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==[[Anti-Plaque Agents|Antiplaque Agents]]==

==[[Anti-Plaque Agents|Antiplaque Agents]]==

Numerous chemical agents have been evaluated for the supplementation of mechanical plaque control. Clinically effective antiplaque agents are characterized by a combination of '''intrinsic antibacterial activity and good oral retention''' properties. Agents that have been evaluated include '''chlorhexidine, essential oils, triclosan, sanguinarine, fluorides, oxygenating agents, quaternary ammonium compounds, substituted amino-alcohols and enzymes'''. Of these, the greatest effect on the reduction of plaque and [[gingivitis]] can be expected from chlorhexidine. '''Chlorhexidine is the gold standard and the agent against which all antiplaque agents are tested.''' Antiplaque agents delivered from toothpastes, gels or mouth rinses can augment mechanical oral hygiene to control the formation of supragingival plaque and the development of early periodontal disease. It must be emphasized that none of these agents will prevent gingivitis on their own, i.e. in the absence of mechanical plaque removal. Moreover, all these agents are associated with '''adverse side effects'''. These effects vary according to the chemical agent, and include poor taste, a burning and/or numbing of oral mucous membranes, staining of teeth and soft tissues, and allergic reactions. The use of chemical antiplaque agents should be seen as adjunctive to the mechanical removal of plaque.<br><br>

Numerous chemical agents have been evaluated for the supplementation of mechanical plaque control. Clinically effective antiplaque agents are characterized by a combination of '''intrinsic antibacterial activity and good oral retention''' properties. Agents that have been evaluated include '''chlorhexidine, essential oils, triclosan, sanguinarine, fluorides, oxygenating agents, quaternary ammonium compounds, substituted amino-alcohols and enzymes'''. Of these, the agent with the greatest effect on the reduction of plaque and [[gingivitis]] is generally chlorhexidine. '''Chlorhexidine is the gold standard and the agent against which all antiplaque agents are tested.''' Antiplaque agents delivered from toothpastes, gels or mouth rinses can augment mechanical oral hygiene to control the formation of supragingival plaque and the development of early periodontal disease. It must be emphasized that none of these agents will prevent gingivitis on their own, i.e. in the absence of mechanical plaque removal. Moreover, all these agents are associated with '''adverse side effects'''. These effects vary according to the chemical agent, and include poor taste, a burning and/or numbing of oral mucous membranes, staining of teeth and soft tissues, and allergic reactions. The use of chemical antiplaque agents should be seen as adjunctive to the mechanical removal of plaque.<br><br>

'''Some examples of situations where adjunctive use of topical chlorhexidine is useful are:'''

'''Some examples of situations where adjunctive use of topical chlorhexidine is useful are:'''

*Immediately postoperatively when discomfort from treatment (deep subgingival debridement, multiple extractions) may prevent mechanical plaque removal with a toothbrush

*Immediately postoperatively when discomfort from treatment (deep subgingival debridement, multiple extractions) may prevent mechanical plaque removal with a toothbrush