Daily Mouthwash Research Articles

Comparative evaluation of microhardness of three restorative materials after immersion in chlorhexidine mouthwash: An in vitro study

Aim: To evaluate and compare the microhardness of Filtek Z250XT, Beautifil II, and Neo Spectra ST HV after immersion in chlorhexidine mouthwash. Materials and Methods: Thirty disc specimens (10 for each group) made of three different restorative materials, Group 1 – Filtek (3M ESPE), Group 2 – Beautifil II (Shofu), and Group 3 – Neo Spectra ST HV (Dentsply). To simulate 1 year of daily mouthwash use, 10 specimens from each group were immersed in chlorhexidine, kept in an incubator at 37°C for 12 h, and later subjected to microhardness measurement using Vicker’s hardness test. Finally, analysis of variance and post hoc tests were used to analyze the results statistically. Results: A significant reduction in microhardness was observed after immersion in chlorhexidine in Groups 1 and 3 compared to Group 2. Conclusions: Filtek Z250XT exhibits the highest microhardness compared to the other two materials. However, Beautifil II is more resistant to chlorhexidine mouthwash and does not show a significant reduction compared to the other two restorative materials.

Effect of Liquorice-Extract-Containing Antimicrobial Mouthwash on Helicobacter Pylori: An In Vitro Study

Background: The oral route is one of the main portals for Helicobacter pylori transmission. The elimination of this bacterial species from the oral cavity might be useful in oral health and decreasing infections due to H. pylori. This study aimed to evaluate the effect of a liquorice-extract-containing mouthwash at different concentrations on the proliferation of H. pylori in vitro. Methods: H. pylori bacterial species was cultured, and the isolated strains from the specific culture medium were prepared for the welling procedures. The liquorice (Glycyrrhiza glabra) mouthwash at 12.5% and 25% concentrations was added to the case group wells at 1,1/2,1/4,1/8, and 1/16 dilutions. In the control group, regular daily mouthwash containing cetylpyridinium chloride and sodium fluoride components was used. The growth inhibition zones were analyzed in the study groups. The data were analyzed by SPSS and reported using descriptive statistics (means±standard deviation). Results: In both the mouthwashes containing 25% and 12.5% concentration, the means of growth inhibition zones at 1, 1/2, 1/4, 1/8, and 1/16 dilutions were larger than those in the control group. Further, the largest growth inhibition zone was seen with the undiluted 25% mouthwash. There were no significant differences in the H. pylori growth inhibition zones between 25% and 12.5% mouthwashes (P=0.14). Conclusions: Mouthwashes containing liquorice extracts inhibited the growth of H. pylori more significantly than mouthwash with no liquorice extract. Therefore, it is suggested that liquorice extract-containing mouthwashes be used to prevent H. pylori infections in the oral cavity in clinical studies.

Does a daily mouthwash with green tea improve overall oral health as compared with chlorhexidine mouthwash?

Carl R. Darnall Family Medicine Residency Program, Fort Hood, TX The corresponding author is Caleb Dickison, DO, CAQSM; [email protected]. The authors declare no conflicts of interest. The opinions and assertions contained herein are those of the authors and are not to be construed as official or as reflecting the views of the U.S. Army Medical Department, the Army at large, or the Department of Defense.

OSTEONECROSIS OF THE JAW ASSOCIATED WITH ORAL ALENDRONATE: CASE REPORT

Medication-related osteonecrosis of the jaw (MRONJ) is clinically defined by persistent necrotic bone exposure for more than 8 weeks, history of antiresorptive or antiangiogenic agents, and no history of radiotherapy. A 67-year-old female, in treatment for hypercholesterolemia, insomnia, diabetes mellitus type 2, and hypertension, without adequate blood pressure and glycemic control. Reported treatment for osteoporosis with bisphosphonate (alendronate) for about 4 years, presents with bone exposure, for 6 months, in the anterior region of the maxilla, without symptoms. Daily mouthwashes were proposed with 0.12% chlorhexidine with monthly follow-up. After 5 months, tomography was performed observing the presence of extensive bone resorption and bone sequestration throughout the maxillary extension, so surgical treatment with sequestrectomy was performed in 2 surgical times. Histopathological analysis that showed fragments of trabecular osteoid tissue with foci of multifocal necrosis. The patient is followed up without new bone exposures.

In Situ Antibacterial Activity of Essential Oils with and without Alcohol on Oral Biofilm: A Randomized Clinical Trial.

Currently, there is little evidence on the in situ antibacterial activity of essential oils (EO) without alcohol. This study aimed to evaluate in situ the substantivity and antiplaque effect on the plaque-like biofilm (PL-biofilm) of two solutions, a traditional formulation that contains EO with alcohol (T-EO) and an alcohol-free formulation of EO (Af-EO). Eighteen healthy adults performed a single mouthwash of: T-EO, Af-EO, and sterile water (WATER) after wearing an individualized disk-holding splint for 2 days. The bacterial viability (BV) and thickness of the PL-biofilm were quantified at baseline, 30 s, and 1, 3, 5, and 7 h post-rinsing (Test 1). Subsequently, each volunteer wore the splint for 4 days, applying two daily mouthwashes of: T-EO, Af-EO, and WATER. The BV, thickness, and covering grade (CG) of the PL-biofilm were quantified (Test 2). Samples were analyzed by confocal laser scanning microscopy after staining with the LIVE/DEAD® BacLight™ solution. To conduct the computations of the BV automatically, a Matlab toolbox called Dentius Biofilm was developed. In test 1, both EO antiseptics had a similar antibacterial effect, reducing BV after a single rinse compared to the WATER, and keeping it below baseline levels up to 7 h post-rinse (P < 0.001). The mean thickness of the PL-biofilm after rinsing was not affected by any of the EO formulations and ranged from 18.58 to 20.19 μm. After 4 days, the T-EO and Af-EO solutions were significantly more effective than the WATER, reducing the BV, thickness, and CG of the PL-biofilm (P < 0.001). Although, both EO antiseptics presented a similar bactericidal activity, the Af-EO rinses led to more significant reductions in the thickness and CG of the PL-biofilm than the T-EO rinses (thickness = 7.90 vs. 9.92 μm, P = 0.012; CG = 33.36 vs. 46.61%, P = 0.001). In conclusion, both essential oils antiseptics had very high immediate antibacterial activity and substantivity in situ on the 2-day PL-biofilm after a single mouthwash. In the 4-day PL-biofilm, both essential oils formulations demonstrated a very good antiplaque effect in situ, although the alcohol-free formula performed better at reducing the biofilm thickness and covering grade.

P098 Adherence to and acceptability of mouthwash as a potential preventive intervention for pharyngeal gonorrhoea among men who have sex with men in Australia – an observational study

Background/Introduction Gonorrhoea infections amongst men who have sex with men (MSM) are at a 20-year high, and antibiotic resistance is also increasing. Pharyngeal gonorrhoea is an important contributor to gonorrhoea transmission, and gonorrhoea acquires genes that confer antibiotic resistance from other pharyngeal bacteria. Aim(s)/Objective(s) This study assessed whether MSM would adhere to a regimen of daily mouthwash use, as a new intervention to prevent pharyngeal gonorrhoea. Methods Ten MSM at were invited to use Listerine® alcohol-containing mouthwash daily for 14 days in August 2015. Participants were asked to complete baseline and follow-up questionnaires about their experience of mouthwash use, and a daily diary to record mouthwash use over the 14-day study period. Results The participants’ mean age was 28 years (SD 7.2). Mouthwash was used at least once daily for 133 of 140 days (95% of days; 95% CI 90% to 98%). All ten men reported willingness to use mouthwash on a daily basis, and nine men were willing to use mouthwash after oral sex. Conclusion This study showed a high adherence to daily use of mouthwash and that it is an acceptable intervention to reduce the risk of pharyngeal gonorrhoea in MSM. Further studies are required to assess whether Listerine® mouthwash is effective against pharyngeal gonorrhoea in vitro andin vivo. If this is confirmed, then this will be a novel strategy to reduce transmission of gonorrhoea amongst MSM and may potentially also reduce rates of antimicrobial resistance.

Neurological Pain as a Result of Mouthwash Usage—A Case Report

Pain in pharynx is one of the leading complaints raised by patients with the common diagnosis pointing to: sore throat, odynophagia, pharyngitis and tonsillitis [1]. Recently, an interesting case of a 47-year-old patient (male-dentist) who claimed to have acquired a sudden sharp pain in pharynx (throat) location was observed. The absurd strength of the pain prevented the patient to even hold short-length verbal communications. The preliminary examinations by a general practitioner (GP) failed to conclude anything from the examinations; therefore the patient was referred for further investigation by specialists. The additional tests and examinations such as laryngoscopy and MRI did not suggest any leads to an appropriate diagnosis either. Inadvertently, the patient had noticed a strong correlation between the pain and the daily mouthwash dose. This was later investigated further and confirmed by the patients’ trial methods. Conclusion: In this case report, it is suggested that mouthwash may contaminate the oral soft tissue and cause a neurological pain.

The Immunomodulatory, Antimicrobial and Bactericidal Efficacy of Commonly Used Commercial Household Disinfectants, Sterilizers and Antiseptics&lt;i&gt; in &lt;/i&gt;&lt;i&gt;V&lt;/i&gt;&lt;i&gt;itro&lt;/i&gt;: Putative Anti-Inflammatory Infection Control Mechanisms and Comparative Biochemical Analysis of the Microbial Growth of Gram-Positive Bacteria

Background: Immunomodulatory/anti-inflammatory and microbial infection control strategies characterize the spiral evolution of public awareness of health safety issues. This is substantiated with burgeoning number of cases of microbial contamination and/or infection in myriad healthcare settings, at the hospital, and even at home. Previously, we have investigated and identified laboratory parameters in the assessment of the antimicrobial effects of a myriad of commercial disinfectants on the growth of pathogenic and saprophytic gram- positive bacteria. The present sequel study investigates the antimicrobial/bactericidal effects of commercially available disinfectants, sterilizers, antiseptics, and chlorhexidine-containing detergents on the growth of saprophytic and pathogenic gram-negative bacteria in vitro. It is an unprecedented wide canopy enveloping standardized comparative assessments of the antimicrobial efficiency of consumer-targeted household detergents, curbing and containing microbial infection, inflammation and contamination propensity. Methods: Given the medical significance and impact of public infection control, we have meticulously examined at least 22 different detergents categorized into four classes (each category comprises a variety of commercially available products commonly used by the public): i) Class A - Daily Mouthwash; ii) Class B - Toilet Bowl Cleaners/Bleaches/Sanitizers; iii) Class C - Surface and Floor Mopping Cleaners/Detergents; and iv) Class D - Hand and Body Wash Gels. Whilst the canonical menu of active ingredients varies among those aforementioned classes, antimicrobial components are well established. Results: Regarding Class A, the most effective against Citrobacter koseri is 'Colgate Plax Mouthwash'; Enterobacter cloacae is 'Colgate Plax Mouthwash'; Escherichia coli is 'Colgate Plax Mouthwash'; Escherichia coli ESBL is 'Colgate Plax Mouthwash'; Klebsiella pneumoniae is 'Colgate Plax Mouthwash'; Proteus vulgaris is 'Colgate Plax Mouthwash'; Pseudomonas aeruginosa is 'Perio.Kin Chlorhexidina 0.20 %'; Salmonella typhimurium is 'Colgate Plax Mouthwash'; and Shigella sonnei is 'Colgate Plax Mouthwash'. Regarding Class B, the most effective against C. koseri is 'Harpic Power Plus Disinfectant'; E. cloacae is 'WC Net Bleach Gel'; E. coli is 'WC Net Bleach Gel'; E. coli ESBL is 'WC Net Bleach Gel'; K. pneumoniae are 'WC Net Bleach Gel' and 'Harpic Power Plus Disinfectant'; P. vulgaris is 'Spartan Max WC Lavender'; P. aeruginosa is 'WC Net Bleach Gel'; S. typhimurium is 'Clorox Bleach Rain Clean'; and S. sonnei is 'Harpic Power Plus Disinfectant'. Regarding Class C, the most effective against C. koseri is 'Dettol Antiseptic/Disinfectant'; E. cloacae is 'Dettol Antiseptic/Disinfectant'; E. coli is 'Vim Cream Multipurpose Fast Rinsing'; E. coli ESBL is 'Dettol Antiseptic/Disinfectant'; K. pneumoniae is 'Dettol Antiseptic/Disinfectant'; P. vulgaris is 'Dettol Antiseptic/Disinfectant'; P. aeruginosa is 'Dettol Antiseptic/Disinfectant'; S. typhimurium is 'Dettol Antiseptic/Disinfectant'; and S. sonnei is 'Dettol Antiseptic/Disinfectant'. Regarding Class D, the most effective against C. koseri, E. cloacae, E. coli, E. coli ESBL, K. pneumoniae, P. vulgaris, P. aeruginosa, S. typhimurium, and S. sonnei is unprecedentedly the 'HiGeen Hand and Body Wash Gel'. Conclusions: These laboratory results emphatically confirm and verify immunomodulatory infection control variations in the antimicrobial/anti-inflammatory effectiveness of household antiseptics and disinfectants that are purportedly identified in ameliorating the growth of saprophytic and pathogenic gram-negative bacteria in culture.

Concomitant caries and calculus formation from in situ dentin caries model

The aim of this study was to test the possibility of the concomitant formation of calculus deposits and caries from in situ dentin caries model for short time periods. Six volunteers wore palatal removal appliances with four polished dentin specimens protected from intra-oral mechanical forces for up to 14 days. Each volunteer applied a 50% sucrose solution (four times a day) on the specimens and performed a daily mouthwash with 0.05% NaF. Samples were removed after 2, 5, 9 and 14 days in situ. Demineralization was analyzed by stereomicroscopy and SEM (secondary electrons and backscattered electrons modes) and calculus was analyzed by energy dispersive spectroscopy and fluorescence spectroscopy. Seventeen samples, at least one sample from each volunteer, presented dental calculus on both carious and non-carious ones, detected in all time intervals. Ca/P ratios of dental calculus ranged from 1.1 to 1.7. Some large calculus deposits on carious surfaces were confirmed by fluorescence. In conclusion, concomitant caries and calculus formation can be found in dentin caries formed in situ. This has important repercussions on the study of surface phenomena on the interface between hard dental tissues and dental plaque.

Antibacterial and Antiinflammatory Kinetics of Curcumin as a Potential Antimucositis Agent in Cancer Patients

The antiinflammatory agent curcumin (diferuloylmethane) has a potential to mitigate cancer therapy-induced mucositis. We assessed the in vitro extent of its bactericidal activity and determined the kinetics of its antiinflammatory effect on pharyngeal cells. Bactericidal activity was assessed using the LIVE/DEAD® Kit after 4 h of exposure to curcumin (50–200 μM) in 18 oropharyngeal species commonly associated with bacteremia in febrile neutropenia. Moraxella catarrhalis or its outer membrane vesicles were used to determine the inhibitory effect of curcumin on bacteria-induced proinflammatory activity as determined by cytokine release into the supernatant of Detroit 562 pharyngeal cells using the Luminex® xMAP® technology. Curcumin exerted a concentration-dependent bactericidal effect on all 18 species tested. After 4 h at 200 μM, 12 species tested were completely killed. Preincubation of Detroit cells with 200 μM curcumin for 5 to 60 min resulted in complete suppression of the release of tumor necrosis factor-α, interleukin (IL)-6, IL-8, monocyte chemoattractant protein 1, granulocyte macrophage-colony stimulating factor, and vascular endothelial growth factor. Fibroblast growth factor-2 and interferon-γ were not affected. Repetitive exposure to curcumin resulted in repetitive suppression of cytokine/chemokine expression lasting from 4 to 6 h. Through reduction of oral microbial density as well as suppression of inflammation cascades curcumin may prevent cancer therapy-induced oral mucositis, e.g., when applied as multiple daily mouth washes.

Topical application of green tea polyphenol (−) epigallocatechin-3-gallate for prevention of recurrent oral neoplastic lesions

A preliminary study was conducted to investigate feasibility of using an oral cancer chemopreventive agent (-)-epigallocatechin-3-gallate (EGCG), the most biologically active component in the green tea extract, in a form of 'swish-and-spit' mouthwash. Such application of EGCG is beneficial as it maximizes exposure of the oral mucosa to the agent but minimizes systemic side effect. The study was conducted on individuals suspected to have oral field cancerization who are at a high risk for developing recurrent oral precancerous and carcinomatous lesions. EGCG was used as a daily mouthwash for 7 days. EGCG's ability to modulate target molecules implicated in oral carcinogenesis was assessed by measuring the change in expression level of biomarkers. Immunohistochemical expression of phosphoactivated epidermal growth factor receptor (pEGFR), cyclooxygenase-2 (cox-2) and ki-67 were evaluated at baseline and at the endpoint (day 8). Although not statistically significant, overall decrease in expression levels of pEGFR (27.5%), cox-2 (15.9%) and ki-67 positive cells (51.8%) were observed following EGCG treatment. Moreover, a detectable level of EGCG was found in saliva but not in plasma after the one-week treatment regime, demonstrating local availability of EGCG in oral mucosa without significant systemic absorption. To best of our knowledge this is the first study to explore use of oral cancer chemopreventive agent in a form of mouthwash in patients with oral field cancerization. Although a definitive conclusion was not reached due to limited sample size, if proven effective, EGCG therapy may offer a non-invasive preventive modality for oral field cancerization.

Effect of a two-year fluoride decay protection protocol on titanium brackets

Fluoride ion can attack titanium, causing its corrosion. Orthodontic patients being high-risk caries developers and in need of fluoride protection, the Center for Disease Control has developed a Fluoride Decay Prevention (FDP) protocol, consisting of a 6-minute tooth-brushing, followed by a 1-minute daily mouthwash, in addition to an in-clinic trimestrial topical fluoride gel application. This study aimed at evaluating gravimetrically, by scanning electron microscopy (SEM), and by sliding mechanics analysis, the consequences of FDP at 6, 12, 18, and 24months on titanium brackets corrosion. One hundred and fifty titanium brackets were randomly divided into five groups of 30. Group 1 was the control group. Groups 2, 3, 4, and 5 each received an equivalent of 6, 12, 18, and 24months of FDP treatment respectively. All groups were placed in artificial saliva for 2months and then rinsed. Subsequently, the brackets were dried, for 48hours, using Silica gel in a desiccator maintained at 37°C before testing. SEM analysis showed that numbers and dimensions of pits gradually increased due to corrosion as we moved from group 1 to group 5. Gravimetrical and sliding mechanics results revealed no statistical difference between groups 2 and 3, and a significant difference between groups 4 and 5 upon comparison with the control group. Surface changes due to corrosion were detected at 6 and 12months of FDP but had no clinical effects. However, the increase in sliding resistance and bracket weight loss became significant at 18 and 24months of FDP.

Prevalence and Treatment Management of Oropharyngeal Candidiasis in Cancer Patients: Results of the French Candidoscope Study

The aim of this pharmaco-epidemiological study was to evaluate the prevalence of oropharyngeal candidiasis (OPC) in cancer patients treated with chemotherapy and/or radiotherapy. Signs and symptoms of OPC were noted for all patients. Antifungal therapeutic management was recorded in OPC patients. Patients receiving local antifungal treatments were monitored until the end of treatment. Enrolled in the study were 2,042 patients with solid tumor and/or lymphoma treated with chemotherapy and/or another systemic cancer treatment and/or radiotherapy. The overall prevalence of OPC was 9.6% (95% confidence interval, 8.4%-11.0%] in this population. It was most frequent in patients treated with combined chemoradiotherapy (22.0%) or with more than two cytotoxic agents (16.9%). Local antifungal treatments were prescribed in 75.0% of OPC patients as recommended by guidelines. The compliance to treatment was higher in patients receiving once-daily miconazole mucoadhesive buccal tablet (MBT; 88.2%) than in those treated with several daily mouthwashes of amphotericin B (40%) or nystatin (18.8%). OPC prevalence in treated cancer patients was high. Local treatments were usually prescribed as per guidelines. Compliance to local treatments was better with once-daily drugs.

Oral health, hygiene practices and oral cancer

To assess the association between oral health and hygiene practices and oral cancer. Hospital-based case-control study in the metropolitan area of São Paulo, southeastern Brazil, from 1998 to 2002. A total 309 patients with squamous cell carcinoma of the mouth and the pharynx and 468 controls matched by sex and age were included in the study. Cases were recruited in seven reference hospitals and controls were selected in five out of the seven participating hospitals. Detailed information on smoking, alcohol consumption, schooling, oral health status and hygiene practices were obtained through interviews. Odds ratios (OR) and 95% confidence intervals (95% CI), adjusted by sex, age, schooling, smoking, alcohol consumption as well as the variables oral health status and hygiene practices were estimated using unconditional logistic regression analyses. The use of complete dental prosthesis was not associated with oral cancer but regular gum bleeding showed a strong association (OR 3.1; 95% CI 1.2-7.9). Those who never attended a dental visit were more likely to have oral cancer (OR 2.5; 95% CI 1.3-4.8). Daily mouthwash use showed a stronger association to pharynx (OR 4.7; 95% CI 1.8-12.5) than mouth cancer (OR 3.2; 95% CI 1.6-6.3). Gum bleeding, no dental care, and daily mouthwash use were factors associated with oral cancer regardless of tobacco and alcohol consumption.

Daily defence mouthwash

Daily defence mouthwash

Efeito da clorexidina na mucosite induzida por radioterapia em câncer de cabeça e pescoço

A radioterapia em pacientes com neoplasias de Cabeça e Pescoço causa alterações na mucosa oral comprometendo a execução terapêutica e o resultado final. OBJETIVO: Avaliar o efeito protetor do gluconato de clorexidina, sobre a mucosa oral, durante o tratamento actínico fracionado e o seu reflexo na qualidade de vida referida pelos pacientes. FORMA DE ESTUDO: Clínico prospectivo. MATERIAL E MÉTODO: Foram selecionados 21 portadores de câncer de Cabeça e Pescoço alocados em dois grupos: grupo Placebo (n=11, 9H e 2M, idade média 58 anos) água destilada - dois bochechos diários e grupo Medicação (n=10, 7H e 2M, idade média 52 anos) gluconato de clorexidina a 0,12% - dois bochechos diários. Os pacientes foram avaliados semanalmente com exame local para detecção das alterações de mucosa (classificação de acordo com a WHO e Grupo de Terapia por Radiação em Oncologia - graus 0 a IV) e preenchimento de questionário de qualidade de vida ressaltando os aspectos de dor, apetite, paladar e hábitos alimentares. A análise estatística realizada pelo teste exato de Fisher. RESULTADOS: A graduação da mucosite foi mais intensa no grupo Placebo em 6 das 10 semanas de avaliação. A freqüência e intensidade das dores foram piores no grupo Placebo na 4ª semana de radioterapia e a modificação de paladar foi mais intensa nos indivíduos que não usavam o medicamento apenas na 7ª semana. Não foram encontradas diferenças nos outros parâmetros de qualidade de vida. CONCLUSÃO: Podemos concluir que o gluconato de clorexidina não eliminou as lesões de mucosa mas diminuiu, significativamente, os seus efeitos deletérios e intensidade sem apresentar um reflexo persistente na qualidade de vida dos pacientes.

A clinical trial to compare the effect of two antiseptic mouthwashes on gingival inflammation

A trial was made comparing the effects of efficient and thorough removal of plaque and debris alone, and with a daily antiseptic mouthwash. The results showed considerable variation but no significant difference in gingival inflammation between hygienic treatment and a daily mouthwash with chlorhexidine-gluconate or povidone-iodine. Povidone-iodine caused less staining of the teeth than chlorhexidine-gluconate.

Oral Cancer and Mouthwash Use&lt;xref ref-type="fn" rid="fn2"&gt;2&lt;/xref&gt;

The role of mouthwash and other factors was examined in relation to oral cavity cancer by means of a retrospective study. Daily use of mouthwash showed an excess risk in females but no excess risk in males. No dose response was seen in females with increased duration of use. In nonsmoking, nondrinking women as well, daily mouthwash use was associated with excess risk. Multiple logistic regression including all factors of interest showed inconsistent results for duration and frequency of mouthwash use. Due to the absence of a dose-response relationship and the possibility of confounding by tobacco and alcohol use, it was not possible to attribute causal significance to the association between daily mouthwash use and oral cancer in women.