What is Chlorhexidine?

Chlorhexidine is a powerful "broad-spectrum" chemical antiseptic effective against Gram-positive, Gram-negative, aerobic and anaerobic bacterial species, with greater activity on Gram-positive than on Gram-negative germs. It is commonly sold in 0.12% and 0.2% solutions as a mouth rinse and also available as a gel.

Amazingly (and helpfully), the typical reason for shunning chemical preparations on your skin (or mucosa for that matter) - the fact that some of the concoction will penetrate into your bloodstream and body where it has to be detoxified by your hard-working liver etc. - does not apply to chlorhexidine.

While it adheres to teeth and oral mucosa for a long time, it does not penetrate into the body via the mucosal lining of your mouth. And about 100% of it is being excreted without being metabolised. So if you'd like to occasionally treat yourself to a mouth free of any odours or most bacteria, have at chlorhexidine, the amazing bacteria killer...

Mode of action

Chlorhexidine works by destroying the cell membrane of bacteria. While some argue that simultaneously all the good (beneficial) bacteria are clubbed to death as well, it can be safely said that when there are somewhat serious issues already present in the mouth, there has been no proper balance of bacteria in the first place - and using chlorhexidine helps the mouth off to a (literally) fresh start.

Chlorhexidine uses

Dentists will use chlorhexidine for a number of applications (using concentrations of 0.03 to 2%) particularly during dental surgery to create a nearly germ-free environment, as well as for gum treatment (gingivitis or periodontitis), halitosis and dry mouth. They may also recommend it for gum pocket and other oral inflammation.

While sellers recommend it as a regular treatment (they would, wouldn't they) such as for gingivitis and plaque reduction, Healing Teeth Naturally suggests to use chlorhexidine oral rinses or gels strictly on an occasional basis, such as when one feels a need to thoroughly clean out one's mouth "from the inside out" - and preferably at night.

(For regular purposes, xylitol (or erythritol) rinses are highly recommended. Additionally it was found that the temporary suppression of Streptococcus mutans [the main bacterium incriminated for causing cavities] following oral chlorhexidine rinses will be maintained if chlorhexidine application is followed by xylitol use.)

When used at bedtime as a stand-alone treatment (after brushing and rinsing teeth just with water for instance), waking with a totally odourless mouth is virtually guaranteed. In case you typically have an issue with "morning breath" you are likely to be delighted when you find yourself without a trace of mouth odour in the morning.

Chlorhexidine can also be helpful for those who for various reasons can't clean their teeth properly (such as wearers of permanent braces) although again xylitol rinses seem more recommended - most certainly for long-term application[6].

Chlorhexidine rinses have also helped people get rid of painful gum infections more quickly as well as deal with toothache (see the following testimonial).

Interestingly, a study from 2005 found that chlorhexidine rinses were even more effective against cavity-causing bacteria when combined with essential oils.[7]

Chlorhexidine and (extreme) toothache: a testimonial

A man who had developed new tooth decay (under an old filling[2]) eventually got great pain in the root of this tooth. The dentist only offered a root canal[3] or extraction[4] but since he wanted to neither have his tooth killed (a root canal kills the tooth while leaving its "skeleton" standing) nor have it extracted, he successfully used salt water and other simple remedies until even that triggered pain.

He then started to "bathe" the tooth in a chlorhexidine rinse daily a number of times (particularly before sleep) for several days in a row. The pain gradually subsided. (In the first round of such pain, he also took antibiotics for several days, and generally MSM in self-filled capsules.)

Eventually, pain could only be elicited by applying direct pressure onto the tooth. Later pain episodes were occasionally triggered by great stress or after brushing his teeth with a manual rather than electric toothbrush (which seemed to have led to plaque buildup). He continues to consider chlorhexidine a "life-saver".[5]

Less severe toothache (if the cause is bacterial which it most often seems to be) should more quickly yield to chlorhexidine rinses. If the solution seems to initially create more pain, try warming it up to body temperature before use.

Chlorhexidine deactivation

As a cation, chlorhexidine is susceptible to or neutralized by anions such as soaps and anionic detergents (e.g. sodium dodecyl sulfate and triclosan, compounds commonly found in conventional toothpaste and mouthwashes[1] but also similar anionic substances found in "health food store" toothpaste).

So do not use chlorhexidine after brushing with toothpaste or leave an interval of two hours or longer before the chlorhexidine rinse.

Chlorhexidine side effects

As with most things in life, and even more so with man-made chemicals, be aware that some people will have negative reactions to them. Pregnant/breastfeeding women as well as individuals with hypersensitivity issues may wish to abstain just to be on the safest possible side.

A short-term study published in Free Radical Biology and Medicine in 2013 (see www.ncbi.nlm.nih.gov/pubmed/23183324) found that twice-daily mouth rinses with 10 ml Corsodyl (containing 0.2% chlorhexidine) led to a slight increase (between 2 and 3.5 mmHg) in both systolic and diastolic blood pressure in the nineteen healthy volunteers tested over a seven-day treatment period.

This increase in blood pressure appeared within one day of starting on the antiseptic mouthwash. While this may indicate some special caution to be taken by people who suffer from high blood pressure (in fact, to be on the safest side they might want to forgo chlorhexidine-based products and use e.g. powerful essential oils instead), people with low or normal blood pressure might not be concerned (the man whose successful experience with chlorhexidine for extreme toothache is featured above continues to have low blood pressure in spite of regular chlorhexidine use).

With regular use of chlorhexidine oral rinses (which as mentioned, Healing Teeth Naturally does not endorse) the following side effects have been observed:

Staining of teeth and other oral structures/appliances incl. the tongue (parts of it can turn nearly black for a while), changes in taste perception, increase in plaque/calculus formation, oral irritation, allergy-type symptoms or mouth sores, tingling/numbness in the oral cavity, slowed healing of oral wounds.

All of these symptoms are typically fully reversible. In the beginning, there may be a bitter after-taste as well as a burning sensation in your mouth.

Also, according to one FDA document, the safety and effectiveness of [a major chlorhexidine product] has not been established in individuals under the age of 18.

Particulary when using chlorhexidine rinses at a higher concentration, do be careful to avoid contact with the eyes and other sensitive tissues adjacent to the mouth, extended contact can damage these susceptible tissues.

Tip: to minimize staining and if you only have a small area of concern in your mouth, use chlorhexidine in gel form and apply it topically just to the tooth and/or gum that actually hurts or is infected.

How to recognize chlorhexidine products: trade/brand names

Chlorhexidine can be found in many guises and is sold under a number of tradenames. In Germany for instance it is marketed under the brand names Chlorhexamed, Dynexan Proaktiv, Hexal-Lösung and Meridol.

The Swiss will encounter it as Corsodyl, Dentohexin, DermaPlast, Hibidil Sterile Lösung, Hibiscrub, Hibitane Konzentrat and Lifo-Scrub.

US-Americans will meet it in the garb of Peridex, Periochip, Perichlor and Periogard. Her majesty's UK subjects know it as Corsodyl or Chlorohex, Australians and New Zealanders as Savacol, and Indians as Clohex, Dejavu-MW, Suthol, and Sterimax.

Caveat: Some chlorhexidine products contain 6-7 % ethanol to extend shelf life and (supposedly) efficacy. Since ethanol carries potential health risks, make sure the product of your choice is free of ethanol.

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1 Not recommended by Healing Teeth Naturally, compare Toothpaste: hazardous to dental and bodily health?.

2 Developing new tooth decay under an existing filling is a common occurrence, see Drilling and Filling - an unwise choice?.

3 See Root Canal Treatment for the risks associated with root canals.

4 See Tooth extraction risks.

5 The page Tooth root infection suggested remedies reports on a number of powerful ways people have successfully gotten rid of tooth root infections without surgery.

6 See Xylitol sugar: more valuable uses for dental hygiene and other purposes.

7 Antimicrobial effects of essential oils in combination with chlorhexidine digluconate.

More on conventional approaches in dentistry