10.25 topical antimicrobials in PD Flashcards
Perfect agent
1) Safe- nontoxic, nonallergenic, nonirritating, does not create unfavorable microflora
2) Effective for both plaque and gingivitis
3) Proper Substantivity - it is bound to and slowly released from oral surfaces
4) Specific effects on pathogenic flora
5) Acceptable taste, low cost, and ease of use
Only Prescription agent approved by FDA
chlorhexidine (they classify OTC antiplaque and anti-gingivitis agents as “cosmetic agents”)
For approval by the ADA about gingivitis claims, what is required?
-tow 6 month clinical trials
Only OTC agent (mouthrinse) approved by ADA is
listerine and its generic forms
Only OTC agent (toothpaste) approved by the ADA is:
Colgate total and Stannous Fluoride
what is the concentration of prescription Chlorhexidine and directions for use
- 12 solution, comes in 16 oz bottles
- rinse with 1/2 oz BID
- it is the most effective agent available
what are the side effects of chlorhexidine rinse?
- “tin” or “metallic taste”
- Stain-both tongue and teeth, reversible
- increased calculus formation bc it binds to the teeth
when would chlorhexidine be used?
Post periodontal surgery for 1 - 2 weeks
Control of severe gingivitis - if to painful to
brush
Non- severe cases of oral Candidiasis
listerine, 4 essential oils
- anit-plaque and anti-gingivitis
- Thymol 0.064%
- menthol 0.042
- eucalyptol 0.092
- methyl salicylate 0.060%
side effects of listerine
none known
colgate total use
antibacterial
- copolymer enhances substantivity
- Triclosan retained and active
stannous fluoride
- not a clinically significant plaque effect
- significant anti-gingivitis effect
- current product Prohealth (toothpaste) from P&G
does listerine promote calculus formation?
No
alcohol content of listerine
21.6%
CPC 14-18%
alcohol used as a solubilizers (activates essential oils in listerine)
when is the use of listerine contra indicated?
- alcoholics
- patients taking metronidazole
Conclusions Interproximal cleaning
Listerine and Chlorhexidine are effective against oral biofilms.
Significant number of studies support the use of Chlorhexidine and Listerine.
There is sufficient evidence to support the clinical efficacy of Listerine adjunctive to:
-Brushing
Brushing and flossing

Sanz study
Peridex (cholorhexidine) enhances post pd surgery care
54.4% reduction in plaque at 6 weeks (P<0.05)
Conclusions anti-plaque and anti-gingivitis agents
Chlorhexidine .12 % Prescription rinse Post-surgical management
Severegingivitis
Listerine OTC mouthrinse
Reduce gingivitis for patients with gingivitis Over 20 clinical trials support its use
CPC
Prohealth is a 0.07 formulation, but supported by only
one long term clinical trial Colgate Total toothpaste
Effective for both plaque and gingivitis
