Since gingivitis is a highly prevalent condition,43 why is it that so many don’t recognize and/or take action when they encounter signs like overt bleeding during toothbrushing (“My gums have always bled!”), and aren’t aware of the risks of ignoring gingivitis?44,45 The role of dental professionals in addressing this disconnect is integral because they conduct and interpret clinical assessments that patients cannot, including:
It has been commonly presumed that there is a fairly predictable correlation between the age and/or the quantity (mass) of unremoved plaque and the severity of the corresponding gingival disease. Because of this, clinicians have typically taken the first-line approach for intervention by encouraging patients to reduce the amount of undisturbed plaque, namely through oral hygiene instruction in proper toothbrushing and flossing techniques and recommending more frequent preventive appointments.
A second (and often combined) professional strategy for addressing gingivitis targets plaque regrowth through adjunctive antimicrobial chemotherapeutic products (e.g., dentifrices and mouthrinses) that can be incorporated into the patient’s home care regimen: cetylpyridinium chloride (CPC), chlorhexidine, triclosan, and bioavailable SnF2 are common oral chemotherapeutics in use today and prescribed or recommended to patients. Their respective modes of action, relative benefits, and notes of interest are outlined in Table 2.
|Chemotherapeutic Oral Antimicrobial||Delivery Mode*||Method of Action(s)||Notes|
|Cetylpyridinium Chloride (CPC)
[e.g., Crest® Pro Health Oral Rinse Multi-Protection;a Philips Sonicare Breath Rx]b
|Mouth rinse||Lysis of cell walls; inhibits/disrupts cell growth and metabolism.51||
|Chlorhexidine Gluconate (CHX)
[e.g., Peridex™;c Paroex®;d Periogard®]e
|Mouth rinse||Bactericidal; also inhibits glycosidic and proteolytic enzymes55|
[e.g., Original Colgate® Total® formula, marketed 1997-2019]e
|Dentifrice||Broad-spectrum anti-bacterial; disrupts cytoplasmic membrane58|
|Stannous Fluoride (SnF2)
[e.g., Crest® Gum Detoxify;a Parodontax®;f Crest® Pro Health paste]a
|Dentifrice||Bacteriostatic and bactericidal; substantive; blocks inflammatory precursors25,26,29,30|
Patients are consumers who regularly encounter a plethora of product advertising through media in the drug store oral health aisle. When patients feel overwhelmed by all the choices, they rely on a trusted professional for product guidance. Evidence-based recommendations from published peer-reviewed research are paramount to help patients choose a well-tested and efficacious product with the best likelihood of addressing their particular needs. In the case of bioavailable SnF2, there is a significant body of research supporting its use for a variety of indications, including plaque and gingivitis.6,7,34,41,61-64