Chlorhexidine gluconate (CHX) mouth rinse remains the gold standard as an adjunct for the management of gingivitis. As recognized by the European Federation of Periodontology (EFP), CHX is an effective chemical adjunct and can be considered for short-term use as an adjunct to mechanical debridement.
With strong antimicrobial properties, CHX reduces the levels of biofilm bacteria associated with periodontal diseases. CHX is also used in the management of oral conditions such as denture stomatitis, alveolar osteitis, oral ulcers, and peri-implantitis.
However, in general, CHX rinses have certain drawbacks that can discourage patients from continued use, and may make dentists reluctant to recommend CHX as a result. First, CHX rinses typically have a strong and distinctive chemical taste that persists after rinsing, something not all patients are willing or able to tolerate. Second, CHX mouth rinses are intended for short-term use of no longer than four weeks, but even in this short time, CHX can cause staining of the teeth. This means that many patients who could benefit from CHX do not use it at all, or not for the required duration.
A next-generation CHX mouthwash
Colgate PerioGard Chlorhexidine (CHX) 0.12% Mouthwash is now available as a next-generation chlorhexidine mouthwash in the UK, which is also available as meridol 0.12% CHX Mouth Rinse in Europe and Savacol Alcohol-Free Antiseptic Mouth and Throat Rinse in Australia. The alcohol-free mouth rinse now has a new and improved mint flavor and unique anti-staining technology, with phosphate salts that are attracted to the tooth surface and shield the tooth from staining. The formula is stabilized with the addition of a tensioactive agent and a poloxamer, ensuring that CHX is still delivered to the tissues to effectively target bacteria. In clinical trials, the formulation has demonstrated significant bacterial reduction, reductions in the gingival index score (Löe and Silness) from baseline after four weeks of use, and 42% less staining than a competing CHX rinse.1
More opportunities for patients to benefit
With the new version of Colgate PerioGard Chlorhexidine (CHX) 0.12% Mouthwash, barriers to CHX use are significantly lowered without compromising its antimicrobial efficacy. With a milder taste and a lower risk of staining, patients may be more likely to accept CHX as an adjunct treatment option for gingivitis or periodontitis, and for other indications. For example, it can be used during the post-surgical management of peri-implantitis, when biofilm management is paramount. In the case of extractions, patients can benefit from the ability of CHX to reduce the symptoms of alveolar osteitis. (In some markets, particular uses of CHX may be off-label.)
Dentists may also consider the off-label use of this new formulation as a pre-procedural rinse in advance of aerosol-generating procedures. While it is noted that much of the evidence relates to bacterial load, CHX is shown to have antiviral properties that may be particularly effective against enveloped viruses. Recent evidence suggests that pre-procedural rinsing with CHX can reduce the microbial load in the oral cavity and, consequently, in aerosols and spatter generated during treatment for a limited time after use.
1 Fine D, et al. (2019). (CRO-2018-05-CHX-ED)