Chlorhexidine incorporated into a toothpaste - supragingival and subgingival effects

Objectives: Mechanical and chemical plaque control are important for periodontal health. The aim of the study was to compare a toothpaste containing 0.12% chlorhexidine digluconate with a sodium fluoride toothpaste regarding their effects on plaque accumulation, gingivitis and subgingival microbiota. Methods: 50 volunteers (mean age 51.6 ± 11.6 years) with moderate chronic periodontitis used the chlorhexidine toothpaste ( GUM Paroex®, Sunstar Butler Europe, A, n= 25) or a sodium fluoride toothpaste (GUM Sensitive, Sunstar Butler Europe, B, n=25) for personal oral hygiene with standardized toothbrushing and interproximal hygiene over 3 months. The interproximal plaque index (API), gingival index (Lobene, GI) and bleeding on probing (BOP) were recorded at baseline, after 6 and 12 weeks. Subgingival plaque samples were analysed for A. actinomycetemcomitans, P. gingivalis, T. forsythia and T. denticola at baseline as well as after 12 weeks. Friedman-/Wilcoxon-tests and the U-test were used for statistical analysis. Results: The results (12 weeks versus baseline) were as follows: A - API - 40.3 ± 30.5% vs. 65.8 ± 28.1% (p=0.001), GI - 1.70 ± 0.55 vs. 1.98 ± 0.67 (p=0.015), BOP - 36.1 ± 14.6% vs. 41.3 ± 17.2% (n.s.); B – API - 49.2 ± 36.8 % vs. 74.2 ± 34.7% (n.s.), GI - 1.63 ± 0.60 vs. 2.06 ± 0.74 (p=0.009), BOP - 33.7 ± 12.4% vs. 45.3 ± 14.2% (p=0.003). There was no significant difference between the two groups. The analysed microflora did not change significantly. Conclusion: Within the limits of the study it can be concluded that there is a slight but not superior effect on periodontal health due to the incorporation of chlorhexidine into a toothpaste formulation.