Hibitane in the treatment of aphthous ulceration

In the absence of a known aetiology the management of recurrent aphthous ulceration is symptomatic with the removal of predisposing factors where possible. Since the severity and duration of ulcers may be increased by bacterial contamination, the effect of chlorhexidine gluconate in mouthwash and gel forms on the natural history of the condition has been studied. The mouthwash study employed a 0.2% chlorhexidine gluconate solution, a 0.5% astringent solution and a control mouthwash. Each mouthwash was used by all of the patients, with 5 ml of each preparation being diluted with 5 ml of water for use three times a day. The gel study employed a 1% chlorhexidine gluconate and a placebo gel with approximately a 1 inch of the gel from the tubes being placed in the mouth three times a day. Both studies were carried out in the double-blind crossover manner with each preparation used for 5 weeks with a 2-week interval between preparations. In the mouthwash trial chlorhexidine gluconate significantly reduced the incidence, duration and severity of ulcers, whereas in the gel trial chlorhexidine significantly reduced the severity and duration but not the incidence of ulceration. Since the dosage regimes for chlorhexidine in the two studies were comparable, the mode of delivery would appear to be important in the therapeutic effectiveness.