Combination chemotherapy of dental plaque infections

Chemotherapy against dental plague micro-organisms has proved effective in combatting both caries and periodontal disease. Chlorhexidine is the drug of choice when a broad-spectrum antiplaque agent is called for. However, because its mechanism of action is unspecific and the high concentrations needed for maximum effect may cause side effects, combination chemotherapy has been suggested. Chlorhexidine has been successfully combined with fluoride and, more recently, with xylitol. The combination allows the use of less concentrated solutions than if the agents were administered alone. Further, the mode of bactericidal action of chlorhexidine, fluoride and xylitol appears to be additive. A new aspect in the prevention is to control the primary bacterial colonization at the very moment when teeth erupt. To achieve this, new ways of delivering chemotherapeutic and other preventive agents are called for.