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Efficacy of adjunctive usage of hydrogen peroxide with chlorhexidine as preprocedural mouthrinse on dental aerosol

Asha Ramesh, Julie Toby Thomas, Muralidharan NP, Sheeja S Varghese.


Background: The microbial reservoirs of infectious bioaerosols include saliva, calculus, and dental unit water line. Previous studies have observed a reduction in salivary bacterial counts with the usage of chlorhexidine. In this study, calculus has additionally been targeted with the adjunctive usage of hydrogen peroxide followed by chlorhexidine mouthrinse.

Aims and Objective: To evaluate the efficacy of preconditioning using 1.5% hydrogen peroxide followed by rinsing with 0.2% chlorhexidine over chlorhexidine alone, with saline as a negative control in reducing the microbial counts in the aerosol produced during ultrasonic scaling.

Materials and Methods: Fifteen chronic periodontitis subjects were randomly allocated into three groups. Before scaling, groups 1 and 2 subjects were made to rinse with saline and 0.2% chlorhexidine, respectively. In group 3 patients, calculus was conditioned with a topical application of 1.5% hydrogen peroxide before chlorhexidine mouthrinse. The aerosol produced from the ultrasonic unit was collected at three designated areas on agar plates. The plates were incubated at 37C for 48 h and colony-forming units (CFU) evaluated.

Result: The CFUs were the lowest in group 3 at the three designated locations (p = 0.007, 0.006, and 0.003, respectively). Hydrogen peroxide as an adjunct to chlorhexidine showed a statistically significant decrease in the CFUs at the patient and assistant sides, when compared with chlorhexidine alone.

Conclusion: This pilot study showed that the adjunctive use of hydrogen peroxide with chlorhexidine is superior to lone usage of chlorhexidine in combating the infected dental aerosols.

Key words: Chlorhexidine, Hydrogen Peroxide, Dental Aerosol, Preprocedural Mouthrinse

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