Chlorhexidine (Oral)

Available as a prescription medication only, Chlorhexidine is used to treat inflammation of the gums and bleeding gums.

Overview

Although it's not uncommon for people to suffer from bleeding gums, it can be indicative of health and dental problems. When patients have bleeding gums and/or irritation and redness of the gums, it's likely that they have a condition called gingivitis.

The gums, or gingiva, can become inflamed when plaque is allowed to form on the teeth. Even individuals who brush their teeth twice daily can experience plaque build-up in between brushing. As bacteria tends to coat the plaque, it can cause serious harm to the teeth, gums and mouth.

Without treatment, patients with gingivitis will experience painful, tender and/or swollen gums and, eventually, their gums will begin to recede. This can increase the risk of tooth decay and infections occurring. Patients may also an unpleasant taste in their mouths and they may suffer from halitosis as gingivitis worsens.

Although gingivitis is an early stage of gum disease, appropriate treatment can lessen symptoms and stop the disease progressing. Chlorhexidine works by killing the bacteria which forms on the plaque, thus preventing toxins from being released on to the gums and into the mouth.

Whilst Chlorhexidine does effectively remove bacteria from the mouth, it is not a suitable alternative to regular brushing and flossing. If individuals are able to remove plaque from their teeth on a regular basis, this reduces the amount of bacteria which occurs in the mouth and also protects their teeth. Chlorhexidine should be used in conjunction with brushing and flossing, as part of a daily oral hygiene routine.

Although Chlorhexidine doesn't remove plaque or tartar build-up, it does effectively kill bacteria in the mouth. This prevents gingivitis from worsening and ensures that patients do not suffer from advanced symptoms of gum disease.

Conditions Treated

Type of Medicine

  • Germicidal mouthwash or rinse

Side Effects

Even though Chlorhexidine oral rinse is a prescription medication, there are relatively few side-effects associated with the drug. In some cases, patients may experience a change in taste, staining of the teeth, fillings or dentures and/or an increase in the amount of tarter on their teeth. As well as this, some patients may notice irritation in their mouth, swollen glands on their face or neck and/or irritation on the tip of their tongue.

Often, these side-effects will reduce as the patient becomes used to the medication and they are not normally uncomfortable or troublesome. If side-effects appear to be severe or if they do not diminish over time, patients should visit their dentist for further medical advice.

In very rare cases, patients may experience more concerning side-effects, such as:

  • Shortness of breath
  • Nasal congestion
  • Hives
  • Swelling of the face
  • Itching

As these symptoms could be indicative of an allergic reaction to Chlorhexidine, patients should seek immediate medical attention if they occur. Even if a patient has not experienced an allergic reaction before, they should access swift medical help if these side-effects begin to develop.

In the vast majority of cases, however, patients suffer no side-effects when using Chlorhexidine to treat gingivitis.

Dosage

When Chlorhexidine is prescribed to a patient, their dentist will tell them how to use the oral rinse and when to use it. As every patient is different, dentists will provide specific instructions regarding on-going treatment.

Generally, adult patients with gingivitis are advised to use approximately 15 milliliters of Chlorhexidine as a mouth wash for approximately 30 seconds. This should be carried out twice daily. If Chlorhexidine is prescribed to patients under the age of 18, their dentist will determine the appropriate dose based on their age, weight and the severity of gingivitis.

Often, Chlorhexidine is prescribed as a 0.12% oral rinse, but the strength of the medication may vary.

In most cases, patients are advised to use Chlorhexidine after brushing their teeth and flossing. This ensures that the patient has removed as much plaque as possible before using the oral rinse. Patients should then rinse their mouth thoroughly to ensure that any residual toothpaste has been removed.

Following this, patients should rinse with the appropriate dose of Chlorhexidine before spitting the liquid out. Under no circumstances should patients swallow Chlorhexidine mouthwash and they should not dilute or mix the oral rinse with water either. Unless otherwise advised, patients should not eat or drink for a number of hours after using Chlorhexidine mouthwash.

When Chlorhexidine is prescribed, it will often be accompanied by a medical measuring device. This will ensure that the patient is able to measure an accurate dose of the medication before using the rinse. In some cases, the cap or top of the medication container will display measuring lines so that it can be used to apportion the correct dose. If not, patients should access a medicine cup so that they can use the correct amount of Chlorhexidine oral rinse.

If patients miss a dose of Chlorhexidine, they should take the medicine as soon as it is possible to do so. If their next dose is due in the near future, however, they should miss the dose and simply return to their normal treatment regime. It is not appropriate to use a double dose of Chlorhexidine mouthwash. If patients have missed a dose and are unsure how to proceed with treatment, they can seek advice from their dentist and/or pharmacist.

Warnings

If patients have been diagnosed with other mouth conditions or gum problems, such as periodontitis, Chlorhexidine oral rinse may not be a suitable treatment for them. In some instances, using a Chlorhexidine mouthwash could make other gum problems worse. Due to this, patients should inform their dentist if they have been diagnosed with any other conditions prior to using Chlorhexidine as an oral rinse.

If patients have existing fillings, they should be aware that Chlorhexidine mouthwash could stain the fillings. This is particularly relevant if the patient has front tooth fillings and if the fillings have a rough surface. In some instances, the staining caused by Chlorhexidine cannot be removed and will mean that the fillings have to be replaced. Patients should be made aware of this prior to beginning treatment with Chlorhexidine.

Before using Chlorhexidine, patients should tell their dentist if they are taking any other medications. This includes vitamins, supplements and/or over-the-counter medications. Similarly, if patients plan to take vitamins, supplements or over-the-counter medications for any other conditions whilst using Chlorhexidine, they should seek medical advice first.

Chlorhexidine has been classified as a category C drug by the Food and Drug Administration. Based on this, it is not known if Chlorhexidine poses a significant risk to an unborn fetus if it is taken by the mother. Although the medication may be prescribed to pregnant women, the potential risks should be discussed before Chlorhexidine is taken.

Although medications can be passed to infants via breastfeeding, studies have shown that Chlorhexidine poses a minimal risk to infants if it is taken by breastfeeding mothers. Due to this, physicians may prescribe the drug to breastfeeding mothers but patients should feel free to discuss any concerns with their physician prior to taking the medication.

Currently, there have been minimal studies on the effects of Chlorhexidine on the geriatric population. It is not thought that Chlorhexidine poses an increased risk to elderly patients. In many cases, however, age-related kidney and liver issues can increase the amount of time it takes for elderly patients to process medications. Due to this, older patients may be given a lower starting dose of Chlorhexidine than is typical.

Chlorhexidine can be prescribed to patients under the age of 18, if their dentist feels that it is an appropriate and necessary treatment. As studies into the effects of Chlorhexidine have only be carried out on adults, it is unknown if this medication presents a significant risk to children and infants. It is unlikely, therefore, that young children and/or infants will be given Chlorhexidine oral rinse.

If patients have accidentally used too much Chlorhexidine oral rinse or if they have swallowed Chlorhexidine oral rinse, they should seek medical help. Patients can contact a Poison Control Center on 1-800-222-1222 if they need further advice or if they suspect an overdose has occurred.

Patients should read the medication's packaging and manufacturer's instructions before using Chlorhexidine mouthwash. They should pay particular attention to the list of ingredients, particularly if they have any known allergies. If patients are aware of any existing allergies, they should inform their dentist or physician before using Chlorhexidine oral rinse.

Storage

When patients are using any type of medication, it should always be stored in a safe place. As Chlorhexidine is prescribed for use at home, patients should use a locked cupboard or secure medicine cabinet to keep their mouthwash.

It is particularly important that children and/or pets cannot gain access to Chlorhexidine oral rinse or any other medications which may be in the home.

In most cases, Chlorhexidine should be stored at room temperature, in a place which is away from heat and moisture. In addition to this, Chlorhexidine oral rinse should be kept in a location which does not get any direct sunlight.

If patients are advised to stop using Chlorhexidine mouthwash or if the medication becomes out-of-date, patients should dispose of it responsibly. Medications should not be thrown out with normal household waste as they could pose a risk to other people.

For assistance with medicine disposal, patients should contact their dentist, pharmacist or physician.

Summary

Although gingivitis is not usually thought of as a serious condition, it can cause uncomfortable symptoms and it can develop into a more serious form of gum disease if it is left untreated. If patients experience bleeding gums or irritation, they should consult their dentist as soon as possible so that a comprehensive diagnosis can be made.

If gingivitis is confirmed, patients can often reverse the symptoms by using Chlorhexidine oral rinse and overhauling their oral hygiene routine. Regular brushing and flossing, along with a prescription mouthwash, can help to prevent a more serious form of gum disease occurring and can reduce the symptoms associated with gingivitis.

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Last Reviewed:
December 24, 2017
Last Updated:
April 02, 2018
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