Chemotherapeautic agents Flashcards
Define ‘Chemotherapeutic agent’
A product that inhibits the necessary bacterial processes, causing a decrease in cell metabolism or a loss of cell function.
What is the function of chemotherapeautic agents?
Allow the tooth surface to remain free of targeted microorganisms for a measureable period of time.
Chlorhexidine gluconate clinical uses
- Reduces subgingival plaque formation
- Prevents gingivitis
- supportive therapy when mechanical removal of plaque is limited?
- Pre-operative rinse
What are potential side effects of chlorhexidine gluconate?
- Staining (prolonged use)
- Taste alteration
- Burning sensation
- Xerostomia
- Increased calculus deposition
What is the active ingredient in Savacol
Chlorhexidine gluconate
What is the active ingredient in cervitec gel?
Chlorhexidine gluconate, fluoride
What is the active ingredient in cervitec liquid?
Chlorhexidine gluconate, essential oils, xylitol
What is chlorhexidine gluconate’s mode of action?
- Bacteria/fungi cidal
- Promotes cell wall lysis
- Binds to hydroxyapatite & glycoproteins- inhibits formation of pellicle
- May interfere with ability of cell to attach to tooth surface
What may interact with/inactivate chlorhexidine gluconate?
Sodium lauryl sulphate (SLS)
What are some active ingredients of essential oils?
- Thymol
- Eucalyptol
- Menthol
- Methyl Salicylate
What is the mode of action for essential oils?
- Bacterial cell wall disruption via removal of proteins
- Inactivation of essential enzymes
What is the clinical use of essential oils?
- reduce plaque formation
- Prevents gingivitis
- Adjunct to daily mechanical plaque removal
What are some potential side effects of essential oils?
- Advantageous over chlorhexidine as side effects are reduced
- Alcohol content may produce burning sensation
What is the active ingredient of Listerine mouthwash?
Essential oils
What is the mode of action of Cetylpyridinium Chloride (CPC)
- Surfactant that reduces bacterial adherence to enamel
- Integrates into cell wall causing lysis
- Decreases bacterial metabolism
- Reduces bacterial aggregation
What are some clinical uses of Cetylpyridinium Chloride?
- Reduces plaque
- Mixed results reducing gingivitis
- Adjunct to adequate removal of plaque
What is the active ingredient in Colgate plax?
Cetylpyridinium Chloride, Sodium benzoate
What is the active ingredient in Oral B mouthwash?
Cetylpyridinium Chloride, Sodium benzoate
What is the active ingredient in Listerine children’s mouthwash?
Cetylpyridinium Chloride
What is the mode of action of Sodium benzoate?
-Preservative: inhibits bacterial growth
- Surfactant: disperses lipids, reducing bacterial adherence to enamel making plaque easier to brush away.
What are some clinical uses of Sodium Benzoate?
- Reduces plaque
- Adjunct to adequate removal of plaque deposits
What is the mode of action of oxygenating agents (peroxyl)
- Foaming action aids in mechanical debridement of calculus
- Releases oxygen, inhibiting growth of anaerobic microorganisms
What are some clinical uses of oxygenating agents\?
- Treatment of acute ulcerative conditions
- Denture related pain
- Orthodontic appliance related pain
- Stain removal
What is the active ingredient of oxygenating agents?
Hydrogen peroxide
What are some side effects of Oxygenating agents (hydrogen peroxide)?
- Spongy gingiva
- Black hairy tongue
- Root sensitivity
- Enamel demineralisation due to product acidity
What is the active ingredient of Colgate peroxyl?
Hydrogen peroxide (oxygenating agent)
What is the mode of action of Neutrafluor (220, 900, 5000)?
- Sodium fluoride promotes the remineralisation of enamel and inhibits demin through deposition of fluoride ions into the enamel
What is the active ingredient of Neutrafluor?
Sodium fluoride
Who should neutrafluor 220/900 mouthwash be prescribed to?
Orthodontic patients at risk of caries, athletes consuming energy
Who should neutrafluor 5000 toothpaste be prescribed to?
High caries risk patients, patients with root caries, patients with xerostomia
What are some side effects of Neutrafluor?
- Burning mouth
- GI (stomach) upset
What is the clinical action of stannous fluoride?
- Antiplaque properties
- Reduces inflammation
- Tin from stannous ions enters cell and alters metabolism
- Affects growth and adherence of bacteria (antibacterial version of fluoride)
What is the active ingredient of Gel-kam?
Stannous fluoride
How does red seal baking soda toothpaste work?
- very abrasive
- very basic
- neutralises acids produced by acidogenic bacteria
What is the clinical action of Caesin phosphopeptide- amorphous calcium phosphate (CPP-ACP)?
- Reduces risk of demineralisation
- Increases remineralisation
- Encourages fluoride uptake
When might tooth mousse (CPP-ACP) be prescribed?
For patients with reduced salivary flow, or patients that don’t get enough fluoride/dont use a fluoride toothpaste
How does xylitol work?
- Inhibits streptococcus mutans
- Not fermented by cariogenic bacteria
- Alters adherent properties of bacteria
- Inhibits new colonisation
When would Biotene be prescribed, how does it work, and what is its active ingredient?
- Dry mouth
- Humectants, lubricants, moisturisers
- Sodium fluoride
When would colgate dry mouth relief be prescribed, how does it work, and what is the active ingredient?
- Dry mouth
- humectants etc.
- Sodium fluoride
What are some points to consider when prescribing medications?
- Allergies
- Sodium content (diets)
- Alcohol content
- Fluoride content
- Manufacturer directions
- Changes to composition of products
What is the active ingredient in sensodyne rapid relief, how does it work?
- Strontium acetate+fluoride
- Occludes the dentinal tubules (quite quickly)
What is the active ingredient in Sensodyne repair and protect and how does it work?
- Novamin bioglass+stannous fluoride
- occludes dentinal tubules and builds up on tooth, stannous fluoride is antibacterial
What is the active ingredient in sensodyne pronamel and how does it work?
- Potassium nitrate
- Sodium fluoride
- Potassium goes into tubules and desensitises
What is the active ingredient in sensodyne mouthwash and how does it work?
- Potassium nitrate
- Sodium fluoride
- Potassium goes into tubules and desensitises
What is the active ingredient in colgate sensitive and how does it work
- Sodium citrate/potassium citrate/potassium nitrate
- Sodium monofluorophosphate
- floods tubules and desensitises
What is the active ingredient in colgate sensitive pro relief and how does it work?
- Arginine+high fluoride
- Occludes dentinal tubules
What is the active ingredient in Colgate sensitive pro relief repair and prevent and how does it work?
-Arginine: floods tubules
- Calcium carbonate binds to hydroxyapatite ‘repairing’
- sodium monofluorophosphate
What is the active ingredient in macleans sensitive and how does it work?
Strontium acetate
occludes dentinal tubules
What is the active ingredient in gelkam and prevent and how does it work?
Stannous fluoride
What is the active ingredient in duraphat and how does it work?
Sodium fluoride (high conc 22600ppm)
Increases surface fluoride and occludes dentinal tubules
What is the active ingredient in superseal and how does it work?
Potassium oxalate
Reacts with hydroxyapatite, leaving a granular precipitate in dentinal tubules
When might superseal be used?
When a patient has exposed dentine
What is the active ingredient in enamel pro varnish and prevent and how does it work?
- sodium fluoride, amorphous calcium phosphate
- stimulates remin of enamel, reduces risk of demin, desensitises dentine (occludes tubules)
