Can mouth washes containing chlorhexidine 0.12% be used as synonym of a water solution of chlorhexidine 0.12%?

Abstract

Chlorhexidine digluconate (CHX) is a gold standard drug in dentistry and is widely used as a reference in both in vitro and in vivo experiments. Due to ease of access, mouth washes containing CHX 0.12% are used as a substitute for aqueous CHX 0.12% solution in laboratory experiments. Additionally, it is well known that for product flavor purposes, volatile compounds are added to mouth washes formulations. Volatiles added to CHX 0.12% may improve wash’s antibacterial ability. Volatiles add potency to the mouth wash formulation. Compared with an aqueous CHX 0.12% solution, it is proposed that CHX solutions and Periogard® would have antimicrobial activity. Antimicrobial activity was assessed in the present study via disk diffusion assays against Streptococcus mutans, Streptococcus sanguinis and Escherichia coli. Periogard® showed a significantly higher antibacterial activity in relation to CHX 0.12% (p<0.05) and a similar activity in relation to CHX 1% (p>0.05). Periogard® volatiles were analyzed by gas-chromatography/mass spectrometry (GCMS) and the presence of antibacterial menthol, menthone, isomenthol, menthyl acetate, trans-anethol and eugenol was verified. Finally, the use of Periogard® as a synonym of CHX 0.12% must be avoided, because its antibacterial activity is closely related to CHX 1%.