Antibacterial agents in the control of supragingival plaque - a review

This review considers the main agents which have been used as antibacterial agents in mouthwashes and other vehicles to inhibit the growth of supragin gival plaque. The agents discussed are bisguanide antiseptics, quaternary a mmonium compounds, phenolic antiseptics, hexetidine, povidone iodine, tricl osan, delmopinol, salifluor, metal ions, sanguinarine, propolis and oxygena ting agents. The plaque inhibitory, anti-plaque and anti-gingivitis propert ies of these agents are considered along with their substantivity, safety a nd possible clinical usefulness. Clinical trials of these agents that have been published are also reported. The possible clinical uses of antiseptic mouthwashes are finally considered along with some advice about assessing m anufacturers claims. Throughout this review the terms plaque inhibitory, an tiplaque and anti-gingivitis have been used according to the clarification of terminology suggested by the European Federation of Periodontology at it s second workshop. This defines a plaque inhibitory effect as one reducing plaque to levels insufficient to prevent the development of gingivitis; an anti-plaque effect as one which produces a prolonged and profound reduction in plaque sufficient to prevent the development of gingivitis; and anti-gi ngivitis as an anti-inflammatory effect on the gingival health not necessar ily mediated through an effect on plaque.