Chlorhexidine Use After Two Decades of Over‐the‐Counter Availability

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Abstract
Chlorhexidine (CHX) is a compound with plaque‐inhibiting effects and available only by prescription in the United States. In Norway, however, CHX has been dispensed over‐the‐counter for over 20 years, and this study was undertaken to evaluate dentists' perceptions regarding its indications, usefulness, and side effects. A written questionnaire was sent to a sample of 10% of dentists registered in Norway, 78% of whom (354) responded. Additionally, representatives from 2% of all dental practices in Norway were contacted by telephone. Fourteen percent (14%) of the respondents reported that they never recommended CHX to their patients. Among those recommending the compound, 85% used it frequently after surgical periodontal procedures; 74% when treating acute gingivitis; 57% following oral surgery in general; and 35% during non‐surgical periodontal therapy. It was used also as an adjunct to other treatment routines. Seventy‐three percent (73%) reported frequent use of CHX when treating stomatitis and 54% in herpes simplex infections. As to side effects, 77% of the dentists indicated that staining of teeth, restorations, and the tongue was a major concern to patients; 12% reported inconveniences due to the bitter taste; and 6% reported other disturbances such as dryness of the mouth and development of oral ulcerations. The majority (94%) of the dentists recommended mouth rinsing, whereas 6% recommended a gel form. Only 4% of the dentists recommended rinsing with a patient‐diluted 0.1% concentration, whereas 96% recommended the standard 0.2% formulation; 88% recommended using CHX mouthwash twice a day or more often. It is concluded that CHX is used frequently in Norwegian dental practices and that its use profile is diverse, though mainly as an anti‐plaque compound over a limited period of time when the use of other mechanical measures is not feasible or sufficient. J Periodontol 1994;65:109–112.