Acta Scientific Dental Sciences (ASDS)(ISSN: 2581-4893)

Review Article Volume 5 Issue 11

Chlorhexidine in Dentistry - Five Decades and Continuing - Where are we Now?

Dr. Krishna Madhukumaran Pillai Sreekaladevi MDS1, Valliammai Rajendran MDS2*, Dr. Veenadevi Thonthula BDS3, Jennifer Joseph Antony MDS4 and Dr. Shreya Kothari BDS MPH 5

1Ex-Post Graduate, Department of oral medicine and maxillofacial radiology, KVG dental college and hospital, Sulliya
2Ex-post Graduate, Department of Periodontology, Manipal College of Dental Sciences, Mangalore, Manipal Academy of Higher Education (MAHE), Manipal, Karnataka, India
3313 orchards Boulevard SW, Edmonton AB T6X1Y9, Canada
4Periodontist, 5/14 Mcilwraith Street, Everton Park QLD 4053, Australia
5Atlanta, Georgia, USA

*Corresponding Author: Valliammai Rajendran, Ex-post Graduate, Department of Periodontology, Manipal College of Dental Sciences, Mangalore, Manipal Academy of Higher Education (MAHE), Manipal, Karnataka, India.

Received: October 05, 2021; Published: October 26, 2021

×

Abstract

Chlorhexidine(CHX) has a wide variety of uses in the management of oral diseases. It is a cationic bisbiguanide with broad antibacterial activity, and a wide spectrum of activity encompassing gram-positive and gram-negative bacteria, yeasts, dermatophytes, and viruses (enveloped). CHX is a commonly used antiseptic mouthwash due to its antimicrobial effects. It is commonly preferred among dentists. The clinical effect of CHX is likely due to both its substantive and antibacterial properties. Search terms were entered into MEDLINE, PubMed, Google Scholar, and the Cochrane database to find evidence about CHX use in the oral cavity. It plays a key role in dentistry and is used to treat or prevent periodontal disease, and has earned its eponym of the gold standard. The aim of this article was to provide a detailed review of the current uses of CHX in dentistry in terms of the management of oral diseases, highlighting the need for further studies to support its safe and appropriate use.

Keywords: Chlorhexidine; Mouthwash; Oral Hygiene

×

References

  1. Sajjan P., et al. “Chlorhexidine as an antimicrobial agent in dentistry—a review”. Oral Health and Dental Management (2016): 93-100.
  2. Balagopal S and Radhika A. “Chlorhexidine: the gold standard antiplaque agent”. Journal of Pharmaceutical Science and Research (2013): 270-274.
  3. Poonam S., et al. “Chlorhexidine—an antiseptic in periodontics”. Journal of Dental and Medical Sciences9(2014): 85-88.
  4. Jones CG. “Chlorhexidine: is it still a gold standard?”. Periodontology 2000 (1997): 55-62.
  5. Lang NP and Brecx MC. “Chlorhexidine digluconate—an agent for chemical plaque control and prevention of gingival inflammation”. Journal of Periodontal Research (1986): 74-89.
  6. Emisilon C. “Susceptibility of various microorganisms to chlorhexidine”. Scandinavian Journal of Dental Research (1977): 255-265.
  7. P Gilbert and L Moore. “Cationic antiseptics: diversity of action under a common epithet”. Journal of Applied Microbiology4 (2005): 703-715.
  8. F Cieplik., et al. “Resistance Toward Chlorhexidine in Oral Bacteria - Is There Cause for Concern?”. Frontiers in Microbiology (2019): 587.
  9. Wood D Payne. “The action of three antiseptics/disinfectants against enveloped and non-enveloped viruses”. Journal of Hospital Infections (1998): 283-295.
  10. Dehghani Nazhvani., et al. “Antifungal Effects of Common Mouthwashes on Candida Strains Colonized in the Oral Cavities of Liver Transplant Recipients in South Iran in 2014”. Hepatitis Monthly (2016): e31245.
  11. N P Lang., et al. “Plaque formation and gingivitis after supervised mouth rinsing with 0.2% delmopinol hydrochloride, 0.2% chlorhexidine digluconate and placebo for 6 months”. Oral Diseases (1998): 105-113.
  12. T Walsh., et al. “Chlorhexidine treatment for the prevention of dental caries in children and adolescents”. Cochrane Database Systematic Review (2015): CD008457.
  13. Y Wang., et al. “Effect of non-fluoride agents on the prevention of dental caries in primary dentition: A systematic review”. PLoS One (2017): e0182221.
  14. Scottish Dental Clinical Effectiveness Programme (SDCEP). “Drug Prescribing for- Dentistry”. Evidence Based Dentistry (2016): 62.
  15. Scottish Dental Clinical Effectiveness Programme (SDCEP). “Prevention and Treatment of Periodontal Diseases in Primary Care Dental Clinical Guidance”. Evidence Based Dentistry (2014): 68-69.
  16. M Sanz., et al. “Treatment of Stage I-III Periodontitis The EFP S3 Level Clinical Practice Guideline”. Journal of Clinical Periodontology 22 (2020): 4-60.
  17. Y Zhang., et al. “Chlorhexidine exposure of clinical Klebsiella pneumoniae strains leads to acquired resistance to this disinfectant and to colistin”. International Journal of Antimicrobial Agents6 (2019): 864-867.
  18. J Kolahi and A Soolari. “Rinsing with chlorhexidine gluconate solution after brushing and flossing teeth: a systematic review of effectiveness”. Quintessence International (2006): 605-612.
  19. D Herrera., et al. “Adjunctive effect of locally delivered antimicrobials in periodontitis therapy. A systematic review and meta-analysis”. Journal of Clinical Periodontology (2020): 239-256.
  20. P James., et al. “Chlorhexidine mouth rinse as an adjunctive treatment for gingival health”. Cochrane Database Systematic Review (2017): CD008676.
  21. J Eberhard., et al. “Fullmouth disinfection for the treatment of adult chronic periodontitis”. Cochrane Database Systematic Review (2008): CD00462.
  22. CV do Amori., et al. “Susceptibility of some oral microorganisms to chlorhexidine and paramonochlorophenol”. Brazilian Oral Research (2004): 242-246.
  23. G Bryce., et al. “Pre- and post-operative management of dental implant placement. Part 2: management of early-presenting complications”. British Dental Journal4 (2014): 171-176.
  24. F Schwarz., et al. “Efficacy of alternative or adjunctive measures to conventional treatment of peri-implant mucositis and periimplantitis: a systematic review and meta-analysis”. International Journal of Implant Dentistry1 (2015): 22.
  25. YC de Waal., et al. “Implant decontamination with 2% chlorhexidine during surgical peri-implantitis treatment: a randomized, double-blind, controlled trial”. Clinical Oral Implants Research9 (2015): 1015-1023.
  26. L Mallya., et al. “Evaluation of the antimicrobial efficacy of 20% Punica granatum, 0.2% chlorhexidine gluconate, and 2.5% sodium hypochlorite used alone or in combinations against Enterococcus faecalis: An invitro study”. Journal of Conservative Dentistry4 (2019): 367-370.
  27. LS Gonçalves., et al. “The Effect of Sodium Hypochlorite and Chlorhexidine as Irrigant Solutions for Root Canal Disinfection: A Systematic Review of Clinical Trials”. Journal of Endodontics4 (2016): 527-532.
  28. M Haapasalo., et al. “Irrigation in endodontics”. British Dental Journal2 (2014): 299-303.
  29. , et al. “Local interventions for the management of alveolar osteitis (dry socket)”. Cochrane Database Systematic Review 12 (2012): CD006968.
  30. NHS England. “Dental Management of Patients Prescribed Bisphosphonates - Clinical Guidance”. (2015).
  31. SL Ruggiero., et al. “American Association of Oral and Maxillofacial Surgeons position paper on medication-related osteonecrosis of the jaw-2014 update”. Journal of Oral Maxillofacial Surgery10 (2014): 1938-1956.
  32. V Rollason., et al. “Interventions for treating bisphosphonate-related osteonecrosis of the jaw (BRONJ)”. Cochrane Database Systematic Review2 (2016): CD008455.
  33. VC Marui., et al. “Efficacy of preprocedural mouthrinses in the reduction of microorganisms in aerosol: A systematic review”. The Journal of the American Dental Association12 (2019): 1015-1026.e1.
  34. G Gupta., et al. “Efficacy of preprocedural mouth rinsing in reducing aerosol contamination produced by ultrasonic scaler: a pilot study”. Journal of Periodontology4 (2014): 562-568.
  35. WG Kohn., et al. “Guidelines for Infection Control in Dental Health-Care Settings”. Morbidity and Mortality Weekly Report (2003): 521-561.
  36. Farzan P Firoozi. “Common Mouthwashes for Pre-procedural Rinsing in Dental Practice: Which One is Appropriate for Eliminating Coronaviruses? A Mini Literature Review”. Journal of Regeneration, Reconstruction and Restoration (2020): e2.
  37. H Xu., et al. “High expression of ACE2 receptor of 2019-nCoV on the epithelial cells of oral mucosa”. International Journal of Oral Science (2020): 8.
  38. JG Yoon., et al. “Clinical Significance of a High SARS-CoV-2 Viral Load in the Saliva”. Journal of Korean Medical Science20 (2020): e195.
  39. X Peng., et al. “Transmission routes of 2019-nCoV and controls in dental practice”. International Journal of Oral Science (2020): 9.
  40. , et al. “The influence of a 0.2% chlorhexidine mouthrinse on plaque regrowth in orthodontic patients. A randomized prospective study. Part II: Bacteriological parameters”. Journal of Orofacial Orthopedics 61.2 (2000): 138-148.
  41. X Tang., et al. “The antimicrobial effect of chlorhexidine varnish on mutans streptococci in patients with fixed orthodontic appliances: a systematic review of clinical efficacy”. International Journal of Dental Hygiene1 (2016): 53-61.
  42. British Orthodontic Society Patient Leaflet. “Fixed Appliances” (2020).
  43. N Kumar., et al. “The oral management of oncology patients requiring radiotherapy, chemotherapy and/or bone marrow transplantation”. Faculty Dental Journal4 (2013): 200-203.
  44. British Periodontal Society. “The Good Practitioner’s Guide to Periodontology”. 3rd Ed. (2016).
  45. The Royal College of Surgeons of England. “Clinical Guidelines and Integrated Care Pathways for the Oral Health Care of People with Learning Disabilities” (2012).
  46. N Zhou., et al. “Efficacy of caries and gingivitis prevention strategies among children and adolescents with intellectual disabilities: a systematic review and meta-analysis”. Journal of Intellectual Disability Research6 (2019): 507-518.
  47. FB Zanatta., et al. “Staining and calculus formation after 0.12% chlorhexidine rinses in plaque-free and plaque covered surfaces: A randomized trial”. Journal of Applied Oral Sciences5 (2010): 515-521.
  48. GM Tartaglia., et al. “Adverse events associated with home use of mouthrinses: a systematic review”. Therapeutic Advances in Drug Safety 10 (2019): 2042098619854881.
  49. BWM Van Swaaij., et al. “Does chlorhexidine mouthwash, with an anti-discoloration system, reduce tooth surface discoloration without losing its efficacy? A systematic review and metaanalysis”. International Journal of Dental Hygiene1 (2020): 27-43.
  50. MN Pemberton and J Gibson. “Chlorhexidine and hypersensitivity reactions in dentistry”. British Dental Journal11 (2012): 547-550.
  51. G Kampf. “Acquired resistance to chlorhexidine - is it time to establish an’ antiseptic stewardship’ initiative?”. Journal of Hospital Infections3 (2016): 213-227.
×

Citation

Citation: Valliammai Rajendran., et al. “Chlorhexidine in Dentistry - Five Decades and Continuing - Where are we Now?”. Acta Scientific Dental Sciences 5.11 (2021):79-85.




Metrics

Acceptance rate33%
Acceptance to publication20-30 days

Indexed In



News and Events


  • Certification for Review
    Acta Scientific certifies the Editors/reviewers for their review done towards the assigned articles of the respective journals.
  • Submission Timeline for Upcoming Issue
    The last date for submission of articles for regular Issues is July 10, 2024.
  • Publication Certificate
    Authors will be issued a "Publication Certificate" as a mark of appreciation for publishing their work.
  • Best Article of the Issue
    The Editors will elect one Best Article after each issue release. The authors of this article will be provided with a certificate of "Best Article of the Issue"
  • Welcoming Article Submission
    Acta Scientific delightfully welcomes active researchers for submission of articles towards the upcoming issue of respective journals.

Contact US