title: The comparative tea staining potential of phenolic, chlorhexidine and anti-adhesive mouthrinses.
abstract: Staining of teeth and mucous membranes is a well-known side-effect with chlorhexidine mouthrinses in which dietary chromogens play an important rôle. The purpose of this study was to determine whether a co-polymer anti-adhesive agent would prevent staining by a low concentration chlorhexidine solution. Additionally, the possibility that an essential oil/phenolic rinse product may cause staining was investigated. The rinses studied were the anti-adhesive alone and combined with 0.02% chlorhexidine and the essential oil/phenolic rinse. These were positioned against a positive control rise, 0.2% chlorhexidine, and a negative control rinse, water. The study was a single blind 5-treatment, randomised Latin square cross-over design, incorporating balance for carry-over effects. 15 volunteers participated and on Day 1 of each study period were rendered stain free by scaling and polishing of the teeth. Oral hygiene was suspended and 8 x per day subjects rinsed under supervision, firstly with the allocated formulation and then with 10 ml of warm black tea. On Day 4, tooth and tongue staining was scored by area and intensity (colour). A washout period of at least 3 1/2 days was permitted between treatment periods when oral hygiene was resumed. Before the study and during washouts, volunteers practised tongue brushing. Tooth and tongue staining was significantly increased with 0.2% chlorhexidine compared to the essential oil/phenolic rinse which in turn was significantly increased compared to the other 3 rinses. The antiadhesive/chlorhexidine rinse produced no more staining than the anti-adhesive or water rise. However, the parallel plaque regrowth study suggests this inhibition of staining resulted from the vitiation of the chlorhexidine activity by the antiadhesive. The methodology would appear a simple and quick way of assessing the propensity of mouthrinses to cause extrinsic staining.
authors.affiliation: Department of Prosthodontics, Dental School, Bristol, England.
authors.forename: M
authors.initials: M
authors.lastname: Addy
authors.forename: J
authors.initials: J
authors.lastname: Moran
authors.forename: R
authors.initials: R
authors.lastname: Newcombe
authors.forename: P
authors.initials: P
authors.lastname: Warren
mesh_terms: D000891:Anti-Infective Agents, Local / Q000009:adverse effects*; D002710:Chlorhexidine / Q000008:administration & dosage / Q000009:adverse effects* / Q000031:analogs & derivatives; D003116:Color; D018592:Cross-Over Studies; D003773:Dental Plaque / Q000517:prevention & control; D003777:Dental Prophylaxis; D012534:Dental Scaling; D004338:Drug Combinations; D006801:Humans; D008297:Male; D009067:Mouthwashes / Q000009:adverse effects*; D009822:Oils, Volatile / Q000009:adverse effects; D009910:Oral Hygiene; D010636:Phenols / Q000009:adverse effects*; D011092:Polyethylene Glycols / Q000009:adverse effects; D011109:Polymethacrylic Acids / Q000009:adverse effects; D012459:Salicylates / Q000009:adverse effects; D016037:Single-Blind Method; D013501:Surface-Active Agents / Q000009:adverse effects*; D013662:Tea / Q000009:adverse effects*; D013729:Terpenes / Q000009:adverse effects; D014059:Tongue / Q000187:drug effects / Q000473:pathology; D014075:Tooth Discoloration / Q000209:etiology*; D014867:Water
chemical_list: D000891:Anti-Infective Agents, Local; D004338:Drug Combinations; C089490:M 239144; D009067:Mouthwashes; D009822:Oils, Volatile; D010636:Phenols; D011109:Polymethacrylic Acids; D012459:Salicylates; D013501:Surface-Active Agents; D013662:Tea; D013729:Terpenes; D014867:Water; D011092:Polyethylene Glycols; C057473:Listerine; C010882:chlorhexidine gluconate; D002710:Chlorhexidine