Pre-procedural Mouthwash in Reducing Bacteria in Dental Aerosols

Summary

The aim of this randomized, single blinded clinical trial was to evaluate the effect of a pre-procedural mouthwash containing cetylpyridinium chloride (CPC), zinc lactate (Zn) and sodium fluoride (F) in the reduction of viable bacteria in oral aerosol/splatter after a dental prophylaxis with ultrasonic scaler.

Timeline

Start

2015-02

Primary completion

2015-03

Completion

2015-04

Publications

• Background Bentley CD, Burkhart NW, Crawford JJ. Evaluating spatter and aerosol contamination during dental procedures. J Am Dent Assoc. 1994 May;125(5):579-84. doi: 10.14219/jada.archive.1994.0093.
• Background Cochran MA, Miller CH, Sheldrake MA. The efficacy of the rubber dam as a barrier to the spread of microorganisms during dental treatment. J Am Dent Assoc. 1989 Jul;119(1):141-4. doi: 10.14219/jada.archive.1989.0131.
• Background Erovic Ademovski S, Lingstrom P, Renvert S. The effect of different mouth rinse products on intra-oral halitosis. Int J Dent Hyg. 2016 May;14(2):117-23. doi: 10.1111/idh.12148. Epub 2015 May 31.
• Background Grenier D. Quantitative analysis of bacterial aerosols in two different dental clinic environments. Appl Environ Microbiol. 1995 Aug;61(8):3165-8. doi: 10.1128/aem.61.8.3165-3168.1995.
• Background Gupta G, Mitra D, Ashok KP, Gupta A, Soni S, Ahmed S, Arya A. Efficacy of preprocedural mouth rinsing in reducing aerosol contamination produced by ultrasonic scaler: a pilot study. J Periodontol. 2014 Apr;85(4):562-8. doi: 10.1902/jop.2013.120616. Epub 2013 Jul 15.
• Background Harrel SK, Molinari J. Aerosols and splatter in dentistry: a brief review of the literature and infection control implications. J Am Dent Assoc. 2004 Apr;135(4):429-37. doi: 10.14219/jada.archive.2004.0207.
• Background Jones CG. Chlorhexidine: is it still the gold standard? Periodontol 2000. 1997 Oct;15:55-62. doi: 10.1111/j.1600-0757.1997.tb00105.x.
• Background Kanjirath PP, Coplen AE, Chapman JC, Peters MC, Inglehart MR. Effectiveness of gloves and infection control in dentistry: student and provider perspectives. J Dent Educ. 2009 May;73(5):571-80.
• Background Keni NN, Aras MA, Chitre V. Chlorhexidine allergy due to topical application. Indian J Dent Res. 2012 Sep-Oct;23(5):674-6. doi: 10.4103/0970-9290.107393.
• Background Kjaerheim V, Skaare A, Barkvoll P, Rolla G. Antiplaque, antibacterial, and anti-inflammatory properties of triclosan mouthrinses in combination with zinc citrate or polyvinylmethylether maleic acid (PVM-MA) copolymer. Eur J Oral Sci. 1996 Oct-Dec;104(5-6):529-34. doi: 10.1111/j.1600-0722.1996.tb00137.x.
• Background Lang C, Murgia C, Leong M, Tan LW, Perozzi G, Knight D, Ruffin R, Zalewski P. Anti-inflammatory effects of zinc and alterations in zinc transporter mRNA in mouse models of allergic inflammation. Am J Physiol Lung Cell Mol Physiol. 2007 Feb;292(2):L577-84. doi: 10.1152/ajplung.00280.2006. Epub 2006 Nov 3.
• Background Leggat PA, Kedjarune U. Bacterial aerosols in the dental clinic: a review. Int Dent J. 2001 Feb;51(1):39-44. doi: 10.1002/j.1875-595x.2001.tb00816.x.
• Background Legnani P, Checchi L, Pelliccioni GA, D'Achille C. Atmospheric contamination during dental procedures. Quintessence Int. 1994 Jun;25(6):435-9.
• Background Mendes L, Coimbra J, Pereira AL, Resende M, Pinto MG. Comparative effect of a new mouthrinse containing chlorhexidine, triclosan and zinc on volatile sulphur compounds: a randomized, crossover, double-blind study. Int J Dent Hyg. 2016 Aug;14(3):202-8. doi: 10.1111/idh.12132. Epub 2015 Feb 26.
• Background Nejatidanesh F, Khosravi Z, Goroohi H, Badrian H, Savabi O. Risk of Contamination of Different Areas of Dentist's Face During Dental Practices. Int J Prev Med. 2013 May;4(5):611-5.
• Background Pandit S, Cai JN, Jung JE, Lee YS, Jeon JG. Effect of brief cetylpyridinium chloride treatments during early and mature cariogenic biofilm formation. Oral Dis. 2015 Jul;21(5):565-71. doi: 10.1111/odi.12312. Epub 2015 Feb 13.
• Background Rivera-Hidalgo F, Barnes JB, Harrel SK. Aerosol and splatter production by focused spray and standard ultrasonic inserts. J Periodontol. 1999 May;70(5):473-7. doi: 10.1902/jop.1999.70.5.473.
• Background Slots J. Low-cost periodontal therapy. Periodontol 2000. 2012 Oct;60(1):110-37. doi: 10.1111/j.1600-0757.2011.00429.x.
• Background Socransky SS, Haffajee AD, Cugini MA, Smith C, Kent RL Jr. Microbial complexes in subgingival plaque. J Clin Periodontol. 1998 Feb;25(2):134-44. doi: 10.1111/j.1600-051x.1998.tb02419.x.
• Background Souza-Gugelmin MC, Lima CD, Lima SN, Mian H, Ito IY. Microbial contamination in dental unit waterlines. Braz Dent J. 2003;14(1):55-7. doi: 10.1590/s0103-64402003000100010. Epub 2003 Jul 31.
• Background Thomas E. Efficacy of two commonly available mouth rinses used as preprocedural rinses in children. J Indian Soc Pedod Prev Dent. 2011 Apr-Jun;29(2):113-6. doi: 10.4103/0970-4388.84682.
• Background Timmerman MF, Menso L, Steinfort J, van Winkelhoff AJ, van der Weijden GA. Atmospheric contamination during ultrasonic scaling. J Clin Periodontol. 2004 Jun;31(6):458-62. doi: 10.1111/j.1600-051X.2004.00511.x.
• Background Toroglu MS, Haytac MC, Koksal F. Evaluation of aerosol contamination during debonding procedures. Angle Orthod. 2001 Aug;71(4):299-306. doi: 10.1043/0003-3219(2001)0712.0.CO;2.
• Background Varoni E, Tarce M, Lodi G, Carrassi A. Chlorhexidine (CHX) in dentistry: state of the art. Minerva Stomatol. 2012 Sep;61(9):399-419. English, Italian.
• Background Veena HR, Mahantesha S, Joseph PA, Patil SR, Patil SH. Dissemination of aerosol and splatter during ultrasonic scaling: a pilot study. J Infect Public Health. 2015 May-Jun;8(3):260-5. doi: 10.1016/j.jiph.2014.11.004. Epub 2015 Jan 3.
• Background Yengopal V. The use of essential oil mouthwashes as preprocedural rinses for infection control. SADJ. 2004 Jul;59(6):247-8, 250. No abstract available.
• Results Costa X, Laguna E, Herrera D, Serrano J, Alonso B, Sanz M. Efficacy of a new mouth rinse formulation based on 0.07% cetylpyridinium chloride in the control of plaque and gingivitis: a 6-month randomized clinical trial. J Clin Periodontol. 2013 Nov;40(11):1007-15. doi: 10.1111/jcpe.12158. Epub 2013 Sep 11.
• Results Feres M, Figueiredo LC, Faveri M, Stewart B, de Vizio W. The effectiveness of a preprocedural mouthrinse containing cetylpyridinium chloride in reducing bacteria in the dental office. J Am Dent Assoc. 2010 Apr;141(4):415-22. doi: 10.14219/jada.archive.2010.0193.
• Results Giertsen E. Effects of mouthrinses with triclosan, zinc ions, copolymer, and sodium lauryl sulphate combined with fluoride on acid formation by dental plaque in vivo. Caries Res. 2004 Sep-Oct;38(5):430-5. doi: 10.1159/000079623.
• Results Kang JH, Jang YJ, Kim DJ, Park JW. Antimicrobial effectiveness of cetylpyridinium chloride and zinc chloride-containing mouthrinses on bacteria of halitosis and peri-implant disease. Int J Oral Maxillofac Implants. 2015 Nov-Dec;30(6):1341-7. doi: 10.11607/jomi.3824. Epub 2015 Oct 16.
• Results Kaur R, Singh I, Vandana KL, Desai R. Effect of chlorhexidine, povidone iodine, and ozone on microorganisms in dental aerosols: randomized double-blind clinical trial. Indian J Dent Res. 2014 Mar-Apr;25(2):160-5. doi: 10.4103/0970-9290.135910.
• Results Logothetis DD, Martinez-Welles JM. Reducing bacterial aerosol contamination with a chlorhexidine gluconate pre-rinse. J Am Dent Assoc. 1995 Dec;126(12):1634-9. doi: 10.14219/jada.archive.1995.0111.
• Results Reddy S, Prasad MG, Kaul S, Satish K, Kakarala S, Bhowmik N. Efficacy of 0.2% tempered chlorhexidine as a pre-procedural mouth rinse: A clinical study. J Indian Soc Periodontol. 2012 Apr;16(2):213-7. doi: 10.4103/0972-124X.99264.
• Results Shetty SK, Sharath K, Shenoy S, Sreekumar C, Shetty RN, Biju T. Compare the effcacy of two commercially available mouthrinses in reducing viable bacterial count in dental aerosol produced during ultrasonic scaling when used as a preprocedural rinse. J Contemp Dent Pract. 2013 Sep 1;14(5):848-51. doi: 10.5005/jp-journals-10024-1414.

Drugs

Indications