1992

Human papillomaviruses in normal oral mucosa: a comparison of methods for sample collection.

The prevalence of six genital genotypes of HPV was assessed in the clinically normal oral mucosa of an adult Caucasian population, and three methods of sample collection compared. HPV DNA was detected in the mouth of 60% of 60 subjects. HPV 16 was the most prevalent genotype, and positive samples were found most frequently in men over 50. A 3% sucrose mouthwash produced more positive results (51%) than mucosal scrapes of three separate sites (45%) or buccal mucosal biopsies (12%). There was no association of a positive result for HPV DNA with any particular mucosal site. A mouthwash was the preferred single screening method for epidemiologic studies of HPV DNA in the mouth, but the greatest yield of positive samples was obtained if multiple sampling techniques were employed.

Adolescent↗

PubMed1997

Gum health product formulations: what is in them and why?

Two dominant factors dictate which ingredients are used in formulating toothpaste and mouthwashes. The major one is the type of active ingredient chosen, especially cationic active ingredients such as chlorhexidine; the other factor is the needs of the consumer. Apart from gum health benefits, the consumer expects to obtain from gum health toothpaste and mouthwashes other benefits of clean teeth (abrasive and detergent), fresh breath (antimicrobial agents and flavor) and protection from caries and possibly tartar. Exhaustive testing involving experimental design and validated laboratory and clinical tests is essential to ensure that all these benefits are delivered. Unless products are developed systematically, then products with relatively poor activity can find their way on to the market.

Chemistry, Pharmaceutical↗

PubMed2001

One-year compliance and effects of amine and stannous fluoride on some salivary biochemical constituents and oral microbes in institutionalized elderly.

Due to old age and poor general health, the institutionalized elderly have often not been used as research subjects for the investigation of oral health protocols. Because the number of elderly is increasing, they are an important target group for the development of oral hygiene aids. This trial was designed to investigate whether the institutionalized elderly could successfully use an amine-fluoride- and stannous-fluoride-containing mouthwash and toothpaste during a 12-month period. A dental hygienist visited the subjects weekly, instructed them, and recorded their self-reported compliance. Plaque and saliva samples were taken at three-month intervals. Some salivary biochemical constituents reflecting mucosal integrity were analyzed. The carrier status of Actinobacillus actinomycetemcomitans, Porphyromonas gingivalis, Bacteroides forsythus, Prevotella intermedia, and Prevotella nigrescens was studied by the polymerase chain-reaction method, and acidogenic bacteria and yeasts by dip-slide methods (Orion Diagnostica, Espoo, Finland). Of those 98 subjects originally included, 44 elderly (30 women and 14 men; mean age, 81.7 +/- 5.9 yrs) completed the trial. Their observations were positive or very positive regarding the use of mouthwash and toothpaste. The number of residents with P. gingivalis decreased statistically significantly throughout the trial, while the carrier status of the other periodontal bacteria and mutans streptococci remained on the same level. The number of subjects with high counts (> or = 10(5) cfu/mL) of yeasts decreased during the study: 26.2% at baseline, 9.1% one year later, respectively. Biochemical analyses of salivary immunoglobulins showed no effect on IgA and IgM levels, but IgG reduced significantly. Albumin and other salivary protein concentrations were found to have a decreasing tendency. Thus, the overall effect of the protocol was beneficial with regard to subjects' oral health as measured in this study. The residents were pleased to participate, but the number of drop-outs was very high, confirming the expected difficulties with the utilization of a group of frail elderly as research subjects.

Aged↗

PubMed1993

The effect of chlorhexidine and zinc/triclosan mouthrinses on the production of acids in dental plaque.

Chlorhexidine, and zinc in combination with triclosan, are used as anti-plaque agents in the prevention of gingivitis. The multifunctional activity of these compounds against bacterial cells has been proposed to include interference with sugar transport and reduction of glycolysis. In this study the ability of the agents to reduce acid production in dental plaque in vivo has been investigated. Samples of smooth-surface plaque were collected from individuals who had been rinsing for several weeks with (a) chlorhexidine (0.12%, Peridex); a combination of zinc and triclosan in mouthwashes containing (b) high and (c) low concentrations of humectant; or (d) a control mouthwash. Analyses using isotachophoresis showed that resting plaques in the chlorhexidine and zinc/triclosan groups contained less acetate than the control group. Acids were also measured 15 min after a glucose rinse. Compared with the control, the amount of lactate was significantly decreased (45%) in the chlorhexidine group, while lactate reduction (20%) in the zinc/triclosan (high humectant) group was not statistically significant.

Acetates↗

PubMed1992

The effect of an experimental chewable antiplaque preparation containing chlorhexidine on plaque and gingival index scores.

This clinical cross-over trial investigated the effects of a chewable preparation containing chorhexidine-fluoride-xylitol, xylitol control tablets, or chlorhexidine mouthwash, twice daily, on plaque and gingival index scores of subjects refraining from mechanical cleaning of their teeth. Both preparations containing chlorhexidine were found to be efficient antiplaque agents when compared with the control. There was no statistically significant difference between the tablet preparation and conventional chlorhexidine rinsings with respect to the recorded parameters. Thus, an efficient antiplaque preparation can be made in tablet form, which may have advantages in instances where use of mouthwash solutions is impracticable.

Administration, Oral↗

PubMed1997

A chemical treatment regimen to reduce bacterial contamination in dental waterlines.

This article describes a pilot study in which the authors used aerobic bacterial cultures to compare the effects of 1:10 mouthwash, 1:20 mouthwash and 2 percent ethanol in reservoir systems with seven conventional water systems. The long-term, low-concentration antiseptic reduced bacteria to within acceptable limits.

Anti-Infective Agents, Local↗

PubMed1975

Clinical evaluation of a quaternary ammonium-containing mouthrinse.

This was a double-blind, radomized, crossover study of adult subjects to evaluate the effect of a test mouthrinse (Cepacol) on plaque accumulation. The study was divided into two parts, four weeks each, one in which only a mouthwash was used (part I) and the other in which a mouthwash and toothbrushing were used (part II). 1. The test mouthrinse produced a satistically significant reduction in dental plaque when compared to a placebo rinse. 2. The GI averaged approximately 1.0 throughout the study regardless of which mouthrinse was used. 3. A possible carryover effect of the test mouthrinse was noted. 4. A lower plaque score was seen in 67 to 75% of all patients during the period in which the test mouthrinse was used as compared to the placebo. 5. Ten subjects reported a burning sensation of the tongue with the test mouthrinse. No objective adverse effects were seen.

Adult↗

PubMed1975

Clinical study of iodine as a chemotherapeutic agent for the control of dental plaque and gingivitis in man.

The present investigation was conducted to study the effect of the local use of iodine solution as a chemotherapeutic agent on the degree of dental plaque formation and ongingival status in the presence and absence of mechanical oral hygiene. Thirty-six male dental students, 20 freshmen and 16 sophomores, at Case Western Reserve University, participated in the study. All subjects received a prophylaxis and oral hygiene instruction to reduce their plaque and gingival scoeres before the start of the experiment. The 20 freshmen dental students were selected for the test of iodine used in a form of mouthwash. The subjects were randomly divided into two groups. One group received a 0.02% iodine mouthwash, the other a placebo solution of distilled water. Each student was randomly assigned to brush and floss the right or left side of his dentition once daily. The students rinsed with 7.5 ml. of the assigned solution twice daily. The 16 sophomore dental students were selected for the test of iodine applied topically on the tooth surfaces. The subjects were assigned to a randomized block design in which each quadrant received one of the following treatments daily: topical application of iodine solution (2.0% I2 and 2.4% NaI) with brushing and flossing, brushing and flossing only, topical application of iodine solution only, and topical application of distilled water only...

Administration, Topical↗

PubMed2003

Efficacy of subgingival irrigation using herbal extracts on gingival inflammation.

BACKGROUND: The aim of the present study was to investigate the efficacy of an herbal-based mouthrinse in combination with an oral irrigator in reducing gingival inflammation. METHODS: A total of 89 patients (45 females, 44 males; mean age 49.1 +/- 1.31 years) were included in this prospective, randomized, double-blind clinical study and allocated to 3 treatment groups: group 1 (n = 34), treated with an oral irrigator with subgingival tips and an herbal-based mouthrinse; group 2 (n = 29), the oral irrigator was applied in combination with a conventional mouthwash; and group 3 (n = 26), treated with the conventional mouthwash without subgingival irrigation. Data collected at baseline and after 4, 8, and 12 weeks included gingival index (GI), sulcus bleeding index (SBI), plaque index (PI), and probing depth (PD). RESULTS: Over a period of 3 months, GI decreased from 1.80 +/- 0.04 to 1.56 +/- 0.04 in group 1; from 1.79 +/- 0.05 to 1.68 +/- 0.04 in group 2; and remained nearly constant in group 3 (from 1.79 +/- 0.05 to 1.81 +/- 0.04). Differences between the groups were significant (analysis of variance, P < 0.05). SBI values in group 1 were reduced from 2.51 +/- 0.06 to 2.13 +/- 0.06 after 3 months and were significantly lower than in group 2 (P = 0.001) and 3 (P = 0.002), with SBIs of 2.44 +/- 0.06 and 2.42 +/- 0.07, respectively, after 12 weeks. A reduction in PI was noted for all 3 groups throughout the follow-up period, with no statistically significant differences. Probing depths were not reduced significantly in any group. CONCLUSION: Subgingival irrigation with an herbal-based mouthrinse led to a significant reduction in both SBI and GI. This regimen can, therefore, be recommended as an adjunctive procedure to reduce gingival inflammation.

Analysis of Variance↗

PubMed2005

Fluoride release/uptake of glass-ionomer cements and polyacid-modified composite resins.

The aim of this study was to investigate the fluoride release and fluoride recharge behaviors of two conventional glass-ionomer cements (GICs) and two polyacid-modified composite resins (PMCRs) after exposure to mouthwash and toothpaste. Fluoride released from the materials was measured at 1st, 2nd, 3rd, 4th, 7th, 14th, 21st, and 28th days. At 28th day, the specimens were divided into three groups. Specimens in the control group were stored in deionized water. For the other two groups, the specimens were exposed to 0.05% NaF solution and fluoridated toothpaste for one month. After refluoridation, fluoride amount was measured at 30th, 31st, 32nd, 36th, 44th, 52nd, and 60th days. All materials released fluoride. The highest amount of fluoride was obtained during the first 24 hours, and there was a statistically significant difference between the amounts of fluoride released from GICs and PMCRs (p < 0.0001). After exposure to mouthwash and fluoridated toothpaste, all materials were recharged and continued releasing fluoride. While the amount of fluoride release from the materials increased after reflouridation, the increase was higher in GICs.

Cariostatic Agents↗

PubMed2000

The efficacy of potassium salts as agents for treating dentin hypersensitivity.

Formulations containing potassium salts (e.g., chloride, nitrate, citrate, oxalate) are widely used for treating dentin hypersensitivity (DH). The purpose of this review was to evaluate evidence for the clinical efficacy of potassium salts in reducing DH and also to consider the biologic basis for any effects. Literature searches were used to identify reports of clinical trials of potassium-containing preparations. Searches revealed 3 trials of potassium nitrate solutions or gels; 2 trials of mouthwashes containing potassium nitrate or citrate; 6 trials of potassium oxalates; and 16 double-blind randomized trials of toothpastes containing potassium nitrate, chloride, or citrate. The toothpaste studies provided quantitative data on treatment effects. These outcome measures were expressed as percentage reductions in sensitivity to cold air and mechanical stimulation and the patients' subjective reports. Trials of topically applied solutions yielded inconsistent results. Potassium-containing mouthwashes produced significant reductions in sensitivity. All potassium-containing toothpastes produced a significant reduction in sensitivity to tactile and air stimuli, as well as subjectively reported sensitivity. In most studies, the active agent (potassium) was superior to the minus-active control (placebo), but a few of the more recent trials have demonstrated significant placebo effects. It is postulated that potassium ions released from toothpastes diffuse along the dentinal tubules to inactivate intradental nerves. However, this principle has never been confirmed in intact human teeth. The mechanism of the desensitizing effects of potassium-containing toothpastes remains uncertain at present.

Dentin Sensitivity↗