Chlorhexidine with or without alcohol against biofilm formation: efficacy, adverse events and taste preference

Braz Oral Res. 2017 May 4:31:e32. doi: 10.1590/1807-3107BOR-2017.vol31.0032.

Abstract

In recent years, different chlorhexidine formulations have been tested, including an alcohol-free alternative, but the effect of this solution on early biofilm formation is not clear. A crossover, randomized, double-blind clinical trial was conducted to evaluate the effect of two chlorhexidine solutions against supra- and subgingival biofilm formation (NCT#02656251). Thirty-five participants were randomized and asked to rinse twice daily with 15 ml of an alcohol-containing 0.12% chlorhexidine solution, an alcohol-free 0.12% chlorhexidine solution, or placebo. The study was conducted in three experimental periods of 4 days each, with a 10-day washout between the periods. All the experimental periods followed the same protocol, except that the solutions were switched. Biofilm distribution was evaluated every 24 hours by the Plaque-Free Zone Index, during 96 hours. Adverse events were self-reported and sensory evaluation was performed using a hedonic scale. Compared to the placebo, the chlorhexidine solutions resulted in a significantly higher number of surfaces free of plaque over 96 hours (p < 0.01), and were able to prevent subgingival biofilm formation (p < 0.01). The alcohol-free chlorhexidine solution was associated with a lower incidence of adverse events, compared with alcohol-containing chlorhexidine (p < 0.05); it also received better sensory evaluation and acceptance by trial participants, compared with the alcohol-containing chlorhexidine (p = 0.007), and had a similar inhibitory effect on the formation of supra- and subgingival biofilms.

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Adolescent
  • Adult
  • Anti-Infective Agents, Local / chemistry
  • Anti-Infective Agents, Local / pharmacology
  • Biofilms / drug effects*
  • Chlorhexidine / chemistry*
  • Chlorhexidine / pharmacology*
  • Cross-Over Studies
  • Dental Plaque / prevention & control
  • Dental Plaque Index
  • Double-Blind Method
  • Drug Combinations
  • Ethanol / chemistry*
  • Ethanol / pharmacology*
  • Female
  • Gingiva / drug effects
  • Gingiva / microbiology
  • Humans
  • Male
  • Mouthwashes / chemistry*
  • Mouthwashes / pharmacology*
  • Taste
  • Time Factors
  • Treatment Outcome
  • Young Adult

Substances

  • Anti-Infective Agents, Local
  • Drug Combinations
  • Mouthwashes
  • Ethanol
  • Chlorhexidine