Fight Caries With Mouthrinses
Different ingredients in mouthrinses can reduce cariogenic bacteria. In a study on the antimicrobial efficacy of mouthrinses containing chlorhexidine, sodium fluoride, fluoride with essential oils, alum, green tea, and garlic with lime, results showed that chlorhexidine was the most effective against Streptococcus mutans and lactobacilli, followed by the garlic with lime mouthrinse.
Different ingredients in mouthrinses can reduce cariogenic bacteria. In a study on the antimicrobial efficacy of mouthrinses containing chlorhexidine, sodium fluoride, fluoride with essential oils, alum, green tea, and garlic with lime, results showed that chlorhexidine was the most effective against Streptococcus mutans and lactobacilli, followed by the garlic with lime mouthrinse. However, the garlic with lime mouthrinse needs more scientific evaluation. The study also showed that green tea and alum mouthrinses were less effective in reducing cariogenic bacteria than the other mouthrinses tested but still showed inhibitory effects on S. mutans and lactobacilli.
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The effect of mouthrinses containing essential oils, chlorhexidine, benzethonium chloride, and povidone-iodine on cariogenic bacteria were studied by Oyanagi et al. Results showed that the rinses containing essential oils and chlorhexidine were highly successful in eliminating significant numbers of planktonic bacteria and bacteria enmeshed within biofilms. The essential oil mouthrinse also demonstrated inhibitory capabilities that helped to prevent demineralization.
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Tehrani et al conducted a study comparing sodium fluoride mouthrinses with green tea mouthrinses. Results showed that both mouthrinses were effective in reducing the colony counts of S. mutans and lactobacilli. The difference between the two mouthrinses was in their mechanisms of action. Sodium fluoride prevents S. mutans from adhering to the tooth structure, inhibits demineralization, and remineralizes incipient carious lesions. Green tea polyphenols inhibit the growth of S. mutans, S. sobrinus, and lactobacilli, and prevent S. mutans from attaching to the tooth structure. Green tea mouthrinses may be a good option in reducing cariogenic bacteria, but they do not remineralize incipient carious lesions, as sodium fluoride does. Sodium fluoride mouthrinses are contraindicated in children younger than 6 age due to the risk of ingestion.
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Povidone-Iodine Vs Chlorhexidine
In a study comparing povidone-iodine and chlorhexidine mouthrinses, children at high-caries risk were divided into three groups following restorative treatment: the first group received the 1% povidone-iodine mouthrinse, the second group received the 0.2% chlorhexidine mouthrinse, and the third group received the placebo mouthrinse.20 All groups showed significant reductions in S. mutans immediately after mouthrinse therapy, with higher reductions seen among the first group. Unfortunately, after 15 days, 30 days, and 90 days, S. mutans counts in all three groups increased, demonstrating a short duration of efficacy.
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Chlorhexidine and Fluoride
A study conducted on children with high-caries risk showed a significant reduction in S. mutans using both chlorhexidine mouthrinses and sodium fluoride mouthrinses. Chlorhexidine is known as the gold standard in reducing cariogenic bacteria, while sodium fluoride is considered the gold standard of caries prevention. However, patient compliance with chlorhexidine mouthrinses may be low due to the taste, staining of teeth, and risk of taste alteration.
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A review of the literature regarding the effects of cetylpyridinium chloride (CPC) showed that CPC is effective in plaque control, reducing gingivitis, and reducing gingival bleeding. An article comparing mouthrinses with CPC and sodium fluoride revealed that CPC-containing test rinses with and without fluoride were both highly bactericidal against S. mutans. The results showed that fluoride did not reduce the antibacterial efficacy of CPC, nor did CPC reduce the efficacy of fluoride in inhibiting demineralization. Mouthrinses containing chlorine dioxide may also decrease plaque scores. In a study conducted on mouthrinses containing aloe vera, chlorine dioxide, and chlorhexidine, both the chlorhexidine and chlorine dioxide rinses caused significant reduction of plaque scores. The study authors suggest that chlorine dioxide may be a suitable alternative for chlorhexidine but more research is indicated. Xylitol also provides plaque-reducing qualities. In a study that investigated mouthrinses containing chlorhexidine, xylitol, and a combination of chlorhexidine and xylitol against S. sanguis and S. mutans, results showed the combination of xylitol and chlorhexidine was most effective against the cariogenic species.