Chlorhexidine (Periodontal)

Chlorhexidine is used to treat periodontal diseases that are caused by a growth of bacteria beneath the gum line.

Overview

Chlorhexidine is used to treat gingivitis, a periodontal disease that is caused by bacterial growth underneath the gum line. Gingivitis causes swelling, pain, and bleeding of the gums.

The medication belongs to a group of medicines called antimicrobials, and it works by killing the bacteria and preventing further growth and spread. Following a deep clean by a dental hygienist or dentist, chlorhexidine implants are inserted between the gums and teeth in areas where deep pockets exist in the gum.

Chlorhexidine is only available via prescription from your dentist.

Conditions treated

  • gingivitis
  • periodontal diseases

Type of medicine

  • antimicrobial
  • dental implant

Side effects

Although chlorhexidine is very effective in treating periodontal diseases, it can sometimes cause unwanted side effects for some patients. Before you are treated with this medication, you should tell your dentist about any bad or allergic reactions that you have suffered from other forms of medication. This should include non-prescription and over the counter products, herbal remedies and vitamin supplements.

Some medications are formulated containing animal products, preservatives or dyes. Remember to tell your dentist if you have any known allergies to any of these.

The side effects that are outlined below have occurred in patients who were treated with chlorhexidine. However, you should note that this list is not exhaustive. If you begin to notice any other effects or if you begin to feel ill while undertaking treatment with this medication, you must tell your dentist or doctor immediately.

If your gums become tender, enlarged, or begin to bleed, you must contact your doctor or dentist straight away. Similarly, if you develop a cough, wheezing, congestion and tightness in your chest, seek medical advice straight away.

If you experience any of the following effects when you first begin your treatment with chlorhexidine, you may find that they resolve themselves within a few days with no need for medical intervention, as your body gets used to the new drug. In the meantime, ask your dentist or doctor for some suggestions on how to prevent or manage some of the more troublesome effects.

  • upset stomach or indigestion
  • tenderness of the gums
  • sore throat
  • mouth, tooth, or gum pain
  • mouth ulcers or sores
  • mild to moderate tooth sensitivity to heat or cold
  • aching, throbbing, soreness, or other gum discomfort

Not everyone who is treated with chlorhexidine will suffer side effects, but you should always consult your doctor if you have any concerns aboutunusual effects that you do experience.

Dosage

You will only be given chlorhexidine by a trained medical professional in a dental clinic or dental hospital. The dose you are given will vary between patients, depending on the strength of the preparation, the condition for which you are being treated, your age and your body weight. Do not change your treatment unless you are told to do so by your dentist.

Before your chlorhexidine implants are placed into your gums, your teeth will be thoroughly, professionally cleaned by a dental hygienist or by your dentist. This is important, as the cleaning process helps to remove any deeply situated pockets of plaque, where bacteria will readily proliferate. If your mouth and gums are as clean as possible prior to insertion, the chlorhexidine implants will stand a better chance of tackling any residual bacteria and clearing up the periodontal disease more quickly.

For the treatment of periodontitis (dental implant)

Adults: one dental implant inserted into every very deep gum pocket. A maximum of eight implants may be used per treatment. The treatment may be repeated on a three monthly basis, as necessary.

Children: use and dose to be decided by your dentist.

You will not have to attend your dentist to have the implants removed, as they will dissolve by themselves. However, you will need to see your dentist for a progress check on your condition every three months. You can use these meetings to voice any concerns that you might have about any side effects that you are experiencing. Your dentist may also decide to prescribe further treatment, if necessary.

If the person receiving treatment with chlorhexidine suddenly develops serious side effects, especially swelling around the mouth or throat, loss of consciousness, or severe breathing difficulties, you should call 911. These symptoms could mean that the patient has anaphylaxis, a potentially life-threatening condition.

Major drug interactions

There are some drugs that can never be safely used together, although in some cases it is appropriate to use two or more different medications, even though an interaction could happen.

Although chlorhexidine is a very safe medication and no major drug interactions have been noted, you should tell your dentist immediately if you are already taking any other medicines. This includes herbal remedies, vitamin supplements and over the counter medicines. Some foodstuffs should be avoided, as should consuming alcohol and tobacco, as interactions may sometimes occur, and your dentist will advise you accordingly on this.

Warnings

For the 10 days following insertion of your dental implants, you must not floss around the teeth and gums that have received treatment. This is because flossing could dislodge the implants or push them out. If you think that one of your implants has come loose or fallen out, contact your dentist immediately. Chlorhexidine implants are easily identified as small, orange-brown, rectangle-shaped chips that are rounded off at one end.

It is very important that you provide your dentist with a full overview of your medical history before you begin your treatment with chlorhexidine.

There is no evidence that chlorhexidine can cause harm to a fetus. However, you should still tell your dentist if you are pregnant or if you are planning to become pregnant during your course of treatment with this medication. You may wish to weigh the benefits and risks of receiving treatment with chlorhexidine.

Chlorhexidine can pass into breast milk, but has been shown to pose only a minimal risk to nursing infants. However, you should mention to your dentist if you are breastfeeding, as it may be advisable to find an alternative method of feeding your infant until your treatment has finished. If you are concerned about any effect that chlorhexidine might have on your infant, do not express breast milk for later use.

There is no information to show that using chlorhexidine in elderly patients has any ill effects.

As part of your course of treatment, you must maintain good dental hygiene in order to prevent plaque forming on your teeth, which could provide an environment attractive to bacteria. Use a good quality anti-bacterial mouthwash twice daily.

The chemicals contained in tobacco smoke can encourage bacterial growth in your mouth. If you smoke, talk to your doctor or pharmacist for advice on how to kick the habit.

Storage

It is unlikely that you will need to store chlorhexidine implants in your home, as they must be fitted by your dentist. However, in the unlikely event that you do, the following advice should be followed:

  • The medication should be kept in a sealed, airtight container.
  • Do not freeze or refrigerate the drug.
  • Do not leave this medication where it will be exposed to direct sunlight, heat or moisture.
  • Keep chlorhexidine implants well away from children and pets.
  • In the event that a pet consumes chlorhexidine, seek veterinary advice immediately.
  • Do not keep supplies of chlorhexidine that have passed their use-by date, or if the packaging appears to be damaged or has already been opened.

Ask your dentist or pharmacist for advice on how to dispose of any out of date medication. Do not flush leftover drugs down the toilet, put them down the drain, or throw them out with your trash, where they could be found and eaten by children or animals.

Summary

Chlorhexidine is used in the treatment of persistent gingivitis. Gingivitis is a periodontal disease that is caused by bacteria growing underneath the gum line. Periodontal disease causes swelling, pain, and bleeding of the gums. It can be a stubborn condition to treat and eradicate.

Chlorhexidine belongs to a group of medicines called antimicrobials. The drug works very effectively by killing the bacteria that cause the disease. It also stops the further growth and spread of the bacteria. Chlorhexidine implants are inserted between the gums and teeth in areas where deep pockets exist in the gum line.

Chlorhexidine is only available via prescription from your dentist.

In order to clear up your periodontal disease completely, it is very important that you attend your dentist for regular, three-monthly check-ups. By its very nature, gingivitis and other forms of periodontal disease tend to be very persistent and re-treatment is often necessary. These regular check-ups allow your dentist to assess your progress and re-treat the condition, if necessary. You will also have the opportunity to ask any questions that you may have about your condition or about any unwanted side effects that you may be experiencing.