The efficacy of Decapinol mouthwash 2 mg/mL in preventing gingivitis

Adverse events associated with home use of mouthrinses: a systematic review

Background

Poor oral hygiene is strongly associated with oral and systemic diseases. Alongside mechanical tooth cleaning, the adjunctive use of mouthrinses has been widely advocated. Although research on the efficacy of various mouthrinse formulations is very active, there are a lack of conclusive data regarding their adverse effects.

Methods

We undertook a systematic review in accordance wih PRISMA guidelines of electronic databases of clinical trials of any duration with daily home use of mouthwashes, presenting clinical and subjective side effects (PROSPERO registration: CRD42016054037).

Results

After evaluating 614 titles and abstracts, 154 studies were selected for full-text analysis; 85 final papers were included. Based on the active ingredient in the test product, nine categories were created: cetyl pyridinium chloride, essential oils, chlorhexidine, triclosan, natural products, diclofenac, fluorides, delmopinol, and miscellaneous active substances. Most of the studies were of short duration (less than 6 months) with a defective 'methods' description; the reporting of adverse events often being overlooked. Both local morphological (oral mucosa and dental-crown staining, mucosal lesions) and functional (taste modifications, abnormal oral sensation) alterations were reported. Tooth staining was the most commonly listed adverse event, but it was quantitatively assessed only in a very small number of papers; most studies relied on patient reports. Staining was time associated; the longer the study, the higher its reported incidence and severity.

Conclusions

The reduced report of side effects may partly be due to a lack of an objective measure and lack of general guidelines that demand studies report their adverse events. The most frequently reported adverse effect was teeth staining. As in most studies, the effect was associated with trial duration; clinical trials should be of sufficient duration. New investigations meeting the suggested criteria of a minimal duration of 6 months should be planned.

Delmopinol hydrochloride reduces Salmonella on cantaloupe surfaces

Since the surfaces of cantaloupes are highly rough or irregular, bacteria can easily attach and become difficult to remove. Appropriate postharvest washing and sanitizing procedures can help control Salmonella and other pathogens on cantaloupe or other melons during postharvest operations. Delmopinol hydrochloride (delmopinol) is a cationic surfactant that is effective for treating and preventing gingivitis and periodontitis. The application of delmopinol to two cantaloupe cultivars was evaluated for reducing the level of inoculated Salmonella. Athena and Hale's Best Jumbo (HBJ) cantaloupe rind plugs (2.5 cm. dia.) were inoculated with nalidixic acid-resistant Salmonella Michigan (approx. 1.0 × 109 CFU/ml). After 15 min, rind plugs were sprayed with 10 ml of a delmopinol spray solution (0% or 1.0% vol/vol) and held at 35°C for 1 hr or 24 hr. Rind plugs were diluted with Butterfield's phosphate buffer, shaken and sonicated, and solutions were enumerated on 50 ppm nalidixic acid-tryptic soy agar. The texture quality and color of additional cantaloupes were evaluated, after 1% delmopinol spray treatment, over 14-day storage at 4°C. A 1.0% application of delmopinol after 1 hr reduced Salmonella concentration by ~3.1 log CFU/ml for both "HBJ" skin rind plugs and "Athena" stem scar rind plugs in comparison to the control (p < .05). No differences were observed in the texture and color (L*, a*, b* values) of 1% delmopinol-treated cantaloupes as compared to control. Storage of cantaloupes treated with 1.0% delmopinol solution for 1 hr had a greater effect on reducing concentration of Salmonella compared to 24-hr treatment. A surface spray application of 1% delmopinol on cantaloupes could be an alternative antimicrobial postharvest treatment that could make surface bacteria more susceptible to sanitizers or physical removal.

Preventive strategies and supportive treatment

There is a preponderance of evidence in the literature that periodontal and other oral diseases, such as caries, can be treated and controlled by thorough mechanical plaque removal by the patient, the use of antimicrobial agents and antibiotics when necessary, and participation with the therapist in a well monitored, long-range program of supportive periodontal therapy. Recent evidence suggests that the control and prevention of oral disease, especially periodontitis, is especially important for patients with various systemic conditions that can be impacted by oral infections. It is far better for patients and therapists to practice primary and even secondary prevention with effective plaque control and regular, consistent supportive periodontal therapy, than having to rely on tertiary prevention for disease that has progressed to a level that requires costly treatment, is time-consuming and carries a greater risk of morbidity.