Effect of toothbrushing with chlorhexidine gel on salivary microflora, oral hygiene, and caries

Abstract

– The effect of daily toothbrushing with 0.5 % chlorhexidine‐containing gel for 12 months was evaluated in a double‐blind study in 37 dental students. The active gel did not markedly influence plaque formation, gingival conditions, or caries as compared with placebo gel treatment. Salivary bacterial counts were performed on subgroups of six subjects using chlorhexidine gel and on six using placebo gel. No differences in the effect of treatment on the microorganisms studied in the two subgroups could be detected except for S. sanguis. The percentage of this species decreased in the placebo group and increased in the chlorhexidine group. The difference became significant after 2 weeks. A tendency to a greater reduction of S. mutans noted in the chlorhexidine group was most marked in individuals who had high initial counts of this species. The proportion of S. sanguis, which could grow on chlorhexidine‐containing mitis salivarius medium, increased and after 12 months of chlorhexidine treatment averaged 34 % of cultivable S. sanguis compared with 0.002 % prior to treatment. The number of less sensitive S. sanguis decreased in the 12 months following termination of treatment. There was no observed tendency for the selection or proliferation of other streptococci, gram‐negative rods, yeasts, or staphylococci.

A Randomised Controlled Trial of the Caries– Preventive Efficacy of a Chlorhexidine–Containing Varnish in High–Caries–Risk Adolescents

“…Studies that used varnish as the method of chlorhexidine delivery have found a cariesreducing effect, but they have focused on specific sites [Bratthall et al, 1995;Petersson et al, 1998] or root caries [Schaeken et al, 1991]. In the study by Emilson and Fornell [1976], the lack of anti-caries effect was partially explained by the low caries incidence. In this study, the active varnish subjects who had a relatively high initial caries experience did exhibit a non-significant reduction in caries increment when compared to the other study groups ( fig.…”

“…Early work that investigated the caries-reducing effect of chlorhexidine was equivocal with some studies showing a marked decrease [Zickert et al, 1982] and others showing no effect [Emilson and Fornell, 1976]. However, these studies did not use varnish application as the method of chlorhexidine delivery.…”

Effect of Professional Flossing with Chlorhexidine Gel on Approximal Caries in 12- to 15-Year-Old Schoolchildren

“…The prevalence of caries on smooth surfaces in children today is, however, low in most industrialized coun tries [Glass, 1982], There are also data indicating that the number of S. mutans is higher on approximal than smooth tooth surfaces [Scheie et al, 1984] and that posterior teeth are more colonized with this cariogenic microorganism than front teeth [Keene et al, 1981], Application of chlorhexidine gel in mouth trays once a day for 14 days in children with > 2.5 x 105 S. mutans/ml saliva has been evaluated by Zickert et al [1982], Obvious caries reduction was found after 3 years, approximately in the same order as in the pres ent study. In other experiments, the chlorhexidine treatment has been carried out at home either by tooth brushing with a dentifrice/gel or by mouth rinsing with a solution [Fehr et al, 1975;Johansen et al, 1975;Emilson and Fornell, 1976;Dolles and Gjermo, 1980], The results from these latter studies indicate that there seems to be very low or no cariostatic effect, probably depending on the difficulties for the patients themselves to expose all tooth surfaces at risk to the chlorhexidine. The advantage with professional ap plication of the gel is therefore obvious, even if such a regimen requires that the patients have to come to the dental office for the treatment.…”

Effect of Chlorhexidine and Iodine on the Composition of the Human Dental Plaque Flora

“…However, chlorhexidine [Emilson et al, 1982] or iodine [Newbrun et al, 1980] also suppressed A. viscosus. S. sanguis seems to be less affected by chlorhexidine as its proportion increased after chlorhexidine application [Emilson and Fornell, 1976;Emilson, 1981].…”