Chlorhexidine
Chlorhexidine is an antiseptic antibacterial agent widely used to disinfect skin and in oral health applications. Primarily available in its chlorhexidine gluconate form, it has been utilized since the 1950s in various medical and dental contexts. This biguanide compound is effective in killing bacteria on the skin and preventing further infection, making it a common choice for health care professionals when preparing patients for surgeries or injections. Chlorhexidine products come in numerous forms, including creams, gels, and liquid solutions, as well as prescription-only toothpastes and mouthwashes that aid in treating conditions like gingivitis and periodontitis.
The World Health Organization recognizes chlorhexidine as an essential medicine due to its safety and versatility. Although generally well-tolerated, topical preparations can cause mild side effects, such as skin irritation or allergic reactions, and precautions are necessary to avoid internal application to sensitive areas like the ears or eyes. In oral formulations, potential side effects may include teeth stains and temporary changes in taste. Overall, chlorhexidine serves a significant role in both medical and dental care, providing effective antibacterial protection while requiring careful usage to minimize risks.
On this Page
Subject Terms
Chlorhexidine
Chlorhexidine is an antiseptic antibacterial agent that is primarily used to disinfect skin. It is also the active ingredient in some prescription-strength toothpastes and mouthwashes, which are typically recommended to patients who have undergone dental surgery or have certain diseases of the mouth and gums. Chlorhexidine has been used for medical and dental applications since the 1950s, typically in its chlorhexidine gluconate form. The substance is a biguanide, which is a type of organic compound that yields a basic (rather than acidic) solution when dissolved in water.
Given its safety profile, widespread availability, and versatility, chlorhexidine is listed in the World Health Organization's WHO Model List of Essential Medicines. This list, which is updated biannually, is a compendium of medications deemed necessary to meet the basic needs of an effective health care system.
Overview
As a topical agent, chlorhexidine is used to kill bacteria on the skin and prevent new bacteria from infecting the treated area. It is utilized as an antiseptic to clean skin after an injury, and health care professionals may also apply it to patients' skin prior to surgery or an injection. Doctors and nurses sometimes sanitize their hands with chlorhexidine products prior to performing medical procedures. Topical chlorhexidine preparations take many forms, including creams, dressings, gels and jellies, liquid solutions, lotions, pads, and sponges.
Oral forms of chlorhexidine are available as toothpastes and mouthwash formulations, and are typically sold by prescription only. Dentists sometimes recommend chlorhexidine-based cleansing agents to patients who have undergone major oral surgeries, but they are most often used to treat the symptoms of gingivitis and periodontitis. Periodontitis, or gum disease, is a chronic gum infection that causes the degradation and loss of the bones and essential soft tissues that support healthy teeth. Gingivitis is an early and reversible symptom of periodontitis marked by gum recession, inflamed and swollen gums, and gums that bleed easily. Chlorhexidine eases these conditions by killing the bacteria that cause gum inflammation, thus slowing the breakdown of oral bones and soft tissues in patients with periodontitis.
Although chlorhexidine has an excellent safety profile when administered correctly, topical preparations can cause side effects including blisters, burning sensations, itching, peeling of the skin, rashes, redness, and swelling. Allergic reactions, such as breathing problems and swelling of the face or appendages, can also occur, albeit very rarely. Topical chlorhexidine products are also known to pose a risk of serious injury when applied internally to the ears, eyes, or mouth.
Side effects of chlorhexidine-based prescription-strength toothpastes and mouthwashes are usually mild and may include stains to teeth and dental fillings, irritations affecting the tip of the tongue, and an increased susceptibility to tartar buildup. However, it can also cause changes in a person's sense of taste. In most instances, these changes only last for the duration of treatment, but some permanent sensory alterations have been reported via post-treatment patient surveillance and follow-up. Hives and skin rashes may also occur as the result of an allergic reaction to oral chlorhexidine.
Bibliography
"Chlorhexidine." Drugs.com, www.drugs.com/pro/chlorhexidine.html. Accessed 20 Nov. 2017.
"Chlorhexidine." PubMed Health, www.ncbi.nlm.nih.gov/pubmedhealth/PMHT0000381/. Accessed 20 Nov. 2017.
"Chlorhexidine Digluconate." PubChem, pubchem.ncbi.nlm.nih.gov/compound/chlorhexidine%20gluconate#section=KEGG--Risk-Category-of-Japanese-OTC-Drugs. Accessed 20 Nov. 2017.
"Chlorhexidine Gluconate Mouthwash." WebMD, www.webmd.com/drugs/2/drug-5356/chlorhexidine-gluconate-mouth-and-throat/details. Accessed 20 Nov. 2017.
"Chlorhexidine (Oral Route)." Mayo Clinic, www.mayoclinic.org/drugs-supplements/chlorhexidine-oral-route/description/drg-20068551. Accessed 20 Nov. 2017.
"Chlorhexidine (Topical Application Route)." Mayo Clinic, www.mayoclinic.org/drugs-supplements/chlorhexidine-topical-application-route/description/drg-20070874. Accessed 20 Nov. 2017.
Millett, Declan, and Richard Welbury. Clinical Problem Solving in Orthodontics and Pediatric Dentistry. Elsevier Health Sciences, 2010, pp. 138–41.
Yagiela, John A., et al. Pharmacology and Therapeutics for Dentistry. Elsevier Health Sciences, 2010, pp. 735–43.