CHEMICAL PLAQUE CONTROL

PLAQUE

 Dental plaque is defined as a highly specific variable
 structural entity formed by sequ...
Plaque control

    It is the removal of microbial plaque and the
  prevention of its accumulation on the teeth and
  adja...
Ideal requisites
• Should decrease plaque & gingivitis
• Prevent pathogenic growth
• Should prevent development of resista...
CLASSIFICATION

CHEMICAL PLAQUE CONTROL AGENTS


                                            FIRST GENERATION
            ...
FIRST GENERATION AGENTS

TRICLOSAN

•   Phenol derivative
•   Is synthetic and ionic
•   Used as a topical antimicrobial
 ...
MECHANISM OF ACTION


               TRICLOSAN




        ACT ON CYTOPLASMIC MEMBRANE



INDUCE LEAKAGE OF CELLULAR CONST...
• Triclosan is included in tooth paste to reduce
  plaque formation
• Used along with Zinc citrate or co-polymer
  Gantrez...
2. METALLIC IONS

  eg: Zn & Cu ions


  MECHANISM OF ACTION


• It reduces the glycolytic activity in bacteria &delays
  ...
3.QUARTERNARY AMMONIUM
             COMPOUNDS



• Cationic antiseptics & surface active agents
• Effective against gram p...
MECHANISM OF ACTION

• Positively charged molecule reacts with negatively
  charged cell membrane phosphates and thereby
 ...
4.SANGUINARINE


• It is a benzophenanthredine alkaloid
• It is most effective against gram –ve organisms
• Used in mouth ...
ANTIBIOTICS


• Vancomycin,erythromycin,Niddamycin and
  Kanamycin
• Due to bacterial resistance problems the use of
  ant...
BISBIGUANIDES

CHLORHEXIDINE
   GLUCONATE(0.2%)

•   It is a cationic
    bisbiguanide
•   Effective against gram
    +ve,...
MECHANISM OF ACTION

Antiplaque action of chlorhexidine

5. Prevents pellicle formation by blocking acidic
   groups on sa...
Antibacterial action of chlorhexidine
It shows two actions
     1. Bacteriostatic at low concentrations

               Ba...
1. Bacteriocidal action
       increased concentration of chlorhexidine

       Progressive greater damage to membrane

  ...
ADVERSE EFFECTS OF CHLORHEXIDINE



5. Brownish staining of tooth or restorations
6. Loss of taste sensation
7. Rarely hyp...
ENZYMES


• Enzymes has been used as active agents in antiplaque
  preparations
• It is due to the fact that enzymes would...
DELMOPINOL
• Inhibits plaque growth and reduces
  gingivitis


Mechanism of action

• Interfere with plaque matrix formati...
Adverse effect of delmopinol

4. Staining of tooth & tongue
5. Taste disturbances
6. Mucosal soreness & erosion
DENTIFRICES
  Dentifrice is a substance used with a
  tooth brush for the purpose of
  cleaning the accessible surfaces of...
COMPOSITION
1. Polishing/ abrasive agents
        • Ca carbonate
        • Dicalcium phosphate dihydrate
        • Alumina...
2.Binding/ thickening agents
          a. Water soluble agents
             • Alginates, Sodium carboxy methyl cellulose e...
4. Humectants
     • Sorbitol, glycerine, polyethylene glycol
Function
      reduces the loss of moisture from tooth past...
6. Sweeteners and colouring agents
7. Antibacterial agents
3. Anti bacterial agents
     •   Triclosan, delmopinol, metall...
Recent developments in dentifrices

•   Tooth paste for children
•   Natural tooth paste (herbal)
•   Whitening tooth past...
DISCLOSING AGENTS
• A disclosing agent is a
  preparation in liquid, tablet
  or lozenge from which
  contains a dye or ot...
IDEAL PROPERTIES

•   Intensity of colour
•   Duration of intensity
•   Taste
•   Irritation to mucous membrane
•   Diffus...
Agents used for disclosing plaque
b. Iodine preparations
      •   Skinners iodine solution
      •   Diluted tincture of ...
Chemical Plaque Control
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Chemical Plaque Control

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Chemical Plaque Control

  1. 1. CHEMICAL PLAQUE CONTROL PLAQUE Dental plaque is defined as a highly specific variable structural entity formed by sequential colonization of microorganism on the tooth surface, epithelium and restorations.
  2. 2. Plaque control It is the removal of microbial plaque and the prevention of its accumulation on the teeth and adjacent gingival tissues. It also deals with the prevention of calculus formation.
  3. 3. Ideal requisites • Should decrease plaque & gingivitis • Prevent pathogenic growth • Should prevent development of resistant bacteria • Should be biocompatible • Should not stain teeth or alter taste • Should have good retentive properties • Should be economic
  4. 4. CLASSIFICATION CHEMICAL PLAQUE CONTROL AGENTS FIRST GENERATION Eg: antibiotics, phenol,quarternary ammonium compounds & sanguinarine SECOND GENERATION Eg: Bisbiguanides,(chlorhexidine) THIRD GENERATION Eg: delmopinol
  5. 5. FIRST GENERATION AGENTS TRICLOSAN • Phenol derivative • Is synthetic and ionic • Used as a topical antimicrobial agent • Broad spectrum of action including both gram positive and gram negative bacterias • It also includes mycobacterium spores and Candida species
  6. 6. MECHANISM OF ACTION TRICLOSAN ACT ON CYTOPLASMIC MEMBRANE INDUCE LEAKAGE OF CELLULAR CONSTITUENTS BACTERIOLYSIS
  7. 7. • Triclosan is included in tooth paste to reduce plaque formation • Used along with Zinc citrate or co-polymer Gantrez to enhance its retention within the oral cavity • Triclosan delay plaque formation • It inhibits formation of prostaglandins & leukotrienes there by reduces the chance of inflammation
  8. 8. 2. METALLIC IONS eg: Zn & Cu ions MECHANISM OF ACTION • It reduces the glycolytic activity in bacteria &delays bacterial growth
  9. 9. 3.QUARTERNARY AMMONIUM COMPOUNDS • Cationic antiseptics & surface active agents • Effective against gram positive organisms
  10. 10. MECHANISM OF ACTION • Positively charged molecule reacts with negatively charged cell membrane phosphates and thereby disrupts the bacterial cell wall structure Eg: Benzanthonium chloride, Benzalleonium chloride and cetylpyredinium
  11. 11. 4.SANGUINARINE • It is a benzophenanthredine alkaloid • It is most effective against gram –ve organisms • Used in mouth rinse
  12. 12. ANTIBIOTICS • Vancomycin,erythromycin,Niddamycin and Kanamycin • Due to bacterial resistance problems the use of antibiotics has been reduced
  13. 13. BISBIGUANIDES CHLORHEXIDINE GLUCONATE(0.2%) • It is a cationic bisbiguanide • Effective against gram +ve, gram –ve organisms, fungi, yeasts and viruses • Exhibit antiplaque & antibacterial properties
  14. 14. MECHANISM OF ACTION Antiplaque action of chlorhexidine 5. Prevents pellicle formation by blocking acidic groups on salivary glycoproteins thereby reducing glycoprotein adsorption on to the tooth surface 6. Prevents adsorption of bacterial cell wall on to the tooth surface 7. Prevents binding of mature plaques
  15. 15. Antibacterial action of chlorhexidine It shows two actions 1. Bacteriostatic at low concentrations Bacterial cell wall(-ve charge) Reacts with +ve charged chlorhexidine molecule Integrity of cell membrane altered CHX binds to inner membrane phospholipids & increase permeability Vital elements leak out & this effect is reversible
  16. 16. 1. Bacteriocidal action increased concentration of chlorhexidine Progressive greater damage to membrane Larger molecular weight compounds lost Coagulation and precipitation of cytoplasm Free CHX molecule enter the cell & coagulates proteins Vital cell activity ceases cell death
  17. 17. ADVERSE EFFECTS OF CHLORHEXIDINE 5. Brownish staining of tooth or restorations 6. Loss of taste sensation 7. Rarely hypersensitivity to chlorhexidine has been reported 8. Stenosis of parotid duct has also been reported
  18. 18. ENZYMES • Enzymes has been used as active agents in antiplaque preparations • It is due to the fact that enzymes would be able to breakdown already formed matrix some plaques and calculus • Some are proteolytic and have bactericidal action eg:Mucinase, mutanase, dextranase etc
  19. 19. DELMOPINOL • Inhibits plaque growth and reduces gingivitis Mechanism of action • Interfere with plaque matrix formation & also reduces bacterial adherence • It causes weak binding of plaque to tooth, thus aiding in easy removal of plaque by mechanical procedures • It is therefore indicated as a pre brushing mouth rinse
  20. 20. Adverse effect of delmopinol 4. Staining of tooth & tongue 5. Taste disturbances 6. Mucosal soreness & erosion
  21. 21. DENTIFRICES Dentifrice is a substance used with a tooth brush for the purpose of cleaning the accessible surfaces of the tooth It contains • therapeutic agent such as fluoride to inhibit caries • Antimicrobial agents- chlorhexidine, cetrimide • Anticalculus agent - Zn- chloride
  22. 22. COMPOSITION 1. Polishing/ abrasive agents • Ca carbonate • Dicalcium phosphate dihydrate • Alumina • Silica Functions  Mild abrasive action aids in illuminating plaque  Removes stained pellicle, restores natural luster, enhances enamel whiteness
  23. 23. 2.Binding/ thickening agents a. Water soluble agents • Alginates, Sodium carboxy methyl cellulose etc b. Water insoluble agents • Colloidal silica, Magnesium aluminium salts etc Functions  Controls stability &constitency of tooth paste 3.Detergents/ surfactants • Sodium lauryl sulfate Functions  Produces foam & removes food debris  Antimicrobial property
  24. 24. 4. Humectants • Sorbitol, glycerine, polyethylene glycol Function  reduces the loss of moisture from tooth paste 5. Flavoring agents • Peppermint oil, spearmint oil, oil of wintergreen Function  Render the product pleasant to use & leaves a fresh taste in mouth after use
  25. 25. 6. Sweeteners and colouring agents 7. Antibacterial agents 3. Anti bacterial agents • Triclosan, delmopinol, metallic ions & Zn-citrate trihydrate 4. Anticaries agents • Na fluoride, stannous fluoride 5. Active agents-fluoride 6. Anticalculus agents(crystal growth inhibitors) • Pyrophosphate, Zn citrate, Zn chloride 7. Desensitizing agents • Sodium fluoride, potassium nitrate
  26. 26. Recent developments in dentifrices • Tooth paste for children • Natural tooth paste (herbal) • Whitening tooth paste • Breath freshening tooth paste • Sodium bicarbonate tooth paste
  27. 27. DISCLOSING AGENTS • A disclosing agent is a preparation in liquid, tablet or lozenge from which contains a dye or other coloring agents • A disclosing agent is used for identifying bacterial plaque • When applied to the teeth, the agents imparts its colour to soft deposits but can be rinsed easily from clean tooth surface
  28. 28. IDEAL PROPERTIES • Intensity of colour • Duration of intensity • Taste • Irritation to mucous membrane • Diffusibility • Astringent and antiseptic property
  29. 29. Agents used for disclosing plaque b. Iodine preparations • Skinners iodine solution • Diluted tincture of iodine c. Mercurochrome preparations • Mercurochrome soln 5 • Flavored mercurochrome disclosing solution d. Bismark brown e. Mebromin f. Erythrosine g. Fast green h. Fluoresin i. Two tone solutions j. Basic fuschin

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