Abstract
BackgroundCetylpyridinium chloride (CPC) and sodium fluoride augment oral hygiene by inactivating bacteria and inhibiting enamel demineralisation, respectively. However, there are few reports in the literature documenting the antibacterial efficacy of their combined use in mouthrinses. We have used six experimental systems to compare the antibacterial effects of mouthrinses containing 0.075 % CPC (test rinse, TR) or 0.075 % CPC with sodium fluoride (test fluoride rinse, TFR).ResultsEffects against planktonic bacteria were determined using viable counting (for Streptococcus mutans and salivary bacteria), a redox dye (for Actinomyces viscosus and salivary bacteria) and viable counting (for ex vivo oral rinses). Effects against saliva-derived biofilms were quantified using confocal microscopy and differential viable counting. Inhibition of biofilm formation was evaluated by pre-treating hydroxyapatite coupons with mouthrinses prior to inoculation. Otherwise-identical controls without CPC (control rinse and control fluoride rinse, CR and CFR, respectively), were included throughout. Compared to the controls, TFR and TR demonstrated significant antimicrobial effects in the redox assays, by viable counts (>3 log reductions) and in oral rinse samples (>1.25 log reductions, p < 0.05). TFR and TR also significantly reduced the viability of oral biofilms. Pre-treatment of hydroxyapatite with TFR and TR significantly inhibited biofilm formation (>3 log difference, p < 0.05). Overall, there were no consistent differences in the activities of TR and TFR.ConclusionsSodium fluoride did not influence the antibacterial and anti-biofilm potency of CPC-containing formulations, supporting the combined use of CPC and sodium fluoride in mouthrinses to control oral bacteria and protect tooth enamel.
Highlights
Cetylpyridinium chloride (CPC) and sodium fluoride augment oral hygiene by inactivating bacteria and inhibiting enamel demineralisation, respectively
Test formulations rapidly inactivate established cultures of oral bacteria Bactericidal effects were assessed by viable counts following exposure to test rinses
Significant effects of both formulations were observed against mixed salivary bacteria (6.2 Log10 and 4.6 Log10 reductions for Test rinse (TR) and Test fluoride rinse (TFR) respectively), but with significantly increased efficacy observed in the non-fluoridated formulation
Summary
Cetylpyridinium chloride (CPC) and sodium fluoride augment oral hygiene by inactivating bacteria and inhibiting enamel demineralisation, respectively. We have used six experimental systems to compare the antibacterial effects of mouthrinses containing 0.075 % CPC (test rinse, TR) or 0.075 % CPC with sodium fluoride (test fluoride rinse, TFR). Dental caries is a major public health problem throughout the world [1, 2]. Extensive research has indicated that the major cause of caries is the acidification of tooth surfaces following fermentation of dietary sugars by cariogenic bacteria which accumulate on the surfaces of teeth within dental plaque [3]. Commonly-implicated causative bacteria include Streptococcus mutans and homofermentative lactobacilli (as reviewed by Marsh [5]). Thorough mechanical removal of plaque twice daily with a fluoride-containing toothpaste is a commonly-taught method of caries prevention. Studies show that incidence of dental caries remains high [9, 10], suggesting that such regimens are commonly not strictly adhered to
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