The effect of chlorhexidine mouthwash on bacterial microcolonies in recurrent tonsillitis

Abstract

Background: Chlorhexidine mouthwash is used to promote oral health and treat periodontal disease. This study aimed to determine the effects of 0.2% chlorhexidine mouthwash on the bacterial microcolonies in the crypts of palatine tonsils in children with recurrent tonsillitis (RT). Methods: The palatine tonsils were removed by extracapsular dissection from 21 participants with RT, age range two to ten years. The participants tonsils were assigned alternately to the treatment group (0.2% chlorhexidine mouthwash) or control group (0.9% sodium chloride). The left tonsils of eleven participants were submerged in 0.2% chlorhexidine mouthwash and gently oscillated for 30 seconds in a sterile pot. The left tonsils of the ten participants in the control group were subjected to the same process, but in 0.9% sodium chloride. Following exposure, the left tonsil (exposed) and right tonsil (unexposed) from each participant were fixed and evaluated for bacteria by Gram-staining and presence of connective tissue by safranin staining. Results: There were significantly fewer bacterial microcolonies observed in the tonsils that were exposed to chlorhexidine mouthwash when compared to the 0.9% sodium chloride group (P<0.05). There were also fewer bacterial microcolonies present in tonsils exposed to chlorhexidine mouthwash when compared to unexposed tonsils (P<0.05). There was no difference in the number of microcolonies in the unexposed tonsils from participants in the chlorhexidine group when compared with the saline group (P=0.68). Conclusions: Chlorhexidine mouthwash appears to be effective in significantly reducing the number of bacterial microcolonies that exist in the crypts of these participants with RT.