At some point during our dentistry careers, we have all heard about Chlorhexidine. We were instructed to use it in office after being taught about it at school. It used to be the only option, but as dentistry changes, it's critical that we talk about the misconceptions and realities surrounding the rinse that experts in the field of dentistry so frequently advocate for and employ.
Here are five myths and the reasons why you should start looking for a substitute.
Myth: Long-term CHX use is possible.
Truth: It should only be used for two weeks at most. A two week time frame doesn't work because tissue needs at least 30 days to recover. For the duration of the healing process, patients will need to continually try to minimize the bacteria and volatile sulfur compounds that inhibit wound healing after a procedure. If used for more than two weeks, the patient's teeth will eventually become visibly stained and will develop further calculus, which can only be removed by a professional cleaning. The aftertaste is greatly disliked by many patients. Patients will have to wait for numerous hours for Chx to take effect, which creates a major barrier and is the reason for low compliance. Using Chx as a long-term alternative should be undesirable because of these adverse effects, the possibility of allergic responses, the inhibition of fibroblasts, and its subpar antibacterial properties.
Myth: The only issue with CHX is that it causes dental discoloration.
Truth: Patients and dental hygienists both complain about staining most frequently, and they both agree that it makes their jobs more challenging. However, it is not the only negative impact. One significant concern involves uncommon but unavoidable allergic reactions, which might present as minor mouth burning or extreme life-threatening symptoms. Chx inhibits fibroblasts, has subpar antibacterial properties, and recent research has discovered problems with Antimicrobial Resistance (AMR), where the rinse itself degrades and develops cross-resistance to other types of bacteria. Every time a patient uses Chx, staff and the patient should keep these more serious hazards in mind.
Myth: Using Chx as a pre-rinse is adequate.
Truth: Chx has weak antiviral properties. In reality, there is conflicting information regarding Chx's capacity to lessen oral microbial load. Studies on Chx's antiviral properties reveal that what it does kill occurs over a long period of time, preventing it from killing viruses quickly enough to be an effective pre-rinse. Can it be helpful if we use it to lower the microbial load before treating a patient but it takes many hours to do so? Isn't that the point behind the pre-rinse?
Myth: You can use chx for perio, implants, and post-operative care.
Truth: Chx should only be used to treat gingivitis. Chx is a powerful weapon against germs, according to research, but it also causes a high rate of cell death in human gingival fibroblasts and kills without discrimination. Chx has a strong potential for cytotoxicity, and since it needs fibroblasts for tissue repair, it slows down the healing process. To aid in healing during the crucial healing phase following an SRP or treatment, healthy cells and fibroblasts are required. Simply put, a salt rinse works better than a Chx rinse after surgery.
Myth: Chlorhexidine is the only rinse that effectively destroys bacteria.
Truth: Chx is not the only professional choice. Even with all of its drawbacks, we already know the truth about Chx: it is efficient against bacteria. But does it make sense to continue using it after taking all of the dangers and adverse effects into account? There is one rinse that is the only other choice. OraCare. When OraCare's active component, chlorine dioxide, is activated, it has the same effectiveness in killing bacteria as Chx while doing so with fewer parts per million. It has been determined to be the best replacement for Chx due to its capacity to eradicate viruses, fungus, and volatile sulfur compounds while posing no adverse side effects and improving home care.
Kristin Goodfellow RDH
Kristin is Chief Clinical Officer of OraCare, a practicing Registered Dental Hygienist