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A Proteomic Analysis of Discolored Tooth Surfaces after the Use of 0.12% Chlorhexidine (CHX) Mouthwash and CHX Provided with an Anti-Discoloration System (ADS).

ABSTRACT: Chlorhexidine (CHX) is considered the gold standard for the chemical control of bacterial plaque and is often used after surgical treatment. However, CHX employment over an extended time is responsible for side effects such as the appearance of pigmentations on the teeth and tongue; the discoloration effects are less pronounced when using a CHX-based mouthwash with added an anti-discoloration system (ADS). The aim of this study was to evaluate, using one- and two-dimensional gel electrophoresis combined with mass spectrometry, the possible proteomic changes induced by CHX and CHX+ADS in the supragingival dental sites susceptible to a discoloration effect. The tooth surface collected material (TSCM) was obtained by curettage after resective bone surgery from three groups of patients following a supportive therapy protocol in which a mechanical control was combined with placebo rinses or CHX or a CHX+ADS mouthwash. The proteomic analysis was performed before surgery (basal conditions) and four weeks after surgery when CHX was used (or not) as chemical plaque control. Changes in the TSCM proteome were only revealed following CHX treatment: glycolytic enzymes, molecular chaperones and elongation factors were identified as more expressed. These changes were not detected after CHX+ADS treatment. An ADS could directly limit TSCM forming and also the CHX antiseptic effect reduces its ability to alter bacterial cell permeability. However, Maillard's reaction produces high molecular weight molecules that change the surface properties and could facilitate bacterial adhesion.

SUBMITTER: Bergamini S

PROVIDER: S-EPMC8347691 | biostudies-literature |

REPOSITORIES: biostudies-literature

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Project description:ObjectivesTo investigate whether chlorhexidine mouthwash (CHX-MW), with an anti-discoloration system(ADS), is effective in preventing extrinsic tooth surface discoloration. Additionally, this paper seeks to evaluate whether CHX combined with an ADS maintains its efficacy with respect to reducing plaque and gingivitis scores.Material and methodsMEDLINE-PubMed and Cochrane-Central were searched up to October 2018 to identify eligible studies. Papers evaluating the effect of CHX-MW+ADS compared to CHX without an ADS were included. A descriptive analysis and when feasible a meta-analysis was performed.ResultsScreening resulted in 13 eligible publications, presenting 16 comparisons. Six of these evaluated the MW in a non-brushing model and ten as an adjunct to toothbrushing. A descriptive analysis demonstrated that the majority showed no differences in bleeding, gingivitis and plaque scores. This was confirmed by the meta-analysis. In non-brushing experiments, the difference-of-means (DiffM) for plaque scores was 0.10 (P = 0.45, 95%CI: [-0.15; 0.34]) and for the gingival index 0.04 (P = 0.15,95%CI: [-0.02; 0.11]). The DiffM in brushing studies for plaque scores was 0.01 (P = 0.29, 95%CI: [-0.01; 0.02]) and for the gingival index 0.00 (P = 0.87,95%CI: [-0.05; 0.06]). With respect to staining scores, the meta-analysis revealed that in non-brushing studies, the standardized mean difference was 3.19 (P = 0.0005,95%CI: [-3.98; -1.41]) while in brushing studies, the DiffM was 0.12 (P = 0.95,95%CI: [-3.32; 3.55]).ConclusionThere is moderate quality evidence from non-brushing studies that the addition of an ADS to CHX-MW reduces tooth surface discoloration and does not appear to affect its properties with respect to gingival inflammation and plaque scores. In brushing studies, there is also moderate quality evidence that ADS does not affect the anti-plaque and anti-gingivitis efficacy of CHX. The majority of comparisons and the meta-analysis including these indicate no significant effect of ADS on tooth staining in situations where the mouthwash is used in addition to toothbrushing.

Project description:IntroductionChlorhexidine (CHX) and essential oil containing mouthwashes like Listerine® can improve oral hygiene via suppressing oral microbes. In hospitalized patients, CHX mouthwash reduces the incidence of ventilator-associated pneumonia. However, CHX use was also associated with increased mortality, which might be related to nitrate-reducing bacteria. Currently, no study determines oral bacteria targeted by essential oils mouthwash in hospitalized patients using a metagenomic approach.MethodsWe recruited 87 hospitalized patients from a previous randomized control study, and assigned them to three mouthwash groups: CHX, Listerine, and normal saline (control). Before and after gargling the mouthwash twice a day for 5-7 days, oral bacteria were examined using a 16S rDNA approach.ResultsAlpha diversities at the genus level decreased significantly only for the CHX and Listerine groups. Only for the two groups, oral microbiota before and after gargling were significantly different, but not clearly distinct. Paired analysis eliminated the substantial individual differences and revealed eight bacterial genera (including Prevotella, Fusobacterium, and Selenomonas) with a decreased relative abundance, while Rothia increased after gargling the CHX mouthwash. After gargling Listerine, seven genera (including Parvimonas, Eubacterium, and Selenomonas) showed a decreased relative abundance, and the magnitudes were smaller compared to the CHX group. Fewer bacteria targeted by Listerine were reported to be nitrate-reducing compared to the CHX mouthwash.DiscussionIn conclusion, short-term gargling of the CHX mouthwash and Listerine altered oral microbiota in our hospitalized patients. The bacterial genera targeted by the CHX mouthwash and Listerine were largely different and the magnitudes of changes were smaller using Listerine. Functional alterations of gargling CHX and Listerine were also different. These findings can be considered for managing oral hygiene of hospitalized patients.

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A Proteomic Analysis of Discolored Tooth Surfaces after the Use of 0.12% Chlorhexidine (CHX) Mouthwash and CHX Provided with an Anti-Discoloration System (ADS).

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