Which antiseptic for your oral care?

antiseptique bouche

The oral microbiota (set of micro-organisms that inhabit the skin and mucous membranes) is complex and presents a great diversity of micro-organisms. About 700 species have been identified in the human oral cavity. This microbiota contributes to the development of the immune system and homeostasis (the body's regulatory mechanism). In order to know which antiseptic to use for your oral care, you need to know the benefits and contraindications of using oral antiseptics in dentistry.

Here is a guide to help you know which antiseptic you should use for your oral care.

What is an oral care antiseptic?

Mouthwashes are an adjunct treatment in case of infection, dental abscess or oral affection. They are prescribed after an odonto-stomatological operation. Because of its role as an interface between the outside world and the inside of the body, the mouth is exposed to potentially pathogenic agents. It plays a variety of fundamental roles in speech and digestion. Any disease of the mouth is therefore difficult to bear. Among the causes of these affections, we find bacteria and fungi. The first, naturally present in the mouth, can proliferate following various factors and induce pathologies. The latter are at the origin of oral mycosis. 

Why use an antiseptic for oral care ?

Under specific environmental and immunological conditions, bacterial plaque (dental biofilm) can become unbalanced, triggering a series of clinical conditions, such as caries and periodontal disease. The most common strategy to prevent and eliminate biofilm accumulation is mechanical removal by brushing. However, if brushing is impossible or insufficient, the use of oral antiseptics, such as chlorhexidine, is essential.

Chlorhexidine (CLX) is a standard antimicrobial agent commonly used in hospitals as a topical antiseptic. Low concentration formulations have a bacteriostatic effect while higher concentrations act as a bactericide. It is effective against both gram-positive and gram-negative bacteria, in addition to having antifungal and antiviral properties. Due to these properties, it is also used as an oral antiseptic, being an effective agent against dental biofilm.  

How does this antiseptic work for your dental care?

The structure of CLX is composed of two chlorophenolic rings and two linked bis-biguanide groups, and is insoluble in water. For this reason, it is used as CLX digluconate, a cationic salt with a broad spectrum of action against microorganisms. After rinsing, some of the CLX is retained in the oral cavity where it is adsorbed by the hydroxyapatite in the tooth enamel and salivary glycoproteins due to its positive charge. Over time, the drug is released (at a lower concentration) by diffusion, providing a bacteriostatic environment. The cationic chlorhexidine molecule interacts with the bacterial cell wall (anionic), increasing its permeability and allowing CLX to enter the cytoplasm, causing osmotic imbalance and cell death (inactivation) by precipitation of its constituents.

What are the possible indications and contraindications?

CLX is a drug with several advantages and, therefore, a good alternative in the treatment of oral infections, as well as in their prevention.

Mouthwash with CLX solution is recommended in the fight against dental biofilm and gingivitis and can act to prevent the formation of dental plaque in patients with motor limitations, users of orthodontic appliances and people with mental disabilities. Its use also reduces biofilm formation in patients with dentures.

It is worth mentioning the important role of CLX in patients hospitalized in intensive care units (ICU), as the amount of biofilm tends to increase during hospitalization, as does the amount of pathogens in this biofilm. Another important indication is prophylaxis of surgical patients, prevention of infections and reduction of contaminating aerosol formation and post-surgical complications.

You should also know that for your health and good oral hygiene, you should use a better quality brush with soft bristles and toothpaste, and do not forget the dental floss. It is also important to have a systematic check-up with your dentist to avoid many problems. Remember also to take care of your gums, and to do your mouthwash regularly for the health of your teeth.

There are adapted products on the market, based on antiseptics, for children and adults, which allow to reduce the risk of infections and oral diseases. The best thing for you to do is to follow your dentist's advice in choosing the best antiseptic for your oral care.

CLX is not indicated for patients with hypersensitivity to its components. Adverse effects described in the literature include: changes in tooth color (with prolonged use), xerostomia (dry mouth sensation), pain, loss of taste and residual taste in the mouth. However, these effects can be prevented with the prescription of a good use in follow-up with a dentist.

The quality brush can be the Y-Brush toothbrush. Indeed, it is a sonic electric toothbrush that has soft bristles and wires that allow you to brush your teeth and gums in the smallest nooks and crannies and very gently according to your dental sensitivity. 

How to use a chlorhexidine mouthwash? 

Chlorhexidine mouthwash is very simple to use. Following the dentist's instructions, the patient should rinse his or her mouth two or three times a day, every 8 to 12 hours, keeping the product in the mouth for 30 to 60 seconds to promote its action. After rinsing, the product is spit out and it is recommended not to eat or drink for at least 30 minutes. Chlorhexidine remains in the mouth for 8 to 12 hours, staying in contact long enough to eliminate or inhibit the causative agent of the infection. It is not necessary to rinse the mouth with water after using the mouthwash.

Other oral care antiseptics

Cetylpyridinium chloride

Cetylpyridinium chloride (CPC) is a safe and effective antiseptic for daily use. It is a chemical that destroys or cleanses harmful bacteria from organic surfaces. It also induces an anti-plaque action and has a remanence in the mouth) of 3 to 5 hours. It very often helps to reduce the viral load of certain viruses present in the mouth, which cause respiratory tract infections.

Hexetidine


Hexetidine is an active substance with a rapid and prolonged effect belonging to the group of local antiseptics for gingival-dental and oropharyngeal use. Hexetidine has a broad-spectrum antibacterial and antifungal effect appropriate for pathogens responsible for oropharyngeal infections. Hexetidine also has healing, hemostatic and local anesthetic properties of the mouth and pharynx.

Hydrogen peroxide


Hydrogen peroxide helps to kill bacteria responsible for gum disease in two ways. First, it releases oxygen. You may have already noticed the formation of bubbles in contact with a wound, which is due to the fact that hydrogen peroxide releases oxygen gas. It eliminates the rarest of gum diseases.

We hope this guide has helped you understand what an oral care antiseptic is. We also hope you understand why it is important to use an oral care antiseptic. Understand how chlorhexidine works but also know the indications, contraindications and the principle of operation. Other oral antiseptics are also used a lot. 

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