Chlorhexidine is an antiseptic antimicrobial which is active against gram-positive and gram-negative bacteria, facultative anaerobes and aerobes, and yeast. Chlorhexidine is indicated for topical use in preoperative skin preparation, skin wound and general skin cleansing, and as a surgical hand scrub for health care professionals. Orally, chlorhexidine is indicated as a mouth rinse for treating gingivitis between dental visits.

Oral chlorhexidine mouth rinses have been effective in decreasing plaque formation and in controlling gingivitis. The formulation should be considered as an adjunct to mechanical toothbrushing and professional dental prophylaxis rather than as a substitute. Chlorhexidine mouthrinse may be used as a short-term substitute for toothbrushing in situations where the patient is unable to tolerate mechanical stimulation of the gums, such as after oral surgery.

Hypersensitivity to chlorhexidine

B

The primary adverse effect with topical chlorhexidine is skin irritation. Deafness has been reported when chlorhexidine is instilled into the middle ear through a perforated eardrum. With oral rinsing, the most common adverse effect of chlorhexidine is tooth staining. This staining is a cosmetic problem and may be removed with professional dental cleaning. Transient alterations in taste perception have also been reported with oral chlorhexidine.

As an oral rinse, about 15 ml of chlorhexidine mouth rinse should be used for 30 seconds twice daily after toothbrushing. Oral mouth rinse should be expectorated, not swallowed.