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Medical Forum / General / Dentistry / January 2007

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Peridex chlorhexidine gluconate 0.12% adverse reactions include "an increase in staining of teeth and other oral surfaces" and "an increase in calculus formation".

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Don Saklad - 31 Jan 2007 12:27 GMT
Peridex chlorhexidine gluconate 0.12% adverse reactions
include "an increase in staining of teeth and other oral
surfaces" and "an increase in calculus formation".

a. Would there be any alternatives?... to this oral rinse
  after bone graft, sinus lift and implant surgeries?

b. In the future, what might be developed
  as an alternative?...
John & Ninetta - 31 Jan 2007 15:28 GMT
> Peridex chlorhexidine gluconate 0.12% adverse reactions
> include "an increase in staining of teeth and other oral
[quoted text clipped - 5 lines]
> b. In the future, what might be developed
>   as an alternative?...

No real alternatives at this point.  Chlorhexidine as a mouthrinse is unique
in that its antimicrobial action lasts after you are done swishing with it.
This is called "substantivity".  Other rinses, like Listerine, do not
possess this.  When using chlorhexidine, one must weigh the risks vs
benefits.  In the case of post-periodontal surgery, the benefits far
outweigh the staining and calculus issues.  I must say, I have not witnessed
the increased calculus formation myself, although I've seen the increased
staining.
don warner saklad - 31 Jan 2007 15:34 GMT
Thank you!

Does that staining go away with routine scaling and cleaning every 6
months?...
Mark & Steven Bornfeld - 31 Jan 2007 15:37 GMT
> Thank you!
>
> Does that staining go away with routine scaling and cleaning every 6
> months?...

Mebbe a little extra elbow grease.  But that's our problem, generally
not yours.

Steve

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Mark & Steven Bornfeld DDS
http://www.dentaltwins.com
Brooklyn, NY
718-258-5001

Mark & Steven Bornfeld - 31 Jan 2007 15:35 GMT
> Peridex chlorhexidine gluconate 0.12% adverse reactions
> include "an increase in staining of teeth and other oral
> surfaces" and "an increase in calculus formation".
>
> a. Would there be any alternatives?... to this oral rinse
>    after bone graft, sinus lift and implant surgeries?

    I'm not sure that chlorhexidene gluconate increases calculus formation,
but it certainly does stain, and will make any calculus much more
obvious because of this.  But good oral hygiene re-instituted as soon
postop as the surgeon allows, will minimize this.
    In any case, in the scheme of things, getting a cleaning after ChG
rinses are discontinued doesn't sound like a big deal.

> b. In the future, what might be developed
>    as an alternative?...

    I'm not aware of any other antimicrobials being used that are nearly as
effective as ChG.  It not only protects against a wide bacterial
spectrum, but also has good substantivity in the mouth as it bonds to
proteins.  This is the same reason chlorhexidene gluconate scrub is
probably the most commonly used surgical scrub ( in 3 or 4% concentration).

Steve

Signature

Mark & Steven Bornfeld DDS
http://www.dentaltwins.com
Brooklyn, NY
718-258-5001


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