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PubMedDate not supplied

Influence of oral detergents and chlorhexidine on soft-layer electrokinetic parameters of the acquired enamel pellicle.

Electron microscopy has described the salivary pellicle as an 'uneven, knotted structure'. This study describes a novel soft-layer model of salivary pellicles, based on measured electrophoretic mobilities and the influence of dentifrices and a chlorhexidine mouthwash on the parameters of the model. The enamel surface was found to possess a high number of fixed, negative charges (zN = -62 mM) and to be electrophoretically hard (1/lambda = 0.6 nm), i.e. impenetrable to fluid flow. Adsorption of a salivary pellicle resulted in a fourfold reduction in the surface fixed charge density (zN = -15 mM) along with an increase in electrophoretic softness (1/lambda = 2.3 nm). Exposure of pellicles to various dentifrices containing sodium fluoride as an active component and sodium lauryl sulfate as a detergent had little effect on the surface fixed charge densities (varying between -15 and -30 mM, depending on the dentifrice involved) and electrophoretic softnesses (varying between 2.3 and 3.4 nm). Exposure of pellicles to a dentifrice containing sodium fluoride and hexametaphosphate as an additional detergent yielded soft (8.0 nm) pellicles, penetrable to fluid flow, with few fixed, negative charges (1 mM). This is opposite to the effects of chlorhexidine, which created an electrophoretically hard pellicle (1.7 nm). This soft-layer electrokinetic model quantitatively shows that the degree to which pellicles are penetrable to fluid flow differs upon exposure to dentifrices, with relevance for plaque formation, de- and remineralization and staining processes.

Adsorption↗

PubMed2006

Increased salivary fluoride concentrations after post-brush fluoride rinsing not reflected in dental plaque.

The aim of the present study was to assess fluoride concentrations in unstimulated saliva and buccal dental plaque 6 h after an oral hygiene procedure that consisted of brushing with an AmF/SnF2 dentifrice and different post-brush rinsing protocols: expectorating the excess of dentifrice foam and rinsing with tap water, expectorating only, or rinsing with 10 ml AmF/SnF2 mouthwash. The fluoride concentrations in plaque and saliva were increased after all three experimental protocols compared to F-free periods. The increase of the fluoride concentration in saliva was more pronounced after AmF/SnF2 mouthrinse as compared to rinsing with water and expectorating the excess of dentifrice foam. Such an effect was not seen in dental plaque. It is concluded that the potentially beneficial effect of not rinsing or fluoride rinsing after tooth brushing is not reflected in an increased fluoride concentration in newly formed dental plaque 6 h after brushing.

Adult↗

PubMed1992

High resolution fluoride profiles of artificial in vitro lesions treated with fluoride dentifrices and mouthrinses during pH cycling conditions.

A pH cycling model which incorporated a severe demineralization component was used to evaluate fluoride uptake and lesion progression for each of a NaF-based dentifrice, NaF-based mouthrinse and a monofluorophosphate (MFP)-based dentifrice. Simultaneous transverse fluoride and calcium profiles across the resulting artificial lesions were obtained using a proton microprobe technique with a resolution of approximately 10 microns. Longitudinal microhardness testing and proton microprobe calcium profiles were used to determine the extent of lesion progression (delta Z) with respect to untreated controls. Under the pH cycling conditions of the present study, the NaF dentifrice and mouthwash were observed to have a considerably higher uptake of fluoride in the lesion than the MFP dentifrice. Although the mineral content profiles of the lesions differed for treatments with each of the fluoride products, the differences were not significantly different in this model.

Calcium↗

PubMed1997

Protective effect of hexetidine against in vitro bacterial demineralisation of bovine enamel and dentin in the presence of fluoride.

Bovine enamel and dentin specimens were overlaid with acidogenic Streptococcus mutans suspensions in agarose. In this model, the minimal demineralisation-inhibiting concentrations (MDIC) of hexetidine was determined in the presence of fluoride. A commercially available mouthwash containing 0.1% (2.9 mmol/l) hexetidine was diluted serially and added to the bacterial suspensions together with 0, 5.3, or 26.3 mumol/l fluoride (NaF). After 22 h of incubation at 37 degrees C the bacterial suspensions were removed and assessed for calcium and lactate. The results showed significant inhibitory effects of hexetidine on the demineralisation of the enamel specimens with a MDIC between 15 and 31 mumol/l hexetidine. In the presence of fluoride, approximately fourfold higher concentrations of hexetidine were needed for a significant additional protection of the enamel. No synergistic effect between hexetidine and fluoride was observed. For the demineralisation of the dentin specimens, the MDIC of hexetidine had a value between 31 and 61 mumol/l. At both these concentrations the dentin specimens were relatively less protected in the presence than in the absence of fluoride, and some synergistic effect between hexeditine and fluoride was observed.

Animals↗

PubMed1994

Potential efficacy of chlorhexidine against mutans streptococci and human dental caries.

Chemotherapeutic agents have been considered as having potential for the prevention of dental caries. Several substances have been evaluated as possible candidates, but no antimicrobial agent, with the exception of fluoride, has received as much experimental attention as the bisbiguanide chlorhexidine. This substance represents, so far, the most effective and best-documented agent. To be effective against caries, therapeutic dosages of the antimicrobial agent have to be given for a sufficient but finite time period to sites with established cariogenic plaque. In studies where this principle has been used, the aim has been to eliminate or strongly suppress the population of mutans streptococci. Of various antimicrobial agents and methods tested, the most persistent reduction of mutants streptococci has been achieved by chlorhexidine varnishes, followed by gels and mouthwashes. The best clinical effect resulting in a considerable caries reduction has been obtained when persons highly colonized with mutans streptococci have been treated with gels and when the results of the antimicrobial measures have been verified by microbiological examination.

Administration, Topical↗

PubMed1980

Ill effects of improper oral hygeine procedure.

Improper use of the tools that prevent tooth decay and gingival disease can also produce harmful effects. For example, dental floss can cause inflammation; toothbrushes could cause abscesses; and water-irrigation devices might drive foreign material into soft tissue. This report discusses the effects of incorrect oral hygiene, the signs the practioner should notice, and the proper corrective steps. Although effective oral hygiene is essential for the maintenance of healthy teeth and supporting tissues, analysis of the literature and clinical observation suggested that six problem areas may be associated with common oral hygiene measures. --Overly vigorous toothbrushing or using the wrong type of brush for the technique often leads to cervical tooth abrasion, gingival irritation, and gingival recession, or all of these problems. --Uncontrolled or overly vigorous dental flossing may lead to irritation, ulceration, or defects of the gingiva. Proximal root surfaces are rarely abraded. --Dentifrices, mouthwashes, and chewing gum may elicit allergic or toxic reactions in susceptible persons. These reactions take a variety of traumatic injuries, especially if used at high pressure. Perhaps, detailed individual instruction should be given by dental personnel before use. --Abscess of gingival tissues may occur from implantation of fragments of such oral hygiene aids as toothbrush bristles and toothpicks. --Bacteria may enter the bloodstream during certain oral hygiene measures, especially in patients with advanced chronic gingival disease. The rate of occurrence is unknown because of conflicting results in different studies. These bacteremias are of concern to patients who have rheumatic heart disease, prosthetic heart valves, prosthetic joints, and renal dialysis shunts, or fistulas used in renal dialysis. A classification of oral hygiene-caused disorders is proposed, based on the injury and the causative agent.

Dental Devices, Home Care↗

PubMed1995

Reducing bacterial aerosol contamination with a chlorhexidine gluconate pre-rinse.

The authors compared the effects of chlorhexidine gluconate, an antiseptic mouthwash with essential oils and water on the bacterial aerosol contamination generated by an air polishing device. Patients rinsed with one of the three solutions before treatment. Bacterial counts collected during the treatment indicate that the chlorhexidine pretreatment rinse was significantly more effective than the other solutions in reducing bacterial aerosols.

Adult↗

PubMed2003

Using chemomechanically assisted diamond bur cutting for improved efficiency.

BACKGROUND: Surface active agents added to handpiece coolants enhance bur cutting rates, or CRs, through chemomechanical effects, or CMEs. The authors evaluate the effect of CMEs on long-term cutting by diamond burs. METHODS: The authors tested medium-grit diamonds in a high-speed handpiece under a 147.5-gram load at 350,000 revolutions per minute, with 22 milliliters per minute coolant flow consisting of distilled water or a 1:10 mouthwash/water mixture. Repeated 6-millimeter-long edge cuts were made through machinable glass ceramic bars until the CR (determined as the time to transect the bars) had decreased by more than 75 percent. The authors used six burs for each coolant and analyzed the data via one-way analysis of variance with post hoc Scheffé tests. RESULTS: CRs with water irrigation continuously decreased with the number of cuts and declined by 87 percent over eight cuts. The authors found faster CRs with CMEs; after 12 cuts, the CR was still close to 40 percent of the initial CR, compared with only 13 percent of the initial CR for water irrigation after eight cuts. These differences between CME-enhanced CRs and those found with water irrigation were statistically significant. CONCLUSIONS: Diluted alcohol- and glycerol-based mouthwash/water mixtures significantly enhanced the CRs of diamond burs and prolonged their service life by more than 50 percent compared with water irrigation alone. CLINICAL IMPLICATIONS: Dentists can increase bur CRs and extend bur cutting life by as much as 200 percent through the addition of diluted alcohol and glycerol mouthwash to the handpiece coolant.

Ceramics↗

PubMed2005

Whole genome amplification of buccal cell DNA: genotyping concordance before and after multiple displacement amplification.

While buccal cells provide an easily accessible source of genomic DNA, the amount extracted may be insufficient for many studies. Whole genome amplification (WGA) using multiple displacement amplification (MDA) may optimize buccal cell genomic DNA yield. We compared the usefulness, in epidemiological surveys, of DNA derived from buccal cells collected by alcohol mouthwash and amplified by WGA protocol and standard protocols. Buccal cell collection kits were mailed to 300 randomly selected members of a large cohort study, and 189 subjects returned buccal cell samples. We determined: (i) which QIAamp DNA Blood Mini Kit extraction protocol (tissue or blood) produced more DNA; and (ii) whether it is feasible to use MDA to prepare DNA for single nucleotide polymorphism (SNP) genotyping of markers such as the methylenetetrahydrofolate reductase (MTHFR) and vitamin D receptor (VDR) genes. The two DNA extraction protocols were tested on 20 different patient samples each. The tissue protocol yielded more DNA than the blood protocol (15.4+/-8.6 vs. 7.6+/-7.1 microg, p<0.0001). The 20 DNA samples extracted using the tissue protocol were then subjected to pre- and post-MDA genotyping using amplicons for the MTHFR SNP at C677T and the intron 8 VDR SNP. No genotyping discrepancies were detected in pair-wise comparisons of pre- and post-MDA. Genotyping DNA from MDA-based WGA is indistinguishable from routine polymerase chain reaction and offers a stable DNA source for genomic research and clinical diagnosis.

Base Sequence↗

PubMed1977

An in vivo comparison of chlorhexidine and picloxydine mouthrinses: a possible association between chemical structure and antiplaque activity.

A double blind clinical trial was conducted in which both the plaque-inhibiting ability and the in vivo effects on the oral flora of chlorhexidine and picloxydine mouthwashes was compared. While picloxydine in higher concentration suppressed the oral flora more effectively than chlorhexidine, the latter agent inhibited plaque development to a much greater extent. This lack of correlation between antibacterial and antiplaque activity can be related to structural differences between these two bis-biguanides.

Bacteria↗

PubMed1987

A comparison of three delivery methods of chlorhexidine in handicapped children. I. Effects on plaque, gingivitis, and toothstaining.

In handicapped groups, the maintenance of oral hygiene can be a major problem, and chemical plaque control offers many advantages. This study compared the effectiveness of chlorhexidine gluconate, delivered as a 0.2% mouthrinse, a 0.2% spray, and a 1% gel in trays, in controlling dental plaque and gingival bleeding in a group of 49 spastic children. All three delivery methods produced an improvement in plaque and gingival bleeding scores. However, the gel was significantly more effective than either the mouthwash or the spray. There was no significant difference between delivery methods in the amount of tooth staining.

Administration, Topical↗

PubMed1987

A comparison of three delivery methods of chlorhexidine in handicapped children. II. Parent and house-parent preferences.

As part of a study of chlorhexidine used for plaque control in handicapped children, preferences and difficulties with the three delivery methods were evaluated by questionnaire. The delivery methods were a 0.2% mouthwash, 0.2% spray, and 1% gel in trays. Responses from parents and house parents revealed the least preference for, and most difficulties with, the gel in trays. The spray was the most popular and 96% of the respondents would be prepared to use this indefinitely as a method of oral hygiene. The most effective method was the gel in trays, but results of the questionnaire suggested that the respondents would be unwilling to use it for prolonged periods. The importance of user acceptance and compliance to the long-term success of oral hygiene methods was evident.

Administration, Oral↗

PubMed1991

The effects of a cetylpyridinium chloride prebrushing rinse as an adjunct to oral hygiene and gingival health.

A NUMBER OF MOUTHWASH PRODUCTS containing cetylpyridinium chloride (CPC) are available. Data for individual products are limited, although overall the antiseptic has been shown to reduce plaque. Results for gingivitis reductions by CPC have been equivocal. This study was an active/placebo parallel group design to evaluate the use of a CPC mouthrinse as an adjunct to oral hygiene when used before toothbrushing. Plaque and gingivitis scores were recorded at baseline and after 6 weeks, following twice daily use of the active or placebo prebrushing rinses. Plaque and gingivitis were significantly reduced at 6 weeks in both groups with no significant treatment differences between the active and placebo formulations. Whether the order of rinsing to toothbrushing influenced these findings cannot be determined. However, the results further question the adjunctive benefits of CPC rinses to gingival health.

Cetylpyridinium↗

PubMed1992

The effect of a number of commercial mouthrinses compared with toothpaste on plaque regrowth.

Mouthwashes are frequently used as adjuncts to oral hygiene. However, for some products there is little supportive evidence that rinses provide greater benefits than plain water or additional benefits to the plaque inhibitory action provided by toothpaste. This study was a single blind, randomized, cross-over design in which 6 rinses were compared for inhibitory action against plaque regrowth. The formulations were a cetylpyridinium chloride rinse, a prebrushing detergent rinse, a peroxyborate rinse a toothpaste slurry rinse, a chlorhexidine rinse, and a saline rinse. From a zero baseline, plaque regrowth at day 5 was significantly reduced by chlorhexidine compared to peroxyborate; and, in turn, significantly reduced by peroxyborate compared to the other rinses. There were no significant differences between saline or a toothpaste slurry and the cetylpyridinium chloride or prebrushing rinse products. The findings would appear pertinent to the value of the respective rinses as adjuncts to oral hygiene.

Adult↗

PubMed1993

Effects of a combination therapy to eliminate Porphyromonas gingivalis in refractory periodontitis.

This report describes the clinical and microbiological features of 30 refractory patients and their response to a combined local and systemic therapy at 6 weeks and 3 years following treatment. The refractory treatment protocol (RefTx) consisted of a 2-week regimen of amoxicillin/clavulanate potassium in conjunction with professional, intrasulcular delivery of povidone iodine, and chlorhexide mouthwash rinses b.i.d. Eighty-seven percent of the patients had favorable clinical responses to the RefTx and could be divided into 3 groups (A, B, C) based upon initial flora patterns and the shifts that occurred following treatment. Pretreatment prevalence of Porphyromonas gingivalis (P.g.) was 36.7%. The RefTx was effective in reducing P.g. below detection levels in 10 of the 11 positive patients at P < 0.01; each of these 10 patients (Group A) demonstrated significant gain in attachment. Other black-pigmented Bacteroides species (OBP) were isolated from 70% of the patients at baseline. Nine of these patients did not harbor P.g., showed clinical improvement upon treatment, and were OBP negative following treatment (Group B). Group C patients (7) demonstrated clinical improvement with therapy and did not fit into either Group A or B based upon microbial patterns. Group D patients (4) did not show clinical improvement with 3 patients harboring either P.g. or OBP after treatment. The RefTx was effective at reducing probing pocket depth with a 56% decrease in the number of pockets greater than 6 mm at 6 weeks. This was accompanied by an overall gain of > or = 1 mm of probable attachment in 45% of all sites. The clinical effects of the RefTx were shown to persist at 34.3 months with an apparent attachment gain of > or = 1 mm in 41.2% of sites. These data suggest that P.g. and OBP are important pathogens in refractory periodontitis and that the RefTx protocol is an acceptable, non-invasive alternative for the management of these patients.

Adult↗

PubMed1994

Chlorhexidine use after two decades of over-the-counter availability.

Chlorhexidine (CHX) is a compound with plaque-inhibiting effects and available only by prescription in the United States. In Norway, however, CHX has been dispensed over-the-counter for over 20 years, and this study was undertaken to evaluate dentists' perceptions regarding its indications, usefulness, and side effects. A written questionnaire was sent to a sample of 10% of dentists registered in Norway, 78% of whom (354) responded. Additionally, representatives from 2% of all dental practices in Norway were contacted by telephone. Fourteen percent (14%) of the respondents reported that they never recommended CHX to their patients. Among those recommending the compound, 85% used it frequently after surgical periodontal procedures; 74% when treating acute gingivitis; 57% following oral surgery in general; and 35% during non-surgical periodontal therapy. It was used also as an adjunct to other treatment routines. Seventy-three percent (73%) reported frequent use of CHX when treating stomatitis and 54% in herpes simplex infections. As to side effects, 77% of the dentists indicated that staining of teeth, restorations, and the tongue was a major concern to patients; 12% reported inconveniences due to the bitter taste; and 6% reported other disturbances such as dryness of the mouth and development of oral ulcerations. The majority (94%) of the dentists recommended mouth rinsing, whereas 6% recommended a gel form. Only 4% of the dentists recommended rinsing with a patient-diluted 0.1% concentration, whereas 96% recommended the standard 0.2% formulation; 88% recommended using CHX mouthwash twice a day or more often.(ABSTRACT TRUNCATED AT 250 WORDS)

Chlorhexidine↗

PubMed2006

Development of a compact and simple gas chromatography for oral malodor measurement.

BACKGROUND: Volatile sulfur compounds (VSCs) in oral air are the only type of gases correlated with the strength of oral malodor. We developed a compact and simple gas chromatograph (GC) equipped with a newly invented indium oxide semiconductor gas sensor (SCS) for measuring the concentrations of VSCs in mouth air. We have assessed the correlation between measurements with a GC-SCS and those with a regular GC. METHODS: Oral air samples from randomly selected volunteers were analyzed with both a GC-SCS and a GC with a flame photometric detector (FPD), which is specific to VSCs, and GC-SCS measurements were compared to those obtained by GC-FPD. Subsequently, oral air samples before and after mouthrinsing with 5% ethanol mouthwash were analyzed to determine the effect of ethanol on VSC measurements by GC-SCS. RESULTS: There were strong correlations between VSC concentrations determined using these two gas chromatography methods (hydrogen sulfide, R=0.821, P<0.0001; methyl mercaptan, R=0.870, P<0.0001; and dimethyl sulfide, R=0.770, P<0.0001). Although GC-SCS can differentiate ethanol and VSCs in oral air samples after mouthrinsing, GC-SCS measurements demonstrated higher values than those obtained by GC-FPD; however, this discrepancy improved over time due to the reduced effect of ethanol. CONCLUSION: The results suggest that GC-SCS may be useful for the diagnosis of halitosis.

Adolescent↗

PubMed2001

PVC matrix membrane sensor for potentiometric determination of cetylpyridinium chloride.

A novel cetylpyridinium chloride-selective membrane sensor consisting of cetylpyridinium-ferric thiocyanate ion pairs dispersed in a PVC matrix placticized with dioctylphthalate is described. The electrode shows a stable, near-Nernstian response for 1 x 10(-3)-1 x 10(-6) mol l-1 cetylpyridinium chloride (CPC) at 25 degrees C over the pH range 1-6 with a cationic slope of 57.5 +/- 0.4. The lower detection limit is 8 x 10(-7) mol l-1 and the response time is 30-60 s. Selectivity coefficients for CPC relative to a number of interfering substances were investigated. There is negligible interference from many cations, anions and pharmaceutical excipients; however, cetyltrimethylammonim bromide (CTMAB) interfered significantly. The determination of 0.5-350 micrograms/ml of CPC in aqueous solutions shows an average recovery of 98.5% and a mean relative standard deviation of 1.6% at 56.0 micrograms/ml. The direct determination of CPC in Ezafluor mouthwash gave results that compare favorably with those obtained by the British Pharmacopoeia method. Precipitation titrations involving CPC as titrant are monitored with a CP sensor. The CP electrode has been utilized as an end point indicator electrode for the determination of anionic surfactants in some commercial detergents.

Cetylpyridinium↗