Control of plaque by chemical agents

Abstract

Abstract The bacteria forming pathogenic dental plaque on the tooth surfaces have long constituted a challenge for researchers with an interest in chemical degerming agents. As the plaque grows outside the vascularized tissues, most trials have been conducted with locally applied antibiotics and antiseptics. When these are introduced into the oral cavity, they will, if effective, reduce the amount of supragingival plaque. No means have so far been demonstrated for chemical control of the plaque growing underneath the gingival margin. The results obtained from trials with various antibiotics have not been very promising, especially when compared to the risks involved. Also many antiseptics with an excellent degerming effect in vitro have been tried. Most of them have proved inactive in the human mouth. Failure may be due to the protective properties of mucus and other constituents of the saliva and, apparently, (o the short retention time of the antimicrobial agent in the oral cavity. Good retentive properties have been observed with chlorhexidine (CHX). Two daily 1‐min rinses with a 0.2 % aqueous solution of CHX digluconate totally prevents growth of supragingival plaque and even when CHX has been included in. gels and dentifrices, a both statistically and clinically significant reduction in the amount of plaque has been demonstrated. At present CHX seems to be agent of choice in chemical control of supragingival dental plaque. However, due to some secondary side effects, it is mostly used only for short period treatments.