Antiplaque biocides and bacterial resistance: a review

Abstract

Modern dentistry emphasizes the importance of dental plaque control to improve oral health. The use of oral care formulations with antiplaque biocides plays a crucial role in patient-directed approaches for plaque control. The antiplaque efficacies of these formulations have been extensively studied in many long-term clinical studies designed in accordance with well-accepted guidelines. The results from these studies conclusively demonstrate that long-term use of oral care formulations with well-known antiplaque biocides such as chlorhexidine and triclosan reduce supragingival plaque and gingivitis. This review summarizes microbiological results from clinical studies conducted with oral care formulations containing antiplaque biocides. Results from a number of long-term clinical studies conducted under real-life use conditions indicate no adverse alterations in the bacteria found in dental plaque or emergent microbial resistance. Additionally, microbial sampling of dental plaque subsequent to extended use of antiplaque biocides reveals no increase in resistant microflora. Large numbers of common oral bacteria isolated from patients using chlorhexidine indicate no increase in microbial resistance to chlorhexidine or to commonly used antibiotics. The effects of antiplaque biocides containing oral care formulations on dental plaque that exists naturally as a biofilm are examined. These formulations contain biocide, surfactants, polymers and other components that are effective against the biofilm. In summary, the results of studies on the real-life use of oral care formulations with antiplaque biocides show no emergence of resistant microflora or alterations of the oral microbiota, while such formulations have been found to provide the benefits of reducing plaque and gingivitis.

Is there a role for triclosan/copolymer toothpaste in the management of periodontal disease?

“…103,104 In addition, regular use of a triclosan containing toothpaste did not demonstrate signifi cant decreases in antibiotic susceptibility in dental bacteria. 74,105 Biocide resistance and antibiotic resistance is not a new problem, but current evidence from environmental studies suggests there is no need to curtail triclosan usage.…”

A study of the control of oral plaque biofilms via antibacterial photodynamic therapy

“…Increasingly, there is also concern about the limited access of topical antibacterial agents to plaque biofilms and bacterial resistance to both antibacterials and antibiotics (Sreenivasan and Gaffar, 2002). Therefore, it would be advantageous to develop alternative strategies for the prevention of dental caries and periodontal disease.…”

Cymbopogon citratus essential oil: effect on polymicrobial caries-related biofilm with low cytotoxicity

“…5 Mouthwashes and dentifrices are recommended for dental biofilm control as adjuncts to mechanical removal. 6,7 Chlorhexidine digluconate is considered the gold standard antimicrobial substance. 8 Nonetheless, the occurrence of adverse effects, such as dental staining and hypersensitivity reactions, has encouraged the search for new molecules.…”