Man in the recent times has achieved a giant leap in the field of dentistry. With the increase in the knowledge and attitude of the newer technological enhanced patients, the concept of treatment is now increasingly been replaced by prevention1. The paradigm is now been shifted from disability limitation to treatment of diseases. Gingivitis is not an exemption here. This reversible form of the disease has seen in the last two decades shows a paradigm shift from treatment to prevention. With improvement at genetic and molecular levels, understanding the disease cause and disease progression has now become easier. With knowledge empowerment in this sector, a lot has been achieved in the treatment and prevention sector. It has been always the mindset of a dental patient that prevention is always better than cure as it is rightly said an ounce of prevention is better than a pound of cure. In the field of dentistry especially with regards to dentistry rings the bell of chlorhexidine in the mind of the dentist. Gingivitis and various forms of periodontal disease have always been attributed to the complex formation of plaque adherence, accumulation, initiation and progression of disease on the biofilm. Enriched information is now increasingly available on the complex mechanism involved in biofilm and plaque formation4. Listerine the first ever formed essential oil antiseptic was given to the world by Joseph Lawrence Lister in the year 18791. Though this has been introduced almost a millennium to chlorhexidine, the usage of essential oil mouthwashes has been limited for the treatment of halitosis in the dental field. With the antiseptic chlorhexidine discovery in the 1940’s when it was first introduced to the world by Imperial Chemical Industries in England1. 1950’s saw chlorhexidine as a popular general antiseptic in comparison with essential oil mouthwash wash2. The ability to inhibit oral plaque by chlorhexidine was first observed by Schroeder in 19693 and it was evidenced in a more scientific manner by Loe and Schiott 19724. From time immemorial plaque buildup was challenged indispensable by chlorhexidine gluconate with practically no replacement or alternate strategies available for it. Since then a war is waged as to which is mightier – chlorhexidine or essential oil mouthwash!
Chlorhexidine (CHX) is a broad-spectrum antimicrobial agent that destroys the cell membrane by precipitation and coagulation of the cytoplasmic proteins of the microbial flora. Chlorhexidine mouth rinses are available in the form of 0.2% and 0.12% and it has been
show that their efficacy is similar at similar doses5. Essential oil mouthwash also inhibits plaque formation by destroying the cell membrane in addition to interference with the inflammatory process. The prophylactic usage of gold standard chlorhexidine and essential oil mouthwash remains a debatable topic. With the usage of antibiotics, chlorhexidine has been scrutinized in the recent times due to complication of resistance and increased staining properties, the usage of chlorhexidine is now warranted. Reports by both the American and British professional societies have now given an insight so as to the usage of prophylactic usage of mouth rinses. Chlorhexidine is still considered as the gold standard for its antimicrobial action but due to increased plaque formation, staining capacity and resistance may now limit its continued use1. These
Arguments bring us to light about the fact that -chlorhexidine can still be considered as a gold standard for prophylactic prevention or the time has come for its reconsideration.