3 ms·

Interestingly enough, there are downsides to chlorhexidine gluconate. "It is well known that CHG causes considerable side effects, such as extrinsic staining,

Interestingly enough, there are downsides to chlorhexidine gluconate. "It is well known that CHG causes considerable side effects, such as extrinsic staining, an alteration in taste perception, and an increase in calculus formation. The calculus surface itself may not induce inflammation in the adjacent periodontal tissue. However, calculus formation is known to be a factor in plaque retention as well as a reservoir for toxic bacterial products and antigens. In addition, a recent investigation has reported that treatment of Porphyromonas gingivalis biofilms with CHG for 5 min did not degrade their external structure or reduce the volume of protein and carbohydrate constituents. The residual structure following CHG exposure may accelerate calculus formation and may serve as an ideal substrate to promote new microbial adhesion." https://bmcoralhealth.biomedcentral.com/articles/10.1186/s12903-018-0517-3 https://bmcoralhealth.biomedcentral.com/articles/10.1186/s12...

derefr 6y ago
No argument about the staining or taste perception. And the calculus formation isn’t too relevant on its own, if you get your teeth cleaned regularly. It chips off. But re: this part — > In addition, a recent investigation has reported that treatment of Porphyromonas gingivalis biofilms with CHG for 5 min did not degrade their external structure or reduce the volume of protein and carbohydrate constituents. IIRC this isn’t a surprising finding; CHG is supposed to do its work in combination with brushing and flossing, not on its own. Picture a biofilm like a tree. A tree is a lot more brittle when it’s dead and dried out, than when it’s living and actively keeping itself hydrated. You wouldn’t try to uproot a live tree; that’d be hell, since all the roots would be stretchy. It’d be like trying to snap a live green branch off a tree, times a thousand. Instead, you cut the tree down; let the stump decay and dry; and then pull it out. Same with biofilms: live colonies are elastic and emit protective mucilage around themselves, rendering them resistant to physical onslaught from brushing. Kill them, though, and they become brittle and able to be abraded away. But, of course, just as with antibiotics, an intervention that kills 99% of a biofilm colony won’t do much if you just do it once and then immediately stop, because that last 1% can use the dead bacteria and the biofilm itself as a growth medium to come right back. With antibiotics, you need to keep the bacteriostatic effect going for long enough for your immune system to pick off the stragglers. With oral rinses, you need the effect to last long enough for the combination of brushing/flossing, saliva, rubbing from the tongue, and abrasion of fibrous food, to fully clean the biofilm away.

derefr 6y ago

No argument about the staining or taste perception. And the calculus formation isn’t too relevant on its own, if you get your teeth cleaned regularly. It chips off. But re: this part — > In addition, a recent investigation has reported that treatment of Porphyromonas gingivalis biofilms with CHG for 5 min did not degrade their external structure or reduce the volume of protein and carbohydrate constituents. IIRC this isn’t a surprising finding; CHG is supposed to do its work in combination with brushing and flossing, not on its own. Picture a biofilm like a tree. A tree is a lot more brittle when it’s dead and dried out, than when it’s living and actively keeping itself hydrated. You wouldn’t try to uproot a live tree; that’d be hell, since all the roots would be stretchy. It’d be like trying to snap a live green branch off a tree, times a thousand. Instead, you cut the tree down; let the stump decay and dry; and then pull it out. Same with biofilms: live colonies are elastic and emit protective mucilage around themselves, rendering them resistant to physical onslaught from brushing. Kill them, though, and they become brittle and able to be abraded away. But, of course, just as with antibiotics, an intervention that kills 99% of a biofilm colony won’t do much if you just do it once and then immediately stop, because that last 1% can use the dead bacteria and the biofilm itself as a growth medium to come right back. With antibiotics, you need to keep the bacteriostatic effect going for long enough for your immune system to pick off the stragglers. With oral rinses, you need the effect to last long enough for the combination of brushing/flossing, saliva, rubbing from the tongue, and abrasion of fibrous food, to fully clean the biofilm away.