3. Introduction
PLAQUER---------- TO PLATE
Dental plaque is an adherent intercellular matrix consisting
primarily of proliferating microorganisms, along with a
scattering of epithelial cells, leucocytes & macrophages.
4. DENTAL PLAQUE:
Dental plaque can be defined as the soft deposits that form
the biofilm adhering to the tooth surface or other hard
surfaces in the oral cavity, Including removable & fixed
restoration. (Newmann, carranza.)
5. Dental plaque is a specific but highly variable structural entity resulting
colonization of microorganisms on tooth surfaces, restorations and other parts
of oral cavity and consists of salivary components like mucin, desquamated
epithelial cells, debris and microorganisms all embedded in a gelatinous
extracellular matrix
WHO
11. Indication
Patient education.
Instruction to pt about plaque control
Self assessment by the pt
Evaluation of effectiveness of plaque control measures.
Assessment of the clinician.
12. Various agents used in disclosing solution
Basic fuchsin
Fast green
Erythrosine
Vegetable and food coloring dyes
Iodine
Gentian violet
Two tone die
13. Various formulations of disclosing agents:
1) Skinner solution
2) Iodine preparations
3) Mercurochrome preparation
4) Bismark brown
preparation:
tincture of iodine-21ml, water-
15ml.
Zinc iodide-1g, water-30ml,
glycerine-16ml, I crystals.
Mercurochrome-1.5g, water,
oil of peppermint, non-
cariogenic sweetener.
Bismark brown, ethyl alcohol,
glycerin.
14. 5) Erythrosine
6) Two –tone solution.
7) plaque light system.
A)Topical application:
Erythrosine, water, alcohol, oil of
peppermint
B) Tablet :
FD & C Red No.3, sodium
chloride, sodium sucaryl, calcium
stearate, white oil.
FD & C Green No.3, FD & C Red
No.3
Sodium fluorescein, glycerine-
75% FD & C Yellow No.8
17. Mechanical methods of plaque control are the most widely accepted
techniques .
Tooth brush MANUAL
POWERED
Brushing technique
Dentrifices.
Flossing
Interdental brushes.
Oral irrigators
Toothette.
Tongue scrapers.
Gauze piece for use in infants
18. Tooth brush-Historical background
3000 BC Egyptians use small branches to clean teeth
1223 Chinese invent bristle toothbrush
1690 First reference to word toothbrush in Europe
1780 William Addis invents toothbrush
1857 First patent for a toothbrush by HN Wadsworth
19. 1938 First nylon bristles introduced by DuPont
1954 Electric toothbrush Broxodent invented by Philippe
Guy Woog, Switzerland.
1960 electric toothbrush introduced in US
1980 First modified angulation of toothbrush-Reach
1987 1st rotary action electric toothbrush for home use
2000 Low-price power toothbrushes become popular
20. Manual tooth brush
Most common method
Variables -design and
fabrication of
toothbrushes.
21. ADA specifications of a tooth brush: The head of the brush should
be :
1) 1 inch to 1 ¼ inches long.
a) 1 inch or less in children.
2) Width—5/16 to 3/8 inches
3) Surface area—2.54 to 3.2 cm
4) 2-4 rows of bristles.
5) 5-12 tufts per row.
6)80-86 bristles per tuft.
23. Bristles :
Two types : a) nylon (synthetic) b) natural (hog).
Nylon bristles are preferred.
Hardness :
Depends on material, diameter & length.
Nylon bristles more flexible.
Soft: nylon filament 0.007 inches to 0.009 inches in
with 24 to 33 tufts-indicated for children.
24. Medium : 0.010 inches to 0.012 inches (No.10, 11,12).
Hard : 0.013 inches to 0.014 inches (No. 13, 14).
Extra hard: 0.015 inches (No.15).
length - 0.406 inch adult
- 0.344 inch kids
25. Seven basic designs predominate in the arrangement of the tufts:
A) oval or convex.
B) curved tuft-ended.
C) straight tuft-ended.
D) short oval.
E) straight serrated trim.
F) straight multi tuft with the center 2 or 3 rows depressed
longitudinally.
G) straight non serrated multituft.
28. • No ideal toothbrush in terms of shape, size, or handle
• Manual toothbrush with short head, straight cut (same
length), round ended soft to medium artificial bristles
(nylon) and 3-4 rows of tufts is recommended and is
more effective
Ideal Toothbrush
29. It was suggested (Frandsen 1986) that the outcome of
tooth brushing is dependent on:
(1) the design of the brush
(2) the skill of the individual using the brush
(3) the frequency and
(4) duration of brushing
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30. Brushing techniques
The more predominant brushing techniques advocated for
children :
A) Roll method
B) Fone’s technique
C)charters method
D) circular scrubbing method.
E) horizontal scrubbing method.
F) Bass method.
G)Modified stillman method.
31. Roll method
The bristles - 45degree angle on the attached gingiva,
Brush head -rolled in a coronal direction using an accurate
motion.
The occlusal surfaces -anteroposterior scrubbing motion.
33. Fones techniques
Recommended for children
Bristle placement: perpendicular to the
tooth
Motion: with teeth in occlusion move
brush in rotary motion over both arches
and gingival margin
34. Advantage
Easy to learn
Young chidren-minimal
manual dexterity.
Disadvantage
Interproximal areas not
cleaned
May cause trauma
35. Charter’s method
-45 degree
-firmly pushed into the interproximal spaces with a slight
rotary & vibratory action.
-Occlusal surfaces-bristles in a slight rotary movement
into pits & fissures.
Advantage
Cleans interproximal areas
Gingival stimulation.
Disadvantage
Hard to learn and position brush
36. Circular scrub method
The tooth brush head -
90°
Entire brush head is
moved in a circular
scrubbing motion using
light pressure.
Disadvantage : no
intrasulcular cleansing.
37. Horizontal scrubbing method
Brush is placed horizontally on B/L surfaces
Moved back & forth with a scrubbing motion.
Disadvantage
Interdental areas not cleaned
Causes cervical abrasion--
& gingival recession
38. Advantages:
Good gingival stimulation
Remove plaque from cervical area,
interproximal & sulcular area.
Disadvantage:
Errors in placement of bristles-
traumatize the attached gingiva.
Bass technique:
40. Recommended Techniques in Pediatric Patients
Scrub or circular scrub technique -
Probably best for young children with little manual
dexterity
Horizontal scrub -
Used most frequently by preschoolers and 6-8 year old
children.
41. Powered tooth brush
Introduced in 1954.
Three basic types of electric tooth brushing
actions:
1) Rotation in an arc of about 60 degree.
2) Back & forth horizontal actions.
3) Elliptical movement (combines oscillating
with back-and-forth.)
42. Recommended for:
individual lacking motor skill
physically handicapped or mentally retarded
patients.
preschool children
patient who have orthodontic appliance.
Removed significantly more plaque than manual
toothbrush in preschool children.
43. Orthodontic brushes
2 rows of longer bristles on each side of a middle row of
shorter & stiffer bristles in order to clean the teeth, gingival
tissues, orthodontic brackets, wires & attachments
45. Dentifrice:
It is a substance used with a toothbrush for
the purpose of cleaning the accessible
surfaces of the teeth
(American Dental Association)
TOOTHPASTE:
Toothpaste is a colloidal suspension of a
mixture of ingredients that must be
carefully balanced in order to provide an
efficacious, safe, and consumer friendly
product
46. COMPOSITION
1. Detergent – 1.2%Sodium lauryl sulphate
• Use – To lower surface tension -Penetrate and loosen
surface deposits and strains
• Emulsify debris for easy removal by toothbrush Contribute
to the foaming action
2. Cleaning and polishing agents - 20-40% Calcium
carbonate, calcium pyrophosphate bicalcium phosphate
• Uses– Act as abrasive agents for cleaning and polishing
objectives.
10
9
47. • Polishing agent is used to produce a smooth shining tooth surface
that resists discoloration, bacterial accumulation and retention
3. Binders – 1.2%Organic hydrophilic colloids, alginates, magnesium
aluminium silicate, colloidal silica
• Use – To prevent separation of the solid & liquid ingredients during
storage
11
0
48. 4. Humectants : 20-40%Glycerin : Sorbitol
• Use – Added to retain moisture
• Prevent hardening on exposure to air.
• To stabilize preparation
5. Preservatives - Alcohol, formaldehyde ; dichlorinated phenols
Use – To prevent bacterial growth and to prolong shelf life
11
1
49. 6. Sweetener : 2-3%Sorbitol ,sodium saccharin, sorbitol,xylitol
Use – To import a pleasant flavor for patient acceptance
7. Flavoring agent : 1-15%Peppermint : cinnamon, menthol
Use – To make the dentifrices desirable
50. 11
2
8. Therapeutic agent 1-2 %Fluoride
• Use – For medical value
9. Coloring agent
10. Water 20-40%Main transport medium
51. Prophylactic or theraputic dentrifices:
Tooth sensitivity reduction
Bacterial plaque formation reduction
Gingivitis reduction
Calculus promotion reduction by adding pyrophosphate
system or zinc system
52. Fluoride dentrifices:
Play a significant role in prevention of caries.
Dental caries prevention by stannous fluoride, sodium
fluoride, sodium monofluorophosphate is well known.
53. Physicomechanical:
Reduce the cariogenicity of the plaque by rinsing or flushing action.
Removes fermantable food debris.
Chemical function
fluoride deposited into the enamel and forms fluorapatite crystals.
increase the acid resistance of the enamel.
54. Recommendation for use of fluoridated
dentrifices in children
CHILD AGE RECOMMENDATION FOR USE OF
FLUORIDE TOOTH PASTE
Below 4 year Fluoride tooth paste is not
recommended
4 to 6 years Brush once daily with fluoridated tooth
paste
6 to 12 years Brushing twice daily using fluoridated
tooth paste
Above 12 years Brushing three times with fluoride tooth
paste
55. Dentifrice for babies aged 4 months to 3 years:
1)Baby orajel tooth & Gum cleanser
It is non-foaming without fluoride & it contains a mild
surfactant & simethicone , sugar free-in vanilla &
fruit flavours.
57. Dental floss:
First paper & inventor - Parmly in 1819
1882, Codman and Shurtuff (first commercial, made of silk)
58. Jhonson & Jhonson company(New Brunswick) manufactured silk dental
flosses of both waxed & unwaxed type--1898.
Dr Charles C Bass who in 1948-nylon is superior to silk
Almost all dental flosses are made of nylon filaments.
59. multiple nylon filaments of 2 to 3 denier thick.
Each dental floss-made with 4 to 18 ends of filaments twisted in a
predetermined number of twists per inch.
Unwaxed floss is most recommended by the dentist.
60. Types of dental floss
1. Flavored and unflavored.
2. Waxed and unwaxed.
3. Thin and thick.
4. Nylon and Teflon.
5. Twisted and non twisted.
6. Banded and non banded.
7. Micro filament and multi filament.
61. According to ADA specification:
Type I: Unbonded dental floss composed of yarn having no
additives.
Type II: Bonded dental floss composed of yarn having no
additives other than binding agent or agent for cosmetic
performance.
Type III: Bonded or unbonded having drug for therapeutic
usage.
62. In school children dental flossing by trained
personnel over a 20 month period show a 50%
reduction of interproximal dental caries.
Flossing should be done at least once a day –
convenient time.
63. For orthodontic patients the use of superfloss or a
floss threader helps in negotiating the floss under
the archwires to allow for interproximal cleaning.
64. Dental floss holder: is a supplimentary tool for flossing
Types of holders
knife shape
y shape
holder with short handle are more difficult to use ,so always
try to select one with longer handle for children
65. Interdental cleaning Aids
Interdental brushes.
These are cone shaped brushes made of bristles mounted
on handle ,single tufted brushes or small cylindrical brushes.
For best results diameter is
larger than the gingival
embrassure.
66. These brushes are classified as:
Tapered ( Christmas tree appearance)
Nontapered (Bottle neck appearance)
According to ISO standard 16409:2006
Passage Hole Diameter in mm.
67. Indications :
Cleaning large irregular or concave tooth surfaces adjacent to
wide interdental spaces.
Single tufted-furcations areas, deep recession, effective on
lingual surface of mandibular molar & premolar.
68. End-tufted Brush
Cleaning along the gumline adjacent to the teeth.
The bristles shaped in a pointed arrow pattern-closer
adaptation to the gums .
69. Uses
ideal for cleaning specific difficult to-reach areas,
between crowns,
bridgework,
crowded teeth and
fixed orthodontic appliances
70. Wooden tooth picks or tips
Used with or without handle
Remove the soft deposit in the interdental area
Handles- improve access to all areas
Wooden tooth tips is useful-anterior areas –buccal
surfaces.
71. Rubber tips
Conical & mounted on handles or the ends of tooth brushes
they can be easily adapted to all proximal surfaces in the
mouth.
It is reusable.
73. Tongue scrapers
They may be flexible ,plastic or
metal stick which helps in
cleaning the rough dorsal surface
of the tongue
74. Benefits of Tongue Scraping
Halitosis-reduced
Enhancing immunity- removes bacteria & toxins
Improving the sense of taste
Digestive system, respiratory system etc improves with a
regular tongue scraping
75. Disadvantages of Tongue Scraping
Gag reflex - vommiting.
Damage to the taste buds
Too much pressure -tongue bleeding
Tongue Scraping With Your Tooth Brush
Tongue Scraping With Tongue Brush
Tongue Cleaning with a Tongue Scrapper
Tongue Scraping Options and Tools
76. Toothette
It is a swab of sponge
attached to a stick
Used in hospitals and in pts
extremely fragile tender
gingiva or mucosal lesions
Used to deliver moisture to
dried oral mucosa as well as
clean oral cavity –topical
anesthetics.
77. Gauze piece for use in infants
A moist gauze piece wrapped
around the finger can be ideal for
cleaning gum pads in infants.
81. Many patients are unable, unwilling or untrained to
practice - mechanotherapy.
Certain pts with dental diseases :
(e. g.periodontitis, immunocompromised conditions -
additional assistance beyond mechanotherapy.
85. FIRST-GENERATION
COMPOUNDS
SECOND-GENERATION
COMPOUNDS
Antibiotics,
Phenols
Quartenary
Ammonium
Compounds
Sanguinarine
Capable of
reducing plaque
scores by about
20-50%.
Efficacy limited –
Due to poor
retention with in
the mouth.
Bis-Biguanides
Triclosan with
other copolymers
or zinc citrate
Reduce plaque
scores by about
70-90%.
More effectively
retained by
tissues due to
slow-release
properties.
According to generation
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THIRD GENERATION
Delmapinol
Octapinol
Blocks by binding
of micro-organisms
to each other or to
the tooth.
86. Action of chemicals can be fit into four categories:-
1. Antiadhesive
2. Antimicrobial
3. Plaque removal
4. Antipathogenic
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88. Chlorhexidine:( developed in late 1940’s)
Primary agent-chemical plaque control
It is a cationic bisbiguanide - broad spectrum anti bacterial activity.
0.2%conc-in oral cavity.
2%-irrigating root canal.
At low con – bacteriostatic
At high con- bactericidal
90. Anti-plaque mode of action
Blocking the acidic groups on the salivary glycoprotein -reducing the
protein adsorption to the tooth surface
Binding to the bacterial surface in sublethal amounts
Substantivity
Precipitating the agglutination factors in saliva and displacing calcium
from the plaque matrix
91. Indication of chlorhexidine:
Adjunct to mechanical oral hygiene
Prevention following oral surgical procedures
For plaque control in physically and mentally handicapped
pts
In high caries risk pts
In pts having fixed orthodontic appliance
Immunocompromised pts
92. Disadvantage:
discolouration of mouth,
increase of Tartar formation on the teeth,
taste problems such as decreased taste or change in taste,
tooth discoloration
serious side effects
mouth ulcer,
white patches or sores inside the mouth or on the lips,
swelling of salivary glands,
signs of an allergic reaction- difficulty in breathing or swelling of
face,lips,tongue and throat
93. Chlorhexidine products
Mouthrinse
0.2% chlorhexidine were first made available in Europe for daily use in
1970
0.1% also became available, however the activity is less
In U.S, a 0.12% mouthrinse was manufactured but to maintain the almost
optimum 20mg doses derived from 10ml of 0.2% rinses, the product was
recommended as a 15ml rinse (18mg dose)
The studies revealed equal efficacy of 0.2% & 0.12% rinses when used at
appropriate similar doses (Segreto et al 1986)
41
94. Gels
1% chlorhexidine gel
Delivered on a toothbrush or in trays
The distribution appears to be poor & preparations must be
delivered to all tooth surfaces to be effective
In trays it was found to be particularly effective against
plaque & gingivitis in handicapped patients.
Available as 0.2% & 0.12% gels.
42
95. Toothpaste
Difficult to formulate into toothpaste.
0.1% chlorhexidine toothpaste with or without fluoride
was found to be superior to the control product for the
prevention of plaque & gingivitis in a 6 month home use
study (Yates et al;1993)
43
96. Varnishes
Has been used mainly for prophylaxis against root
caries than as antiplaque agent in the mouth
CHX-containing varnishes were developed
increase the substantivity,
length of the time of suppression
44
H.J. SANDHAM et al Clinical trial in adults of an antimicrobial
varnish for reducing mutans streptococci.Journal of Dental
Research,1991
97. Varnish has been shown to reduce the numbers of S mutans in several studies.
Suppression of S mutans for periods of up to five months has been achieved by
the application of a varnish containing a high concentration of chlorhexidine
(40%).
1991. Clinical trial in adults of an antimicrobial varnish for reducing mutans
streptococci. Journal of Dental Research
98. Twetman stated in his review that clinical data on caries in prevention
effects remain sparse and that the recent literature was inconclusive for
use of chlorhexidine varnishes for caries prevention in risk groups.
99. SPRAYS
0.1% & 0.25% chlorhexidine in sprays
Studies with 0.2% spray have revealed that small doses of
approximately 1 – 2 mg delivered to all tooth surfaces
produces similar plaque inhibition to a rinse with 0.2%
mouthrinses (Kalaga et al 1989)
They appear particularly useful in physically & mentally
handicapped groups.
100. Chlorhexidine is considered gold standard because:-
Superior antiplaque effect
Irreversible adsorption
Dual antibacterial effect
Dicationic nature
45
101. Quaternary ammonium compounds
Most commonly used con - 0.025% to 0.05 %
(antiplaque properties).
Cationic and bind to the oral tissues
Used orally - bind strongly to plaque and tooth
surfaces.
Cetylpyridinium chloride as main ingredient.
102. Mechanism of action
Rupture the cell wall and alter the cytoplasmic contents.
Adverse effects
Yellowish brown discoloration
Burning sensation
Occasional desquamation also seen
105. Listerine
Most widely --listerine
1ST over the counter mouth rinse to be accepted by the
council of dental therapeutics.
effectiveness in plaque reduction- 20 to 34 %
Gingivitis reduction -28 to 34%.
106. Mechanism of action
cell wall disruption and inhibition of bacterial enzyme
Adverse effects
An initial burning sensation and bitter taste in the mouth
107. Sanguinarine
Used in mouth rinse & toothpaste.
It is an alkaloid extract-blood root plant-sanguinalia
canadenses.
It contains the extract at 0.03% & 0.2% zinc chloride.
Plaque reduction-17-42%, gingivitis reduction-18-57%.
Adverse effect:
Burning sensation-initially.
108. Triclosan
It is a broad spectrum effective
against gram +ve and -ve bacteria
Acts on microbial cytoplasmic
membrane
leakage of the cell contents /
bacteriolysis
Reduces plaque formation and
gingival bleeding.
110. Stannous fluoride
Reduces dental plaque formation
Anti-plaque property at conc of 0.1 to 8%.
Stannous fluoride above 125 ppm – bactericidal against S.
mutans
Low con 10ppm –alteration in DNA and glucan production
by s.mutans
111. Stannous fluoride used as a adjunctive therapy in periodontal
treatment
It reduces plaque formation , gingivitis, and bleeding on
probing.
Stannous fluoride chlorhexidine dentrifice reduce and control
supra and sub gingival plaque bacteria.
112. Antibiotics
Kanamycin ,
non absorbable aminoglycan with a broad spectrum activity
reduce plaque and gingivitis when used topically.
Antibiotics - penicillin, tetracyclines , metronidazole and
clindamycin used- conjunction with scaling and root planing.
113. Treatment of juvenile periodontitis
–local application of tetracycline by hollow cellulose
acetate fibers
–delivers an effective conc of drug in the gingival fluid.
Long term use of antibiotic for plaque control is
inappropriate
-high risk & low benefit
114. Enzymes :
A dentifrice (zendium, oral-B)-its enzyme system is able to inhibit plaque
bacteria.
enzymes - amyloglucosidase, glucosidase and lactoperoxidase
It enhances the lactoperoxidase system already present in human saliva.
Thyocyanate oxidizes(H2o2) hypothycyanate.
115. Hypothiocyanate + sulfhydril groups of oral micro-organisms
resulting in their inhibition.
Clinical trials has shown that some reduction in plaque &
gingivitis
116. Antitartar agents:
Dentrifice containing 3.3 % pyrophosphatase shows 26 %
reduction calculus formation
It prevent calcification by interfering with the conversion of
amorphous calcium phosphate to hydroxy apatite.
2% zinc chloride is an effective ingredient in anti calculus
dentrifice
117. plaque-modifying agents, and plaque
attachment interferance agents :
Urea peroxidase as a plaque modifying agent
- increased stability and
- protein denatauration effect of urea
Delmopinol affects by binding to salivary proteins & altering the
cohesiveness of the plaque film
Editor's Notes
THE TERM PLAQUE DERIVED FROM FRENCH WORD
Materia alba: soft accumulations of bact and tissue cells that lack the organized structure of dental plaque
Calculus..hard deposits that form by mineralization of dental plaque and covered by layer of unmineralised plaque
SUPRA GINGIVAL.. CLINICAL EVIDENT…GRAMPOSITIVE, AEROBES…
Total removal of dental plaque from teeth either by mechanical or chemical elimination will markedly reduce the development of caries , gingivitis & periodontitis in children.
Every child pt and parents should be educated about daily plaque control.
It is a preparation in liquid, capsule, tablet or lozenges - contain a dye or other coloring agent - identify bacterial plaque deposits for instruction ,evaluation and research.
Tablets, capsules,& wafers are easily managed by children & parents for home use.
Dis-plaque is a dye that differentiates plaque by staining older plaque in blue tones & recent thin deposits in red tones.
It is the removal of dental plaque on a regular basis and the prevention of its accumulation on the teeth and adjacent gingival surface.
The mechanical cleaning of teeth can be traced back to ancient times.
• Evidence says that oral hygiene was practiced by Egyptians 5000 years ago; Romans used toothpick made up of boneand metals.
• The first bristle toothbrush was found in China during the Tang dynasty
The toothbrush is the most common method for removing plaque from the oral cavity.
A number of variables enter into the design and fabrication of toothbrushes.
Consists of handle , shank & head.
Bristles - bunched together-tufts.
The extreme end of the head is toe & close to the handle is the heel.
Size –large, medium and small.
Lateral profile-flat, convex, concave & scalloped.
Both types remove plaque, however, in homogenecity of the material,
uniformity of bristle size, elasticity,resistances to fracture and repulsion of water and debris, nylon filament is clearly superior
Choose acdg to the dexterity
AREAS WITH GINGVAL RECESSION
Apical, towards gingival into sulcus at 45°, to tooth surface
Short back and forth vibratory motion while bristles remain in sulcus
Pointing apically at an angle of 45° to tooth surface Bristles rest on gingiva and cervical part
On buccal and lingual slight rotary motions with bristle ends stationary
DR PHILIP GUY OF SWITZERLAND
DETERGENT, CLENG N POLISHG AGENT,HUMETANT, THERAPEUTIC, SWEETNERS,BINDERS , PRESERVATIVES ETC
Nylon floss superior
An end-tufted brush is a type of toothbrush used specifically
for cleaning along the gumline adjacent to the teeth.
• The bristles are usually shaped in a pointed arrow pattern
to allow closer adaptation to the gums (Fig. 27.25).
• An end-tufted brush is ideal for cleaning specific difficultto-
reach areas, such as between crowns, bridgework,
crowded teeth and fixed orthodontic appliances
Introduction of tooth brush much easir
1st generation agents:
(Decrease plaque by 20-50% Good antimicrobial activity but poor substantivity)
2nd generation agents:
(Decrease plaque by 60-90% . Good antimicrobial activity and excellent substantivity)
3rd generation agents:
(They prevent plaque formation by inhibiting the pellicle attachment.)
.
Substantivity
is the ability of an agent to be
retained in the oral cavity and
slowly released in its active
form over an extended period
of time.
Mouthrinses:-
Aqueous alcohol solutions of 0.2% chlorhexidine were first made available in Europe for daily use in 1970
0.1% also became available, however the activity is less
In U.S, a 0.12% mouthrinse was manufactured but to maintain the almost optimum 20mg doses derived from 10ml of 0.2% rinses, the product was recommended as a 15ml rinse (18mg dose)
The studies revealed equal efficacy of 0.2% & 0.12% rinses when used at appropriate similar doses (Segreto et al 1986)
In a study by Yates et al it was found that 0.1% chlorhexidine toothpaste with or without fluoride was found to be superior to the control product for the prevention of plaque & gingivitis in a 6 month home use study
CHX-containing varnishes were developed to
increase the substantivity,
length of the time of suppression
1. Explained in terms of its superior degree of persistence at the tooth surface