CATEGORY 54 AUSTRALASIAN DENTIST CLINICAL Chlorhexidine, introduced in the 1950s, is a widely used antimicrobial agent in dentistry for plaque control, management of minor oral lesions, and as a pre- or postprocedural rinse to reduce bacterial load. Despite its well-established antibacterial efficacy, chlorhexidine is associated with recognised adverse effects, and emerging evidence has raised concerns regarding its clinical effectiveness and potential disruption of oral microbial homeostasis. Common adverse effects include xerostomia, taste disturbance (particularly salt and bitter), tongue coating or discolouration, and increased calculus formation. Less frequent reactions include oral burning, mucosal desquamation, parotid swelling, and altered oral sensation. Tooth staining is the most clinically significant drawback and typically develops after several weeks of use due to pigment binding to tooth surfaces. Rare but serious adverse events include hypersensitivity reactions, including anaphylaxis. Repeated chlorhexidine exposure has also raised concerns regarding antimicrobial resistance and potential cross-resistance to antibiotics, contributing to reduced patient satisfaction and compliance. Recent research has further challenged the position of chlorhexidine as a preferred antimicrobial. A notable study by Bescos et al. in 2020 investigating the effects of chlorhexidine in healthy individuals demonstrated that just seven days of use resulted in increased oral acidity and elevated salivary glucose levels. These changes created a more cariogenic oral environment, despite participants having a healthy baseline microbiota. Microbiome analysis showed increased abundance of Neisseria, Streptococcus, and Granulicatella, with a reduction in Actinomyces, while Veillonella levels remained unchanged. The authors concluded that the clinical implications of these microbial shifts remain uncertain, as changes were observed in bacterial taxa associated with both caries and periodontal disease. Although chlorhexidine has traditionally been prescribed for patients with established oral disease, emerging evidence suggests that it may exert destabilising effects even within otherwise healthy oral ecosystems. Reviews assessing its use as a preprocedural rinse have also questioned the speed and breadth of its PerioGold® Gel: An Effective Alternative to Chlorhexidine in Dentistry! By Mr Brett Chalklin and A/Prof Ramesh Balasubramaniam OAM Ready to use bioceramic root canal sealer Bio-C® Sealer amalgadent.com.au 1800 806 450 malgadent ●Ready to Use ●Resin-Free ●Excellent Flowability ●High Alkalinity (Ph~12) ●Setting Expansion ●High Release of Calcium Ions ●Chemical Adhesion to Dentin ●High Radiopacity Images provided by Euclides Valadão, DDS, MSc. Initial x-ray 12 months follow up Clinical Case FREE BONUSES VALUED AT $85 Join us at Booth 226 PURCHASE BIO-C SEALER 2g KIT FOR $179 & RECEIVE 1 X BIO-C TEMP 0.5g PLUS 1 X BIO-C REPAIR 0.5g
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