Periodontal diseases affects over 70% of the US population aged 65 or older. That means that seven out of every ten seniors in Worcester are likely to have gum disease. This is often characterized by inflammation and infection of the gums and the supporting structures of the teeth, eventually leading to tooth loss and requiring procedures such as laser dentistry or dental implants if left untreated.
Chlorhexidine, a broad-spectrum antimicrobial agent, has emerged as a cornerstone in periodontal treatment, known for its efficacy against oral bacteria that cause gum disease. One of the main side effects of using chlorhexidine, however, is tooth staining, particularly brown staining where the teeth meet the gums or each other. But why does it stain the teeth and what can be done about it?
When chlorhexidine comes in contact with bacteria it disrupts the outer layer membranes of the bacteria causing them to burst and die. Since bacteria are responsible for the formation of plaque accumulation and gingival inflammation this process is now halted. The chlorhexidine used for periodontal disease often comes in mouthwash form that is swirled around in the mouth for 30 seconds twice a day, killing bacteria it comes in contact with and preventing them from colonizing a patient’s mouth. Without the bacteria there to cause inflammation, the gums now have a chance to heal and recover.
Chlorhexidine is often used in conjunction with other periodontal treatments such as deep cleanings – also known as scaling and root planing. This is because chlorhexidine isn’t as effective agains bacteria once they come together to form a colony known as a biofilm. Once the cleaning disrupts the biofilm the chlorhexidine can have better access to the bacteria in order to eliminate them.
This treatment applies to people who are suffering from peri-implantitis – a bacterial inflammation around a dental implant as opposed to the base of a natural tooth – helping them save their implants from failure.
Because chlorhexidine is so potent it kills the good bacteria in the mouth as well. This is why dentists don’t recommend using it for more than two weeks. The prescription is just long enough for the gums to recover and for your mouth to get a brand new start.
The mechanism through which chlorhexidine satins teeth isn’t fully understood yet. One theory is that chlorhexidine has an affinity to bind to staining materials such as those found in wine, coffee, and tea. By avoiding staining foods and drinks or drinking them through a straw in order avoid tooth exposure patients can avoid staining.
The good news is that these stains are just surface stains that can be removed with abrasive whitening toothpastes and dental cleanings at the dentist.
If you are undergoing chlorhexidine treatment and you have any concerns, whether it’s staining or anything else, always be sure to communicate with your dentist.