Does Chlorhexidine Turn Gums Pink Again
In this blog for our Show for Everyday Health Choices series, dentist Bosun Hong writes nigh the latest evidence on the use of chlorhexidine mouthwash for gum health (when used in addition to usual toothbrushing and cleaning).
Page last updated: 13 January 2022.
Take-home points
I am a 5.two foot, petite, female dentist. I currently piece of work in an oral surgery department where I spend a lot of my time taking teeth out and the frequently asked question is, "have you got enough strength in you lot to pull my molar out?". The truth is that often I feel my patients have done half the job for me past loosening their teeth with gum disease.
House built on the sand
The mucilage really is the foundation for your teeth. A lot of people fall on the spectrum of gum affliction – somewhere between the more mild, reversible form (gingivitis) and the more severe, irreversible form (periodontitis). Gingivitis is when the mucilage becomes red and swollen and bleeds hands, merely gets amend when you commencement looking later on your mucilage. If you neglect to keep your gum happy, then your gingivitis may progress to periodontitis where you lot start to lose the structures that hold the tooth in place, such equally the tooth-bearing bone. Your tooth-bearing bone will non naturally grow back once you lose it, and if you lot lose enough bone, the tooth becomes loose. At this point, my patients would ask, "and so how tin I look after my gum? Should I employ that mouthwash that my dentist recommended? The i that starts with C". A contempo Cochrane Review looked at the effectiveness and side effects of chlorhexidine mouthwash.
Chlorhexidine mouthwash – does information technology piece of work?
Chlorhexidine is an clarified against a wide spectrum of leaner. The authors found high-certainty The certainty (or quality) of testify is the extent to which we tin be confident that what the research tells us about a particular treatment consequence is likely to be accurate. Concerns about factors such as bias can reduce the certainty of the evidence. Evidence may be of high certainty; moderate certainty; low certainty or very-low certainty. Cochrane has adopted the Course approach (Grading of Recommendations Cess, Development and Evaluation) for assessing certainty (or quality) of prove. Discover out more hither: https://training.cochrane.org/class-approach evidence that short-term (4-6 weeks) and longer-term (6 months) employ of chlorhexidine mouthwash in addition to usual toothbrushing and cleaning leads to a large reduction in the build-up of plaque. They also found this mouthwash is moderately helpful in improving balmy gingivitis. There is currently insufficient prove on the effectiveness The ability of an intervention (for case a drug, surgery, or exercise) to produce a desired effect, such as reduce symptoms. of chlorhexidine mouthwash for people with moderate-to-severe mucilage disease.
Simply remember…
The authors investigated the effectiveness of chlorhexidine mouthwash when used in addition to mechanical oral hygiene regimen such as toothbrushing and cleaning between teeth.
Sometimes, I come across patients who experience a sense of betrayal from mouthwashes when they are told they have a gum illness; "why have I got gum affliction? I use the mouthwash". Often, these are people who have relied heavily on mouthwashes and nether used the conventional methods of cleaning teeth. The importance of toothbrushing cannot be overemphasized – chlorhexidine mouthwash will not magically deliquesce the sesame seed firmly stuck between the teeth, for case. Although, there are some specific circumstances where mouthwashes may have to play the principal office in an oral hygiene regimen; later on surgery (especially surgery involving the jaws) and in some individuals with intellectual and concrete disabilities.
Which concentration of chlorhexidine mouthwash is best?
You can buy chlorhexidine mouthwashes without prescription in the Uk at the pharmacy. The most readily available concentrations in the Great britain are 0.12% and 0.ii%. Does it thing which one you lot get? The authors of this review establish no prove that 1 concentration is more constructive than the other. There are as well lower concentration (0.05%/0.06%) chlorhexidine mouthwashes marketed for long-term daily use, but the authors found the effectiveness of this concentration on gingivitis to be unclear.
How often is best?
The participants of studies included in this review were instructed to use the mouthwash twice a mean solar day. The authors could non find whatever other frequency being used. Until new evidence is plant, information technology seems the generally accepted chlorhexidine mouthwash regimen is to swirl 10-15ml of it effectually the mouth for 30-sixty seconds twice a twenty-four hours.
Does chlorhexidine mouthwash take any side effects?
Chlorhexidine mouthwash causes brown staining on the surface of teeth if used for 4 weeks or longer. This is a type of staining that comes off afterwards scaling and polishing by a dental professional. Does the prospect of having chlorhexidine-induced teeth staining put yous off from using this mouthwash? Are y'all at present at a crossroads of vanity and salubrious glue? Drinking tea can likewise cause a similar appearance of teeth staining; does this fact put you off from drinking tea, or would yous rather continue to savour your Earl Greyness five times a day?
The primal is moderation. If your gingivitis is mild and your oral hygiene could ameliorate within a brusque period of time, then you lot may only need to use the chlorhexidine mouthwash for a couple of weeks and take lilliputian or no staining. On the other hand, if your gum is bleeding every time you brush and you are finding information technology challenging to get used to the right toothbrushing technique, then you may need to use the mouthwash a trivial longer and end up seeing a hygienist for the removal of some brown staining. It is as well a case of standing back and looking at the bigger pic; some removable brown stains versus the appearance of neglected gum illness (fiery-ruddy, swollen gum).
Other side effects of chlorhexidine mouthwash include taste disturbance and soreness of rima oris lining – these are transient in nature and ordinarily resolve when y'all stop using the mouthwash.
The lesser line
So, it seems chlorhexidine mouthwash would be a good improver to your oral hygiene routine (such as toothbrushing and cleaning between teeth) if you lot have glue affliction. Await out for the signs of gum affliction (red, swollen, bleeding gum) and ask your dentist to have a look inside your oral cavity first. Your dentist should be able to discuss the possible causes of your gum disease, determine together how long you lot need to use the mouthwash for, and whether yous demand any other gum treatment Something done with the aim of improving health or relieving suffering. For example, medicines, surgery, psychological and physical therapies, nutrition and practise changes. .
Bosun Hong has no conflict of interest to disclose.
Link:
James P, Worthington HV, Parnell C, Harding Chiliad, Lamont T, Cheung A, Whelton H, Riley P. Chlorhexidine mouthwash as an adjunctive treatment for gingival health. Cochrane Database of Systematic Reviews In systematic reviews we search for and summarize studies that answer a specific inquiry question (e.thou. is paracetamol effective and safety for treating back pain?). The studies are identified, assessed, and summarized by using a systematic and predefined approach. They inform recommendations for healthcare and research. 2017, Consequence 3. Art. No.: CD008676. DOI: 10.1002/14651858.CD008676.pub2. http://onlinelibrary.wiley.com/doi/10.1002/14651858.CD008676.pub2/total
Source: https://evidentlycochrane.net/bleeding-gums-chlorhexidine-mouthwash-help/
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