Münchenstein, April 4, 2004 – Nearly all commercially available mouthrinses display good to very good antibacterial and thus potentially plaque-inhibiting properties in vitro. For long-term use, however, the combination of active substances amine fluoride/stannous fluoride contained in meridol is to be recommended. It possesses marked substantivity. Its plaque- and inflammation inhibiting properties in vivo have repeatedly been clinically confirmed. This is the result of a literature analysis published in two parts by Brecx, Netuschil and Hoffmann in the International Journal of Dental Hygiene. The team of authors from the Technical University Dresden (Germany) investigated which mouthrinses can be used to complement mechanical plaque removal. The meaningfulness of various study designs and possible side effects were taken into consideration.
When examining the efficacy of mouthrinses it must be taken into consideration that bacteria organised in a biofilm are clearly more resistant to antimicrobial active substances than, for example, planktonic bacteria present in the saliva. To achieve plaque inhibition, the active substances in a mouthrinse must be present at concentrations clearly above the minimum inhibiting concentration of the active substance in vitro. This applies to the amine fluoride/stannous fluoride in meridol® mouthrinse.
A general requirement for a mouthrinse is that long-term disturbances of ecological equilibrium in the oral cavity should be avoided. The active substances chlorhexidine (CHX) and triclosan (when using additional zinc salt or copolymer to enhance their effect) also have good plaque reducing and inhibiting properties. At a concentration of 0.2 percent chlorhexidine drastically reduces bacterial counts on dental surfaces. It should thus not be used for prolonged periods and should only be used if there is an appropriate situation, e.g. if mechanical oral hygiene cannot be performed or can only be performed incompletely.
“The older and thicker the dental plaque, the greater the number of anaerobic, pathogenic bacteria,” the authors explain. “If the mouthrinse can reduce the plaque thickness or prevent plaque maturation and the shift to anaerobic conditions, then a more aerobic biofilm will develop.” meridol® mouthrinse with amine fluoride/stannous fluoride has this capacity, facilitating promotion of healthy oral flora. “Used as a complement to brushing, in several studies it displayed marked and significant clinical efficacy against plaque and gingivitis.”
Mouthrinses should be used as a complement to brushing, thus it is sensible to use toothpaste and mouthrinse containing the same active substance, e.g. amine fluoride/stannous fluoride. Mouthrinses containing chlorhexidine may lead to incompatibility with the anionic detergent sodium lauryl sulphate frequently used in toothpastes. As well as the cationic tenside amine fluoride, meridol® toothpaste contains a further non-ionic tenside, and can be combined with a rinse containing CHX without any problems.
The alcohol content of mouthrinses was a further aspect taken into consideration by the authors. Alcohol is often used as a solubiliser – in the opinion of Brecx, Netuschil and Hoffmann without reason: “From a chemical standpoint, use of alcohol is superfluous. And with justifiable alcohol concentrations, neither in vitro nor in vivo has an antibacterial effect with respect to biofilm bacteria been established. Only at very high concentrations is plaque growth influenced.” Thus alcohol-free preparations are preferable, especially since ethanol at high concentrations can cause painful side effects, and since a connection with the development of cancer of the oral cavity cannot then be excluded, at least not totally. meridol® mouthrinse is alcohol free.
Of the many mouthrinses available, the authors can only recommend two products: a mouthrinse with 0.2% chlorhexidine for short-term use and a mouthrinse with amine fluoride/stannous fluoride as a complement to daily brushing for long-term use.
meridol® mouthrinse contains
the combination of active substances
amine fluoride/stannous fluoride, which
is preferred by experts for long-term use.