An in vivo study of dietary factors in the aetiology of tooth staining associated with the use of chlorhexidine

Abstract

An in vivo study was carried out to investigate the role of tea, coffe and cigarette smoking upon the staining of teeth associated with the use of chlorhexidine gluconate. Three groups of volunteers, one of which consisted of cigarette smokers, rinsed with a 0.2% chlorhexidine gluconate mouthwash three times a day throughout two 10 day periods. The two non smoking groups were allocated tea and coffe respectively for consumptionduring on 10 day period. The smoking group were allocated coffee during one 10 day period. During the other 10 day periods the volunteers refrained from all hot beverages. A fourth group refrained from all hot bevrages during a 21 day period. The staining which developed on the previously cleaned teeth and tongues of the volnteers at the end of the respective rinsing periods was scored. All volunteers kept a diet record throughout the whole study. The drinking of tea and coffe significantly increased staining of teeth and tongue when compared with not drinking. Staining by tea was significantly worse than staining by coffee. Cigarette smoking appeard to have an additive effect on the staining. Dietary analysis indicated that other factors ar important to development of chlorhexidine staining and some apeared particularly chromogenic in this respect.

An in vitro evaluation of the availability of cetylpyridinium chloride and chlorhexidine in some commercially available mouthrinse products

“…However, both laboratory and clinical evidence strongly support a dietary aetiology whereby staining is caused by the precipitation of dietary chromogens by cationic antiseptics such as chlorhexidine and CPC. [16][17][18][19][20] This phenomenon has been exploited in vitro to assess the availability of cationic antiseptics in commercially available mouthrinse formulations. [21][22][23] Indeed, the method has been employed to predict plaque inhibitory properties of mouthrinses containing cationic antiseptics.…”

The chemical stain removal properties of 'whitening' toothpaste products: studies in vitro

“…The method has been used in clinical studies to both investigate stain formation and removal in vivo. 12,14,15 In the present in vitro study, the method allows the potential of agents to chemically remove organic stain, from a substrate surface, to be measured. The laboratory environment is almost certainly a best case scenario for agents to work within for a number of reasons.…”

Tooth staining potential of experimental amine fluoride/stannous fluoride mouth rinse formulations—a randomized crossover forced staining study

“…In particular, teeth and tongue are affected. CHX is especially known to promote staining through an interaction with dietary chromogens such as those found in tea, coffee or red wine [2][3][4][5]. While, on the one hand, the occurrence of extrinsic stains is a kind of proof that the formulation seems to be effective against plaque, it is, on the other hand, a limiting factor for long-term use.…”