Chlorhexidine digluconate–an agent for chemical plaque control and prevention of gingival inflammation

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Abstract
In selecting antimicrobial agents for the prevention and treatment of periodontal diseases, the following factors should be considered: 1. Specificity, 2. Efficacy, 3. Substantivity, 4. Safety, 5. Stability. Using these criteria, several antibiotics and antiseptics have been evaluated in recent years for chemical plaque control. While antibiotics are mostly used under a specific plaque hypothesis, antiseptics are more suitable for a non‐specific plaque concept. Several antiseptics hinder plaque formation or even break up old plaque. For example, quaternary ammonium compounds, combinations of metal ions with pyrimidines or with fluorides, phenolic compounds, and plant alkaloids have yielded a plaque reducing effect of 20–20% and have also delayed slightly the development of gingivitis. Years of documented research have established that chlorhexidine digluconate is safe, stable, and, owing to its great substantivity, effective in preventing and controlling plaque formation, breaking up existing plaque, and inhibiting and reducing the development of gingivitis. In studies of 6 months and longer, chlorhexidine has been shown to reduce gingivitis by 50–50% compared to a placebo control. Chlorhexidine is the most effective and most thoroughly tested antiplaque and antigingivitis agent known today.

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