CATEGORY 56 AUSTRALASIAN DENTIST CLINICAL antimicrobial activity. While chlorhexidine demonstrates strong antibacterial efficacy, its activity against fungi and viruses appears limited, which is clinically relevant when preprocedural rinsing aims to reduce overall microbial load rather than selectively target bacteria. Collectively, these findings prompt clinicians to re-evaluate not only the extent of chlorhexidine’s benefits but also its long-term clinical utility. In most clinical situations, chlorhexidine is recommended for shortterm use, typically no longer than two weeks, due to its associated adverse effects. However, many oral conditions including gingivitis, periodontitis, and post-surgical wound healing require substantially longer periods of management. Periodontal tissues often need weeks to months of ongoing support to achieve sustained clinical improvement. This mismatch between healing timelines and the safe duration of chlorhexidine use limits its effectiveness as a standalone therapy and has driven interest in alternative agents that provide antimicrobial and anti-inflammatory benefits without the side-effect profile or usage restrictions of chlorhexidine. Among emerging alternatives, PerioGold® Gel has gained attention as a botanical-based formulation developed to support gingival health, reduce microbial load, and promote tissue healing without the adverse effects commonly associated with traditional antimicrobials such as chlorhexidine. Its palatable formulation contains microencapsulated curcumin, aloe vera, elderberry extract, and xylitol – agents recognised for their antiinflammatory, antimicrobial, antiviral, antioxidant, and wound-healing properties. Microencapsulated curcumin offers enhanced bioavailability and targeted anti-inflammatory activity, while aloe vera supports tissue integrity through its polysaccharide- and micronutrientrich composition. Elderberry contributes polyphenol-mediated antioxidant and antimicrobial effects, and xylitol assists in reducing pathogenic oral bacteria associated with caries and periodontal disease. Collectively, these ingredients provide a synergistic approach to oral health support while avoiding tooth staining, taste disturbance, and calculus accumulation associated with chlorhexidine use. A further advantage of PerioGold® Gel is its favourable patient experience and associated compliance. Patients consistently report a pleasant taste, which enhances acceptance when compared with chlorhexidine-based formulations. Unlike chlorhexidine, PerioGold® Gel does not exhibit adverse interactions with toothpaste surfactants and can be readily incorporated into routine daily oral hygiene practices. This ease of integration is particularly relevant for patients requiring ongoing maintenance or extended periodontal therapy, where sustained compliance is critical. As clinicians increasingly seek solutions that patients can tolerate over extended periods, botanical-based formulations such as PerioGold® Gel stand out as practical, comfortable, and biologically gentle options. Although PerioGold® Gel is not a direct substitute for chlorhexidine in all clinical scenarios, its profile supports its use in many situations where chlorhexidine has traditionally been prescribed. Viewed within this broader context, chlorhexidine remains a valuable clinical agent but can no longer be considered a singular or universally optimal solution. Its contemporary role is best defined as targeted and short term, suited to acute bacterial challenges where rapid antibacterial activity is required, and shortduration adverse effects are acceptable. In contrast, for longer-term management, particularly in chronic periodontal disease or for patients sensitive to chlorhexidine’s side effects, alternative therapies may provide more favourable outcomes. A clear understanding of both the benefits and limitations of chlorhexidine allows clinicians to facilitate individualised and clinically appropriate treatment decisions. Dental professionals are expected to ground treatment recommendations based on the scientific evidence and best practice principles. The availability of newer antimicrobial agents has prompted a re-evaluation of chlorhexidine’s long-standing designation as the “gold standard,” particularly considering its welldocumented adverse effects and emerging evidence questioning aspects of its clinical effectiveness. Both recent research and clinical experience now challenge whether chlorhexidine continues to warrant preference as a first-line option, especially as newer formulations including botanicalbased products such as PerioGold® Gel offer effective and well-tolerated alternatives. While ongoing research will further define the relative roles of different antimicrobial agents, dentistry now benefits from a broader therapeutic landscape than existed when chlorhexidine was introduced in the 1950s. Within this evolving context, chlorhexidine retains a role in certain clinical situations but can no longer be regarded as the unchallenged standard of care. u References: Pałka Ł, Nowakowska-Toporowska A, Dalewski B. Is chlorhexidine in dentistry an ally or a foe? A narrative review. Healthcare. 2022;10:764. doi:10.3390/healthcare10050764 Cieplik F, Jakubovics NS, Buchalla W, Maisch T, Hellwig E, Al-Ahmad A. Resistance toward chlorhexidine in oral bacteria – Is there cause for concern? Front Microbiol. 2019;10:587. doi:10.3389/ fmicb.2019.00587 Brookes ZLS, Bescos R, Belfield LA, Ali K, Roberts A. Current uses of chlorhexidine for management of oral disease: a narrative review. J Dent. 2020;103:103497. doi:10.1016/j.jdent.2020.103497 Bescos R, Ashworth A, Cutler C, Brookes ZL, et al. Effects of chlorhexidine mouthwash on the oral microbiome. Sci Rep. 2020;10:61912. doi:10.1038/ s41598-020-61912-4 Idrees M, Kujan O. Curcumin is effective in managing oral inflammation: an in vitro study. J Oral Pathol Med. 2024;53(6):376-385. doi:10.1111/ jop.13547 Ready to use bioceramic root canal sealer Bio-C® Sealer amalgadent.com.au 1800 806 450 malgadent ●Ready to Use ●Resin-Free ●Setting Expansion ●Excellent Flowability ●High Alkalinity (Ph~12) ●High Release of Calcium Ions ●Chemical Adhesion to Dentin ●High Radiopacity FREE BONUSES VALUED AT $85 Join us at Booth 226 Proudly distributed by PURCHASE BIO-C SEALER 2g FOR $179AND RECEIVE 1 X BIO-C TEMP 0.5g + 1 X BIO-C REPAIR 0.5g
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