Abstract
Introduction/ObjectivesChlorhexidine (CHX) is a commonly used mouthwash with potent anti-microbial effects useful for the management of oral disease. However, we are moving away from the view of simply ‘killing’ bacteria, towards managing oral microbial ecosystems (oral microbiome), as an integrated system, to promote oral and systemic health. Here, we aimed to review the effects of CHX mouthwash on the balance of microbial communities in the mouth in vivo in oral health and disease. Sources and study sectionThe hierarchy of evidence was applied, with systematic reviews and randomised controlled trials consulted where available and case controlled studies being described thereafter. Search terms for each subject category were entered into MEDLINE, PubMed, Google Scholar and the Cochrane database. Focussing on metagenomics studies provides unique overview of the oral microbiome as an integrated system. DataEvidence was limited, but several next generation sequencing case-controlled studies suggested that in an integrated system, CHX may cause a shift towards lower bacterial diversity and abundance, in particular nitrate-reducing bacteria in vivo. CHX also appeared to alter salivary pH, lactate, nitrate and nitrite concentrations in saliva. Evidence regarding the effects of CHX on the oral microbiome during oral disease is still emerging. ConclusionsCHX alters the composition the oral microbiome. However, as CHX use remains widespread in dentistry to manage oral disease, urgent research using metagenomics studies of microbial communities in vivo are still needed to determine CHX mouthwash is ‘good’, ‘bad’ or otherwise for bacteria, in the context of oral and systemic health.
Highlights
Following a single blind, cross-over and non-randomized design we investigated the effect of 7-day use of chlorhexidine (CHX) mouthwash on the salivary microbiome as well as several saliva and plasma biomarkers in 36 healthy individuals
CHX increased the abundance of Firmicutes (FDR < 0.001) and Proteobacteria (FDR < 0.001) and lowered the abundance of Bacteroidetes (FDR < 0.001), TM7 (FDR < 0.001), SR1 (FDR < 0.001) and Fusobacteria (FDR = 0.043)
This study showed that CHX mouthwash significantly changed the oral microbiome towards greater abundance of Firmicutes and Proteobacteria species, with lower abundance of Bacteroidetes, TM7, SR1 and Fusobacteria
Summary
Cross-over and non-randomized design we investigated the effect of 7-day use of chlorhexidine (CHX) mouthwash on the salivary microbiome as well as several saliva and plasma biomarkers in 36 healthy individuals. We and others have recently shown that the use of CHX in healthy subjects can attenuate the nitrate-reducing activity of oral bacteria by at least 80%8–11 This in turn leads to lower nitrite availability and an increase of blood pressure, suggesting that the oral microbiome can regulate cardiovascular health in healthy individuals and hypertensive patients[8,11]. The main aim of this study was to investigate the effects of 7-day use of CHX mouthwash on the oral microbiome of healthy participants, and its impact on several saliva markers such as pH, buffering capacity, lactate and glucose levels. Age (years) Gender (F:M) Weight (kg) Height (cm) Systolic blood pressure Diastolic blood pressure Mean arterial blood pressure
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Disclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.