Chlorhexidine

Chlorhexidine has a limited role in prevention of dental caries in patients at elevated risk. Chlorhexidine prevents plaque formation on a cleaned tooth surface and may reduce the level of cariogenic bacteria in the mouth. However, further evidence is needed to assess whether this prevents dental caries. Use clinical judgment to determine if chlorhexidine is an appropriate option in patients at elevated risk of dental caries; if indicated, use:

1 chlorhexidine+fluoride 0.2%+0.0033% (15 ppm) gel (pea-sized amount) brushed on to the teeth daily or weekly1 dental caries chlorhexidine + fluoride    

OR

1 chlorhexidine 0.5% gel (pea-sized amount) brushed on to the teeth daily or weekly1. dental caries chlorhexidine    

The low concentration of fluoride in the combination formulation is not clinically significant, so it should be used in addition to the recommended fluoride toothpaste (see Recommended concentration of fluoride toothpaste according to age and risk of dental caries). Recent research has shown that chlorhexidine is not inactivated by the detergent sodium lauryl sulfate used in standard toothpaste, so they can be used at the same time. For more information about chlorhexidine, see here.

For dental caries management, chlorhexidine gel is preferred to mouthwash:

  • alcohol-containing chlorhexidine mouthwashes may increase the risk of oral cancer, and cannot be used in children younger than 12 years
  • alcohol-free chlorhexidine mouthwashes have a short expiry after opening.
1 When used for more than a few days, chlorhexidine may cause a superficial discolouration of the teeth and fillings (see Chlorhexidine for more information).Return