Antibacterial Mouth Rinse Research Articles

Effects of antibacterial mouth rinses on multiple oral biofilms model

Effects of antibacterial mouth rinses on multiple oral biofilms model

Antiseptic mouthwash inhibits antihypertensive and vascular protective effects of L-arginine

L-arginine supplementation increases nitric oxide (NO) formation and bioavailability in hypertension. We tested the possibility that many effects of L-arginine are mediated by increased formation of NO and enhanced nitrite, nitrate and nitrosylated species concentrations, thus stimulating the enterosalivary cycle of nitrate. Those effects could be prevented by antiseptic mouthwash.We examined how the derangement of the enterosalivary cycle of nitrate affects the improvement of endothelial dysfunction (assessed with isolated aortic ring preparation), the antihypertensive (assessed by tail-cuff blood pressure measurement) and the antioxidant effects (assessed with the fluorescent dye DHE) of L-arginine in two-kidney, one-clip hypertension model in rats by using chlorhexidine to decrease the number of oral bacteria and to decrease nitrate reductase activity assessed from the tongue (by ozone-based chemiluminiscence assay). Nitrite, nitrate and nitrosylated species concentrations were assessed (ozone-based chemiluminiscence).Chlorhexidine mouthwash reduced the number of oral bacteria and tended to decrease the nitrate reductase activity from the tongue. Antiseptic mouthwash blunted the improvement of the endothelial dysfunction and the antihypertensive effects of L-arginine, impaired L-arginine-induced increases in plasma nitrite and nitrosylated species concentrations, and blunted L-arginine-induced increases in aortic nitrate concentrations and vascular antioxidant effects.Our results show for the first time that the vascular and antihypertensive effects of L-arginine are prevented by antiseptic mouthwash. These findings show an important new mechanism that should be taken into consideration to explain how the use of antibacterial mouth rinse may affect arterial blood pressure and the risk of developing cardiovascular and other diseases.

BISPHOSPHONATE RELATED OSTEONECROSIS OF THE JAWS (BRONJ) STAGE 3 IN A PATIENT WITH LUNG CANCER AND BONE METASTASIS—A CASE REPORT

<h3>Background</h3> Bisphosphonates are used mainly to treat osteoporosis, multiple myeloma, and bone metastasis of tumors. However, their use has been associated with the appearance of osteonecrosis of the jaw (BRONJ), even though their exact mechanism of action is not yet well understood. Research shows that it is related to the suspension of bone resorption as a result of the reduction of the osteoclast activity. <h3>Objective</h3> The present study reports the case of a 61-year-old male patient with lung cancer exhibiting bone metastasis who developed BRONJ while receiving zoledronic acid. According to the American Association of Oral and Maxillofacial Surgeons staging system he was in stage 3, which includes exposed and necrotic bone, oral antral/oral nasal communication, and extraoral fistula. <h3>Results</h3> The patient was managed with antibacterial mouthrinse, antibiotic therapy and pain control, surgical debridement, and resection for long-term palliation of infection and pain, as well as closure of the oral antral/nasal communication and extraoral fistula. The patient was in excellent condition after 8 months and continued his treatment with dental restoration. <h3>Conclusions</h3> Our case study shows that with proper treatment there can be complete recovery of a patient with stage 3 BRONJ. The methods of prevention and treatment of BRONJ are discussed based on references and clinical experience.

Severe Acute Respiratory Syndrome Coronavirus 2 and Dentistry: A Summative Review of Guidelines issued by National Health Authorities.

COVID-19 was first reported in China, in November 2019 and since then the spread of this disease was so rapid that on March 11, 2020, it was declared a pandemic by the World Health Organization. Due to the high transmissibility of the COVID virus and the associated morbidity and mortality, various International and National health authorities released different guidelines for day-to-day living, laying down "new norms" which has impacted our lives enormously. Although these guidelines seem to be convoluted but owing to some differences in the guidelines, it raises an ambiguity in the minds of dentists. Hence, we felt the need of this review to summarize different guidelines issued by various National health authorities for catering emergency and routine dental care. We included guidelines from CDC, ADA, NHS, India, UAE, Egypt, and Tunisia and compared and consolidated to reach a consensus that teledentistry is a good alternative to face-to-face management for nonemergency patients. Triage should be done for all patients coming to the health-care facility. Temperature and other vital parameters should be recorded in our daily practice. Antibacterial mouth rinses before the dental procedure can reduce the microbial load and therefore can alleviate transmission. To reduce indirect transmission through fomites on inanimate objects various waiting area changes must be ensured. Air conditioners can be used in well-serviced conditions with due care given to ventilation of the operatory after each patient. Strict disinfection protocols and personal protective equipment for dentist safety are mandatory.

Oral Mouth Rinses against Supragingival Biofilm and Gingival Inflammation.

Caries and inflammatory periodontal diseases have a high prevalence worldwide. Although improvements in oral health status in our patients have been shown, there is still an increased demand for preventive measurements - especially in view of the systemic influence of the chronic disease periodontitis. The main focus of such measurements lies on an optimal biofilm management which can be divided into professional biofilm management and home care measurements. Since home care mechanical measurements such as toothbrushing and interdental cleaning are often insufficient or not on a regular basis, they can be supported by antibacterial agents which are able to inhibit or kill any oral microorganisms that remain. Besides a proven effect on plaque bacteria and gingival inflammation, agents should have a high substantivity in the oral cavity that outlast the short rinsing period. This chapter aims to present the background and rationale of using antibacterial mouth rinses, their common agents, to show sensible indications, and to evaluate the scientific evidence of their additional effect over toothbrushing alone.

Influence of different restorative materials on the sensitivity of Streptococcus mutans biofilm to different antimicrobial mouthrinses in vitro

Objectives. The aim of this study was to assess the antibacterial effects of chlorhexidine gluconate, sodium fluoride, and sodium fluoride-xylitol combination mouthrinses on S. mutans biofilm, and most significantly, we aimed to compare different restorative materials regarding the sensitivity of S. mutans biofilms formed on their surfaces to the antibacterial effects of the tested mouthrinses. Materials and methods. Ten clinical isolates of S. mutans were used to form biofilms on specimens of four commercial restorative materials (resin composite, glass-inomer cement, amalgam, and stainless steel crowns); enamel specimens were used as controls. The adhesion of each of the ten isolates on the surface of each of the specimens was evaluated using viable count method and it was considered as the base level of adhesion to which the adhesion levels after the application of antibacterial mouthrinses (chlorhexidine gluconate 0.12%, sodium fluoride 0.05%, and sodium fluoride 0.05%- xylitol 25%) was compared. Results. Chlorhexidine gluconate 0.12%, sodium fluoride 0.05%, and sodium fluoride 0.05%-xylitol 25% combination exhibited statistically significant antibacterial effects on S. mutans biofilm. The addition of xylitol 25% to sodium fluoride 0.05% mouthrinse was associated with higher antibacterial effects compared with sodium fluoride alone, prominently for GIC and amalgam specimens. S. mutans biofilms formed on GIC specimens exhibited the highest sensitivity to antibacterial treatments, whereas biofilms formed on stainless steel specimens showed the lowest sensitivity. Conclusion. S. mutans biofilms formed on different restorative materials exhibited different sensitivity levels to antimicrobial mouthrinses.

A clinical comparison of antibacterial mouth rinses in orthodontic patients

A clinical comparison of antibacterial mouth rinses in orthodontic patients

Microbiota in intra-oral halitosis – characteristics, effects of antibacterial mouth rinse treatment

Relevance. Modern data confirm multimicrobial etiology of oral malodor that can significantly compromise effective therapy. Thus, it is relevent to perform comprehensive study of causes of oral malodour, based on microbiological study of composition of mixed microbial biofilms including culturable and non-culturable microbes and evaluation of efficacy of mouth rinses with broad-spectrum antimicrobial agents.Purpose. To study oral microbiota in oral malodor and its correction with antibacterial mouth rinses.Materials and methods. Subjects, involved in the study, were divided into 3 groups, each having 20 people. Controls didn’t use mouth rinses; experimental group used mouth rinse, containing multicidum; in comparison group chlorhxidine containing mouth rinse was used. Orgnoleptic measurement based on 0-5 Rosenberg scale was applied to score intensity of oral malodor. Coating of the root of the tongue was studied by culture-based methods.Results. The research showed that Multicidum® mouth rinse in comprehensive oral malodor treatment affects aerobic bacteria involved in the pathologic process causing bad breath. Positive effect manifested itself organoleptically according to Rosenberg scale in foul breath reduction and in composition changes of microbiota of the root of the tongue. At thus, amount of microorganisms producing smelly volatile compounds decreased and the number of bacteria inhibiting this process increased amid reduction of spore-forming bacteria that contribute to maintenance of stable microbial communities in oral malodor.Conclusion. Gram-positive cocci and Bacillus-Streptococcus, Enterobacter, Staphylococcus, Granulicatella adiacens, Rothia and aerobic spore-forming bacteria from the Bacillus family that are involved in maintaining the functions of resistant bacterial communities-predominated among the bacteria identified in patients with halitosis. There was a statistically significant decrease in the severity of halitosis under the action of a rinse aid, the main active substance of which is Multicidum , and the absence of a statistically significant effect when using a rinse aid based on chlorhexidine.

Saliva-coated titanium biosensor detects specific bacterial adhesion and bactericide caused mass loading upon cell death

Bacteria adhering to implanted medical devices can cause invasive microbial infections, of e.g. skin, lung or blood. In dentistry, Streptococcus gordonii is an early oral colonizer initiating dental biofilm formation and also being involved in life-threatening infective endocarditis. To treat oral biofilms, antibacterial mouth rinses are commonly used. Such initial biomaterial-bacteria interactions and the influence of antibacterial treatments are poorly understood and investigated here in situ by quartz crystal microbalance with dissipation monitoring (QCM-D). A saliva-coated titanium (Ti) biosensor is applied to analyze possible specific signal patterns indicating microbial binding mechanisms and bactericide-caused changes in bacterial film rigidity or cell leakage caused by a clinically relevant antibacterial agent (ABA), i.e., a mouth rinse comprising chlorhexidine (CHX) and cetylpyridinium chloride (CPC). Apparent missing mass effects during the formation of microscopically proven dense and vital bacterial films indicate punctual, specific binding of S. gordonii to the saliva-coated biosensor, compared to unspecific adhesion to pure Ti. Coincidentally to ABA-induced killing of surface-adhered bacteria, an increase of adsorbed dissipative mass can be sensed, contrary to the prior mass-loss. This suggests the acoustic sensing of the leakage of cellular content caused by bacterial cell wall rupturing and membrane damage upon the bactericidal attack. The results have significant implications for testing bacterial adhesion mechanisms and cellular integrity during interaction with antibacterial agents.

Influence of Standardized Orientation on Patient Perception of Perioperative Care Following Alveolar Cleft Repair: A Survey Based Study of Patients Treated in a Large Academic Medical Center.

This study aims to better understand patient-reported outcomes for iliac bone grafting surgery for alveolar cleft repair and to determine how standardizing perioperative patient instruction affects patient-reported outcomes. Retrospective survey-based assessment of patients undergoing iliac bone grafting with and without hospital-based systems standardization. Academic tertiary care hospital. Of the 195 identified patients, 127 participated. Survey on pain and satisfaction regarding iliac bone grafting surgery. Survey answers measured patient opinions about the surgery. Answers of the pre- and poststandardization patients were compared to determine the effect of standardizing patient instructions. Patients rated their satisfaction with the surgery and recovery a 4.5 and 4.4 out of 5, respectively. They rated their overall pain in the hospital a 5.5 out of 10 (4.9 in the mouth, 5.7 in the hip). Patients were discharged an average of 1.2 days after surgery and could return to normal daily activity in 6.1 days. Poststandardization patients were more likely to adhere to instructions regarding use of an antibacterial mouthrinse and a protective oral splint. Patients were highly satisfied with the iliac bone grafting procedure and the recovery and reported only moderate levels of postoperative pain. Implementing standardized patient instructions may not affect patient satisfaction or pain severity, but it significantly increased patient adherence to physician instructions.

Comparative evaluation of mouth rinsing with plain water and an antibacterial mouth rinse on salivary pH: A randomized clinical trial

Introduction: Salivary pH plays an important role in maintaining oral health and in particular affecting dental caries. Studies have confirmed the antibacterial beneficial effects of chlorhexidine on dental health by increasing salivary pH (changing acidic pH to more neutral pH). Water, the most precious/omnipresent liquid also bears an effect on salivary pH. Materials and Methods: A double-blind concurrent parallel study design was employed on 40 individuals to evaluate changes in salivary pH before and after having meals. The study participants were divided into two groups with 20 each in Group A (those who rinsed with plain water) and Group B (those who rinsed with Chlorhexidine) who were assessed for the pH before and after meals. Results: On intragroup comparison, it was found that the mean pH of Group A was 5.56 ± 1.83 while the mean pH of Group B was 6.48 ± 1.49 after meals, which was statistically nonsignificant at P = 0.09. Conclusion: Water has a beneficial effect on salivary pH and in turn oral health, which is comparable with a standard mouth rinse.

Early detection and treatment of Speckled leukoplakia

Background: Leukoplakia is one of potentially malignant disorders that can be found on oral mucosa. Speckled leukoplakia is a rare type of leukoplakia with a very high risk of premalignant growth. Approximately 3 % of worldwide population has suffered from leukoplakia, 5-25% of which tend to be malignant leukoplakia. Purpose: This case report was aimed to discuss about early detection of speckled leukoplakia as one of potentially malignant disorders. Case: A 62 year old male patient came with chief complaint of bald and painful tongue since one month ago. The patient has a history of allergic reaction, hypertension, uric acid, and hepatitis B. He had been a heavy smoker since young until 10 years ago. Intra oral examination showed a firm, rough, non scrapable white plaque lesion with a size of 1 x 1.5 cm, surrounded by painful erosion with diffuse boundary. Case Management: Based on cytology examination, the patient was reffered to oncologist to get an excisional biopsy. Next, the patient succesfully underwent the excisional biopsy and came for control. The results showed the healing process of the lesion with a minimal complaint of bald tongue, especially when eating spicy or hot meal. To improve healing process, the patient then was given an antibacterial mouth rinse containing zinc and mulvitamin. Conclusion: Speckled leukoplakia could show high malignant transformation rate, therefore, early detection and treatment are necessary.

A New Strategy for Surgical Intervention of Bisphosphonate-Related Osteonecrosis of the Jaw : A retrospective study.

Bisphosphonates (BPs) are now widely used to treat various skeletal complications. Although the number of reported cases of bisphosphonate-related osteonecrosis of the jaw (BRONJ) is rapidly increasing worldwide, therapeutic strategies remain contro- versial. Conservative treatments including antibacterial mouth rinses, the systemic administration of antibiotics, and superficial debridement in stage II BRONJ have been recommended by the American Association of Oral and Maxillofacial Surgeons posi- tion paper. However, these treatments are only partially successful. We performed a surgical intervention that consisted of os- teotomy and primary wound closure in patients with stages II and III BRONJ. Forty-three out of 44 cases were treated effec- tively by this strategy, leading to improvements in quality of life. All BRONJ patients treated with oral BPs were treated successfully by the surgical intervention. We also proposed a surgical intervention for patients with stage II BRONJ. ACTA MEDICA NAGASAKIENSIA 60: 97−102, 2016

Conservative treatment of bisphosphonate-related osteonecrosis of the jaw in multiple myeloma patients.

The use of intravenous bisphosphonates (pamidronate or zoledronic acid) is the cornerstone for the management of multiple myeloma-(MM-) related bone disease. However, osteonecrosis of the jaw (ONJ) is a rare, but sometimes difficult to manage, adverse effect of bisphosphonates therapy. A retrospective review of all MM patients who were treated with bisphosphonates in our department, from 2003 to 2013, and developed ONJ was performed. According to inclusion criteria, 38 patients were studied. All these patients were treated as conservatively as possible according to the American Association of Oral and Maxillofacial Surgeons criteria. Patients were managed with observation, oral antibacterial mouth rinse with chlorhexidine, oral antibiotics, pain control with analgesics, nonsurgical sequestrectomy with or without simultaneous administration of antibiotics, or major surgery with or without antibiotics. Healing of the lesions was achieved in 23 (60%) patients who were treated with conservative measures; the median time to healing was 12 months (95% CI: 4–21). The number of bisphosphonates infusions influenced the time to healing: the median time to healing for patients who received <16 infusions was 7 months and for those with >16 infusions was it 14 months (P = 0.017). We conclude that a primarily nonsurgical approach appears to be a successful management strategy for bisphosphonate-related ONJ.

Design features of the Diabetes and Periodontal Therapy Trial (DPTT): A multicenter randomized single-masked clinical trial testing the effect of nonsurgical periodontal therapy on glycosylated hemoglobin (HbA1c) levels in subjects with type 2 diabetes and chronic periodontitis

BackgroundEvidence suggests that periodontitis is associated with prevalent and incident type 2 diabetes mellitus (T2DM), raising the question of whether periodontitis treatment may improve glycemic control in patients with T2DM. Meta-analyses of mostly small clinical trials suggest that periodontitis treatment results in a modest reduction in glycosylated hemoglobin (Hb) A1c. PurposeThe purpose of the Diabetes and Periodontal Therapy Trial (DPTT) was to determine if periodontal treatment reduces HbA1c in patients with T2DM and periodontitis. MethodsDPTT was a phase-III, single-masked, multi-center, randomized trial with a planned enrollment of 600 participants. Participants were randomly assigned to receive periodontal treatment immediately (Treatment Group) or after 6months (Control Group). HbA1c values and clinical periodontal measures were determined at baseline and 3 and 6months following randomization. Medication usage and dosing were assessed at each visit. Periodontal treatment consisted of scaling and root planing for a minimum of two 90-minute sessions, plus the use of an antibacterial mouth rinse for at least 32days afterwards. The primary outcome was change in HbA1c from baseline to 6months and the trial was powered to detect a between-group difference of 0.6%. Secondary outcomes included changes in periodontal clinical measures, fasting plasma glucose, the Homeostasis Model Assessment (HOMA2) and the need for rescue diabetes or periodontal therapy. ConclusionDental and medical researchers collaborated to recruit, treat and monitor participants with two chronic diseases to determine if treatment of one condition affects the status of the other.

Corrosion Response of Ti6Al4V and Ti15Mo Dental Implant Alloys in the Presence of Listerine Oral Rinse

The influence of a commonly used antibacterial mouth rinse, Listerine, on the corrosion behavior of one of the commonly used titanium alloys Ti6Al4V (two-phase structure, i.e.,αandβ) and a newer Ti15Mo (singleβphase) in normal saline solution has been investigated using electrochemical techniques. Interfacial electrochemical changes occurring at the oxide-solution interface have been analysed using EIS circuit modeling. Listerine acts as a corrosion inhibitor for Ti15Mo alloy and a corrosion promoter for Ti6Al4V alloy.

Do antibacterial mouthrinses affect bacteraemia in third molar surgery? A pilot study

The aim of this pilot study was to evaluate the effects of mouthrinses containing 7.5% povidone iodine and 0.2% chlorhexidine on bacteraemia following impacted third molar surgery. Thirty-four patients were enrolled in this study. Patients in the first group were asked to rinse their mouth with the mouthrinse containing 7.5% povidone iodine, patients in the second group were asked to rinse with the mouthrinse containing 0.2% chlorhexidine and patients in the third group were asked to rinse with 0.9% NaCl (sterile saline) solution. All rinses were used for one minute preoperatively. Peripheral venous blood samples were collected at baseline (preoperatively), 1 and 15 minutes after the completion of surgical tooth removal. Each blood sample was divided in two, placed in aerobic and anaerobic culture bottles and processed for microbiological examination. Bactaeremia was detected in 33% of the povidone iodine group, 33% of the chlorhexidine group and 50% of the control group. Isolated bacteria were 58% anaerobes and predominantly 92%Streptococcus species. Incidence of bacteraemia was reduced with chlorhexidine and povidone iodine mouthrinses in third molar surgery, although the difference was not statistically significant (p > 0.05). Bacteraemia was reduced with antibacterial mouthrinses in third molar surgery. The results of this study should be confirmed with further studies conducted on a larger patient population and with different antibacterial mouthrinses.

Successful treatment of advanced bisphosphonate‐related osteonecrosis of the mandible with adjunctive teriparatide therapy

The management of bisphosphonate-related osteonecrosis of the jaws (BRONJ) is challenging and controversial. At present, there is no established medication treatment for the disease. A 78-year-old osteoporotic woman with osteonecrosis of the mandible related to alendronate therapy was referred for treatment. The disease was unresponsive to conservative therapy, including antibacterial mouth rinse, antibiotics, and minor surgical debridement. Teriparatide, a human recombinant pararthyroid hormone peptide 1-34, was then used for treatment. The oral mucosa completely regrew, and pain subsided 4 weeks after the initiation of teriparatide administration. Progressive bone regeneration was found during and after the 6-month period of teriparatide therapy. Our case demonstrated that teriparatide can be an important adjuvant in the management of advanced BRONJ and should be considered prior to major resection with reconstruction. Its true value in the treatment of BRONJ for noncancer patients with osteoporosis warrants future studies.

51: Use of alcohol free antibacterial mouth-rinse is associated with a decreased incidence of PTB

The study tested the hypothesis that reducing the severity of periodontal disease with an alcohol free antimicrobial mouth-rinse containing cetylpyridinium chloride (CPC) decreases the incidence of preterm birth (PTB).

Interventions for replacing missing teeth: maintaining and recovering soft tissue health around dental implants

It is important to institute an effective supportive therapy to maintain or recover soft tissue health around dental implants. Different maintenance regimens have been suggested, however it is unclear which are the most effective. To assess the effects of different interventions for 1) maintaining and 2) recovering soft tissue health around osseointegrated dental implants. We searched the Cochrane Oral Health Group's Trials Register, the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE and EMBASE. Handsearching included several dental journals. We checked the bibliographies of the identified randomised controlled trials (RCTs) and relevant review articles for studies outside the handsearched journals. We wrote to authors of all identified RCTs, to more than 55 oral implant manufacturers and to an Internet discussion group to find unpublished or ongoing RCTs. No language restrictions were applied. The last electronic search was conducted on 2 June 2010. All randomised controlled trials comparing agents or interventions for maintaining or recovering healthy tissues around dental implants. Screening of eligible studies, assessment of the methodological quality of the trials and data extraction were conducted in duplicate and independently by two review authors. Results were expressed as random-effects models using standardised mean differences for continuous data and risk ratios for dichotomous data with 95% confidence intervals. Five trials compared interventions for maintaining soft tissue health around implants and a further six trials compared interventions to recover soft tissue health where there was evidence of peri-implant mucositis. No statistically significant differences were found between the effectiveness of powered versus manual toothbrushes for either maintaining or recovering soft tissue health. There was no statistically significant difference found between different types of self administered antimicrobials for maintaining soft tissue health (hyaluronic acid gel compared to chlorhexidine gel, amine fluoride/stannous fluoride mouthwash compared to chlorhexidine mouthwash) and triclosan dentifrice compared to sodium fluoride dentifrice showed no statistically significant difference in recovering soft tissue health. However chlorhexidine irrigation was more effective in reducing plaque and marginal bleeding scores compared to chlorhexidine mouthwash and Listerine mouthwash was found to be statistically significantly better than placebo with regard to reducing mean plaque scores and marginal bleeding scores. When interventions administered by dental professional were compared there was no statistically significant difference found between chlorhexidine and physiologic solutions as irrigants at second stage surgery to maintain health of soft tissues. In patients with peri-implant mucositis two trials evaluated interventions performed by dental professionals. There was no statistically significant difference between mechanical debridement followed by either minocycline or chlorhexidine gel, or between debridement with a titanium curette compared to an ultrasonic debridement tool. There was only low quality evidence for which are the most effective interventions for maintaining or recovering health of peri-implant soft tissues. The included RCTs had short follow-up periods and few subjects and although overall the risk of bias of the studies was either low or unclear, only single trials were available for each outcome. There was no reliable evidence as to which regimens are most effective for long term maintenance. This should not be interpreted as meaning that current maintenance regimens are ineffective. There was weak evidence that antibacterial mouthrinses are effective in reducing plaque and marginal bleeding around implants. More RCTs should be conducted in this area. In particular, there is a definite need for trials powered to find possible differences, using primary outcome measures and with much longer follow up. Such trials should be reported according to the CONSORT guidelines (www.consort-statement.org/).