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Chemotherapeutics

Chemotherapeutics and mouth rinses

Chemotherapeutics is broadly defined as 'the prevention or treatment of disease through the use of chemical substances'. In medicine, this would normally refer to the use of drugs such as antibiotics in infectious disease.1 In dentistry, a variety of antimicrobial and antiplaque agents have been used to augment mechanical plaque control methods.2

Types of chemotherapeutic anti-plaque agents:3

  • Surfactants/detergents
  • Antiseptic agents
  • Antimicrobial agents
  • Enzymes
  • Non-enzymatic plaque modifying agents
  • Agents which interfere with the attachment of micro-organisms

Surfactants facilitate plaque dispersal. Antiseptic agents aim at killing or preventing proliferation of plaque micro-organisms (should not be confused with disinfectants that kill micro-organisms on non-living surfaces). Antimicrobial agents inhibit (bacteriostatic) or kill (bactericidal) specific micro-organisms. Enzymes disperse the plaque matrix whereas non-enzymatic plaque-modifying agents alter the structure of plaque or its metabolic activity. Additionally, there are agents which interfere with the attachment of micro-organisms to the tooth surface (pellicle).3

Antibiotics are used medically to eliminate recognised pathogens within the body and therefore can affect dental plaque, although they are not used specifically for this purpose within dentistry.2,3

The chemical classification

Antiplaque agents can be classified as phenolics, essential oils, surfactants, herbal extracts, metal salts and enzymes.1,2

The use of antiseptics

Antisepsis is the elimination of disease-causing micro-organisms, and an antiseptic is a compound that is sufficiently non-toxic to be used in a living system.1 Antiseptics can be categorised as bactericidal – which kill bacteria – or bacteriostatic, which inhibit bacterial growth.2

References

  1. Concise Medical Dictionary. 1982, Corgi.
  2. Marsh PD. Contemporary perspective on plaque control. Brit Dent J 2012; 212(12): 601–606.
  3. Heasman P et al.Pharmacological control of periodontal disease. I. Antiplaque agents.J Dent 1994; 22(6): 323–335.