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PubMed1995

Plaque formation and gingivitis after mouthrinsing with 0.2% delmopinol hydrochloride, 0.2% chlorhexidine digluconate and placebo for 4 weeks, following an initial professional tooth cleaning.

A double-blind, randomised, 4-week clinical trial with parallel group design in 57 patients with gingivitis was conducted for studying the antibacterial efficacy and safety of a delmopinol HCl aqueous solution 2 mg/ml (0.2% w/v), which was used for unsupervised mouth-rinsing and compared with placebo and chlorhexidine digluconate 2 mg/ml (0.2% w/v, Hibitane Dental, ICI Pharmaceuticals, UK). The plaque index and plaque wet weight were used to measure plaque formation, and gingival fluid flow and bleeding on probing to measure gingivitis. According to the reduction from baseline, chlorhexidine showed a significantly better effect on plaque formation than the placebo after 4 weeks treatment for both plaque measurements. Delmopinol exhibited significantly lower plaque index scores than placebo. The difference between chlorhexidine and delmopinol was not statistically significant for any of the plaque measurements. For gingivitis, no statistically significant differences were obtained between the effects of delmopinol, chlorhexidine and placebo. A transient anaesthetic sensation in the oral mucosa was experienced more clearly by the patients in the delmopinol group than by those using chlorhexidine or placebo rinses. Rinsing with chlorhexidine resulted in more staining of the teeth and tongue than did delmopinol and placebo. The placebo solution tasted better than the 2 active solutions. The results showed that rinsing with either delmopinol HCl aqueous solution 2 mg/ml or chlorhexidine digluconate 2 mg/ml 2x daily for 60 as a supplement to normal oral hygiene, following an initial professional tooth cleaning, leads to a lower plaque formation than rinsing with placebo.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗

PubMed1996

An evaluation of an antiadhesive copolymer agent on plaque inhibition by chlorhexidine.

The high molecular weight copolymer M239144 has proven antiadhesive action in vitro but clinically lacked effect, even when combined with chlorhexidine. This latter result was thought to arise from inactivation of chlorhexidine by the copolymer. The aim of this study was to determine whether improved activity might arise if the copolymer and chlorhexidine were applied sequentially rather than combined. The study was a double-blind, randomised crossover design balanced for carryover using a 24-h plaque regrowth method. 2 groups of 25 subjects from a zero plaque baseline rinsed 1x with 15 ml volumes of the allocated paired rinses for 60 s. Subjects abstained from toothcleaning for 24 h and were scored for plaque by area. The paired regimens were: 1. placebo: placebo; 2. placebo: 0.03% chlorhexidine; 3. 1% co-polymer and 0.03% chlorhexidine; 4. placebo: 1% co-polymer; 5. placebo: 0.12% chlorhexidine. Plaque regrowth was greatest with regimen 1 and least with regimen 5. However, regimens 3 and 4 were not significantly different from regimen 1, whereas regimen 2 was significantly more effective than regimen 3. The results indicate that the copolymer alone is ineffective, and even delivered sequentially, inactivates chlorhexidine.

Anti-Infective Agents, Local↗

PubMed1996

Effect of chlorhexidine on the adherence properties of Porphyromonas gingivalis.

Chlorhexidine is a bisbiguanide compound that possesses substantive and antibacterial properties. The aim of the present investigation was to evaluate the effect of chlorhexidine on the adherence of Porphyromonas gingivalis to epithelial cells and erythrocytes. Both pretreatment of bacterial cells with chlorhexidine (> 20 micrograms/ml) and incorporation of chlorhexidine in an adherence assay markedly affected the ability of P. gingivalis to adhere to epithelial cells. Chlorhexidine also strongly inhibited hemagglutination by P. gingivalis. It is suggested that chlorhexidine binds to cells, altering the structural conformation of the outer membrane and reducing adherence. This ability of chlorhexidine to prevent bacterial adherence may represent an additional mechanism by which this antimicrobial agent exerts its beneficial clinical effect when used as an adjunct to periodontal therapy.

Animals↗

PubMed1998

6-month use of 0.2% delmopinol hydrochloride in comparison with 0.2% chlorhexidine digluconate and placebo. (I). Effect on plaque formation and gingivitis.

A double-blind, randomised, 6-month clinical trial with parallel group design in 149 patients with gingivitis was conducted to study the efficacy and safety of delmopinol hydrochloride 2 mg/ml (0.2% w/v, Decapinol Mouthwash) used for partly supervised mouthrinsing in comparison with chlorhexidine digluconate 2 mg/ml (0.2% w/v, Hibitane Dental, ICI Pharmaceuticals, UK) and placebo as an addition to normal oral hygiene. Assessments of efficacy were performed using the plaque index and bleeding on probing (BOP). Delmopinol showed 22% lower plaque index scores than placebo after 3 months (p<0.01) and 13% lower scores after 6 months. The corresponding figures for chlorhexidine were 38% (p<0.001) and 38% (p<0.001) after 3 and 6 months, respectively. Bleeding on probing was reduced for delmopinol in comparison with placebo by 11% after 3 months and by 18% (p<0.05) after 6 months. For chlorhexidine the corresponding figures were 18% (p<0.01) and 22% (p<0.01) after 3 and 6 months, respectively. While chlorhexidine showed greater plaque reduction than delmopinol (p<0.01 at 6 months), no statistically significant difference was reached between these two solutions regarding BOP. Both active solutions showed an increased amount of dental calculus in comparison with placebo. A transient anaesthetic sensation in the oral mucosa and taste affection were commonly reported adverse events in both the delmopinol and the chlorhexidine groups. The number of patients withdrawn from treatment due to adverse events or lack of cooperation was 7 in the chlorhexidine group, 4 in the placebo group and 1 in the delmopinol group. The results showed that rinsing with either 0.2% delmopinol hydrochloride or 0.2% chlorhexidine digluconate twice daily for 60 secs for 6 months results in less plaque formation and gingivitis than rinsing with placebo. Mouthrinsing with the 0.2% delmopinol hydrochloride solution was well accepted in this study.

Adult↗

PubMed2004

The effect of a chlorhexidine regimen on de novo plaque formation.

OBJECTIVE: To evaluate the effect of a pretreatment regimen that combined meticulous mechanical tooth cleaning with the daily use of chlorhexidine (rinse, gargle and tongue application) on de novo plaque formation and on the recolonization of various microbiological species in plaque and saliva during a 4-day period of no oral hygiene. MATERIAL AND METHODS: Ten subjects aged 24-36 years with gingivitis were recruited. The study was designed as a double blind cross-over clinical trial including two phases. Each experimental phase comprised one preparatory period of 7 days and one plaque accumulation period of 4 days. During the preparatory period, the volunteers (i) performed meticulous mechanical tooth cleaning using toothbrush and dentifrice and (ii) were, in addition, given two sessions of professional tooth cleaning (PTC) The final PTC was delivered after bacterial sampling had been made on Day 0. In the Control group, no additional plaque control measures were included. In the Test group, the participants in addition to the mechanical measures (i) rinsed twice daily, for 60 s each time with a 0.2% chlorhexidine solution, (ii) gargled twice daily for 10 s with the chlorhexidine preparation, and finally (iii) brushed the dorsum of the tongue for 60 s, twice daily, with a 1.0% chlorhexidine gel. During the 4-day plaque accumulation period, the participants abstained from all mechanical and chemical plaque control measures. On Days 0, 1, 2 and 4 the quantity and quality of plaque formed was assessed by clinical means and by DNA probe techniques. The microbiota of the saliva was studied in samples obtained on Days 0 and 4. RESULTS: It was demonstrated that chlorhexidine used as a mouthrinse combined with gargling and tongue application during the preparatory period significantly retarded the amount of plaque that formed on tooth surfaces during the following 4 days of no oral hygiene. Further, the number of microorganisms present in the biofilm representing Days 0, 1 and 2 of the "plaque accumulation period" was apparently affected by the use of the antiseptic. Among the microorganisms influenced by the chlorhexidine regimen, a substantial number belonged to the genus Actinomyces. It was also observed that the adjunctive use of chlorhexidine reduced the number of bacteria present in saliva at the end of the preparatory period (i.e. on Day 0). After 4 days of no oral hygiene, the microbiota of the newly formed plaque in the Test and Control groups had many features in common. CONCLUSION: Habitat is critical in controlling the bacterial composition of the dental biofilm. The microbiota will tend to go back to the one that is characteristic of a given subject, once chemical antimicrobial means are withdrawn.

Adult↗

PubMed2004

Comparative antiplaque and antigingivitis effectiveness of a chlorhexidine and an essential oil mouthrinse: 6-month clinical trial.

OBJECTIVES: The objective of this study was to compare the antiplaque and antigingivitis effectiveness and the side-effect profiles of an essential oil-containing mouthrinse and a chlorhexidine-containing mouthrinse. MATERIAL AND METHODS: One hundred and eight qualifying subjects, aged 20-57 years, were randomized into three groups: essential oil mouthrinse (ListerineAntiseptic); 0.12% chlorhexidine mouthrinse (Peridex); or 5% hydroalcohol negative control. At baseline, subjects received a complete oral soft tissue examination and scoring of the Loe-Silness gingival index (GI), Quigley-Hein plaque index (PI), Volpe-Manhold calculus index (CI), and Lobene extrinsic tooth stain index (SI). Following a complete dental prophylaxis, subjects started rinsing twice daily with their respective mouthrinse as an adjunct to their usual mechanical oral hygiene procedures. One of the rinses on each weekday was supervised. Subjects were reexamined at 3 and 6 months. The treatment groups were compared with respect to baseline demographic and clinical variables. The primary efficacy variables were GI and PI. Intergroup differences for all clinical variables were tested at 3 and 6 months using appropriate statistical procedures. RESULTS: All of the 108 randomized subjects were evaluable at 3 months, and 107 subjects were evaluable at 6 months. There were no statistically significant differences among the three groups at baseline, with the exception that the control group PI was significantly lower than that of the essential oil group (p<0.05) and the chlorhexidine group (p<0.001), and the essential oil mouthrinse group had a significantly greater number of subjects than the control group with body region SI scores > or =1.0 (p=0.021). At 6 months, the essential oil and chlorhexidine mouthrinses produced statistically significant (p<0.001) GI reductions of 14.0% and 18.2%, respectively, and statistically significant (p<0.001) PI reductions of 18.8% and 21.6%, respectively, compared with the control and were not statistically significantly different from each other with respect to plaque and gingivitis reduction. The chlorhexidine mouthrinse group had significantly more calculus and extrinsic tooth stain than either the essential oil mouthrinse group or the control group. CONCLUSION: This 6-month controlled clinical study demonstrated that the essential oil mouthrinse and the chlorhexidine mouthrinse had comparable antiplaque and antigingivitis activity. Insofar as side effects associated with the chlorhexidine mouthrinse may limit patient compliance, it is suggested that each product can have a distinct role in the management of patients with periodontal diseases.

Adult↗

PubMed1977

Binding of dyes to chlorhexidine-treated hydroxyapatite.

The binding of some selected food dyes to hydroxyapatite with and without a coating of chlorhexidine was studied. The apatite had bound 0.6 mumol chlorhexidine per g dry weight. The bound chlorhexidine was in equilibrium with a free concentration of 115 microgram ml (128 micron). The dyes investigated were brilliant blue (FD&C Blue No. 1), indigo carmine (FD&C Blue No. 2), tartrazine (FD&C Yellow No. 5), sunset yellow (FD&C Yellow No. 6), amaranth (FD&C Red No. 2), and riboflavin. Riboflavin did not bind to either chlorhexidine-treated apatite or untreated apatite, whereas the other dyes showed a considerable affinity for chlorhexidine-treated apatite as compared with untreated apatite. Because the dyes with binding ability possess two or three acidic groups, and because riboflavin has none, it was suggested that the binding of the dyes is mediated by an interaction between the anionic groups of the dye molecules and the cationic groups of the chlorhexidine molecules. The results are discussed and related to the formation of the brownish discolorations seen on the teeth of patients using chlorhexidine mouthrinses. A mechanism to explain the development of tooth stains is proposed.

Amaranth Dye↗

PubMed1979

Determination of fluoride and chlorhexidine from chlorhexidine/fluoride-containing dentifrices.

The intention of the present experiment was to study the effects of a possible interaction between fluoride and chlorhexidine when both agents were incorporated in the same vehicle. The amount of fluoride extractable from dentrifrices containing 0.1% NaF and the fluoride ion activity were not reduced by the addition of 2% chlorhexidine digluconate. Less than 50% of the added chlorhexidine was available when the dentifrices were dissolved in deionized water. This was not affected by the presence of fluoride. The in vitro antibacterial activity of the chlorhexidine-containing dentifrices was not reduced by the addition of fluoride. Approximately 40% of the chlorhexidine was retained in the human oral cavity after brushing for 1 min with both the chlorhexidine- and the chlorhexidine/fluoride-containing dentifrice. Thus the binding of chlorhexidine to vehicle ingredients when dissolved in water is probably too weak to affect the retention in the mouth.

Bacteria↗

PubMed1991

In vitro antibacterial effect of chlorhexidine added to glass-ionomer cements.

The aims of the present study were to investigate the antibacterial properties of glass-ionomer cements containing different concentrations of chlorhexidine and the possible release of chlorhexidine from the compound. Chlorhexidine gluconate or diacetate was mixed with glass-ionomer cements and tested in vitro against strains of Lactobacillus casei and mutans streptococci. A spectrophotometric test was used to monitor the release of chlorhexidine from the mixture. In a broth culture test, the higher the concentrations of chlorhexidine in the mixture, the longer the time of antibacterial effect on Streptococcus mutans and the greater the tendency of the material to deteriorate. Agar diffusion tests revealed bacterial inhibition in a dose-response manner. The tested bacterial strains were similarly inhibited and the antibacterial properties decreased with time. A minor portion of added chlorhexidine was released from the cement. The deterioration of the cements indicates that the material could be useful as a varnish-like chlorhexidine carrier.

Acrylic Resins↗

PubMed2006

Adsorption of chlorhexidine and black tea onto in vitro salivary pellicles, as studied by ellipsometry.

The adsorption from 0.2% (w/w) chlorhexidine and black tea solutions onto an in vitro pellicle from whole unstimulated saliva on hydroxyapatite discs was studied by ellipsometry. It was found that chlorhexidine adsorbed to the pellicle and caused a modification of the pellicle properties, leading to a subsequent increase in adsorption of salivary and black tea components. There was a distinct order-of-addition effect, whereby chlorhexidine followed by black tea gave an overall greater adsorption of components compared with black tea followed by chlorhexidine. This increase in adsorption resulted in a concomitant increase in color or stain, as measured by a reflectance chromameter. The increase in adsorbed amounts and stain was modified, in part, by the adsorption of salivary fractions between the chlorhexidine and black tea treatments. In all cases, the chlorhexidine and black tea-modified pellicles were not readily removed by either phosphate or sodium dodecyl sulfate rinses. Thus, following exposure to chlorhexidine, the accelerated adsorption of salivary and black tea components can ultimately lead to increased staining of the pellicle.

Adsorption↗

PubMed2005

Chlorhexidine digluconate induces mitotic recombination in diploid cells of Aspergillus nidulans.

UNLABELLED: Chlorhexidine digluconate (1,1'-hexamethylene-bis[(5-p-clorophenyl)-biguanide]) is a bisbiguanidine antiseptic, used to decrease plaque formation and to control periodontal diseases. The determination of the frequency of mitotic crossing-over constitutes a very important method for detecting carcinogenic agents. OBJECTIVE: The recombinogenic potential of chlorhexidine digluconate was evaluated on Aspergillus nidulans by the production of cells homozygous for the following nutritional markers: riboA1, pabaA124, biA1, methA17 and pyroA4. METHOD: A. nidulans was exposed to three concentrations of chlorhexidine digluconate (1, 5, and 10 microM). RESULTS: Inhibition of colony development, conidiophore morphological alteration (cytotoxic effect), and the recombinogenic effect, indicated by homozygotization index (HI) values higher than 2.0, were observed for all concentrations of chlorhexidine digluconate. A homozygous pyro+//pyro+ diploid strain and a diploid homozygous for the recessive w gene were isolated from UT448//A757 diploid treated with chlorhexidine digluconate, emphasazing its recombinogenic potential. CONCLUSION: Although, beneficial effects of chlorhexidine, as an antiseptic agent, are reported in the literature, our results revealed that chlorhexidine digluconate, at less levels lowered those used clinically, caused toxic and recombinogenic effects on diploid A. nidulans strain.

Anti-Infective Agents↗

PubMed1999

High-performance liquid chromatographic analysis of chlorhexidine in saliva after mouthrinsing.

A high-performance liquid chromatographic method was developed to quantify chlorhexidine in human saliva. After addition of an internal standard and acidic-deproteinization, saliva samples were chromatographed by the reversed-phase ion-pair system using pentanesulfonate as a counterion and the eluates were detected by a diode array detector. Under optimal conditions, the baseline separation of analytes was achieved within 4.5 min without interference from components in saliva matrix. The method showed high selectivity to salivary chlorhexidine, quantitative range (50. 0ng/ml-50.0 microg/ml), recovery (96.0-97.8%) and analytical precision (intra- and interassay CVs within 0.41%), permitting the effective application to both saliva and aqueous solutions. Chlorhexidine was found in saliva at microgram per milliliter levels for at least 8 h after mouthrinsing with 10 ml of an aqueous solution of chlorhexidine (0.1 or 1.0 mg/ml) for 1 min. The concentrations of salivary chlorhexidine were reduced by ingesting the acidic beverage and food, but not by ingesting the neutral beverage. The adsorption experiments in artificial saliva revealed that chlorhexidine was significantly adsorbed to saliva-coated hydroxyapatite, buccal epithelial cells and mucin. The proposed method will be a useful tool to study salivary chlorhexidine after oral application and its retention in the oral cavity.

Adsorption↗

PubMed1988

Effect of professional flossing with chlorhexidine gel on approximal caries in 12- to 15-year-old schoolchildren.

The aim of the investigation was to evaluate the effect of chlorhexidine gel treatment on caries development of approximal tooth surfaces and on salivary counts of Streptococcus mutans. 220 12-year-old schoolchildren, divided into three groups, participated: (1) chlorhexidine gel group (n = 72), (2) placebo gel group (n = 77), and (3) control group (n = 71). The study was carried out double blind with respect to the two gel groups. Group 1 was treated 4 times/year with 1% chlorhexidine gel and group 2 with a placebo gel. Approximately 1 ml of gel was applied interdentally by means of a flat dental floss. The control group did not receive any gel treatment or flossing. Number of S. mutans in the saliva was estimated on five occasions during the study with the spatula method. After 3 years, the mean approximal caries increment, expressed as new DFS, was 2.50 in the chlorhexidine gel group and 4.30 in the placebo gel group (p less than 0.05). The corresponding figure in the control group was 5.25 (p less than 0.001 when compared to group 1). 44% of the children in the chlorhexidine gel group and 32% in the placebo gel group did not develop any new approximal caries lesion during the 3-year observation period compared to 18% in the control group (group 1-3 p less than 0.001; group 2-3 p less than 0.05). The number of new approximal fillings (FS) was 0.24 in the chlorhexidine gel group, 0.75 in the placebo gel group and 0.82 in the control group (group 1-3 p less than 0.01; group 2-3 p less than 0.05). There was no statistically significant difference between the groups with respect to numbers of S. mutans in saliva. However, there were more individuals with low numbers of S. mutans in the chlorhexidine gel group at the final examination compared to the baseline level (p less than 0.05).

Adolescent↗

PubMed1987

Structural determinants of activity of chlorhexidine and alkyl bisbiguanides against the human oral flora.

We assayed chlorhexidine and a series of its analogues, in which the chlorophenyl terminal substituents were replaced with alkyl chains, for their in vitro antimicrobial activity against the Gram-negative and Gram-positive oral bacteria. Changes in antimicrobial activity were correlated with changes in agent structure for identification of structural criteria which may be important in the optimization of agent activity. Chlorhexidine showed substantial antimicrobial activity against the Gram-negative as well as the Gram-positive oral bacteria. The alkyl agents were comparable with chlorhexidine in their activity against Bacteroides gingivalis and Bacteroides intermedius, black-pigmented Gram-negative obligate anaerobes associated with periodontal disease in adults. Alkyl agents alexidine, heptihexidine (1,6-bis-n-heptylbiguanidohexane), hexoctidine (1,8-bis-n-hexylbiguanidoctane), and hexhexidine (1,6-bis-n-hexylbiguanidohexane), as well as chlorhexidine, were active against Actinobacillus actinomycetemcomitans, a Gram-negative organism associated with localized juvenile periodontitis. Hexidecidine (1,10-bis-n-hexylbiguanidodecane) and heptoctidine (1,8-bis-n-heptylbiguanidooctane) were more active, and hexhexidine was as active as chlorhexidine against Fusobacterium nucleatum, also associated with periodontal disease. Seven of the agents were more active than chlorhexidine against Actinomyces species. All test agents were active against Streptococcus mutans, a Gram-positive coccus associated with dental caries. Hexidecidine had activity equal to that of chlorhexidine when evaluated against the entire battery of organisms. Analysis of structure-activity relationships revealed that alkyl chains could replace chlorophenyl groups with retention or improvement of antimicrobial activity.(ABSTRACT TRUNCATED AT 250 WORDS)

Actinomyces↗

PubMed1989

The effect of pH on the sensitivity of species of Lactobacillus to chlorhexidine and the antibiotics minocycline and spiramycin.

The purpose of this study was to determine the sensitivity of a range of Lactobacillus species to chlorhexidine, Minocycline, and Spiramycin, at a range of pH from 5.0 to 7.4. Strains of Streptococcus were also tested for their sensitivity to chlorhexidine, as a comparison between the genera. There were both inter- and intra-species variations in the sensitivity of these strains to chlorhexidine. The strains tested were sensitive at pH 6.7 to the following levels of chlorhexidine (micrograms/mL): L. casei (6 strains), 10-60; L. plantarum (4 strains), 40; L. fermentum (13 strains), 2-20; L. brevis (1 strain), 10; and L. acidophilus (3 strains), 10-60. The Streptococcus species were sensitive to 1-4 micrograms/mL (13 strains); 4-10 micrograms/mL (3 strains); and 10-20 micrograms/mL (2 strains). One strain was able to survive 20 micrograms/mL. Chlorhexidine was found to be less effective at lower pH levels. The following examples show sensitivity (micrograms/mL) at pH 6.5 followed by sensitivity at pH 5.0: L. casei (ATCC 15008), 40,60; L. plantarum (CH 374), 40,100; L. fermentum (CH 324) 10,40; L. acidophilus (ATCC 4356), 10,40; and S. mutans (BM 52), 2,2. All of the strains of Lactobacillus tested with Spiramycin were resistant at pH 5.0. Minocycline was less affected by changes in pH, but at pH 7.4 Lactobacillus strains were more resistant to Minocycline as compared with Spiramycin. Both of these antibiotics are bacteriostatic, and therefore may have a more limited effect than a bactericidal agent such as chlorhexidine. The Lactobacillus strains tested required higher concentrations of chlorhexidine than did the strains of Streptococcus for a killing effect in vitro.

Chlorhexidine↗

PubMed1989

Development and in vitro evaluation of an intra-oral controlled-release delivery system for chlorhexidine.

Copolymers of hydroxyethyl methacrylate (HEMA) and methyl methacrylate (MMA) were prepared and used to fabricate a membrane-controlled reservoir-type controlled-release delivery system for chlorhexidine that should be suitable for intra-oral use. The reservoir of the system was prepared by softening an 80:20 mixture of chlorhexidine diacetate and 50:50 HEMA:MMA copolymer with methyl ethyl ketone (MEK), and pressing standard amounts of the resulting dough-like mixture into silicone rubber molds. A membrane was applied to the reservoirs by rotating them through a solution of 30:70 HEMA:MMA copolymer in MEK. The finished oval-shaped controlled-release pellets were approximately 4.7 mm wide, 3.3 mm high, and 7.4 mm long, and contained 45.0 +/- 3.7 mg of chlorhexidine diacetate. The mean in vitro release rate of chlorhexidine diacetate from the pellets into 37 degrees C water was 608 +/- 55 micrograms/24 h for days 2 through 11, and 389 +/- 50 micrograms/24 h for days 15 to 30 of the test period. The chlorhexidine released on day 30 was biologically active, as determined by a serial dilution assay against Streptococcus mutans. The extended release of biologically active chlorhexidine at a controlled rate from this system suggests that it is worthy of further evaluation for the intra-oral therapy of chlorhexidine-treatable oral infections in non-compliant and physically or mentally compromised individuals.

Analysis of Variance↗

PubMed1989

Effects of varnishes containing chlorhexidine on the human dental plaque flora.

This study describes the effects of varnishes containing 0%, 10%, 20%, or 40% chlorhexidine diacetate on the microflora of human fissure dental plaque. Sandarac, a natural resin, was used as the varnish base. Ten subjects, each with at least four sound fissures harboring high levels of Streptococcus mutans, participated in the study. The fissures in each of the individuals were randomly assigned to four experimental groups, in each of which one of the varnishes was tested. The varnish treatment consisted of a single application of a small amount of varnish onto the fissures. Apart from the selected fissures, the rest of the dentition was left untreated. All chlorhexidine-containing varnishes selectively suppressed S. mutans in fissure plaque, and had no effect on total viable counts or on the numbers of Actinomyces viscosus/naeslundii and Streptococcus sanguis beyond one week. The extent of the suppression depended upon the concentration of chlorhexidine in the varnish, 40% chlorhexidine varnish giving the greatest suppression of S. mutans. At 22 weeks, after a single treatment with varnish containing 40% chlorhexidine, mean S. mutans counts were more than ten times lower than in the control or 10%-chlorhexidine varnish group. At that time, S. mutans was still undetectable in five out of ten experimental fissures in this group. The results suggested that sandarac varnishes containing high concentrations of chlorhexidine can be used successfully for long-term suppression of S. mutans in dental fissures.

Actinomyces↗

PubMed1993

Synergistic, growth-inhibitory effects of chlorhexidine and copper combinations on Streptococcus mutans, Actinomyces viscosus, and Actinomyces naeslundii.

The purpose of this investigation was to determine whether chlorhexidine combined with copper would exert a synergistic, growth-inhibitory effect against selected oral bacteria. Actinomyces viscosus, Actinomyces naeslundii, and Streptococcus mutans were all susceptible to chlorhexidine individually, with S. mutans displaying the highest sensitivity. Much higher concentrations of copper were needed to achieve growth inhibition of the micro-organisms tested. Determination of minimum inhibitory concentrations (MICs) of chlorhexidine and Cu2+ combinations suggested synergistic activity. Bactericidal kinetics assays confirmed synergism of chlorhexidine and Cu2+ combinations with 1 to 2 log greater decreases in viable cell numbers compared with chlorhexidine alone. Under the constraints of the conditions employed, these data demonstrate the efficacy of chlorhexidine and Cu2+ combinations against the oral bacteria tested. These studies suggest that a chlorhexidine and copper formulation could be useful as a mouthrinse in helping control cariogenic micro-organisms and/or in the treatment of gingivitis.

Actinomyces↗