Chemical agents for the control of plaque and plaque microflora: an overview

Abstract

This presentation provides an overview of the technologies available for the chemical control of plaque. It is generally accepted that the formation of dental plaque at the interfaces of tooth/gingiva is one of the major causes of gingival inflammation and dental caries. Several therapeutic approaches have been used to control dental plaque and supragingival infections. These include fluoride preparations such as stannous fluoride, oxygenating agents, anti-attachment agents, and cationic and non-cationic antibacterial agents. Among the fluoride preparations, stable stannous fluoride pastes and gels have been shown to reduce supragingival plaque, gingivitis, hypersensitivity and caries. The effect of the oxygenating agents on the supragingival plaque has been equivocal, but recent data indicate that a stable agent which provides sustained active oxygen release is effective in controlling plaque. A polymer, PVPA, which reduced attachment of bacteria to teeth was shown to significantly reduce plaque formation in humans. A new generation of antibacterials includes non-ionics such as triclosan, which in combination with a special polymer delivery system, has been shown to reduce plaque, gingivitis, supragingival calculus and dental caries in long-term studies conducted around the world. Unlike the first generation of agents, the triclosan/copolymer/sodium fluoride system is effective in long-term clinicals and does not cause staining of teeth, increase in calculus, or disturbance in the oral microbial ecology.

Supragingival Calculus: Formation and Control

“…The mechanism by which PVM/MA copolymer enhances the delivery of triclosan has been elucidated (Gaffar et al, 1997). The copolymer is composed of two groups: an attachment group and a solubilizing group.…”

The cariogenic dental biofilm: good, bad or just something to control?

“…Stannous fluoride and amine fluoride as well as numerous metallic ions have demonstrated antimicrobial effectiveness. 32,33 Tin, zinc, copper and others have demonstrated anti-microbial effects, but none have demonstrated anti-caries effectiveness. Essential oils, a mixture of thymol, eucalyptol, methyl salicylate and menthol have been demonstrated to be effective in preventing the build-up of supra-gingival plaque and gingivitis, 34,35 but have not demonstrated effectiveness in the reduction of caries lesions.…”

Dispersal of Biofi lms by Secreted, Matrix Degrading, Bacterial DNase

“…A large number of chemical adjuncts to support mechanical tooth cleaning have been developed and proven to contribute to caries control [5][6][7]. While most of these agents, such as chlorhexidine or essential oils, aim at killing bacteria in the oral cavity, non-bactericidal approaches that target bacterial adhesion and biofilm formation have gained increasing attention in recent years [8][9].…”