CONTENTS
Plaque control
Types of Plaque control
Chemical Plaque Control
Goals of Chemical Plaque Control
Factors influencing effects of Chemical Plaque Control
Types of Chemical Plaque Control
1. Chlorhexidine Gluconate
2. Non prescription Essential oil rinses
3. Other Plaque Control Agents
a. Triclosan
b. Delmopinol
c. Metallic ions
d. Quarternary Ammonium Compounds
e. Enzymes
f. Antibiotics
Plaque control
“The removal of microbial plaque and the prevention of its accumulation on the teeth and adjacent gingival tissues”.
TYPES
Mechanical plaque control
Chemical plaque control
CHEMICAL PLAQUE CONTROL
Chemical plaque control should always be regarded as needs-related supplement to and not a substitute for mechanical plaque control.
Therefore, based on individual patients' predicted risk for oral disease, the choice of agent and frequency of use.
Goals of Chemical Plaque Control
1. To prevent plaque formation
2. To control plaque formation
3. To reduce, disrupt or remove existing plaque
4. To alter composition of plaque flora
5. To exert bactericidal or bacteriostatic effects on micro flora implicated in caries and periodontal disease
6. To alter surface energy of the tooth, in turn, affecting the plaque adherence
Factors Influencing Effects of Chemical Plaque Control
1. Substantivity
2. Penetrability
3. Selectivity
4. Solubility
5. Accessibility
Ideal requisites of an Antiplaque agent
Plaque and gingivitis
Pathogenic bacteria
Resistant bacteria
Compatible
Stains/ taste
Retentive property
Inexpensive and easy to use
CHLORHEXIDINE GLUCONATE:
Cationic bisbiguanide
Both antiplaque and antibacterial properties
Mechanism of action:
Substantivity
Bacteriostatic and bactericidal
5 hours – antibacterial, over 12 hours – bacterial count
80-90% reduction
Inhibits plaque by:
Preventing pellicle formation
Preventing adsorption of bacterial cell wall
Preventing binding of mature plaque
Adverse effects
Brownish staining
Taste sensation
Hypersensitivity
Stenosis of parotid duct
Indications of Chlorhexidine Gluconate
1. As an adjunct to mechanical oral hygiene
2. As root canal disinfectant
3. Following oral surgical procedures, including periodontal therapy, periodontal surgeries root planning, gingivectomy and after extraction.
4. In patients with intermaxillary fixation, removable and fixed orthodontic appliance and prosthesis.
5. Effective plaque control among physically and mentally handicapped individuals.
6. Management of recurrent aphthous ulceration
NON PRESCRIPTION ESSENTIAL OIL RINSES:
Thymol
Eucalyptol
Menthol
Methyl salicylate
Other Plaque Control Agents:
Triclosan :
Phenol derivative
Synthetic, non-ionic, antimicrobial
Mycobacterium spores and candida species
Bacteriolysis
In combination with zinc citrate
Delay plaque maturation
Inhibit formation of prostaglandins and leukotrienes
Delmopinol:
Morpholino ethanol derivative
Pre-brushing mouthrinse
Adverse effects:
Numbness of Tongue
Staining of tooth and tongue staining
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CHEMICAL PLAQUE CONTROL.pptx
1.
2. CONTENTS
• Plaque control
• Types of Plaque control
• Chemical Plaque Control
• Goals of Chemical Plaque Control
• Factors influencing effects of Chemical Plaque Control
• Types of Chemical Plaque Control
• Chlorhexidine Gluconate
3. • Non prescription Essential oil rinses
• Other Plaque Control Agents
Triclosan
Delmopinol
Metallic ions
Quarternary Ammonium Compounds
Enzymes
Antibiotics
4. Plaque control
“The removal of microbial plaque and the prevention of its
accumulation on the teeth and adjacent gingival tissues”.
6. CHEMICAL PLAQUE CONTROL
• Chemical plaque control should always be regarded as needs-related
supplement to and not a substitute for mechanical plaque control.
• Therefore, based on individual patients' predicted risk for oral
disease, the choice of agent and frequency of use.
7. Goals of Chemical Plaque Control
1) To prevent plaque formation
2) To control plaque formation
3) To reduce, disrupt or remove existing plaque
4) To alter composition of plaque flora
5) To exert bactericidal or bacteriostatic effects on micro flora implicated
in caries and periodontal disease
6) To alter surface energy of the tooth, in turn, affecting the plaque
adherence
8. Factors Influencing Effects of Chemical Plaque
Control
1) Substantivity
2) Penetrability
3) Selectivity
4) Solubility
5) Accessibility
9. 1) Triclosan
2) Delmopinol
3) Metallic ions
4) Quaternary Ammonium
compounds
5) Enzymes
6) Antibiotics
Chemical Plaque Control
Prescription
Chlorhexidine
rinse
Non Prescription
Essential oil rinses
Other Plaque
control agents
1) Thymol
2) Eucalyptol
3) Menthol
4) Methyl salicylate
10. • Ideal requisites of an Antiplaque agent
– Plaque and gingivitis
– Pathogenic bacteria
– Resistant bacteria
– Compatible
– Stains/ taste
– Retentive property
– Inexpensive and easy to use
11. – Cationic bisbiguanide
– Both antiplaque and antibacterial properties
Mechanism of action
Substantivity
Bacteriostatic and bactericidal
5 hours – antibacterial, over 12 hours – bacterial count
80-90% reduction
CHLORHEXIDINE GLUCONATE
14. Indications of Chlorhexidine Gluconate
1) As an adjunct to mechanical oral hygiene
2) As root canal disinfectant
3) Following oral surgical procedures, including periodontal therapy,
periodontal surgeries root planning, gingivectomy and after extraction.
4) In patients with intermaxillary fixation, removable and fixed
orthodontic appliance and prosthesis.
15. 5) Effective plaque control among physically and mentally handicapped
individuals.
6) Management of recurrent aphthous ulceration
17. Triclosan
• Phenol derivative
• Synthetic, non-ionic, antimicrobial
• Mycobacterium spores and candida species
Bacteriolysis
In combination with zinc citrate
Delay plaque maturation
Inhibit formation of prostaglandins and leukotrienes
OTHER PLAQUE CONTROL AGENTS
18. Delmopinol
• Morpholino ethanol derivative
• Pre-brushing mouthrinse
Adverse effects
1. Numbness of Tongue
2. Staining of tooth and tongue
3. Taste disturbance
4. Mucosal soreness and erosion