First insights into chlorhexidine retention in the oral cavity after application of different regimens

Bashar Reda,Dietrich A Volmer,Matthias Hannig,Klaus Hollemeyer,Simone Trautmann

doi:10.1007/s00784-021-03910-y

Bashar Reda, Dietrich A Volmer + Show 3 more

Open Access

https://doi.org/10.1007/s00784-021-03910-y

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Abstract

ObjectivesThis in situ study aimed to determine and compare the chlorhexidine (CHX) retention in the oral cavity after the application of different CHX pharmaceutical regimens.MethodsFive volunteers used different CHX treatment regimens including mouth rinses, dental spray and toothpaste gel. After the application of the different CHX regimens, 2-μl samples were taken from saliva and buccal mucosa pellicle as well as the dental pellicle samples formed on standardized enamel surfaces. Sample collection was conducted at six time points within 12 h. Retention of CHX was measured using matrix-assisted laser desorption/ionization time-of-flight (MALDI-TOF) mass spectrometry.ResultsCHX retention values in the oral mucosa pellicle were significantly higher than those in saliva. CHX remained in the mucosal pellicle at microgrammes per millilitre levels for 12 h after mouth rinsing, 10 h after spray application and 2 h after using the toothpaste. CHX was detected in the dental pellicle for at least 12 h after application of mouth rinsing and spray. Retention of CHX after mouth rinsing or spray application was significantly higher than the retention after using toothpaste.ConclusionsOral mucosa was the favourable site for CHX retention. Higher mouth rinse concentration and longer rinsing time produced a slight increase in CHX retention. CHX spray provided considerable retention values, whereas toothpaste gel delivered the lowest retention after application. MALDI-TOF was a sensitive method with excellent limits of quantification for CHX detection.

Highlights

Chemotherapeutic agents have the potential to inhibit plaque growth, reduce gingivitis and improve oral health in combination with mechanical plaque control [1].Dietrich A
The results of the present study suggest that the maximum level of CHX retention is achieved when the 0.2% CHX rinsing regimen is used for 60 s
The results of the present study suggest that CHX concentration and the CHX delivery system play an essential role in CHX retention in the oral cavity after application

Summary

Introduction

Chemotherapeutic agents have the potential to inhibit plaque growth, reduce gingivitis and improve oral health in combination with mechanical plaque control [1].Dietrich A. Clinical relevance CHX rinses and spray provided effective retention values for biofilm management focused on patients unable to reach adequate oral hygiene. CHX has been delivered in a variety of formulations and vehicles, such as mouth rinse, spray, toothpaste, gel, varnish and slow-release devices. Solutions with alcohol or alcohol-free 0.2% CHX have been recommended as a mouth rinse in 10-ml volumes (20 mg dose). CHX solutions with a concentration of 0.12% are used as a mouth rinse but in 15-ml volumes (18 mg dose) [7, 8]. Small doses of approximately 1.5 ml CHX (3 mg dose) delivered from a spray to tooth surfaces, in physically and mentally handicapped groups, showed good anti-biofilm activity [9,10,11,12].

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