The Gold Standard Oral Antimicrobial Rinse: Chlorhexidine Gluconate

Date: April 2021

Author: Natalie Bradley BDS MFDS Dip SCD RCSEd

Professional and public press contains claims for oral rinses. These rinses often compare themselves to the gold standard for oral rinses, chlorhexidine gluconate (CHX).

It is recognized that maintaining a high standard of oral hygiene is important for the prevention and treatment of oral health problems such as gingivitis and caries. Toothbrushing is the main method for maintaining good oral hygiene but other methods such as interdental brushes and floss are commonly used. Some people who have difficulty controlling plaque build-up and who have gingivitis use only home care with brushing and sometimes use mouth rinses containing CHX.

CHX is an effective broad spectrum antimicrobial oral rinse that reduces biofilm and has been shown to reduce gingivitis as well as helping to reduce halitosis. It offers substantivity which means the antibacterial effects last well beyond the time of rinsing. Therefore its anti-plaque and anti-gingivitis effects offer benefits that last longer than just the time the patient spends rinsing. CHX works by interacting with the bacterial cell wall, which results in it rupturing and the bacterial cell dying, thereby inhibiting dental plaque formation and build-up.

When should you recommend CHX?

CHX is indicated for patients who have gingivitis when used as an adjunct to oral care between dental visits as part of a professional program for the treatment of gingivitis.

Dentists may also recommend its use after surgical procedures when it may not possible for patient's to maintain effective oral hygiene.

Typically, CHX rinse is recommended to patients for use for a limited time, until their gingival infection is under control and they can begin normal brushing and flossing. CHX should be used after brushing and flossing, and patients should not rinse after using it.

Patients should be informed that in some people use of CHX may result in surface staining of the teeth. Its use may also result in increased calculus formation and alterations in taste perception.

In the US, Colgate PerioGard CHX rinse is available by prescription only. Depending on your location, CHX rinse may be available over the counter such as in the UK. CHX rinse is also available as an alcohol-free version.

While there is no replacement for thorough brushing and interdental cleaning to maintain oral health, and professional treatment when needed, CHX is an additional tool in the home care armamentarium to help our patients with gingivitis.

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