Chemical Plaque control Flashcards
Give example of each class of inhibitor
Answer is here
What can you change about the oral environment to reduce the efficacy of chlorhexidine?
Lower ph below 5.5
Increase ph above 7
Organic matter or present Ca2+ ions
How is CHX highly substantive?
Binds oral surfaces and gradually released into saliva at bacteriostatic conc.
What is the mechanism of action of CHx?
Cationic - binds negatively charges phospholipid bilayer plasma membrane of bacteria
Binding displaces divalents ions such as calcium
displacement of divalent ions cause hydrophilic domains to open up on the membrane and disrupts membrane osmolarity, fluidity and enzymes
Adverse effects of CHx with long term use?
teeth staining, calculus formation, taste disturbances
CHX is better than CPC, true or false? Why?
True due to better substantivity
CPC mechanism of action?
Similar mode of action of CHX
Also inhibits GTF enzymes that produce extracellular polysaccharides
What is listerine comprised of and why is it a chemical plaque control agent?
Methyl Salicylate, Menthol, Thymol, Eucalyptol,
Anti inflammatory, prevents bacteria aggregation, disrupts biofilm, disrupt bacteiral cell wall
What is triclosan? What is it’s mechanism of action? Substantivity?
Phenol
Inhibits lipids sythesis – pertubations in cell membrane
low substantivity – needs combination with zinc citrate of copolymer
What is the gold standard for dental plaque control?
CHX based on a recent study by Takenaka et al
Chemical plaque agents on dental caries vs gingivitis?
conflicting evidence on dental caries
however good evidence for reducing gingivitis
What is the effect of chlorhexidine on biofilms? Why why would mechanical brushing be better for patients vs chlorhexidine?
Cells lose vitality overtime, however the biofilm is not removed
Chlorhexidine only effected the most superficial layers
Better at inhibiting plaque accumulation rather than existing biofilm
Why shouldn’t you use CHX after brushing teeth?
SLS surfactanct (anionic) binds CHX and interferes with it
Wait 30 min but preferentially 2 hours
How does CHX compare with essential oils on gingivitis?
CPC?
CHX is effecting in chemical plaque control and therefore reduces gingivitis as well
Short term more effective than essential oils, long term, same effectiveness due to anti-inflammatory propertieis of essential oils
Anti-inflammatory action takes time to show up
CPC also is effective anti plaque and anti gingivitis
When might CHX exhibit anti-caries effect?
Extremely high concentrations as a varnish but it is inconclusive
