Use of toothpicks for chlorhexidine staining

Area of Science:

• Dentistry
• Periodontology
• Preventive Dentistry

Background:

• Chlorhexidine gluconate (CHX) mouthrinse is effective in managing oral hygiene but can cause extrinsic dental staining.
• Managing CHX-induced staining is crucial for patient compliance and aesthetic outcomes.

Purpose of the Study:

• To investigate if patients can prevent or control extrinsic dental staining caused by chlorhexidine gluconate (CHX) mouthrinse using toothpicks.
• To assess the efficacy of a self-administered toothpick technique in reducing CHX staining.

Main Methods:

• 25 subjects used 0.12% CHX mouthrinse twice daily for 3 months after a dental prophylaxis.
• One side of the mouth served as a control, while the other (experimental) side involved using a toothpick to remove visible stain.
• Stain amount and intensity were photographed and graded by a blinded examiner at baseline and at 2 weeks, 1, 2, and 3 months.

Main Results:

• A statistically significant difference in stain amount, intensity, and a composite score was observed between the control and experimental sides.
• The toothpick intervention demonstrated a measurable effect on reducing CHX-related dental stain.
• While statistically significant, the clinical differences in stain reduction were noted as slight.

Conclusions:

• A simple toothpick technique can effectively impact and help manage extrinsic dental staining associated with chlorhexidine gluconate mouthrinse.
• Patient-applied mechanical removal may offer a viable strategy for controlling CHX-induced tooth discoloration.
• Further research could explore optimal techniques and long-term effects.