First insights into chlorhexidine retention in the oral cavity after application of different regimens

Clin Oral Investig. 2021 Nov;25(11):6109-6118. doi: 10.1007/s00784-021-03910-y. Epub 2021 Apr 6.

Abstract

Objectives: This in situ study aimed to determine and compare the chlorhexidine (CHX) retention in the oral cavity after the application of different CHX pharmaceutical regimens.

Methods: Five volunteers used different CHX treatment regimens including mouth rinses, dental spray and toothpaste gel. After the application of the different CHX regimens, 2-μl samples were taken from saliva and buccal mucosa pellicle as well as the dental pellicle samples formed on standardized enamel surfaces. Sample collection was conducted at six time points within 12 h. Retention of CHX was measured using matrix-assisted laser desorption/ionization time-of-flight (MALDI-TOF) mass spectrometry.

Results: CHX retention values in the oral mucosa pellicle were significantly higher than those in saliva. CHX remained in the mucosal pellicle at microgrammes per millilitre levels for 12 h after mouth rinsing, 10 h after spray application and 2 h after using the toothpaste. CHX was detected in the dental pellicle for at least 12 h after application of mouth rinsing and spray. Retention of CHX after mouth rinsing or spray application was significantly higher than the retention after using toothpaste.

Conclusions: Oral mucosa was the favourable site for CHX retention. Higher mouth rinse concentration and longer rinsing time produced a slight increase in CHX retention. CHX spray provided considerable retention values, whereas toothpaste gel delivered the lowest retention after application. MALDI-TOF was a sensitive method with excellent limits of quantification for CHX detection.

Keywords: Chlorhexidine; MALDI-TOF MS; Mouth rinse; Spray; Substantivity; Toothpaste.

MeSH terms

  • Anti-Infective Agents, Local*
  • Chlorhexidine*
  • Humans
  • Mouth
  • Mouthwashes
  • Saliva
  • Toothpastes

Substances

  • Anti-Infective Agents, Local
  • Mouthwashes
  • Toothpastes
  • Chlorhexidine