The effects of a 0.12% chlorhexidine‐digluconate‐containing mouthrinse versus a placebo on plaque and gingival inflammation over a 3‐month period

Abstract

Several previous studies have evaluated the effects of 0.12% chlorhexidine digluconate (ChD) mouthrinses on plaque and gingival inflammation. However, previously, none have been based in general dental practices. The aim of this study was to evaluate the potential to conduct controlled periodontal clinical trials in co-operation with general dental practitioners (gdps). The project took place in 5 general dental practices in the South of England. 121 healthy subjects (24 at 4 sites and 25 at the 5th), aged 18-65 years, mean 35 +/- 12) years participated in a double-blind, randomised study during which they received full mouth assessments for plaque and gingival bleeding at baseline, 6 and 12 weeks. 60 subjects were randomly assigned to use the 0.12% ChD mouthwash and 61 the placebo. The assessments were carried out by 5 gpds, who had previously achieved inter-examiner kappa scores of 0.78-0.85 (mean 0.81) for the plaque index (PII), and of 0.73-0.94 (mean 0.87) for a modified gingival index (mGI), and who maintained kappa scores of 0.51-0.90 for PII and of 0.73-1.00 for mGI during the 12 months required to complete the study. 98 subjects (48 ChD and 50 placebo) completed the study. Even though the baseline levels of plaque and gingivitis were low, by week 12, mean whole mouth plaque score of the ChD mouthwash users had fallen from 1.33 at baseline to 0.96 and was significantly lower (p < 0.001) than for the placebo users, 1.31 at baseline to 1.13. Whole-mouth gingival bleeding score fell from 0.56 to 0.42 in the ChD mouthwash group but was unchanged (0.54-0.55) in the placebo group. A subsidiary data analysis which considered the effects at sites indicated that within these overall differences, the ChD users experienced almost 2 x the reduction from plaque score 2 at baseline at proximal molar sites over a 12-week period (50.6% ChD versus 27.6% placebo). It was concluded that 0.12% ChD mouthwash reduced plaque accumulation by 28% and gingival inflammation by 25% over a 12-week period, that it is feasible for a group of gdps to maintain high levels of inter-examiner consistency in the use of PII and mGI, that it is also feasible to carry out such a multicentre study in general dental practice, and that the use of mean mouth scores per subject to analyse the effects of mouthrinses may well mask variations in response throughout the mouth.

The effect of adjunctive chlorhexidine mouthrinse on clinical parameters and gingival crevicular fluid cytokine levels in untreated plaque-associated gingivitis

“…Although there are many products used to control plaque and gingivitis, chlorhexidine digluconate (CHX) has received the greatest attention due to its superior clinical and microbiological effectiveness [5][6][7][8]. It is considered as the gold standard for oral antiseptics [9].…”

“…Previous studies investigating antiplaque and antigingivitis effectiveness of different CHX mouthrinse formulations on clinical periodontal parameters have shown that CHX containing mouthrinses improved the supragingival plaque control and had an additional beneficial effect on both the degree of inflammation and the microbial accumulation within the oral cavity [7,11,[20][21][22][23][24]. There has been no study that evaluated the efficacy of CHX mouthrinse in addition to daily plaque control on biochemical markers of gingival inflammation in the presence of gingivitis associated with dental plaque.…”

Higiene bucal com clorexidina na prevenção de pneumonia associada à ventilação mecânica

“…It is absorbed by the tissues and has a residual effect over time, presenting activity even 5 h after administration. (14,15) Various aspects affect oral cavity hygiene and further favor microbial growth, such as difficulty in or impossibility of self-care, presence of tracheal tube, which makes access to the oral cavity difficult, and the consequent formation of dental plaque biofilm. (10)(11)(12)16) The Centers for Disease Control and Prevention (CDC) recommends oral hygiene with chlorhexidine in patients in the perioperative period of cardiac surgery.…”

The effect of adjunctive chlorhexidine mouthrinse on GCF MMP-8 and TIMP-1 levels in gingivitis: a randomized placebo-controlled study

“…It has been stated that CHX mouthrinses is very efficient agent in reducing and/or preventing dental plaque [32-34] and had an additional effect on the degree of inflammation in oral cavity [3,6,32,34,35]. CHX can inhibit MMPs and prevent oxidative activation of MMPs and oxidative inactivation of α1-antitrypsin [36-38].…”