[Dysphagia] Chlorhexidine and oral care

[skware1 at msn.com (Sarah Ware)]

This can be obtained from your dentist.



Sarah





>From: Irene Campbell-Taylor <eripley@yahoo.com>
>To: dysphagia@b9.com
>Subject: [Dysphagia] Chlorhexidine and oral care
>Date: Fri, 11 Aug 2006 05:58:17 -0700 (PDT)
>
>The following is the information from Glaxo-Smith-Kline, manufacturers of 
>Corsodyl, OTC chlorhexidine product that is, unfortunately, available only 
>in Europe.  Like so many other useful OTC products such as topical 
>ibuprofen etc., it is not available in either the US or Canada although I 
>believe it can be ordered online.
>   I used to have the hospital pharmacists make such a mouthwash that I 
>used as a spray but that was in the good old days of full patient care 
>without damaging penny pinching.
>
>   ?Chlorhexidine gluconate is an antiseptic and disinfectant agent, which 
>is active against various bacteria, viruses, bacterial spores and fungi. It 
>kills the micro-organisms associated with various mouth and throat 
>infections, and other common conditions in the mouth. These include the 
>Candida albicans fungi that causes thrush infection in the mouth, and 
>bacteria that may infect mouth ulcers or other sore areas in the mouth, eg 
>after dental surgery. Infection of these areas increases discomfort and 
>delays healing. Chlorhexidine has also been shown to prevent the formation 
>and build up of plaque on teeth, which helps prevent inflammation of the 
>gums (gingivitis). It can therefore be used as an aid to oral hygiene, 
>particularly in instances where toothbrushing is a problem, eg following 
>dental surgery or in physically or mentally handicapped people. 
>Chlorhexidine is available as a mouthwash, a spray or a dental gel for the 
>treatment of common dental conditions. The gel is
>  used to brush the teeth, or for direct application to sore areas in the 
>mouth. The action of rinsing the mouth with the mouthwash provides a 
>mechanical cleaning action in the mouth. The spray is applied to tooth and 
>gum surfaces, ulcers and other sore areas. All kill micro-organisms in the 
>areas they are in contact with and help maintain oral hygiene. The spray is 
>applied to tooth and gum surfaces, ulcers and other sore areas. All kill 
>micro-organisms in the areas they are in contact with and help maintain 
>oral hygiene. (Note, as it mixes with saliva, it also bathes the cheeks. 
>Some may be aspirated but I know of no resultant problems since the amount 
>is so small).
>   ·  The mouthwash should be used as directed to rinse the mouth. It 
>should be spat out, not swallowed.
>   ·  Chlorhexidine is incompatible with certain ingredients of 
>conventional toothpastes. Toothpastes should be used first and the mouth 
>(and if necessary toothbrush) rinsed before using chlorhexidine, or they 
>should be used at a different time of day.
>   ·  Avoid contact of this medicine with the eyes and ears. If it comes 
>into contact with the eyes, rinse immediately with plenty of water.
>   ·  When treating mouth ulcers or oral thrush infections, treatment 
>should be continued for two days after the symptoms have cleared up.
>   ·  When treating inflammation caused by denture rubbing, the dentures 
>should be cleaned and soaked for 15 minutes twice a day in chlorhexidine 
>mouthwash.
>   It is important to be aware of and/or test for sensitivity/allergic 
>reaction to chlorhexidine as a few people are significantly susceptible.
>
>   Comparison of a phenolic and a 0.2% chlorhexidine mouthwash on the 
>development of plaque and gingivitis.
>Clin Prev Dent. 1991 Jul-Aug;13(4):31-5.
>Moran J, Pal D, Newcombe R, Addy M.
>
>Chlorhexidine and phenolic mouthrinses have attracted considerable interest 
>as adjuncts to oral hygiene. The aim of this study was to compare two well 
>known proprietary mouthrinse products for their effects on plaque regrowth, 
>the development of gingivitis and the formation of toothstaining. The study 
>was a single-blind, randomized, placebo-controlled, triple cross-over 
>experimental, gingivitis design. A group of 15 volunteers with a very high 
>standard of oral hygiene and gingival health used each rinse for 19 days in 
>the absence of normal toothcleaning. Each period was separated by a 21 day 
>washout. Plaque scores were significantly different between the rinses, 
>being lowest with chlorhexidine and highest with saline. The plaque area 
>increased 3-fold with the phenolic rinse and 6-fold with the saline rinse 
>compared to the chlorhexidine rinse. Similarly, gingivitis increments were 
>lowest with chlorhexidine and highest with saline but differences between 
>rinses did not reach
>  significance. Staining was significantly different between rinses, 
>primarily due to minimal staining associated with the saline rinse. 
>Staining occurred with both the chlorhexidine and phenolic mouthrinses. It 
>is concluded that the 0.2% chlorhexidine rinse offers greater oral hygiene 
>benefits than the phenolic rinse. The question of indications and durations 
>of use of mouthwash products should be addressed. It also should not be 
>used in patients with cancer-treatment stomatitis.
>
>   Chlorhexidine does stain the teeth and oral tissue but this is much less 
>when the spray is used. Peridex is available on prescription  in Canada and 
>the US but is not available as a spray. It can be decanted into a small, 
>plastic spray bottle and used for patients who can?t swish and spit.
>
>
>Dr I Campbell-Taylor
>Clinical Neuroscientist
>Exclusive Distributor:
>www.interactivetherapy.com
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