Chlorhexidine Gluconate 0.12%

Chlorhexidine is a liquid used to kill bacteria. It is used to irrigate the gums after some procedures such as scaling and root planing, or if a patient is showing active signs of periodontal disease or gingivitis. In these same situations it is used as a mouth rinse at home by the patient, swished around like a mouthwash. Here is a little information about it.

What does it taste like?

Chlorhexidine has a very strong minty flavor. It most often has alcohol so it tends to have the burning sensation that is associated with products like Listerine. It is not the same as Listerine though. It is much stronger, lasts longer in the mouth after use and is not an over the counter rinse. You have to get it through your dental office. Formulations that do not contain alcohol are available but are not as effective.

What is it for?

Chlorhexidine reduces plaque formation by killing bacteria. Plaque is the slimy white stuff that can be scratched off your tooth with a fingernail. It is made up of bacteria. The bacteria produce a sticky slime layer around themselves as a form of protection. The slime helps the bacteria stick to the surface of the teeth and tongue even when you swish with water or eat food.

Who needs it?

Chlorhexidine should be used if there is an active bacterial infection such as active periodontal disease or gingivitis. These are indicated by the presence of bleeding on probing when the hygienists checks your gums.

Chlorhexidine is also used in combination with fluorides in the management of rampant decay.

Are there any side effects?

Some patients experience staining of the teeth. This is only surface stain and it can be removed by your hygienist. Stain is more pronounced on patients that do not remove plaque from the teeth properly. Brushing well can help avoid this. You could brush three times a day if you are worried about stain or use an electric toothbrush. I strongly recommend electric toothbrushes they do a much better job. By electric toothbrushes I mean the ones that plug in to the wall.

A few patients experience altered taste when using Chlorhexidine. This is much less common than the staining. If you experience this let your hygienist or dentist know so they can reevaluate your condition to see if you will be able to discontinue treatment or switch to a different therapy.

Why use Chlorhexidine instead of an over the counter rinse?

Chlorhexidine has a high level of substantivity.  This means that it keeps working for a long time after you use it.  Research shows that it sticks in the mouth for 8-12 hours after used, it has even been detected in saliva up to 24 hours after use.  That is not the case with over the counter products.  They work while they are in there, once you rinse or saliva flushes it out it is gone and no longer killing bacteria.

How Will I Use it?

The way chlorhexidine is used depends on why you are using it.

Irrigation with Chlorhexidine is performed by your dentist or dental hygienist.  Chlorhexidine will be squirted using a syringe into the space between the tooth and the gums.  This is usually done at the end of a scaling and root planing appointment, periodontal maintenance appointment or dental prophylaxis appointment if bleeding is present.  The syringe looks like a needle but this procedure is not an injections.

Chlorhexidine is used as an at home prescription rinse for patients with gingivitis or active periodontal disease.  Directions for use at home.  Chlorhexidine is used as a mouth rinse twice a day.  Swish for 3o seconds with 15 ml (about half a cap full).  The rinse has a strong minty flavor so it is best to rinse after eating.  Do not rinse with water immediately after using Chlorhexidine because the minty flavor will be rinsed away leaving a less desirable taste.  Continue use for the length of time advised by your hygienist or dentist.  Generally you will be using the rinse from 2 weeks to a month.

If Chlorhexidine has been recommended for rampant decay at home instructions are different.  The patient will use the rinse once a day as instructed above for two weeks, then stop for two weeks and this cycle will continue for no longer than 6 months.

References

Chlorhexidine. (2010) Retrieved June 2011 from http://www.drugs.com/pro/chlorhexidine.html.

Management of Dental Caries in Children. (2004) Retrieved June  2011 from http://dentalresource.org/topic54dentalcaries.html

Zanatta FB, Antoniazzi RP, Rosing CK. (2010). Staining and calculus formation after 0.12% chlorhexidine rinses in plaque-free and plaque covered surfaces: a randomized trial. Journal of Applied Oral Science, 18(5). Retrieved June 2011 fromhttp://www.ncbi.nlm.nih.gov/pubmed/21085810

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