Chlorhexidine – an effective tool for treating periodontal issues
Featured Products Promotional FeaturesPosted by: Dental Design 1st February 2023
Chlorhexidine (CHX) is the gold standard for treating a number of periodontal issues.[i] These include patients with gingivitis, periodontitis, and those who have undergone periodontal surgery. However, CHX has side effects which may present challenges when you’re trying to encourage patient compliance. Ensuring your patients understand the enormous benefits of using CHX, particularly post-surgery, is vital, and minimising the side effects will be beneficial to your patients’ compliance – and therefore long-term oral health.
Benefits of using chlorhexidine
Chlorhexidine has long been established as a key tool for biofilm control, having been used as a medical antiseptic since 1953.[ii] CHX shows good adherence to teeth and mucosa, remaining on the oral mucosa for up to 12 hours,[iii] and it is therefore able to intercept bacteria for extended periods of time. It has also been found to exhibit antibacterial activity in saliva for around five hours. Because of these properties, CHX is appropriate for use in an oral rinse.ii
This is especially useful for patients post oral-surgery as oral rinses can be used regardless of a patient’s ability to brush their teeth, therefore creating less barriers to patient acceptance. This is the ideal preventative measure for many patients after surgical interventions, especially if post-operative pain, discomfort, or inflammation are making mechanical plaque control difficult. While this is not intended for long term use, as mechanical plaque removal is important for long term oral health, it is useful for maintaining low levels of bacterial plaque in the short term. This will help periodontal surgery patients maintain a reduced or plaque free oral environment, even if they’re unable to brush. This creates the optimal environment for post-surgical healing – as well as preventing the development of periodontitis and gingivitis, and has the potential to aid recovery.ii
Common issues and side effects
Despite its numerous benefits, chlorhexidine is burdened by its well-known side effects, which may lead to patients avoiding or rejecting use. These side-effects may include temporary taste alteration, staining of the teeth, mucosa and/or tongue, and an increase in calculus formation. Staining is the most common adverse side effect, and seems to get worse with more frequency of consumption of chromogenic products such as coffee, tea, wine and tobacco, as well as with increased concentrations of CHX.ii
Why is patient compliance important for those with periodontal concerns?
Research suggests that the regular use of oral rinse combined with brushing resulted in reduced interproximal plaque, when compared with brushing and daily flossing.i However, patient compliance is very important in terms of reducing microbial colonisation – particularly important after oral surgery to keep surgical sites free of bacteria. Research suggests that clinical attachment levels and probing depth are significantly improved when patients use an oral rinse containing CHX. This is in addition to a 48% reduction of bleeding on probing and a 54% plaque-reduction after scaling and root planing and CHX use.ii Reducing levels of plaque and bacteria while patients are recovering from periodontal surgery, as well as treating gingivitis or periodontitis, is important to prevent infection and improve healing.
The main negative side effect, staining, brings with it the possibility of reduced compliance. Because of this, innovative CHX oral rinses have been developed with anti-discolouration systems (ADS)ii and research suggests that compliance in post-periodontal surgery patients improved if they were treated with a chlorhexidine-based oral rinse with an anti-discolouration system (ADS).[iv]
The patented ADS is a feature unique to the Curasept range of oral rinses, available from J&S Davis. Curasept ADS Perio Pro Oral Rinse, for example, offers specialist treatment for patients with periodontal issues, with significantly reduced risk of staining. It is designed for the prolonged and highly effective rehabilitative care of red, inflamed and bleeding gingiva; making it an ideal solution for your patients with gingivitis, periodontitis and peri-implantitis, including any patients who have undergone periodontal surgery. Formulated with 0.12% chlorhexidine, it provides a strong anti-bacterial and anti-plaque action. Its formula also includes hyaluronic acid and sodium DNA to reduce inflammation, soothe irritation, and boost the healing process.
For your patients with periodontal issues, communication is vital for encouraging oral hygiene compliance. Ensure patients understand the enormous benefits of using an oral rinse containing chlorhexidine, including its anti-plaque properties and benefits for post-operative healing. To further encourage compliance, recommend an oral rinse with ADS to your patients. If your patients understand that they will be able to access the benefits of CHX, without the well-known side effects, they will be far more likely to use as recommended, and complete their treatment cycle. This will give them the best chance at reducing levels of bacterial plaque and improving healing.
For more product information and samples,
visit www.js-davis.co.uk, call 01438 747 344
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[i] Balagopal, Shruti, and Radhika Arjunkumar. “Chlorhexidine: the gold standard antiplaque agent.” Journal of Pharmaceutical sciences and Research 5.12 (2013): 270. https://www.researchgate.net/profile/Radhika-Arjunkumar/publication/287637432_Chlorhexidine_The_gold_standard_antiplaque_agent/links/5df9e38aa6fdcc283728f54a/Chlorhexidine-The-gold-standard-antiplaque-agent.pdf
[ii] Solderer, Alex, et al. “Efficacy of chlorhexidine rinses after periodontal or implant surgery: a systematic review.” Clinical oral investigations 23.1 (2019): 21-32. https://www.zora.uzh.ch/id/eprint/167430/1/32_Solderer_Chlorhexidine_ClinOralinvestig_2018.pdf
[iii] Brookes, Zoë LS, et al. “Current uses of chlorhexidine for management of oral disease: a narrative review.” Journal of Dentistry 103 (2020): 103497. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7567658/
[iv] Polizzi, E., et al. “Antibacterial properties and side effects of chlorhexidine-based mouthwashes. A prospective, randomized clinical study.” Journal of Osseointegration 12.1 (2020): 2-7. file:///Users/officeone/Downloads/calchera,+311_Tete%C3%8C%E2%82%AC_chlorhexidine.pdf
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