Current evidence on chlorhexidine, toothpaste, gels, and mouthwashes

The universal advice from dental care professionals is to brush twice daily with a fluoride dentifrice. It would be ideal to incorporate an effective antimicrobial agent such as chlorhexidine (CHX) in a
dentifrice formulation. CHX dentifrice can be successfully formulated and will inhibit plaque growth to
some degree but not to the same extent as a CHX mouthwash. A low-dosage 0.12% CHX dentifrice
gel, which is available in Europe, was the subject of two clinical research projects. The dentifrice
gel appeared to be as effective as a regular dentifrice in the prevention of plaque accumulation.
However, it was considered as a poor alternative for a dentifrice because it is does not contain
fluoride. Systematic evaluation of the available literature shows that when daily oral hygiene cannot
be performed, CHX mouthwash is the first product of choice. When comparing 0.2% with 0.12% CHZ, a small but significant difference in plaque scores was observed in favor of the higher concentration. A CHX mouthwash can be used in conjunction with a regular fluoride toothpaste. Combining CHX mouthwash with an oxygenating agent mouthwash reduces teh well-known side effect of tooth discoloration.