1976 first used in dentistry when deemed safe and effective anti-plaque agent
chlorhexidine in dentistry (types)
m/w, gel, t/p, spray, impregnated floss, subgingival applicator, chips (perio)
the gold standard of plaque control. no risk of resistant strains. if used for a long time oral flora balance changes and taste disturbances
max 0.2% in m/w, spray 0.2%, daily m/w 0.06%. 1% in gel
What does chlorhexidine do? NEED TO KNOW
broad spectrum, effective against a wide range of micro-organisms. acts on gram -ve and gram +ve bacteria, viruses and fungi. effective for up to 12 hrs - good substantivity due to IONIC bond. initially bactericidal then becomes bacteriostatic. disrupts integrity of bacterial cell wall.
What does chlorhexidine do? GOOD to know
Attraction between chlorhexidine ions (+) and bacterial cells (-). chlorhexidine ions are also attracted to the hydroxyapatite of enamel and salivary pellicle coating the tooth. this is due to the + and - charges involved and facilitates the 12 hr action. IONIC bond= chemical bond formed by atoms.
What does chlorhexidine do? NUTS to know
chlorhexidine froms ionic bond with hydroxyapatite of tooth enamel, salivary pellicle and salivary mucins. one ion donates an electron to another and they are subsequently boned by an electrostatic reaction. chlorhexidine (+) always looking for electron . negative ions always have an electron to give away. when chlorhexidine gains an electron from negative ion. both positive and negative ions become neutral so ionic bond is formed which is electrostatic reaction. over time the bond breaks down.
kills/destroys bacteria (+ and -) damages cell wall.
maintains balance and reduces replication
tenacious brown stain, taste disturbance (long term), oral desquamation (long term), parotid swelling, disturb oral flora (long term)
SLS (sodium lauryl sulphate)
ionic component in t/p, interferes with attraction of chlorhexidine to salivary pellicle and its release to have anti bacterial effect.
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