10.25 topical antimicrobials in PD

Question 1

Perfect agent

Answer 1

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

Question 2

Only Prescription agent approved by FDA

Answer 2

chlorhexidine (they classify OTC antiplaque and anti-gingivitis agents as “cosmetic agents”)

Question 3

For approval by the ADA about gingivitis claims, what is required?

Answer 3

-tow 6 month clinical trials

Question 4

Only OTC agent (mouthrinse) approved by ADA is

Answer 4

listerine and its generic forms

Question 5

Only OTC agent (toothpaste) approved by the ADA is:

Answer 5

Colgate total and Stannous Fluoride

Question 6

what is the concentration of prescription Chlorhexidine and directions for use

Answer 6

0. 12 solution, comes in 16 oz bottles
   - rinse with 1/2 oz BID
   - it is the most effective agent available

Question 7

what are the side effects of chlorhexidine rinse?

Answer 7

• “tin” or “metallic taste”
• Stain-both tongue and teeth, reversible
• increased calculus formation bc it binds to the teeth

Question 8

when would chlorhexidine be used?

Answer 8

Post periodontal surgery for 1 - 2 weeks
Control of severe gingivitis - if to painful to
brush
Non- severe cases of oral Candidiasis

Question 9

listerine, 4 essential oils

Answer 9

• anit-plaque and anti-gingivitis
• Thymol 0.064%
• menthol 0.042
• eucalyptol 0.092
• methyl salicylate 0.060%

Question 10

side effects of listerine

Answer 10

none known

Question 11

colgate total use

Answer 11

antibacterial

• copolymer enhances substantivity
• Triclosan retained and active

Question 12

stannous fluoride

Answer 12

• not a clinically significant plaque effect
• significant anti-gingivitis effect
• current product Prohealth (toothpaste) from P&G

Question 13

does listerine promote calculus formation?

Answer 13

No

Question 14

alcohol content of listerine

Answer 14

21.6%
CPC 14-18%
alcohol used as a solubilizers (activates essential oils in listerine)

Question 15

when is the use of listerine contra indicated?

Answer 15

• alcoholics

- patients taking metronidazole

Question 16

Conclusions Interproximal cleaning

Answer 16

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


Question 17

Sanz study

Answer 17

Peridex (cholorhexidine) enhances post pd surgery care

 54.4% reduction in plaque at 6 weeks (P<0.05)

Question 18

Conclusions anti-plaque and anti-gingivitis agents

Answer 18

 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