Chlorhexidine Gluconate Mouthrinse Research Articles

Comparing the Effectiveness of Octenidine Hydrochloride and Chlorhexidine Gluconate Mouthrinses in Reducing Plaque and Oxidative Stress in Institutionalized Children with Down Syndrome.

Due to decreased manual dexterity, a lack of motivation, and difficulty on the part of the caregiver conducting efficient oral hygiene measures at home, patients with Down syndrome (DS) are badly affected. The objective of this study is to compare the efficacy of 0.1% octenidine (OCT) hydrochloride and 0.12% chlorhexidine (CHX) gluconate on plaque control and oxidative stress in institutionalized children with DS. In 20 children, salivary samples were collected for analysis of the inflammatory marker high-sensitive C-reactive protein (hsCRP) and oxidative stress markers, specifically malondialdehyde (MDA). Plaque index (PlI) and gingival index (GI) were scored. After oral prophylaxis, the participants were randomly assigned to two groups, each consisting of 10 individuals (octenidol and CHX). Salivary oxidative stress marker assays were carried out using a modified version of Yagi's (1984) method, and absorbance was measured at 540 nm using an ultraviolet-visible spectrophotometer at 535 nm. hsCRP assays were conducted via latex turbidimetric immunoassay. On comparison between the two groups, the OCT group showed a statistically significant reduction in GI, PlI, and MDA values (p < 0.05). It was seen that the use of 0.1% OCT hydrochloride could facilitate the maintenance of good oral hygiene and periodontal status, especially in patients with motor difficulties. PMS/IEC/2016/02. Raj AS, George S, S A, et al. Comparing the Effectiveness of Octenidine Hydrochloride and Chlorhexidine Gluconate Mouthrinses in Reducing Plaque and Oxidative Stress in Institutionalized Children with Down Syndrome. Int J Clin Pediatr Dent 2024;17(4):437-441.

Antibacterial Efficacy of Herbal and 0.2% Chlorhexidine Mouth Rinse Against Oral Pathogens – An In vitro Study

ABSTRACT Background: Nature has given us an enormous number of medicines for every disease that affects people. Aim: To compare the antimicrobial efficacy of an herbal and 0.2% chlorhexidine gluconate mouthrinse against Streptococcus mutans, Staphylococcus aureus, and Enterococcus faecalis. Materials and Methods: The antimicrobial effectiveness (zone of inhibition) of a herbal mouthrinse and 0.2% chlorhexidine mouthrinse were determined by agar well-diffusion method. Results: At 50% concentration, the experimental mouthrinse inhibits the growth of Streptococcus mutans, Staphylococcus aureus, and Enterococcus faecalis. Conclusion: Against the three strains, chlorhexidine mouthrinse (0.2%) performs better in terms of antimicrobial effectiveness.

Improving predoctoral education related to caries risk assessment in adults.

This project examined patterns of adult patient management using a caries risk assessment (CRA) protocol at East Carolina University, School of Dental Medicine. Usage of the CRA protocol from 2014 to 2019 was assessed. Non-operative anti-caries treatments were measured against caries risk status (high, moderate, low, or none). Steps to improve the appropriate management of patients based on caries risk are presented to align with accreditation standards for predoctoral education programs. The CRA protocol is based on the Caries Management by Risk Assessment approach. Risk-based patterns for two non-operative interventions were examined: (1) prescriptions for 0.12% chlorhexidine gluconate (CHX) mouth rinse and (2) prescriptions for 5000 ppm fluoride toothpaste (PreviDent 5000 [PreviDent]). Statistical analyses included chi-square tests and logistic regression. Over the study period only 16.4% of adult patients had completed the CRA form. Among 29,411 patients from nine community sites, treatment rates for PreviDent were 18.7% among high-risk patients, 11.6% for moderate-risk adults, and 6.4% for low-risk adults (p<0.01). Treatment rates for CHX were 23.0%, 22.6%, and 17.1%, respectively (p<0.05). Patients without a CRA status were least likely to receive any anti-caries treatments, indicating that CRA status affects clinical, non-operative care. Patterns for prescription of PreviDent and CHX are consistent with CRA status. Future efforts to improve usage of the CRA protocol using faculty calibration, tracking with quality improvement tools, and reassessment. Training in the community-based educational setting is enhanced through data-based tracking to assure evidence-based decision making.

THU442 A Case Of Early Medication Related Osteonecrosis Of The Jaw In Patient Receiving Intravenous Zoledronate For Treatment Of Osteoporosis

Abstract Disclosure: V. Ekpe: None. X. Au: None. M. Golson: None. L.E. McGuire: None. L.E. Aguirre: None. Introduction: Medication related Osteonecrosis of the jaw (MRONJ) is a rare side effect in patients receiving nitrogen-containing bisphosphonates intravenously and other anti-bone resorptive agents such as denosumab . The incidence is 0.1% in patients with metabolic bone disease1. Annual infusions of zoledronic acid have been recommended in order to improve patient compliance, optimize therapeutic effects and to minimize side effects in selected patients. Risk factors include history of malignancy, smoking, poor dental health, prior oral surgery, high dose exposure to zoledronic acid and longer duration of treatment with anti-resorptive therapy. Increasing usage of bisphosphonates and other antiresorptive drugs, have led to an increased incidence of MRONJ. Clinical Case: We report the case of a 63-year-old Caucasian female suffering from osteoporosis who developed early stage MRONJ. She has a history of several years of oral bisphosphonate treatment and three annual administrations of zoledronic acid. Patient presented with a new complaint of gum pain and a sore above her tooth. Prior routine dental exams have all been unremarkable. She was promptly referred and evaluated by a dental provider. Dental photographs showed a resorptive defect at the gumline. Patient was diagnosed with medication related osteonecrosis of the jaw (MRONJ) in the gum area above tooth number 9. Our patient was treated with oral amoxicillin 500mg twice daily and chlorhexidine gluconate mouth rinse twice daily. The intravenous zoledronic acid was discontinued. Her gum infection resolved. Discussion: Early detection of MRONJ is possible in patients potentially at risk for this rare complication. Providers should be aware of MRONJ and refer those patients on antiresorptive drugs to the dentist for frequent evaluation and assessment for any drug-related jaw changes.

Evaluation of the effectiveness of green tea mouth rinse on oral halitosis, tongue coating, and plaque accumulation in comparison with 0.2% chlorhexidine mouth rinse - A double-blind randomized control trial.

Green tea (Camellia sinensis) mouth rinse is found effective in reducing periodontitis. However, studies evaluating the effectiveness of green tea extracts in reducing oral halitosis and tongue coating on Indian population were scanty. The objective of this study was to evaluate the effectiveness of green tea-based mouth rinse in comparison with 0.2% chlorhexidine gluconate mouth rinse in reducing dental plaque, tongue coating, and halitosis among human volunteers. This was a parallel-arm double-blind randomized controlled trial conducted in two residential hostels in Mysuru city over 21 days. 90 adult participants were recruited and randomized into three groups: Group A: mouth rinse containing saline, Group B: 5% C. sinensis mouth rinse, and Group C: 0.2% chlorhexidine diluted to with equal quantity of water. Preintervention prophylaxis was done; tongue coating and oral halitosis scores were recorded and compared between the groups at baseline and after 21 days. The mean plaque buildup at postintervention was highest in Group 1 (2.45 ± 0.38) followed by Group 3 (1.18 ± 0.12) and Group 2 (1.08 ± 0.11) in the descending order. The mean oral halitosis score was highest in Group 1 (3.00 ± 0.79) followed by Group 3 (1.53 ± 0.50) and Group 2 (1.50 ± 0.50) in the descending order. The mean tongue coating score was highest in Group 1 (1.17 ± 0.47) followed by Group 2 (0.75 ± 0.36) and Group 3 (0.69 ± 0.34) in the descending order. Five percent C. sinensis mouth rinse is as effective as commercially available 0.2% chlorhexidine mouthwash in reducing plaque deposition, tongue coating, and oral halitosis.

Pneumonia-associated microbial species and stabilized chlorine dioxide–containing oral care products

BackgroundThis study evaluated the antifungal and antibacterial effects of stabilized chlorine dioxide–containing oral care products against yeast and bacterial species associated with pneumonia. MethodsSix yeast species (Candida albicans, Candida glabrata, Cryptococcus neoformans, Candida dubliniensis, Candida krusei,Candida tropicalis) and 5 bacterial species (Streptococcus pneumoniae, Klebsiella pneumoniae, Haemophilus influenzae, Staphylococcus aureus, Pseudomonas aeruginosa) were grown in Sabouraud dextrose broth and brain-heart infusion media, respectively, overnight. Each microorganism was treated with individual chlorine dioxide–containing ClōSYS (Rowpar Pharmaceuticals) products (Silver Multi-Benefit Fluoride Mouthwash, Sensitive Fresh Breath Mouthwash, Ultra Sensitive Mouthwash, Oral Spray, Silver Toothpaste, Sensitive Toothpaste, Fluoride-free Toothpaste) at serial dilutions. Chlorhexidine gluconate (0.12%) mouthrinse and water were positive and negative controls, respectively. Treated species were grown overnight. Minimum inhibitory concentration (MIC) was evaluated. Five microliters of each culture were transferred to blood agar plates incubated overnight, and minimum fungicidal concentration (MFC) and minimum bactericidal concentrations (MBC) were evaluated. ResultsAll undiluted products produced antifungal effects against tested yeast species. Similarly, antibacterial effects were observed for all products except for S pneumoniae and H influenzae, which were resistant to killing by some products. All tested products produced fungistatic or bacteriostatic effects against tested fungal or bacterial species. Different concentrations of each product are required to produce MIC, MFC, and MBC for each species tested. Some species required an equal or higher MIC than MFC and MBC. ConclusionsStabilized chlorine dioxide–containing ClōSYS oral care products exhibit antifungal and antibacterial effects against common yeast and bacterial species associated with pneumonia.

Impact of Fluoridated Mouthwashes on Strength and Durability of Three Different Synthetic Absorbable Suturing Materials: An In Vitro Study

The aim of the current in vitro research was to assess the effect of fluoride-containing mouthwashes on the strength and durability of three different synthetic absorbable suturing materials. Three types of synthetic absorbable suture materials were employed in this research, and every group comprised 20 suture samples. These include group I: Polyglactin 910, group II: Polyglycolic acid, and group III: Poliglecaprone 25. This research utilized 4-0 gauge sutures. Each example was tied using a square surgeon's knot about elastic rubber tubing. The biology of the oral milieu was replicated in vitro through the use of artificial saliva. The medium that was subjected to test prior to inclusion were 0.2% chlorhexidine gluconate as well as 0.044% sodium fluoride. The tensile strength of the specimen suture materials was subjected to test at a particular time intervals: prior to immersion, the 1st day, the 7th day, as well as the 14th day after immersion. Tensile strength was evaluated using a Universal Ultra Test machine. Post-immersion in 0.2% chlorhexidine gluconate mouthrinse, the mean tensile strength of polyglactin (PLG) 910 sutures was 24.48 ± 0.08 at pre-immersion and 4.36 ± 0.01 on the 14th day. The mean tensile strength of polyglycolic acid (PGA) sutures was 24.04 ± 0.26 at pre-immersion and 2.10 ± 0.02 on the 14th day. The mean tensile strength of Poliglecaprone 25 sutures was 23.82 ± 0.11 at pre-immersion and 1.34 ± 0.08 on the 14th day. Post-immersion in 0.044% sodium fluoride mouthrinse, the mean tensile strength of PLG 910 sutures was 24.18 ± 0.02 at pre-immersion and 5.12 ± 0.21 on the 14th day. The mean tensile strength of PGA sutures was 24.88 ± 0.34 at pre-immersion and 4.58 ± 0.10 on the 14th day. The mean tensile strength of Poliglecaprone 25 sutures was 24.48 ± 0.27 at pre-immersion and 5.08 ± 0.14 on the 14th day. A statistically noteworthy difference was noted amid the three types of sutures at dissimilar time points evaluated with p <0.001. The current research arrived at a conclusion that there is a significant difference between the mean tensile strength and purpose of the medium used for immersion as well as the tenure. Polyglactin suture material exhibited superior strength as compared to PGA and poliglecaprone suture substances following immersion in the investigational media. Suture materials are employed in the closure of incised flaps, to aid healing by primary intention, along with control of bleeding. In oral as well as periodontal surgery, the right choice of sutures is very important for good healing. Suture choice for the mouth should be influenced by the requirements of the anticipated repair and the surgeon's fondness.

An In vitro Study to Determine the Antibacterial Activity of Chlorhexidine and Herbal Mouthrinses against Enterococcus faecalis.

Background:Oral diseases have a strong history of treating by natural remedies. Chemical plaque reduction techniques, including dental mouthwashes, are intriguing because they can help patients who are unable to maintain appropriate mechanical plaque management. They are a less technically difficult alternative to mechanical control.Aim:This study aimed to compare the antibacterial efficacy of an herbal and 0.2% chlorhexidine gluconate mouthrinse against Enterococcus faecalis.Methodology:The antimicrobial effectiveness (zone of inhibition) of an herbal mouthrinse and chlorhexidine mouthrinse was determined by agar well diffusion method.Results:The zone of inhibition for control mouthrinse was 19 mm, and there was no zone of inhibition observed for the experimental mouthrinse.Conclusion:The result of this investigation suggests 0.2% chlorhexidine gluconate has a better antimicrobial activity than herbal mouthrinse.

The effects of various mouth rinses on enamel bond strength of a universal adhesive system

Background/Aim. Although essential oil-containing mouth rinses have some advantages, it is not well-known what effects they have on the bond strength of the universal resin adhesives system to the enamel. The aim of the study was to evaluate the effect of essential oil-containing mouth rinse on the enamel bond strength of the universal adhesive system. Methods. The ninety-six bovine incisors were used. The teeth were divided into four different groups according to the control group and 3 different mouth rinses: Group I (Control) - distilled water, Group II - Listerine Cool Mint (essential oil mouth rinse), Group III - Kloroben (0.12% chlorhexidine gluconate mouth rinse) and Group IV - Oxyfresh (0.05% sodium fluoride mouth rinse). Each group was divided into two subgroups according to the application mode of the universal adhesive (etch-and-rinse mode or self-etch mode) (n = 12). Mouth rinses were applied daily for 30 sec to the enamel surfaces for a month and the samples were soaked in distilled water. After the shear bond strength (SBS) tests were performed with the universal test machine at a speed of 1 mm/min, the SBS data were statistically analyzed (p = 0.05). Results. Two-way ANOVA showed that enamel bond strength of universal adhesive was not affected by mouth rinse and was significantly affected by the application mode. Conclusion. The use of essence oil-containing mouth rinse and other mouth rinses tested in the study is safe in terms of the quality of enamel bonding of the tested adhesive.

Comparative evaluation of the anti-plaque efficacy of green tea extract mouthrinse and white tea extract mouthrinse with chlorhexidine gluconate mouthrinse-A clinical and microbiological study

Introduction: Numerous studies have been conducted based on the natural mouthwashes, with fewer side effects, as an alternative to chemical ones. The aim of this study is to compare clinically and microbiologically the anti plaque efficacy of mouthwash containing extract of green tea, white tea extract with chlorhexidinegluconate mouthwash. Materials and Methods: This clinical study was performed in the department of Periodontology and Oral Implantology, I.T.S Dental College, Muradnagar, Ghaziabad, India. All the patients were educated about the study and then a written informed consent was acquired before enrolment in the study. The study was conducted for a period of 10 days. A total of 30 Dental students were selected as patients of age group of 19-23 years(from 1st to 2nd year) according to assigned inclusion criteria, oral prophylaxis was performed & the subjects were randomly allocated equally to one of the three treatment groups (10 each) Group A – Green Tea Extract , Group B – White Tea Extract , Group C- Chlorhexidinegulconate. The subjects were assessed both preoperatively and postoperatively clinically by recording the plaque and gingival indices and microbiologically by counting the number of colonies forming units/mL (CFU/mL). Results: Green Tea showed statistically significant difference in clinical parameters and in CFUs/ml compared to White Tea. Conclusion: The results of the current study indicated that White Tea and Green Tea mouth rinse were found to be a potent anti-plaque agent although less efficacious than chlorhexidine mouth rinse. Green tea catechin mouthwash was comparably efficacious to chlorhexidinegluconate as an antiplaque agent when used for 10 days. Keywords: Green tea, White tea, Chlorhexidinegluconate mouth rinse, Antiplaque.

Using metagenomic analysis to assess the effectiveness of oral health promotion interventions in reducing risk for pneumonia among patients with stroke in acute phase: study protocol for a randomized controlled trial

BackgroundThe prevalence of pneumonia complicating stroke in acute phase has a poor prognosis and higher risk for death. Oral opportunistic pathogens have been reported to be associated with pneumonia among people with compromised health. Oral health promotion is effective in reducing dental plaque among patients with stroke, which is considered as reservoirs for oral opportunistic pathogens. This study evaluates the effectiveness of oral health promotions in reducing the prevalence of pneumonia via its effects on composition and relative abundance of oral opportunistic pathogens.Methods/designThis study is a randomized, single-blind, parallel trial of 6 months duration. The study is being conducted at one of the largest medical teaching hospitals in Hefei, China. A total of 166 patients with stroke and free from any post-stroke complication will be recruited. After enrollment, patients will be randomized to one of the following groups: (1) oral hygiene instruction (OHI) or (2) OHI, 6-month use of powered tooth brushing, and 0.2% chlorhexidine gluconate mouth rinse (10 ml twice daily). The primary outcome is the prevalence of pneumonia complicating stroke. Patients will be monitored closely for any occurrence of pneumonia over the entire period of this trial. Oral rinse samples will be collected at baseline and multiple follow-up reviews (3, 5, 7 days, and 1, 3, 6 months after baseline). Next-generation sequencing will be employed to detect composition and relative abundances of the microorganism in the oral rinse samples. Questionnaire interviews and clinical oral examinations will be conducted at baseline and 1, 3, and 6 months after baseline.DiscussionThe findings of this trial will provide evidence whether oral health promotion intervention is effective in reducing the prevalence of pneumonia complicating stroke via its effect on the oral microbiome. The analysis of the outcomes of this trial is empowered by metagenomic analysis at 16S rRNA level, which is more sensitive and comprehensive to help us detect how oral health promotion inventions affect the oral microbiome in terms of its composition, relative abundance, and interactions between species, which all may contribute to the occurrence of pneumonia complicating stroke.Trial registrationClinicalTrials.gov NCT04095780. Registered on 19 September 2019

Tolerability of a green tea-based mouth rinse: A pilot study

IntroductionMouth rinse containing essential oil is one of the most popular, over the counter dental products which has been promoted to have anti-inflammatory, anti-plaque and anti-microbial properties. An essential oil alcohol-free mouth rinse with green tea has been introduced recently and promoted for management of periodontitis and gingivitis. As the role of chlorhexidine gluconate (CHX) mouth rinse in management of periodontal disease has been evaluated previously, the aim of this study is to compare the tolerability of none-alcohol containing green tea-based (NAGT) mouth rinse with CHX mouth rinse. MethodsForty healthy subjects were enrolled in September 2018 at King Abdulaziz University and allocated randomly to two study arms: NAGT mouth rinse and chlorhexidine gluconate mouth rinse. Study subjects were instructed to follow the manufacturer instructions and rinse twice daily for two weeks. Collected data included age, gender, smoking history in addition to subjective assessment using a validated questionnaire. Intraoral clinical examination was completed at baseline and 2-weeks time point. ResultsThe data of 36 patients were included in this study and analyzed. At 2 weeks, NAGT group reported higher burning sensation score compared to chlorhexidine group (mean: 4.33 and 0.6 respectively; P < 0.05). Reported mucosal dryness was more evident in NAGT group (mean: 1.9 Vs 1.7 for chlorhexidine group). Oral examination revealed significant mucosal desquamation (27.8%) in NAGT group. However, oral ulceration was reported equally in both groups (5.6%). ConclusionThe current data demonstrates an overall less tolerability of a non-alcohol containing green tea-based mouth rinse compared to chlorhexidine gluconate. Further long term randomized clinical trials are recommended to confirm our findings.

Antimicrobial Efficacy of Two Mouthrinses Against Candida albicans: An In Vitro Study.

Background:Mouthrinses have been used for centuries with the objective of reducing the amount of microorganisms in the oral cavity. Mouthrinses are used as adjuncts to mechanical oral hygiene. Therapeutic mouthwashes are often recommended as an adjunct to mechanical plaque control for prevention of plaque accumulation and to maintain gingival and periodontal health. Mechanical control alone for reducing recalcitrant biofilms in the oral cavity has been challenged because it is considered to be rather time-consuming and most importantly insufficient for effective oral hygiene. The aim of this study was to evaluate the antimicrobial efficacy of herbal and 0.2% chlorhexidine gluconate mouthrinse against Candida albicans.Materials and Methods:The minimum inhibitory concentration and antimicrobial effectiveness (zone of inhibition) of a herbal mouthrinse and 0.2% chlorhexidine mouthrinse were determined by broth macro-dilution and agar well diffusion method, respectively.Results:The zone of inhibition of C. albicans was 26 mm for the 0.2% chlorhexidine mouthrinse, whereas it was 12 mm for the Arowash liquid mouthrinse.Conclusion:Chlorhexidine mouthrinse (0.2%) has a better antimicrobial efficacy against the C. albicans when compared to herbal mouthrinse (Arowash liquid).

The antiplaque efficacy of lantibiotic Nisin extract mouthrinse.

Aim:This study aimed to determine the antiplaque efficacy of Nisin Z extract mouth rinse (Test) as compared to 0.2% chlorhexidine gluconate mouthrinse (Positive control) and distilled water (Placebo) and to assess minimum inhibitory concentrations (MICs) and minimum bactericidal concentrations (MBCs) of Nisin Z against Prevotella intermedia (Pi), Porphyromonas gingivalis (Pg), and Aggregatibacter actinomycetemcomitans (Aa) in vitro.Materials and Methods:Forty-five individuals were randomly divided into three groups (15 in each group). The baseline plaque scores were brought to 0 with scaling and polishing. They were asked not to use any kind of mechanical oral hygiene aid for 4 days and advised to use mouthwashes A, B, or C (Group A: Nisin Z; Group B: distilled water; Group C: chlorhexidine) for 4 days. Following the 4-day plaque re-growth model, Plaque Index was checked on days 1 and 5.Results:In intergroup comparison, a statistically significant difference was seen between Nisin and placebo groups and chlorhexidine and placebo groups, with Nisin and chlorhexidine showing superior antiplaque activity. There was also statistically significant difference between Nisin and chlorhexidine groups, with chlorhexidine showing superior antiplaque activity. In vitro Nisin showed effective inhibition against all three bacterial strains Pi, Pg, and Aa exhibited the highest sensitivity to Nisin with a MIC of 2.5 μg/ml and MBC of 15 μg/ml.Conclusion:Nisin Z mouthrinse was found to be a potent plaque inhibitor, though less effective than chlorhexidine mouthrinse. However, it can serve as a good natural alternative to the gold standard.

Cost-effectiveness of pre-operative Staphylococcus aureus screening and decolonization.

We developed a decision analytic model to evaluate the impact of a preoperative Staphylococcus aureus decolonization bundle on surgical site infections (SSIs), health-care-associated costs (HCACs), and deaths due to SSI. Our model population comprised US adults undergoing elective surgery. We evaluated 3 self-administered preoperative strategies: (1) the standard of care (SOC) consisting of 2 disinfectant soap showers; (2) the "test-and-treat" strategy consisting of the decolonization bundle including chlorhexidine gluconate (CHG) soap, CHG mouth rinse, and mupirocin nasal ointment for 5 days) if S. aureus was found at any of 4 screened sites (nasal, throat, axillary, perianal area), otherwise the SOC; and (3) the "treat-all" strategy consisting of the decolonization bundle for all patients, without S. aureus screening. Model parameters were derived primarily from a randomized controlled trial that measured the efficacy of the decolonization bundle for eradicating S. aureus. Under base-case assumptions, the treat-all strategy yielded the fewest SSIs and the lowest HCACs, followed by the test-and-treat strategy. In contrast, the SOC yielded the most SSIs and the highest HCACs. Consequently, relative to the SOC, the average savings per operation was $217 for the treat-all strategy and $123 for the test-and-treat strategy, and the average savings per per SSI prevented was $21,929 for the treat-all strategy and $15,166 for the test-and-treat strategy. All strategies were sensitive to the probability of acquiring an SSI and the increased risk if SSI if the patient was colonized with SA. We predict that the treat-all strategy would be the most effective and cost-saving strategy for preventing SSIs. However, because this strategy might select more extensively for mupirocin-resistant S. aureus and cause more medication adverse effects than the test-and-treat approach or the SOC, additional studies are needed to define its comparative benefits and harms.

The Evidence for Caries Management by Risk Assessment (CAMBRA®).

A system for Caries Management by Risk Assessment (CAMBRA®) has been developed in California. The purpose of this article is to summarize the science behind the methodology, the history of the development of CAMBRA, and the outcomes of clinical application. The CAMBRA caries risk assessment (CRA) tool for ages 6 y through adult has been used at the University of California, San Francisco (UCSF), for 14 y, and outcome studies involving thousands of patients have been conducted. Three outcomes assessments, each on different patient cohorts, demonstrated a clear relationship between CAMBRA-CRA risk levels of low, moderate, high, and extreme with cavitation or lesions into dentin (by radiograph) at follow-up. This validated risk prediction tool has been updated with time and is now routinely used at UCSF and in other settings worldwide as part of normal clinical practice. The CAMBRA-CRA tool for 0- to 5-y-olds has demonstrated similar predictive validity and is in routine use. The addition of chemical therapy (antibacterial plus fluoride) to the traditional restorative treatment plan, based on caries risk status, has been shown to reduce the caries increment by about 20% to 38% in high-caries-risk adult patients. The chemical therapy used for high-risk patients is a combination of daily antibacterial therapy (0.12% w/v chlorhexidine gluconate mouth rinse) and twice-daily high-concentration fluoride toothpaste (5,000 ppm F), both for home use. These outcomes assessments provide the evidence to use these CRA tools with confidence. Caries can be managed by adding chemical therapy, based on the assessed caries risk level, coupled with necessary restorative procedures. For high- and extreme-risk patients, a combination of antibacterial and fluoride therapy is necessary. The fluoride therapy must be supplemented by antibacterial therapy to reduce the bacterial challenge, modify the biofilm, and provide prevention rather than continued caries progression.

Comparative Evaluation of Tongue Coat Inhibitory Effect of 1% Stabilized Chlorine Dioxide Mouthrinse with that of 0.2% Chlorhexidine Gluconate Mouthrinse in the Treatment of Halitosis using N-benzoyl-DL-arginine-2-naphthylamide Assay: A Randomized Crossover Study

Comparative Evaluation of Tongue Coat Inhibitory Effect of 1% Stabilized Chlorine Dioxide Mouthrinse with that of 0.2% Chlorhexidine Gluconate Mouthrinse in the Treatment of Halitosis using N-benzoyl-DL-arginine-2-naphthylamide Assay: A Randomized Crossover Study

Palatal Health of Those Wearing Complete Dentures: For How Long Must a Tissue Conditioner and Chlorhexidine Gluconate Mouthrinse be Used?

Amac : Tam protez kullanimi sonucu damak bolgesinde eritema olan hastalarin tedavisinde rutin olarak kullanilan klorheksidin glukonat agiz gargarasinin ve doku duzenleyicilerin etkisini retrospektif olarak degerlendirmektir. Yontemler : Klinigimize basvuran tam protez kullanan ve palatal bolgesinde eritem bulunan hastalarin klinik tedavisi suresince palatinal orta hattindan alinan fotograflar incelendi ve Butz Jorgensen Indeksine gore degerlendiridi. Hastalar 3 gruba ayrildi (n=8). Birinci gruba doku duzenleyici, ikinci gruba sadece % 0,2’lik klorheksidin glukonat agiz gargarasi verildi ucuncu gruba her iki yontem birlikte uygulandi. Tum gruplar icin degerlendirme suresi iki hafta olarak belirlendi. Hastalarin palatal orta hat bolgesinden baslangic, tedaviden 1. hafta ve 2. hafta sonrasinda agiz ici fotograflar cekildi. Niteliksel verilerin karsilastirilmasinda Ki-Kare testi, parametrelerin grup ici karsilastirmalarinda ise Wilcoxon isaret testi kullanildi. Anlamlilik p 0,05).Doku duzenleyici ve %0,2’lik klorheksidin glukonat agiz gargarasinin birlikte kullaniminin palatal enflamasyonun azalmasinda etkili oldugu goruldu. Sonuc : Tam protez kullanimi sonucu meydana gelen palatal enflamasyon tedavisinde 2 haftalik doku duzenleyici ve %0,2’lik klorheksidin glukonat agiz gargarasinin kullanimi etkilidir.

Comparison of Dill Seed Oil Mouth Rinse and Chlorhexidine Mouth Rinse on Plaque Levels and Gingivitis - A Double Blind Randomized Clinical Trial.

Introduction:Mouthrinses have been in use for centuries as breath fresheners, medicaments, and antiseptics. Dill is said to be a good source of calcium, manganese and iron. It contains flavonoids known for their antioxidant, anti-inflammatory, and antiviral properties. Dill can help with microbial infections in the mouth; and its anti-oxidants minimize damage caused by free radicals to the gums and teeth. Being a good source of calcium, dill also helps with bone and dental health.Aims and Objectives:To compare the effectiveness of commercially available 0.2% chlorhexidine gluconate mouthrinse and dill seed oil mouthrinse on plaque levels and gingivitis.Material and Methods:A randomized controlled, double blind parallel arm study was conducted over 90 days on 90 subjects. The subjects were randomly divided into 2 groups and baseline data was collected using Loe and Silness gingival index and Quigley Hein plaque index and oral prophylaxis was performed on all the subjects. The mouthrinses included in the present study were dill seed oil and Hexodent (0.2% chlorhexidine gluconate). Intervention regarding the mouthrinsing was given to the subjects and were followed up for 45 days and 90 days, after this post intervention changes were assessed using the respective indices.Results:It was observed that there is no significant difference in gingival & plaque scores among two mouthrinses from baseline to 45 days and 90 days. It was observed that there is statistical difference in gingival and plaque scores when compared with baseline to 45 days (p<0.001), baseline to 90 days (p<0.001) and 45 days to 90 days (p<0.001) when intergroup comparisons were done.Conclusion:It was concluded that dill seed oil and Hexodent (0.2% chlorhexidine gluconate) mouthrinse have similar antiplaque and antigingival effectiveness.

Comparison of a commercially available herbal and 0.2% chlorhexidine mouthrinse for prevention of oral malodor: A clinical trial.

Objectives:Despite the adverse effects of chlorhexidine (CHX) in the oral cavity, it is still the most commonly prescribed mouthrinse for halitosis control due to its excellent results. The purpose of this study was to compare the efficacy of a mouthrinse with herbal formulation for halitosis control with 0.2% CHX gluconate containing rinse and to simultaneously assess adverse effects caused by the herbal mouthrinse if any.Materials and Methods:Ninety-six systemically healthy subjects with chronic generalized gingivitis were recruited in the study and divided into three groups receiving 0.2% CHX gluconate mouthrinse, herbal mouthrinse, or negative control, respectively as Group A, B, and C. The halimeter scores and organoleptic scores were recorded for each subject at baseline and after scaling. Others parameters recorded were plaque index and gingival index. All scores were reassessed on the 7th and 14th day, respectively. Statistical analysis was performed using Kruskal–Wallis ANOVA, Mann–Whitney U-test, and Wilcoxon matched pairs test.Results:There was an overall reduction in the halimeter scores both in Group A and B subjects which were not statistically significant within the groups; this was in accordance with the decrease in the mean organoleptic scores. Reduction in Group C scores was the least and differed statistically from both Group A and B scores.Conclusions:The results indicate an equivalent reduction in breath odor by both the herbal mouthrinse and CHX. Furthermore, side effects were less, and patient compliance was more with the herbal mouthrinse, which can thus be prescribed more safely and with predictable outcomes for oral malodor.