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CHEMICAL PLAQUE
   CONTROL


    INDIAN DENTAL ACADEMY
 Leader in Continuing Dental Education

   www.indiandentalacademy.com
 Periodontal disease = microbial and
  plaque induced inflammation.
 Therapeutic intervention and maintenance

  therapy is based on plaque removal.
 100% plaque removal is a myth.




         www.indiandentalacademy.com
What is plaque control?
   It is the regular removal of plaque and the
    prevention of its accumulation on the teeth
    and adjacent gingival surfaces.




           www.indiandentalacademy.com
Is plaque the major etiologic agent
      in periodontal disease?




       www.indiandentalacademy.com
Loe et al (1965)
   Experimental gingivitis study……




           www.indiandentalacademy.com
Effect of good supragingival
plaque control on subgingival
    plaque and on disease
          progression




     www.indiandentalacademy.com
   Toothbrushing alone is insufficient




           www.indiandentalacademy.com
   Use of adjuncts to oral hygiene
    maintenance is essential




           www.indiandentalacademy.com
Indications for chemical plaque
                 control
 As an adjunct to mechanical plaque
  control
 Post periodontal surgery

 Medically compromised patients eg.

  Leukemia, type I DM..
 During orthodontic therapy.

 Intermaxillary fixation

 Supra & subgingival irrigation

         www.indiandentalacademy.com
Classification
 1st Generation
 2nd generation

 3rd generation




         www.indiandentalacademy.com
Chlorhexidine
 Bisbiguanide of dicationic nature.
 Excellent substantivity

 Saliva– up to 5 hrs

 Mucosal surfaces--- up to 12 hrs

 Pincushion effect.




         www.indiandentalacademy.com
Concentrations used

 0.12%-- 15ml.
 0.2%-- 10ml.




         www.indiandentalacademy.com
   Bacteriostatic in lower concentrations,
    bactericidal in higher .




            www.indiandentalacademy.com
Side effects of CHX use
 Tooth staining.
 Increased calculus formation.

 Oral mucosal lesions.

 Parotid gland enlargements in some

  cases.




         www.indiandentalacademy.com
Essential oil rinses
   LISTERINE: Thymol,
               Eucalyptol,
               Methyl salicylate,
               Menthol.




           www.indiandentalacademy.com
 More of an antigingivitis than antiplaque
  agent.
 Available OTC….




          www.indiandentalacademy.com
Other agents…
 Triclosan….
 Cetylpyridinium chloride…..

 Delmopinol….

 Sanguinarine….

 Flourides….




         www.indiandentalacademy.com
What next….
 Is CHX still the gold standard?
 Can any of the agents match CHX in their

  substantivity and antiplaque efficacy?




         www.indiandentalacademy.com
   Can chemical agents ever replace
    toothbrushing?




           www.indiandentalacademy.com

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Chemical plaque control / /certified fixed orthodontic courses by Indian dental academy

  • 1. CHEMICAL PLAQUE CONTROL INDIAN DENTAL ACADEMY Leader in Continuing Dental Education www.indiandentalacademy.com
  • 2.  Periodontal disease = microbial and plaque induced inflammation.  Therapeutic intervention and maintenance therapy is based on plaque removal.  100% plaque removal is a myth. www.indiandentalacademy.com
  • 3. What is plaque control?  It is the regular removal of plaque and the prevention of its accumulation on the teeth and adjacent gingival surfaces. www.indiandentalacademy.com
  • 4. Is plaque the major etiologic agent in periodontal disease? www.indiandentalacademy.com
  • 5. Loe et al (1965)  Experimental gingivitis study…… www.indiandentalacademy.com
  • 6. Effect of good supragingival plaque control on subgingival plaque and on disease progression www.indiandentalacademy.com
  • 7. Toothbrushing alone is insufficient www.indiandentalacademy.com
  • 8. Use of adjuncts to oral hygiene maintenance is essential www.indiandentalacademy.com
  • 9. Indications for chemical plaque control  As an adjunct to mechanical plaque control  Post periodontal surgery  Medically compromised patients eg. Leukemia, type I DM..  During orthodontic therapy.  Intermaxillary fixation  Supra & subgingival irrigation www.indiandentalacademy.com
  • 10. Classification  1st Generation  2nd generation  3rd generation www.indiandentalacademy.com
  • 11. Chlorhexidine  Bisbiguanide of dicationic nature.  Excellent substantivity  Saliva– up to 5 hrs  Mucosal surfaces--- up to 12 hrs  Pincushion effect. www.indiandentalacademy.com
  • 12. Concentrations used  0.12%-- 15ml.  0.2%-- 10ml. www.indiandentalacademy.com
  • 13. Bacteriostatic in lower concentrations, bactericidal in higher . www.indiandentalacademy.com
  • 14. Side effects of CHX use  Tooth staining.  Increased calculus formation.  Oral mucosal lesions.  Parotid gland enlargements in some cases. www.indiandentalacademy.com
  • 15. Essential oil rinses  LISTERINE: Thymol, Eucalyptol, Methyl salicylate, Menthol. www.indiandentalacademy.com
  • 16.  More of an antigingivitis than antiplaque agent.  Available OTC…. www.indiandentalacademy.com
  • 17. Other agents…  Triclosan….  Cetylpyridinium chloride…..  Delmopinol….  Sanguinarine….  Flourides…. www.indiandentalacademy.com
  • 18. What next….  Is CHX still the gold standard?  Can any of the agents match CHX in their substantivity and antiplaque efficacy? www.indiandentalacademy.com
  • 19. Can chemical agents ever replace toothbrushing? www.indiandentalacademy.com