The effect of topical application of chlorhexidine on the bacterial colonization of the teeth and gingiva

Abstract

Six dental students participated in two experiments throughout which they ceased all active oral hygiene measures. In the first experiment a 2 per cent solution of chlorhexidine and in the second a placebo solution was applied topically each day to all teeth. Throughout both 15 day experiments the bacterial colonization of the attached gingiva, gingival margin and tooth surface was examined using impression preparations and a microcolony technique. Bacterial colonization of the tooth surface occurred rapidly using the placebo and a bacterial plaque accumulated at the gingival margin as described in previous no‐oral‐hygiene experiments. No bacterial colonization of the tooth surface was observed throughout the chlorhexidine experiment. The bacterial flora of the attached gingiva remained unaltered, but at the gingival margin an increase in the numbers of gram negative cocci and rods occurred between days 5 and 10. A tendency was noted for this flora to revert back to gram positive by the end of the experiment. It is concluded that the inhibition of plaque formation by chlorhexidine is primarily a result of its ability to interact with the organic or inorganic components of the tooth surface.

In Vitro Evaluation of Three Iodine-Containing Compounds as Antiplaque Agents

“…The results of the preclinical antiplaque agent screening procedure used here were previously demonstrated to be remarkably consistent with those established empirically in assessing the minimal conditions for efficacy of the bisbiguanide chlorhexidine in human clinical trials testing its antiplaque, antigingivitis, and anticaries effects (5,31,45). It is felt that such preclinical screening ofagents against target plaque-forming microorganisms might avoid costly, time-consuming, and potentially hazardous empirical approaches to human clinical trials.…”

In vivo efficacy of alkaline peroxide tablets and mouthwashes on Candida albicans in patients with denture stomatitis

“…These include the C. albicans which causes thrush infection in the mouth, and bacteria that may infect mouth ulcers or other mouth sores, e.g. after dental surgery 5,9,10,14 . The clinical and microbiological efficacy of chlorine dioxide (ClO 2 ) as a topical antiseptic and disinfectant agent also used for the treatment of chronic atrophic candidiasis in geriatric patients has been assessed 25 .…”

Tooth discolouration and staining: a review of the literature

“…55 Davies et al suggested that locally adsorped chlorhexidine complexed with ions from the oral environment and showed this in vitro with the colour produced between chlorhexidine and food dyes. 56 Following this observation, in vitro and in vivo experiments showed that chlorhexidine and other antiseptics known to cause staining in vivo could bind dietary chromogens to surfaces to produce staining.…”

“…No longer accepted theories of stain formation with chlorhexidine include breakdown of chlorhexidine in the oral cavity to form parachloraniline 54 and also that chlorhexidine may reduce bacterial activity such that partly metabolised sugars were broken down and then degraded over time to produce brown-coloured compounds. 55 Most recent debate has centred around three possible mechanisms. 7 Non-enzymatic browning reactions: Berk suggested that the protein and carbohydrate in the acquired pellicle could undergo a series of condensation and polymerisation reactions leading to discolouration of the acquired pellicle.…”