Archive for the ‘Antimicrobial Mouthrinses’ Category

Chlorhexidine Mouth Rinse

Posted on: January 21st, 2011 by Sheree Wertz, RDH, BS No Comments

 

What is a Chlorhexidine Mouth Rinse? 

A chlorhexidine mouth rinse  provides antimicrobial activity during rinsing and for several hours thereafter. Rinsing with chlorhexidine inhibits the buildup of plaque by reducing certain microbes that cause gingivitis.

Why use it?

Indications

Chlorhexidine is recommended for the treatment of moderate to severe gingivitis, and for management of gingival bleeding and inflammation between dental visits.

Contra-Indications:

Use is not recommended by persons who are known to be hypersensitive to chlorhexidine or other formula ingredients. Read warnings on lable.

 
 

 If the risk of stain and/or permanent discoloration is unacceptable.

Recommended home use is rinsing for 30 seconds, twice daily morning and evening. Usual dosage is 15 mL (marked in cap) of undiluted chlorhexidine. It is not intended for ingestion and should be expectorated after swishing.

Rinsing the mouth (with water or other mouthwashes), brushing the teeth, eating or drinking should be avoided for about 30 minutes before or after using chlorhexidine because most dentifrices inactivate chlorhexidine.

 A chlorhexidine mouth rinse can be used as a preprocedural mouthrinse as well.


Side effects:

Chlorhexidine may cause staining of oral surfaces such as tooth surfaces, restorations, and the tongue. Stain may be more pronounced in patients who have heavier unremoved accumulations of plaque.

 Stain resulting from use of chlorhexidine does not adversely affect the health of other oral tissues. Stain can be removed from most tooth surfaces by conventional prophylactic techniques, however it may require additional appointment time to complete stain removal.

 Discretion should be used when treating patients with exposed root surfaces or anterior facial restorations with rough surfaces or margins. Prophy jet works the great to remove chlorhexidine stain. If stains cannot be removed from these surfaces with a dental prophylaxis, patients should be excluded from chlorhexidine treatment. On rare occasions stains on restorations that are difficult to remove by prophylaxis may need replacement.

 A few patients may experience an alteration in taste perception while using chlorhexidine. Most of these patients continued with use of chlorhexidine.

 Rare instances of permanent taste alteration following chlorhexidine use have been reported.

 
Brands availible:

PERIDEX®  is one of the most common brands of  chlorhexidine gluconate mouth rinses used by dental professions in the office and for home use  between dental visits as part of a professional program for the treatment of gingivitis.

Colgate Periogard Mouthrinse  is an alcohol free chlorhexidine digluconate mouth rinse also given to patients in dental offices and for home use.

 

For more information and references:

http://solutions.3m.com/wps/portal/3M/en_US/3M-ESPE-NA/dental-professionals/products/category/preventive/ 

 

http://solutions.3m.com/wps/portal/3M/en_US/3M-ESPE/dental-professionals/products/category/preventive/peridex/

 

  
How to use it:

Antimicrobial Mouthrinses

Posted on: January 6th, 2011 by Sheree Wertz, RDH, BS No Comments

 

Preprocedural Antimicrobial Mouthrinses

 

What is it?

 Antimicrobial mouth rinses are another adjunct to our armamentarium when used prior to patient treatment.
 

Antimicrobial mouth rinses are much more powerful than your everyday over-the-counter mouthwashes, meaning that they can reduce the number of microbes or bacteria in the mouth to an almost undetectable level.
 

Chlorhexidine is the most commonly prescribed antimicrobial mouth rinse that we use to reduce the number of bacteria in the mouth as part of our treatment regimen.


Why Use them?

Antimicrobial mouth rinses used by patients before a dental procedure are intended to reduce the number of microorganisms released by a patient in the form of aerosols or spatter that subsequently can contaminate equipment, operatory surfaces, and dental health care personnel.


No scientific evidence indicates that preprocedural mouth rinsing prevents clinical infections among patients or dental health care personnel. However, studies have shown that a preprocedural antimicrobial mouth rinse product can reduce the level of oral microorganisms generated in aerosols or spatter during routine dental procedures with rotary instruments.

 

Preprocedural mouth rinses can be most beneficial before procedures (e.g., prophylaxis with a cup, prophy jet or ultrasonic scaling).  

Antimicrobial mouth rinses used by the patient before a dental procedure can decrease the number of microorganisms introduced into the patient’s bloodstream during invasive dental procedures.


The American Heart Association (1997) suggests that patients at risk for bacterial endocarditis use an antimicrobial mouth rinse before dental treatment. CDC makes no recommendation regarding the use of preprocedural antimicrobial mouth rinses to prevent clinical infections among dental health care personnel or patients.

 One study found that even a preliminary rinse with water temporally reduced the bacteria aerosol by 61 %, brushing by 85% and an antimicrobial mouth rinse by 97%.  Prevent bacteria from floating around the office by having the patient rinse before begging an aerosol producing procedure.

 Another report showed the efficiency of antimicrobial mouth rinses, containing pharmaceutical grade denatured alcohol as a vehicle to deliver antimicrobial ingredients, mainly Listerine, completely killed microorganisms in 10 to 30 seconds.

 

How to use them:

- Choose a brand

- Give the patient 15 ml in a cup

- Have patient swish for 30 seconds

- Have patient expectorate after swishing.  It is not intended for ingestion.
- Start  planned procedure.

 

Given the growing evidence of the connection between oral health and whole-body health, dental practitioners may seek to respond to their patients’ oral hygiene needs by providing research-based products with “naturally occurring” active ingredients that achieve the desired antimicrobial and anti-inflammatory effects.

 

Products that contain such natural ingredients as grapefruit seed extract may be appealing because they work without alcohol,1 artificial preservatives, or artificial flavors and colors.

 

The Natural Dentist Healthy Gums Daily Oral Rinse (The Natural Dentist, Medford, Mass.) (formerly named Herbal Mouth and Gum Therapy) has been shown to have beneficial effects in the oral environment—such as reducing gingival bleeding and gingivitis 2and inhibiting the growth of aerobic, microaerophilic and anaerobic bacteria.3

 

Why not have your patients rinse with an antimicrobial mouthrinse for 30 seconds before starting any dental procedure, it can’t hurt.

  

References:

                 Wyler D Miller, Micik R. Efficacy of self-administered preoperative oral hygiene procedures in reducing the concentration of bacteria aerosols generated during dental procedures. J Dent Res. 1990;124:556-58.

1.Giamperi L, Fraternale D, Bucchini A, Ricci D. Antioxidant activity of Citrus paradisiseeds glyceric extract. Fitoterapia 2004;75(2):221–224.[Medline]

2. Scherer W, Gultz J, Lee SS, Kaim J. The ability of an herbal mouthrinse to reduce gingival bleeding. J Clin Dent 1998;9(4):97–100.[Medline]

3.Gultz J, Kaim JM, DeLeo J 4th, Scherer W. An in vivo comparison of the antimicrobial activities of three mouthrinses. J Clin Dent 1998;9(2):43–45.[Medline]

http://www.ncbi.nlm.nih.gov/pubmed/8292118 

http://www.cdc.gov/OralHealth/infectioncontrol