The effect of chlorhexidine mouthrinses on the human oral flora

Schiøtt, C. Rindom; Löe, Harald; Jensen, Stig; Kilian, Mogens; Davies, Robin; Glavind, K

doi:10.1111/j.1600-0765.1970.tb00697.x

Cited by 233 publications

(17 citation statements)

References 6 publications

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“…An experienced surgeon performed all operations under well-controlled, aseptic conditions. The surgical area was washed with a potent anti-plaque agent, i.e., chlorhexidine gluconate, which is known to eliminate approximately 90% of the oral microflora (18). Still, a sterile field of operation was not to be expected.…”

Section: Discussionmentioning

confidence: 99%

“…This was reflected in our culture findings where microorganisms were recovered from the oral mucosa in 23 of the 30 patients. In addition, the bacteria located subgingivally are known to be especially difficult to reach by oral antiseptics (18). We therefore included one group of patients where submarginal incisions were made to avoid involving the sulcular area of the teeth in the operation.…”

Section: Discussionmentioning

confidence: 99%

“…In Group 2, where a submarginal incision was made, only three of 15 samples from the bone surface gave bacterial growth. This may reflect the fact that the gingival sulcus, even in patients with healthy gingiva, is colonized by bacteria that were not removed by the chlorhexidine wash (18). It is likely that following a marginal incision, some of these bacteria were translocated into the surgical site and were sampled on the bone surface after reflection of the flap, even though an experienced surgeon with his approach and technique did all he could to prevent this.…”

Section: Discussionmentioning

confidence: 99%

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Extraradicular infection: a methodological study

Sunde

Olsen²,

Lind³

et al. 2000

Dental Traumatology

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Whether bacteria live or die in periapical lesions of endodontic origin is debated. Sampling of periapical bacteria is difficult due to possible contamination from the indigenous microflora. The aim of this study was to examine whether bacteria were present in periapical lesions of asymptomatic teeth before sampling or were transferred there during sampling. Thirty patients with root-filled teeth and periapical radiolucencies were divided into two groups, each containing 15 patients. In Group 1, a marginal incision was made to explore the periapical lesion. In Group 2, a submarginal incision was made. Before incision, the gingiva and mucosa were washed with 0.2% chlorhexidine gluconate. Bacterial samples were taken from the mucosa before reflecting the flap, and from the alveolar bone and the periapical lesion immediately after. All samples were cultured anaerobically on all-purpose and selective media. In Group 1, 12 of the 15 patients (80%) yielded bacteria from their mucosal samples despite the chlorhexidine wash. Bacterial growth was observed in all samples (100%) from the alveolar bone while the periapical lesions gave bacterial growth in 11 of 15 cases (73%). In Group 2, bacteria were cultured from the mucosa in 11 of 15 (73%) patients. Three samples (20%) from the alveolar bone and 10 from the periapical lesions (67%) gave positive growth. The predominant cultivable bacteria were anaerobic. Phenotypic profiling, performed with the data-based API bioMérieux system, indicated that the sampling technique used prevented mucosal bacteria from reaching the exposed bone and the periapical lesions. Profiling also indicated that following marginal incision, bacteria from the periodontal pocket might have reached the underlying tissues by surgeon-released bacteremia or direct translocation. Most organisms detected in the periapical lesions were clearly different from the bacteria present at neighboring sites and appeared to have been there before sampling.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Extraradicular infection: a methodological study

Sunde

Olsen²,

Lind³

et al. 2000

Dental Traumatology

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“…In general, it may be advisable to prescribe a 0.2% chlorhexidine rinse twice daily 1 week before and 2 weeks after the surgery. Chlorhexidine reduces plaque growth significantly (44,45), reduces postoperative discomfort, and promotes healing (46,47). Moreover, rinsing with chlorhexidine markedly reduces the bacterial load and contamination of the operative area, operator and staff (48).…”

Section: Periodontal Conditionsmentioning

confidence: 99%

Soft tissue management: flap design, incision, tissue elevation, and tissue retraction

Velvart¹,

Peters²,

Peters³

2005

Endodontic Topics

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The ultimate goal in surgical endodontics is not only the eradication of periapical pathosis but also preservation of periodontal conditions using suitable surgical techniques. Acceptable treatment outcomes are no longer possible without consideration of esthetic consequences for all involved dentoalveolar structures. During surgical endodontics the cortical bone is exposed by incising, elevating, and reflecting a full‐thickness tissue flap. Certain basic principles must be considered before deciding on the type of incision and flap design. Thorough knowledge of regional anatomical structures in conjunction, as well as prevailing periodontal conditions affect and must be considered when making the proper decision on how and where to reflect the mucoperiosteal tissues. Various modes of incision can be selected, including horizontal, sulcular, submarginal, and vertical releasing incisions. The variety of flaps reflects the number of variables to be considered before choosing an appropriate flap design. While many flap designs have been suggested over the years, some have become obsolete and new techniques have emerged. It is critical that incisions and tissue elevations and reflections are performed in a way that facilitates healing by primary intention. This can be obtained by complete and sharp incision avoiding severing or traumatizing the tissues during elevation; it is equally important to prevent drying of tissue remnants on the root surface and drying of the flap during the procedure. The introduction of microsurgery to surgical endodontics attempts to minimize trauma and to enhance surgical results. Because of the combination of magnification and more delicate instruments, improved and careful tissue handling has become possible. Additional improvements in flap design and soft tissue manipulation are considered key elements in enhanced biological and esthetic outcomes of marginal soft tissues.

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“…Bacterial counts in saliva consistently drop to between 10 to and 20% of baseline after single rinses and remain at this level for at least 7 hours[2] and probably more than 12 hours. [3]…”

Section: Introductionmentioning

confidence: 99%

Allergic urticaria: A case report of rare skin allergy with a common mouthwash

Chopra

Sharma

2013

Indian J Dermatol

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Chlorhexidine is a widely used antiseptic and disinfectant in medical and non-medical environments. Compared to its ubiquitous use, allergic contact dermatitis from chlorhexidine has rarely been reported and so its sensitization rate seems to be low. Chlorhexidine has been used for more than 50 years but it was only in the last two decades, that reports of immediate- type reactions to chlorhexidine were seen. Reactions ranging from localized urticaria to anaphylactic shock and hypersensitivity reactions, including delayed hypersensitivity reactions such as contact dermatitis, fixed drug eruptions, and photosensitivity reactions, began to appear more frequently. However the prevalence of contact urticaria and anaphylaxis due to chlorhexidine remains to be unknown. In this case report we have reported a case of urticaria due to oral use of chlorhexidine. The adverse reaction was confirmed by a skin prick test.

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The effect of chlorhexidine mouthrinses on the human oral flora

Cited by 233 publications

References 6 publications

Extraradicular infection: a methodological study

Extraradicular infection: a methodological study

Soft tissue management: flap design, incision, tissue elevation, and tissue retraction

Allergic urticaria: A case report of rare skin allergy with a common mouthwash

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