328
Australian Dental lourn;il. August. 1978
Volume 2 3 . No. 4
In vitro studies on the use of cetylpyridinium chloride as a bacterial plaque control agent James
D. Holbeche AND
Peter C . Reade
lkparttnetil of Dental Medicine atid Surgery, Tlii, U n i i * ~ ~ r s of i / v Melhorirrrr
ABSTRACT-Studies have shown that cetylpyridinium chloride (CPC) containing mouthwash may in vitro inhibit artificial bacterial plaque accumulation under certain conditions. These studies, together with the findings of clinical trials, suggest that the clinical activity of CP C in partially limiting plaque accumulation depends on its adherence to cleaned enamel surfaces. rather than its penetration in preformed plaque.
(Received for piiblicririoti Iirne, 1977. Rr\~i.redMarch. I978 )
Introduction
For some years an attractive concept in the prevention of dental caries has been the control of plaque by chemical means'.*. One antibacterial agent tested39 was the quarternary ammonium compound ( C P C ) used as a mouthwash. This mouthwash containing 0.05 per cent w/v CPC* was used after meals in association with toothbrushing and it was found that the thickness and extent of accumulated plaque was significantly reduced. The concentration of
* Cepncol - W . S. Merrell
' Mandel,
1. D.-New
approaches to plaque prevention. Dent. Clin. North Amer. 16:4, 661-671 (Oct.) 1972. 3 Scherp, H. W.-Dental carie's: prospects for prevention. Science 173: 1199-1205 (Sept.) 1971. ''Holbeche 'J. D.. Ruljancich, M. K., and Reade P. C.A clidical trial of the efficacy of a cetylpiridinium chloride-based mouthwash. 1. Effect on plaque accumulation and gingival condition. Austral. D. I., 206, 397-404 (Dec.) 1975. 4 Holbeche, J. D.. Ruljancich, M. K.. and Reade,, P., C. A clinical study of the effect of a cetylpyrldmum chloridebased mouthwash on the concentration of Sireprococcus mutans in dental plaque. Austral. D. I . , 2 1 : 5 . 383-387 ( a t . ) 1976.
Strrp~oc~occus inrtfutrs in the accumulated plaque
was not affected. This report describes related in bsifro studies of this antibacterial substance and
complements the findings of the clinical trial3. Methods
Two procedures utilizing artificial plaque produced by Strrp. niulans were used to examine the plaque-inhibiting capabilities of the proprietary mouthwash*. In both cases the bacterial culture used to produce artificial plaque was a strain of S t r e p . rnirtaris originally isolated from human dental plaque and known to produce large adherent deposits when grown in medium containing sucrose.
1. Tests on preformed artificial plaque on wires This method, modified slightly from that of Keyes and McCabe5, tests the ability of an agent to penetrate and kill the organisms present in artificial bacterial plaque.
j
Keyes, P. H.. and McCabe. R. M.-The potential of various compounds to suppress microrganisms in plaques produced in vitro by a streptococcus or an :ictinomycete, J.A.D.A.. 86:2. 396-400 (Feb.) 1973.
Australian Dental Iournal. August. 197X
3 29
TABLEI
TABLE2
A.s.~e.s.vtierrtof in vitro activity against preformed urtificial plaques on wires
A.ssessniertr of in vitro inhibition of the formation of artificial plaque on teeth
Antiseptic and concentration
Immersion time (min)
I 5 10 0. I(.$
CPC
20 I 5 10
1 % CPC
0.25 I 5 I0 ).2% chlorhexidine I 5 gluconate 0.1% benzal5 konium chloride Distilled water 10 (control)
"t -
**
Acid Production.
24 hr
48 hr
+++ + ++ +
+++ + +++ ++ +2 *__
k t 2
*
.-
+
+
Antiseptic and concentration
7 days
+++ + + + ++ ++ +
-~
+
acid production (ph < 5 . 2 )
no acid production (ph
Australian Dental lourn;il. August. 1978
Volume 2 3 . No. 4
In vitro studies on the use of cetylpyridinium chloride as a bacterial plaque control agent James
D. Holbeche AND
Peter C . Reade
lkparttnetil of Dental Medicine atid Surgery, Tlii, U n i i * ~ ~ r s of i / v Melhorirrrr
ABSTRACT-Studies have shown that cetylpyridinium chloride (CPC) containing mouthwash may in vitro inhibit artificial bacterial plaque accumulation under certain conditions. These studies, together with the findings of clinical trials, suggest that the clinical activity of CP C in partially limiting plaque accumulation depends on its adherence to cleaned enamel surfaces. rather than its penetration in preformed plaque.
(Received for piiblicririoti Iirne, 1977. Rr\~i.redMarch. I978 )
Introduction
For some years an attractive concept in the prevention of dental caries has been the control of plaque by chemical means'.*. One antibacterial agent tested39 was the quarternary ammonium compound ( C P C ) used as a mouthwash. This mouthwash containing 0.05 per cent w/v CPC* was used after meals in association with toothbrushing and it was found that the thickness and extent of accumulated plaque was significantly reduced. The concentration of
* Cepncol - W . S. Merrell
' Mandel,
1. D.-New
approaches to plaque prevention. Dent. Clin. North Amer. 16:4, 661-671 (Oct.) 1972. 3 Scherp, H. W.-Dental carie's: prospects for prevention. Science 173: 1199-1205 (Sept.) 1971. ''Holbeche 'J. D.. Ruljancich, M. K., and Reade P. C.A clidical trial of the efficacy of a cetylpiridinium chloride-based mouthwash. 1. Effect on plaque accumulation and gingival condition. Austral. D. I., 206, 397-404 (Dec.) 1975. 4 Holbeche, J. D.. Ruljancich, M. K.. and Reade,, P., C. A clinical study of the effect of a cetylpyrldmum chloridebased mouthwash on the concentration of Sireprococcus mutans in dental plaque. Austral. D. I . , 2 1 : 5 . 383-387 ( a t . ) 1976.
Strrp~oc~occus inrtfutrs in the accumulated plaque
was not affected. This report describes related in bsifro studies of this antibacterial substance and
complements the findings of the clinical trial3. Methods
Two procedures utilizing artificial plaque produced by Strrp. niulans were used to examine the plaque-inhibiting capabilities of the proprietary mouthwash*. In both cases the bacterial culture used to produce artificial plaque was a strain of S t r e p . rnirtaris originally isolated from human dental plaque and known to produce large adherent deposits when grown in medium containing sucrose.
1. Tests on preformed artificial plaque on wires This method, modified slightly from that of Keyes and McCabe5, tests the ability of an agent to penetrate and kill the organisms present in artificial bacterial plaque.
j
Keyes, P. H.. and McCabe. R. M.-The potential of various compounds to suppress microrganisms in plaques produced in vitro by a streptococcus or an :ictinomycete, J.A.D.A.. 86:2. 396-400 (Feb.) 1973.
Australian Dental Iournal. August. 197X
3 29
TABLEI
TABLE2
A.s.~e.s.vtierrtof in vitro activity against preformed urtificial plaques on wires
A.ssessniertr of in vitro inhibition of the formation of artificial plaque on teeth
Antiseptic and concentration
Immersion time (min)
I 5 10 0. I(.$
CPC
20 I 5 10
1 % CPC
0.25 I 5 I0 ).2% chlorhexidine I 5 gluconate 0.1% benzal5 konium chloride Distilled water 10 (control)
"t -
**
Acid Production.
24 hr
48 hr
+++ + ++ +
+++ + +++ ++ +2 *__
k t 2
*
.-
+
+
Antiseptic and concentration
7 days
+++ + + + ++ ++ +
-~
+
acid production (ph < 5 . 2 )
no acid production (ph
