Chlorhexidine

introduction

Self-medication is increasingly being promoted by the provisions of the Health Structure Act. Of course, this means that the number of over-the-counter drugs in pharmacies has been greatly increased.

The illnesses identified in the law as so-called minor illnesses are excluded from the medical prescriptions. This also includes sores in the mouth and throat. Chlorhexidine is also part of the therapy for such diseases.

Synonyms in a broader sense

Chlorhexidine digluconate, Paroex

Chlorhexidine and chlorhexidine digluconate

Chlorhexidine is an antiseptic that was developed back in the 40s of the last century. It belongs to the group of Polyguanides. However, it is not readily soluble in water and is therefore not suitable as a rinsing solution. Hence it was through Chlorhexidine digluconate replaced, which is very soluble in water and identical in terms of effectiveness. Today only chlorhexidine digluconate is used. This includes, for example, the means Chlorhexamed® forte.

Initially, it was used in veterinary and human medicine for skin infections (see also: skin) and wounds. Chlorhexidine digluconate is available as ready-to-use solutions in concentrations of 0.1%, 0.15% and 0.2%. Also available as a 1% gel. Its effectiveness has been proven in over 3,000 scientific publications. Heard with it Chlorhexidine digluconate one of the most frequently examined drugs of all.

Indications

Chlorhexidine digluconate has the ability to tooth and sticking the oral mucosa for long periods of time. This not only has an immediate effect, but also a depot effect. That is why it was soon used to treat infections in the oral cavity and to block the plaque on the teeth. This results in an indication for chlorhexidine digluconate, inflammation of the oral mucosa caused by bacteria (Stomatitis) and the gums (Gingivitis). Before and after surgery in the oral cavity Chlorhexidine digluconate used as a rinse solution to avoid bacterial complications.

Another application is the rinsing of root canals Root canal treatment by the dentist.

The gel is used to treat gingival pockets. Long-term use to reduce the bacteria in the Plaque However, it is not advisable, since, of course, in addition to the pathogens, the beneficial bacteria are also affected, and this leads to a disruption of the oral flora. There is a risk that the germs of the antiseptic cannot be recorded.

In special cases, such as in patients who are severely restricted in oral hygiene because of a broken jaw, it makes sense to use chlorhexidine digluconate for a short time. It is applied by rinsing with the undiluted solution. To protect the dentist from bacteria in the AerosolFor example, when removing tartar, prophylactic rinsing with chlorhexidine digluconate has proven its worth.

Accidental ingestion of the solution is not harmful, as chlorhexidine digluconate is not absorbed and is excreted 100% unchanged. When using oral irrigators, the addition of chlorhexidine digluconate increases the cleansing effect. In the case of prosthesis wearers, storage of the prosthesis overnight in one Chlorhexidine digluconate solution proven. This removes the germs that lead to inflammation of the mucous membrane caused by prostheses (Prosthetic stomatitis) inactivated.

Chlorhexidine against tooth decay

Since tooth decay is caused by bacteria and chlorhexidine has a bactericidal effect, it can be said very clearly that chlorhexidine greatly reduces the risk of tooth decay. However, the side effects of long-term use are more problematic. CHX does not differentiate between good and bad bacteria. The good bacteria that are necessary for the body to function properly are also destroyed. One application brings the entire oral flora out of balance. It should therefore only be limited to exceptional cases. General caries prophylaxis by CHX is to be rejected!

Chlorhexidine for disinfecting wounds

Chlorhexidine is used in prescribed wound sprays to disinfect wounds. After cleaning the wound, these preparations can be sprayed directly onto the affected area without touching them. An application without burning is often advertised. In the event of symptoms, the application can be repeated several times a day, especially as part of periodontal therapy with gum pockets.

Bepanthen plus wound spray contains not only the healing agent dexpanthenol but also chlorhexidine. When treating fresh wounds for the first time, this ensures a reduction in the number of germs by fighting bacteria and fungi, thereby preventing infections.

effect

The effect of chorhexidine digluconate is based on its ability to attach to the cell wall of the bacteria, destroy them and thereby prevent the bacteria from spreading. In higher doses of the Antiseptic it penetrates the cell and destroys it.

In addition to the effect on bacteria, it has also been shown to be effective against certain viruses. These are above all the so-called Herpes viruses.
A big advantage of Chlorhexidine digluconate is that to date no resistance among the pathogens to the effects of chlorhexidine has been demonstrated. Successful therapy can be proven after a few days.

Side effects

As with other effective drugs, there are side effects even with longer duration of therapy with chlorhexidine digluconate. So it can too Taste irritations come. Also there is brown discoloration of teeth, plastic fillings and the tongue. The appearance of discoloration can vary greatly from individual to individual.

The reason for this is still unclear. A possible explanation would be a different composition of the saliva. In rare cases, wound healing may be delayed. All side effects are however reversible, that is, they disappear again after stopping the drug or can be removed by the dentist.

Forms of application of chlorhexidine

Chlorhexidine (also Chlorhexidine digluconate, CHX or Chlorhexamed is an antiseptic that has a wide range of uses in dentistry.

There are several dosage forms: such as gel, spray, ointment, varnish and chips. What they all have in common is that the active ingredient adheres to the teeth and mucous membrane for a long time and destroys the bacterial cell membrane.

1. Chlorhexidine gel

is used according to dental instructions for antibacterial therapy of gum inflammation and periodontitis (inflammation of the tooth supporting apparatus; popularly often incorrectly referred to as periodontosis). The dentist can apply it into the spaces between the teeth with a brush or with a disposable syringe and a blunt cannula.

It is also used as a final polish before fluoridation. The 1% gel is recommended to patients for home use as a support for periodontal therapy. The gel is used e.g. even during orthodontic treatment when oral hygiene is restricted.

Before use, brush your teeth as usual with a toothpaste, making sure that the oral cavity is then thoroughly rinsed with water. Then you apply the gel with a cotton swab to the areas in need of treatment and let it act for at least 1 minute. The gel can also be used like toothpaste. Treatment should not last longer than a month.

2. Chlorhexidine spray 1.5%

As a spray, chlorhexidine is often recommended as a disinfectant for denture wearers. It prevents bacterial plaque (the so-called dental film) from sticking to the prosthesis and the adjacent mucous membrane. Toothbrushes, tongue brushes or splints can also be disinfected using sprays.

Chlrohexidine is also contained in throat sprays such as. Collu tarpaulin. Chlorhexidine digluconate is also very helpful for a sore throat.

3. Chlorhexidine ointment, cream

Chlorhexidine digluconate is used in the care of infected wounds, friction-induced inflammation and navel care. The widespread ointment Bepanthen® Antiseptic Wound Cream contains dexpanthenol as well as chlorhexidine.

4. Mouthwash: 0.1% or 0.2%

The most well-known form of chlorhexidine is the fluid form. There are studies that prove that the use of a chlorhexidine-containing mouth rinse solution in the case of oral hygiene that is difficult to perform (e.g. postoperative, handicap) significantly reduces the formation of the bacterial tooth film.

The liquid form is used preoperatively to prevent bacteremia (Presence of bacteria in blood) use. It is also used in case of dry mouth (Xerostomia) and unpleasant halitosis are used. Furthermore, the liquid form of chlorhexidine digluconate is used in endodontics, often the root canals are rinsed with this solution in order to combat bacteria.

Often the cavities that arise after the removal of caries (colloquially referred to as "holes in the tooth") are cleaned with this solution before the filling is placed. Some patients are recommended to use a mouthwash as part of their daily care routine (e.g. if they have problems with their gums) - it must be noted, however, that after about two weeks the risk of discoloration on the tooth, tongue and mucous membrane is quite high.

Mouthwash

Chlorhexidine is used in many common mouthwash solutions (0.1% or 0.2%). Every day after brushing your teeth, a mouthwash solution is also appropriate. Such mouthwashes are particularly popular post-operatively, e.g. after a tooth is extracted to prevent possible infection of the wound.

The use of chlorhexidine is also advisable for treating periodontal disease. Even if oral hygiene is difficult for different reasons, rinsing with chlorhexidine is recommended.
This can apply to people with a physical or mental handicap, or to a hospital stay where adequate hygiene is not possible. Due to its positive charge, it adheres well to the oral mucosa, the tooth and the bacteria, where it is then slowly released. As a result, it offers long-lasting protection and fights the bacteria, which cannot cause inflammation as a result.

Mouthwashes that contain chlorhexidine are medicinal products and therefore only available in pharmacies. The mouthwashes should only be used for a limited period of time, as prolonged use can lead to discoloration of the teeth, tongue and oral mucosa. This brown discoloration can be removed by a prophylactic assistant after discontinuing the product.

A toothpaste with abrasive components can also provide the first remedy. Furthermore, the sense of taste can be impaired, which will subside again after you stop taking it. In any case, the duration of the use of the preparation must be discussed with a dentist.

Also read the article on the topic: Parodontax® mouthwash

gel

Chlorhexidine is also part of it 1% in dental applied Gels.
Such a gel is used for bacterial conditional Inflammation of the gums, at a Periodontal disease, at a high risk of tooth decay and in people with limited oral hygiene.

After a completed surgery is often the Oral hygiene difficult, so such a gel Can help. Some people like that too do the washing up with a Mouthwash not making a gel one alternative represents. These gels are a drug and can only in Pharmacies be concerned.

The duration of application should be limited as it is too Taste sensation disorders and brownish discoloration in the mouth. The type of application can be different. Either you wear it after Brush teeth with a cotton swab on the affected areas and let it act. Also use like a whole normal toothpaste is possible.
There is also the option to convert it into a individually made dental splint to give and on the teeth to put. It won't come with that saliva thinned, so intensive treatment of teeth and Gums is possible.

powder

Chlorhexidine can also be part of a Powder its field of application is similar to that of Gels is. As mentioned above, it also has a supportive effect in this form treatment from Inflammation of the Oral mucosa because of a bacterial infection.

It is also used postoperatively and at difficult oral hygiene. But it also comes as a Powder form or as cream in the Umbilical care of newborns for use.
Furthermore you can infected wounds provide with it. Inflammation at the female breast or which ones in the Pubic area, caused by friction, are also provided with an ointment containing chlorhexidine, a cream or a powder.
But also skin areas at risk of infection as the Armpit and skin folds caused by obesity can be cared for with it. Apply the powder to the affected skin areas several times a day. As Side effects when applied to the skin it can possibly burn or one allergy to be triggered. Overall, chlorhexidine does not go well with soaps.

Soap are also one of the Components from toothpaste. Therefore you should brush your teeth before using chlorhexidine and then rinse your mouth well with water. All soap residues should also be removed from the skin before showering. If you apply chlorhexidine in powder form to heavily exuding skin areas, this can cause the Wound healing because of a Crust formation delay.

Chlorhexamed® forte

Chlorhexamed® forte is an alcohol-free mouth rinse solution with 0.2% chlorhexidine. Other ingredients are peppermint flavor, purified water and sorbitol solution, a sugar alcohol. The mouthwash temporarily reduces the number of bacteria and can thus have a positive effect on healing in the case of bacteria-related diseases of the oral cavity.

Also the Plaque build-up is reduced for the time of application. To do this, rinse twice a day (morning & evening) with about 10ml solution for half a minute. Finally, the medicine is spit out, not swallowed. In order not to reduce the effect, do not rinse with water afterwards. The duration of treatment prescribed by the dentist should not be exceeded. Other areas of application are the limited ability to maintain oral hygiene, such as after an operation or fracture in the jaw area. The dentist also often prescribes Chlorhexamed® forte after one Periodontal Treatmentto improve wound healing. Periodontosis or periodontitis describes a general inflammation of the entire periodontium.

A Chlorhexamed® forte spray is also produced, which also contains 0.2% active ingredient. You spray it directly on the affected areas and spit out again after the exposure time. Like the mouth rinse, the spray should be used a maximum of twice a day.

Chlorhexidine in pregnancy

During one pregnancy is the use of Chlorhexidine to consider and with the treating doctor should agree Skin areas be treated with it.

But it will orallye.g. in form of a Mouthwash used, there is no danger and can be used. Also the longer use in the mouth area is not contraindicated. In the case of mouthwashes, however, make sure that they are used in addition to chlorhexidine no other ingredients, such as. Alcohol, because it is included in the pregnancy and Lactation is to be waived.

Toothpaste with chlorhexidine

Toothpastes with chlorhexidine are available from different manufacturers with different active ingredient concentrations.They are intended to increase the cleaning effect in daily oral hygiene and to ensure that bacteria remain free of bacteria. However, they are not indicated for long-term use because, like mouth rinsing, they also cause side effects. The duration of use should therefore be strictly observed. They are often recommended by dentists together with a chlorhexidine-containing mouthwash after a periodontal treatment or other inflammations in the mouth.

The bacteria-inhibiting effect can be increased by double use. Manufacturers such as Curaprox or Sunstar (Gum) offer corresponding products here. The dose of these preparations varies from toothpaste to toothpaste. Furthermore, when using both preparations, it should be noted that the toothpaste does not contain the additive sodium lauryl sulfate. This is a foaming agent which dissolves the effect of the CHX. Before buying, you should ask the dentist or pharmacist you are treating for advice in order to find the right product.

Shampoo with chlorhexidine

Shampoo with chlorhexidine is made by some companies. However, it is not for personal use on humans intended, but for Cleaning the pet. This product is particularly recommended if a strong cleaning effect is to be produced in dogs and cats. This is for example with a bacterial skin disease or at one Fungal attack necessary.

The foam removes dead cells and other dirt. This allows bacteria or yeasts to multiply more slowly and there is less unpleasant smell. For use, the animal must first be showered and then lathered well. After an exposure time, which differs slightly depending on the preparation, the pet is washed off and dried again. Many of these shampoos are intended to be used for around four weeks, especially in acute illness. However, there are also preparations that are designed for a longer period of use.

Since side effects occur here too with frequent use, it is recommended that the shampoo only be used in accordance with medical instructions or the instructions in the package insert. In order to avoid incorrect use, the request should be explained at the time of purchase so that the right shampoo can be found.

Is there any chlorhexidine without alcohol?

Chlorhexidine is a chemical compound made of chlorine and acetic acid, which naturally does not contain alcohol. Often, however, an alcohol-containing solution and other active ingredients are added to this active ingredient in order to obtain an even broader spectrum of activity. In this way, a sustainable and comprehensive killing of germs can be guaranteed. However, many manufacturers are also working on producing products without alcohol, since such comprehensive bacterial control is not necessary everywhere and many consumers especially want mouthwashes without alcohol.

Nasal ointment containing chlorhexidine

Nasal ointments such as "Panthenol Nasal ointment" can be purchased with and without chlorhexidine. They are used to support the nose in healing superficial mucosal injuries. Chronic wounds or abrasions are also treated this way. The additive chlorhexidine promotes wound healing by ensuring that it is permanently free from bacteria. Even slightly soiled, superficial wounds heal quickly without becoming infected. However, deep wounds are not treated with this ointment. If you are unsure, you should contact the pharmacist in advance.

Eye drops containing chlorhexidine

Eye drops containing chlorhexidine are placed in the eye as needed, similar to other eye drops. They moisturize and counteract lens and vitreous opacity. The chlorhexidine it contains can protect the eye from various bacteria and thus avoid inflammatory reactions. Problems often arise when using soft contact lenses at the same time. The active ingredient is then stored in the lens and changes it in such a way that the cornea is damaged. Therefore, this type of contact lens should not be used during the period of use!

Chlorhexidine as a disinfectant

Chlorhexidine is used as a bacteriostatic, i.e. bacteria-inhibiting active ingredient in many disinfectants. These are mainly used for the skin and the lining of the mouth and throat. For oral disinfection, the dentist often prescribes it in the event of inflammation, operations or after periodontal therapy.

According to current studies, home disinfection with chlorhexidine before operations has a very positive effect on the risk of infection. Compared to other disinfectants, it was possible in some cases to show an operation risk that is around 40% lower.

CHX is rarely used in surface disinfection. The reason for this is the slow onset of action, the build-up of resistance, and the fact that it has a reduced effect on bacterial spores and non-enveloped viruses compared to other surface disinfectants. CHX is rarely used in hand disinfection, and if so, then only in conjunction with other active ingredients. The reason for this is also the slow onset of action and the development of resistance. The development of resistance means that some germs have learned to assert themselves against the agent and have become immune to it

Read more on the topic: Betaisodona oral antiseptic

Summary

Chlorhexidine is as Chlorhexidine digluconate a very effective antiseptic in the mouth. It is used as an undiluted solution. The indications are mainly bacterial diseases of the oral mucosa and the reducing influence on the plaque. Chlorine oxide digluconate has a broad spectrum of activity on bacteria and viruses without the risk of developing resistance. Side effects can occur, but are harmless and reversible.