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PubMed1986

Effects of 1% chlorhexidine gel treatment on sympathetic adrenergic nerves in human buccal mucosa.

The effect of treatment with a commercially available 1% chlorhexidine gel (Hibitane Dental) in custom trays for 14 days (10 min daily) on the sympathetic adrenergic nerves in biopsies from human buccal mucosa was investigated. Chemical assay of endogenous noradrenaline concentration and immunocytochemical demonstration of tyrosine hydroxylase served as markers for structural and functional integrity of the adrenergic nerves. The mean concentration of noradrenaline in chlorhexidine treated tissues did not differ from the mean concentration in control. No morphologic or fluorescence intensity differences of the tyrosine hydroxylase immunoreactivity were found in the chlorhexidine treated tissues when compared to controls. These findings indicate that a relatively intense treatment with a commercially available 1% chlorhexidine gel does not affect the adrenergic innervation of human buccal mucosa.

Adrenergic Fibers↗
PubMed1986

Oral implantation of Streptococcus mutans in man with and without prior chlorhexidine mouthrinses.

Oral implantation of streptomycin resistant S. mutans was enhanced when chlorhexidine mouthrinses were applied before implantation. The difference in recovery of implanted bacteria between implantations with and without prior chlorhexidine mouthrinses was significant 9 days (P less than 0.05), 15 days (P less than 0.05) and 28 days (P less than 0.01) after implantation. After 28 days implanted bacteria were no longer detected in any of the 20 test subjects when chlorhexidine was not used prior to implantation, but persisted in 11 subjects when chlorhexidine was used.

Chlorhexidine↗
PubMed1995

Susceptibility of Streptococcus mutans and Streptococcus sobrinus to antimicrobial agents after short-term oral chlorhexidine treatments.

Effects of three different types of short-term applications (1-3 times during 1 week) of chlorhexidine (1 or 40%) on the susceptibility of 863 clinical isolates of Streptococcus mutans and 53 isolates of Streptococcus sobrinus from 58 subjects were studied. Chlorhexidine-resistant isolates were not found either before or after the treatment. The minimum inhibitory concentrations (MICs) to chlorhexidine of all isolates of S. mutans were < or = 1 microgram/ml, and of S. sobrinus < or = 2 micrograms/ml. S. mutans and S. sobrinus were also susceptible to ampicillin, penicillin, cefuroxime, and tetracycline. In conclusion, different short-term chlorhexidine regimens do not induce resistance in S. mutans or S. sobrinus and, furthermore, these species have so far retained their susceptibility to common antibiotics.

Ampicillin↗
PubMed2006

Differences between single- and dual-species biofilms of Streptococcus mutans and Veillonella parvula in growth, acidogenicity and susceptibility to chlorhexidine.

Streptococcus mutans, considered a primary pathogen in dental caries, thrives in dental plaque, which is a multispecies biofilm. Metabolic interactions between S. mutans and Veillonella parvula have been suggested. In this study we developed a biofilm model to quantify single-species (S. mutans or V. parvula) and dual-species (S. mutans and V. parvula) biofilm formation, and we identified the differences between the respective biofilms in terms of growth, acid formation, and response to chlorhexidine. Polystyrene 96-well microtiter plates were used for biofilm formation. These biofilms were exposed to various chlorhexidine concentrations (0.025-0.4 mg ml(-1)) and treatment conditions. Growth of the biofilms and the effects of chlorhexidine were evaluated by viable counts. Viability of the two species in all biofilm types was similar ( approximately 10(8) colony-forming units per well) after 72 h. Lactic acid accumulation of dual-species biofilms was significantly lower at 48 and 72 h than single-species biofilms of S. mutans. Dual-species biofilms were less susceptible to chlorhexidine than single-species biofilms when a neutralization step was included. These results indicate that bacteria in dual-species biofilms have different properties from bacteria in single-species biofilms.

Acetic Acid↗
PubMed1990

Antimicrobial effect of chlorhexidine in a controlled release delivery system.

Chlorhexidine is widely used as a mouth rinse in the prevention and treatment of periodontal diseases and dental caries. The purpose of the present study was to evaluate the in vitro antimicrobial effect of chlorhexidine in a controlled release delivery system. The controlled release dispenser comprised a polymeric inner core matrix containing the medicament with an outer vinyl membrane controlling the drug release. The effect on the following bacteria was studied: Actinobacillus actinomycetemcomitans, Actinomyces viscosus, Streptococcus mutans, Wolinella recta, Bacteroides gingivalis, Bacteroides intermedius, Eikenella corrodens, Pseudomonas aeruginosa, Enterobacter aerogenes, and Enterobacter cloacae. Chlorhexidine-containing vinyl patches with a diameter of 5.5 mm were placed on blood agar plates containing the various bacteria. The plates were incubated aerobically or anaerobically at 37 degrees C for 24 h or longer, when appropriate, and examined for inhibition of bacterial growth. Distinct zones of inhibition were seen surrounding all vinyl patches on all plates with all bacteria. Thus, the vinyl dispenser appeared to be an effective vehicle for releasing chlorhexidine to a localized area such as the surface of a tooth, a periodontal pocket, or a root canal.

Bacteria↗
PubMed1998

Chlorhexidine as a root canal medicament for treating inflammatory lesions in the periodontal space.

The purpose of the present study was to investigate the therapeutic effect of intra-canal application of chlorhexidine on inflammatory root resorption. Dental pulps from monkey incisors were infected and resealed prior to extraction of the teeth. Root dentin was mechanically exposed and the teeth were replanted under aseptic conditions. After 4 weeks, the experimental teeth were dressed with chlorhexidine gel and resealed. Animals were sacrificed 4 weeks later, and their jaws prepared for histologic examination. Results showed that both marginal and apical periodontal inflammation and resorption were reduced in the chlorhexidine-treated teeth. It was concluded that the use of intra-canal chlorhexidine may be a useful adjunct in the treatment of inflammatory root resorption, but further human trials need to be undertaken before its clinical use can be recommended.

Animals↗
PubMed2000

Effects of 0.12% chlorhexidine gluconate on experimental gingivitis in non-human primates: clinical and microbiological alterations.

OBJECTIVE: This study examined the efficacy of 0.12% chlorhexidine gluconate (Peridex) to reduce gingival inflammation in the absence of mechanical hygiene and its effect on the oral microbial ecology in a non-human primate (NhP) model of gingivitis. DESIGN: Twelve NhP were stratified based on existing inflammation into two groups of six NhP per group. Oral hygiene was performed on both groups so as to reach a level of gingival health (BOP < or = 0.3) at the conclusion of the hygiene phase. One group received 30 ml of 0.12% chlorhexidine gluconate twice daily 7 days/week, and a second group received 30 ml of placebo (distilled water colored to match the active) using the same regimen for 10 weeks. MEASUREMENT OUTCOMES: Clinical parameters including plaque (PLI), pocket depth (PD), attachment level (AL), and bleeding on probing (BOP) were evaluated at 2-week intervals. Subgingival plaque samples were collected by paper point at 2-week intervals and cultured for predominant cultivable bacteria. RESULTS: By week 2, there was a difference in BOP between the groups, which reached statistical significance by week 4. This difference in BOP was maintained throughout the course of the study. Chlorhexidine gluconate (0.12%) had no significant effect on PLI, PD, or AL; although PD was greater in the placebo group after week 2 and throughout the study. Microbiologically, at week 4, the treatment group had a reduction in total bacterial counts, as well as Gram positive bacteria, and total black pigmented bacteria, compared to the placebo group. However, only the differences in Actinomyces spp. reached significance. Interestingly, when both groups received only one treatment/day on the weekends (i.e., day 6 and 7), an associated loss of statistically significant differences between the two groups was observed. Additional experiments dosing the non-human primates once daily, 5 days/week yielded no significant differences in clinical parameters, including bleeding, when compared with the placebo group. CONCLUSION: Non-human primates provided a model system of gingivitis for testing antimicrobial agent effects on the subgingival ecology and accompanying inflammatory responses. Chlorhexidine gluconate (0.12%), even in the absence of mechanical hygiene, was effective in inhibiting clinical signs of inflammation, associated with alterations in the subgingival microbial ecology, most notably Actinomyces spp.

Actinomyces↗
PubMed2005

A non-staining chlorhexidine mouthwash? Probably not: a study in vitro.

BACKGROUND AND AIM: Tooth staining is a common side effect of chlorhexidine mouth rinses and caused by the interaction of the di-cationic antiseptic with dietary chromogens. A product is now available, which claims an anti-discolouration system (ADS) with one clinical study in support. This study in vitro aims to determine whether two ADS rinses do or do not bind dietary chromogens. METHOD AND MATERIALS: Optically clear acrylic specimens were cycled through human saliva (2 min), one of the three chlorhexidine rinses (two ADS and a positive control) (2 min) or water and then soaked in tea (60 min). After each cycle the optical density (OD) of specimens were read on a UV/visible spectrophotometer. The exit point was the cycle at which OD was >2.0. RESULTS: All three rinses exceeded OD 2 at 11 cycles and there was no significant difference in staining for the ADS rinses compared with the positive control rinse. CONCLUSION: Based on extensive literature for the correlation of this test in vitro with chlorhexidine anti-plaque activity and propensity to stain in vivo these ADS rinses will have the same anti-plaque efficacy and potential to cause stain as established chlorhexidine rinse products.

Chlorhexidine↗
PubMedDate not supplied

Clinical and microbiological effects of chlorhexidine and arginine sustained-release varnishes in the mentally retarded.

Local applications of sustained-released varnishes of chlorhexidine and arginine were used in a controlled pilot study of 34 mentally retarded patients, ages 18-45, assigned to one of these groups: chlorhexidine (C), arginine (A), or placebo (P). A professional scaling followed by four weeks of professional brushing to reach a Plaque Index (PII) and Gingival Index (GI) of 1.0 at baseline preceded eight weeks of daily varnish application to the buccal and labial surfaces of all teeth. Clinical parameters (PII and GI) and bacterial samples from selected teeth were collected at predetermined intervals. Four and eight weeks following the baseline, the PII was significantly different among the groups, with the lowest score in the chlorhexidine group. No significant differences among the three groups were noted for the GI. The chlorhexidine and arginine groups showed significant reductions (p < 0.05 and p < 0.01, respectively) in the number of S. mutans. The arginine group showed a nonsignificant increase in the number of S. sanguis. These results suggest that the topical antimicrobial agents may have some relevance to plaque control among patients with mental retardation.

Administration, Topical↗
PubMedDate not supplied

Chlorhexidine swabbing applications under various conditions of use in preventive oral care for persons with disabilities.

A sample of 44 adults with severe disabilities completed a randomized single-blind cross-over study testing chlorhexidine swabbing under various conditions: with/without prior dental prophylaxis, reduced frequency of application (2 vs. 5 times per week), and prolonged use (42 weeks). All subjects received therapeutic doses of 10 mL 0.12% chlorhexidine gluconate (Peridex, Procter & Gamble) and 10 mL 0.05% NaF applied with a Toothette (Sage Products). Clinical effectiveness of chlorhexidine swabbing compared with placebo was previously reported. In the present study, while initial benefits were observed to be independent of dental prophylaxis, significant reductions in periodontal scores were sustained by a combination of dental prophylaxis and swabbing protocol, at reduced frequency of application and over prolonged time. High levels of acceptance and compliance by subjects/caregivers were maintained. Subjects/caregivers reported improvements in dental health as well as in attitude, quality of life, and smile. Chlorhexidine swabbing at maintenance frequency, combined with periodic dental prophylaxis, may offer an effective and pragmatic long-term preventive regimen for persons with disabilities.

Adult↗
PubMed1982

Comparative antimicrobial activity, in vitro and in vivo, of soft N-chloramine systems and chlorhexidine.

Antimicrobial activity of the following four new N-chloramine compounds was evaluated: two chlorinated simple amino acids, a chlorinated half-ester of succinic acid, and a chlorinated half-ester of glutaric acid. For comparison, the known bactericidal agents 3-chloro-4,4-dimethyl-2-oxazolidinone and chlorhexidine were evaluated by the same procedure. The contact germicidal efficiency screen was used to examine the in vitro bactericidal activity of all six compounds in the absence and presence of 5% horse serum or 5% Triton X-100. The four new compounds were found to have greater germicidal activity than the other compounds tested and to exhibit low toxicity and skin irritation values. The in vivo bactericidal activity was evaluated in two studies. In the occlusion test, three of the four new compounds plus chlorhexidine diacetate were tested. The N-chloramines were significantly superior to chlorhexidine in preventing the expansion of the normal flora under occlusion. In the scrub test, a gloved-hand wash method was used to compare the antimicrobial effect of a 1% solution of the chlorinated half-ester of succinic acid in triacetin with that of a commercial germicidal hand wash containing 4% chlorhexidine gluconate. The two preparations exhibited essentially the same hand-degerming activity.

Animals↗
PubMed2002

Skin disinfection before epidural catheterization: comparative study of povidone-iodine versus chlorhexidine ethanol.

BACKGROUND: Chlorhexidine is better than povidone-iodine for skin preparation before intravascular device insertion or blood culture collection, but it is not known whether chlorhexidine is superior in reducing the colonization of continuous epidural catheters. METHODS: Patients requiring an epidural catheter for postoperative analgesia were randomly assigned to receive skin preparation with 0.5% chlorhexidine ethanol (CE group) or 10% povidone-iodine (PI group) before catheter insertion. Using surgical aseptic techniques, catheters were inserted into either the lumbar or the thoracic epidural space. Gloves used at catheter insertion, swabs of insertion site skin and the catheter tip at catheter removal were qualitatively cultured. RESULTS: Of 70 randomly assigned patients, 62 were evaluable. The clinical characteristics of the patients and the risk factors for infection were similar in the two groups. Catheters were kept in place for 49 +/- 7 h (mean +/- SD). Seven cultures from gloves yielded microorganisms. In 1 case, the leak test of gloves was positive. Fifteen cultures of catheter insertion sites yielded microorganisms: 7/28 (25%) in the PI group and 8/34 (24%) in the CE group. Six cultures of catheter tips yielded microorganisms: 3/28 (11%) in the PI group and 3/34 (9%) in the CE group. As for the incidence of isolation of bacteria, no difference was seen between the two groups. In none of these 62 cases was any inflammatory reaction seen in the skin locally at catheter removal. CONCLUSIONS: The effect of 0.5% chlorhexidine ethanol is not different from that of 10% povidone-iodine in reducing catheter colonization associated with short-term epidural catheter placement.

Adult↗
PubMed2006

Inhibition of cultivable bacteria by chlorhexidine treatment of dentin lesions treated with the ART technique.

The aim of this study was to examine the changes in the cultivable microflora of carious dentin before and after atraumatic restorative treatment (ART) and investigate the inhibitory effect of chlorhexidine-gluconate-based cavity disinfectant in the microflora. Using a split mouth design, 35 primary molar pairs with class II carious lesions in 35 patients (mean age 7.31+/-0.47 years) were selected. The total viable counts (TVC), Streptococcus mutans and lactobacilli were first measured in the center of the infected demineralized lesion and then from the hard dentine after caries removal by the ART technique. Chlorhexidine-gluconate (2%)-based cavity disinfectant was applied to one of the molar pairs and the other molar received no disinfectant treatment. Thereafter, all of the teeth were restored with glass ionomer cement (GIC). Cavities were reassessed after 6 months and again dentine samples were microbiologically investigated. Removal of carious dentine by ART significantly reduced TVC, S. mutans and lactobacilli. After 6 months, application of chlorhexidine exhibited a greater significant reduction in TVC (p=0.013), and a significant reduction in S. mutans compared to the nondisinfected group (p<0.001). A significant reduction in lactobacilli counts was observed in both groups after 6 months, but the difference between the disinfected and nondisinfected groups was not significant (p=0.056). ART was found to be effective in reducing the cultivable microflora and chlorhexidine-gluconate-based cavity disinfectant might serve as a suitable additional agent in inhibiting the residual bacteria in the dentine.

Analysis of Variance↗
PubMed1993

The effect of chlorhexidine and zinc/triclosan mouthrinses on the production of acids in dental plaque.

Chlorhexidine, and zinc in combination with triclosan, are used as anti-plaque agents in the prevention of gingivitis. The multifunctional activity of these compounds against bacterial cells has been proposed to include interference with sugar transport and reduction of glycolysis. In this study the ability of the agents to reduce acid production in dental plaque in vivo has been investigated. Samples of smooth-surface plaque were collected from individuals who had been rinsing for several weeks with (a) chlorhexidine (0.12%, Peridex); a combination of zinc and triclosan in mouthwashes containing (b) high and (c) low concentrations of humectant; or (d) a control mouthwash. Analyses using isotachophoresis showed that resting plaques in the chlorhexidine and zinc/triclosan groups contained less acetate than the control group. Acids were also measured 15 min after a glucose rinse. Compared with the control, the amount of lactate was significantly decreased (45%) in the chlorhexidine group, while lactate reduction (20%) in the zinc/triclosan (high humectant) group was not statistically significant.

Acetates↗
PubMed1995

Interaction of chlorhexidine with cytoplasmic membranes of Streptococcus mutans GS-5.

Cytoplasmic membranes of Streptococcus mutans GS-5 were extracted by incubating cells with 1% sodium lauroyl sarcosinate for 20 min at room temperature. The profiles of membrane proteins were determined by SDS-PAGE and isoelectric focusing. The effect of chlorhexidine digluconate on cell membranes was studied after treating the extracted proteins for 30 min with the drug at final concentrations of 0.05 and 0.2%. Chlorhexidine caused selective reduction in the intensity of the membrane proteins. Five densely staining bands with molecular weights of 24.2, 19.6, 18.1, 17.6 and 16.4 kD were obviously diminished. Isoelectric focusing indicated that chlorhexidine preferably precipitated acidic cytoplasmic proteins (pI 4.0-4.92). Our results are consistent with the hypothesis that the mode of action of this drug is mainly attributed to its hydrophilic property. Chlorhexidine, being cationic, may interact with bacteria by attraction to negative-charge membrane components.

Adenosine Triphosphatases↗
PubMed1996

Effect of chlorhexidine varnish on Actinomyces naeslundii genospecies in plaque from dental fissures.

This study describes the effects of varnish containing 40% chlorhexidine diacetate on Actinomyces naeslundii populations in plaque from human molar fissures. In each of 15 subjects two dental fissures with high levels of mutants streptococci were selected. The experimental treatment consisted of the single application of a small amount of chlorhexidine varnish onto the selected fissures. The varnish was removed 15 min after application. One month after varnish application a significant increase was observed in A. naeslundii counts while the number of mutans streptococci had decreased significantly compared with preexperimental levels. From 85 randomly selected Actinomyces isolates taken from blood agar plates before varnish application, 44% belonged to A. naeslundii genospecies 1 and 56% to A. naeslundii genospecies 2. From 106 isolates taken 1 month after chlorhexidine varnish application, 42% belonged to A. naeslundii genospecies 1 and 58% to A. naeslundii genospecies 2. At baseline 28% of A. naeslundii genospecies 1 strains were catalase-positive, but 1 month after varnish application 4% of the strains were catalase-positive (p < 0.05). It is concluded that chlorhexidine varnish application caused an increase of A. naeslundii in dental plaque, but induced no significant changes in the distribution of the two A. naeslundii genospecies.

Actinomyces↗
PubMed1996

Effect of repeated treatment with sustained-release chlorhexidine mouth guards on salivary levels of mutans streptococci.

The effect of multiple treatments with chlorhexidine mouth guards on salivary levels of mutans streptococci (MS) was studied. Eleven subjects with salivary MS > or = 10(5) CFU/ml were randomly assigned to an experimental or control group. Complete-arch mouth guards were coated internally with one of two ethylcellulose varnishes, one containing 30% dry w/w chlorhexidine and one containing no chlorhexidine. Subjects wore the mouth guards up to four times, each time for 7 consecutive nights while sleeping, with at least a 1-week break between treatment weeks. Subjects in the control group subsequently crossed over and also wore the chlorhexidine-containing mouth guards. Each of the week-long mouth guard sessions resulted in a reduction in mean salivary MS levels as follows (log10 CFU/ml): for the experimental group, -1.0, -0.9, -1.0 and -1.2, and for the crossover group, -1.7, -0.6, -0.5 and -0.6. Salivary MS levels were (mean +/- SD) 6.4 +/- 0.5 at baseline and 3.8 +/- 0.5 after the last mouth guard session for the experimental group and 6.0 +/- 0.5 and 4.3 +/- 0.7, respectively, for the crossover group. For the control group, there was no significant change in MS levels.

Adult↗
PubMed1997

Reduced chlorhexidine tooth stain coverage by sequential administration of monoperoxyphthalic acid in the beagle dog.

Extrinsic tooth stain is sometimes a side-effect observed with the chronic use of chlorhexidine-containing oral care products. This chlorhexidine (CHX)-induced tooth staining is observed both in humans as well as in experimental animals. The present study tested the hypothesis that the sequential administration of monoperoxyphthalic acid (MPA) will reduce the development of chlorhexidine-induced tooth stain coverage in a beagle dog. For this study, dogs were treated with 30 mL of mouthrinse b.i.d. for 28 days. The following treatment groups ( = 12 dogs/group) were tested: water (negative control), 1.0% MPA rinse, 0.12% CHX rinse, and 1.0% MPA rinse followed by 0.12% CHX rinse. The sequential dosing of 1.0% MPA followed by 0.12+ CHX resulted in significantly (p < or = 0.05) less tooth stain than when dogs were dosed with 0.12% CHX alone. Additionally, the sequential dosing of MPA followed by chlorhexidine resulted in a 75% reduction in plaque formation in this model, which was significantly different (p < or = 0.05) from results with either treatment alone. A further study demonstrated that similar results could be obtained when MPA plus CHX treatment alone. A further study demonstrated that similar results could be obtained when MPA plus CHX treatments were separated by approximately a five-hour period in an AM and PM schedule. We conclude that the oxidizer, MPA, can significantly reduce tooth stain induced by CHX while enhancing its antiplaque and antigingivitis activity.

Animals↗