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MECHANISM OF ACTION:

Classification of chemical agent according to anti-microbial efficiency :

5-Oral irrigator

3.QUARTERNARY AMMONIUM COMPOUNDS3.

Cationic antiseptics & surface active agents

Effective against gram positive organisms

MECHANISM OF ACTION :

 

Positively charged molecule reacts with negatively charged cell membrane phosphates and thereby disrupts the bacterial cell wall structure

Eg: Benzanthonium chloride, Benzalleonium chloride and cetylpyredinium

2. METALLIC IONS

  • eg: Zn & Cu ions

 

MECHANISM OF ACTION:

  • It reduces the glycolytic activity in bacteria &delays bacterial growth

4-CHEWING GUM

  • The physical act of chewing increases the flow of saliva in your mouth. If chew after eating, the increased salivary flow can help neutralize and wash away the acids that are produced when food is broken down by the bacteria in plaque on teeth.

 

  • the minerals generated by the extra saliva can even help strengthen your tooth enamel, which also reduces the risk of a dental plaque.

(also called a dental water jet) is a home care device that uses a stream of pulsating water to remove plaque and food debris between teeth and below the gumline and improve gingival health.

  • Triclosan is included in tooth paste to reduce plaque formation
  • Used along with Zinc citrate or co-polymer Gantrez to enhance its retention within the oral cavity
  • Triclosan delay plaque formation
  • It inhibits formation of prostaglandins & leukotrienes there by reduces the chance of inflammation

1- First generation

  • decreases plaque scores by 20-50%, but efficacy is decreased by poor retention in the mouth. E.g. antibiotics , phenols etc.

1- TRICLOSAN :

  • Phenol derivative
  • Is synthetic and ionic
  • Used as a topical antimicrobial agent
  • Broad spectrum of action including both gram positive and gram negative bacterias
  • It also includes mycobacterium spores and Candida species

6-Fluoride varnish

  • is a highly concentrated form of fluoride which is applied to the tooth's surface, by a dentist, dental hygienist or other health care professional, as a type of topical fluoride therapy. It is not a permanent varnish but due to its adherent nature it is able to stay in contact with the tooth surface for several hours.

  • It may be applied to the enamel , dentine or cementum of the tooth and can be used to help prevent decay, remineralise the tooth surface and to treat dentine hypersensitivity.

2- Second generation

BISBIGUANIDES

(CHLORHEXIDINE )

 

  • It is a cationic bisbiguanide
  • Effective against gram +ve, gram –ve organisms, fungi, yeasts and viruses
  • Exhibit antiplaque & antibacterial properties

4.SANGUINARINE

  • It is a benzophenanthredine alkaloid
  • It is most effective against gram –ve organisms
  • Used in mouth rinse

3-SPRAY

  • Spray in the post-surgical control of dental plaque is similar to that of CHX mouthwash.
  • The effect will be lower in the spray at sites not surgically involved.

Vehicles used to deliver anti plaque agents

  • MOUTH RINSES
  • TOOTHPASTES
  • SPRAY
  • IRRIGATORS
  • CHEWING GUM
  • VARNISHES

Learning outcomes :

PLAQUE

Dental plaque is defined as a highly specific variable structural entity formed by sequential colonization of microorganism on the tooth surface, epithelium and restorations.

After this presentation you will be able to :

  • Define plaque
  • Recognize importance of plaque control in periodontal disease
  • Enumerate various criteria required for ideal anti-plaque agent
  • Vehicles used to deliver anti plaque agents.
  • Classification of chemical agent according to anti-microbial efficiency
  • Mechanism of action for each chemical agent

Importance of plaque control in periodontal disease

MECHANISM OF ACTION:

Antibacterial action of chlorhexidine

It shows two actions

1-Bacteriostatic at low concentrations

Plaque control

It is the removal of microbial plaque and the prevention of its accumulation on the teeth and adjacent gingival tissues. It also deals with the prevention of calculus formation.

  • Plaque accumulation is vital in the progression of periodontitis as the bacteria in plaque release enzymes which attack the bone and cause it’s to break down, and at the same time the osteoclasts in the bone breakdown the bone as a way to prevent further infection.
  • This can be treated with strict oral hygiene to remove the accumulated plaque such as tooth brushing and cleaning in between the teeth and as well as surgical debridement completed by a dental professional.

Antiplaque action of chlorhexidine

  • Prevents pellicle formation by blocking acidic groups on salivary glycoproteins thereby reducing glycoprotein adsorption on to the tooth surface
  • Prevents adsorption of bacterial cell wall on to the tooth surface
  • Prevents binding of mature plaques

Ideal requisites

  • Should decrease plaque & gingivitis
  • Prevent pathogenic growth
  • Should prevent development of resistant bacteria
  • Should be biocompatible
  • Should not stain teeth or alter taste
  • Should have good retentive properties
  • Should be economic

2-Toothpaste

is a paste or gel dentifrice used with a toothbrush as an accessory to clean and maintain the aesthetics and health of teeth. Toothpaste is used to promote oral hygiene . it serves as :

  • abrasive that aids in removing the dental plaque and food from the teeth.
  • assists in suppressing halitosis.
  • delivers active ingredients (fluoride) to help prevent tooth and gum disease .

1-MOUTH WASH

Ideal characteristics :

  • Range of antibacterial activity against the various plaque bacteria.
  • Substantively to the oral surface.
  • Possible anti - inflammatory effect.
  • Acceptable taste.
  • Ability to promote fresh mouth sensation

Uses of anti-plaque mouthwash :

1-To replace mechanical tooth brushing

2-As an adjunct - to normal mechanical oral hygiene

3-THIRD GENERATION

DELMOPINOL

  • Inhibits plaque growth and reduces gingivitis .

Mechanism of action:

  • Interfere with plaque matrix formation & reduces bacterial adherence
  • It causes weak binding of plaque to tooth, thus aiding in easy removal of plaque by mechanical procedures
  • It is therefore indicated as a pre brushing mouth rinse.

Chemical plaque control

BY: Ebtisam Althawab

Noorah Alsalhi

Nora Alargaj

Raghad Alharkan

Wasan Alhatlani

References:

  • Newman MG, Takei H, Klokkevold PR, Carranza FA. Carranza’s clinical periodontology: Saunders; 2011. 2.
  • Loesche W, Syed S, Schmidt E, Morrison E. Bacterial Profiles of Subgingival Plaques in Periodontitis. Journal of Periodontology. 1985;56(8):447-56.
  • Lindhe J, Lang NP, Karring T. Clinical periodontology and implant dentistry: Wiley-Blackwell; 2009.
  • Mandel ID. Chemotherapeutic agents for controlling plaque and gingivitis. Journal of Clinical Periodontology. 1988;15(8):488-98.

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