Antibacterial and anti-biofilm activity of mouthrinses containing cetylpyridinium chloride and sodium fluoride

Abstract

BackgroundCetylpyridinium chloride (CPC) and sodium fluoride augment oral hygiene by inactivating bacteria and inhibiting enamel demineralisation, respectively. However, there are few reports in the literature documenting the antibacterial efficacy of their combined use in mouthrinses. We have used six experimental systems to compare the antibacterial effects of mouthrinses containing 0.075 % CPC (test rinse, TR) or 0.075 % CPC with sodium fluoride (test fluoride rinse, TFR).ResultsEffects against planktonic bacteria were determined using viable counting (for Streptococcus mutans and salivary bacteria), a redox dye (for Actinomyces viscosus and salivary bacteria) and viable counting (for ex vivo oral rinses). Effects against saliva-derived biofilms were quantified using confocal microscopy and differential viable counting. Inhibition of biofilm formation was evaluated by pre-treating hydroxyapatite coupons with mouthrinses prior to inoculation. Otherwise-identical controls without CPC (control rinse and control fluoride rinse, CR and CFR, respectively), were included throughout. Compared to the controls, TFR and TR demonstrated significant antimicrobial effects in the redox assays, by viable counts (>3 log reductions) and in oral rinse samples (>1.25 log reductions, p < 0.05). TFR and TR also significantly reduced the viability of oral biofilms. Pre-treatment of hydroxyapatite with TFR and TR significantly inhibited biofilm formation (>3 log difference, p < 0.05). Overall, there were no consistent differences in the activities of TR and TFR.ConclusionsSodium fluoride did not influence the antibacterial and anti-biofilm potency of CPC-containing formulations, supporting the combined use of CPC and sodium fluoride in mouthrinses to control oral bacteria and protect tooth enamel.

Study on the Correlation between Salivary pH and the Use of Mouthrinses in Young Adults

“…Fluoride inhibits glycolysis of oral microorganisms by interfering with enolase enzyme and by blocking oxygenation of metabolic cycle for energy supply and reproduction and stabilizes oral eco-system. Moreover, accumulated fluoride in plaque by application of sodium fluoride mouthrinse can interfere with the metabolism of bacterial dental plaque [16][17][18]. Similar results in what concerns the effect of sodium fluoride mouthrinse on salivary pH were found in other studies, too [7,19,20].…”

Cetylpyridinium chloride mouth rinses alleviate experimental gingivitis by inhibiting dental plaque maturation

“…31 Studies based on traditional methods, such as viable counting and confocal microscopy, also supported the anti-bacterial and anti-biofilm effectiveness of CPC on certain culturable pathogenic bacteria (such as Porphyromonas gingivalis , Prevotella intermedia and Prevotella nigrescens ), anaerobic bacterial communities and even oral biofilms. 7, 20, 39, 40 This suggests that CPC can diffuse into oral biofilms and exert anti-bacterial effects in vivo . 41 Notably, oral bacteria that were difficult to grow in culture or were not yet cultured, such as TM7, SR1 and Uncultured_ Lachnospiraceae , were also inhibited by CPC mouth rinses, suggesting the importance of culture-independent approaches in unveiling a global landscape of microbial responses in plaque.…”

Efficacy of Mouth Rinse Formulation Based on Cetylpyridinium Chloride 0.1% in the Control of Dental Calculus Buildup

“…Clinical efficacy for these agents typically has been assessed as the reduction in tartar area coverage on the teeth between dental cleanings [13]. Research shows that topically applied mineralization inhibitors also can influence adhesion and hardness of calculus deposits on the tooth surface, facilitating removal [14,15].…”