Abstract

CHLORHEXIDINE: A CATIONIC BISBIGUANIDE, MEMBRANE ACTIVE DRUG IN PERIODONTAL MEDICINE, STRUCTURE- ADVANTAGES AND ASSOCIATED ADVERSE EFFECTS, A BRIEF COMMUNICATION

Abhishek Singh Nayyar*

ABSTRACT

Chlorhexidine (CHX) is an antibacterial used for numerous applications. It is a cationic polybiguanide (bisbiguanide) used primarily as its salts, dihydrochloride, diacetate, and digluconate. Chlorhexidine is one of those drugs which are enlisted/included in the World Health Organization's List of Essential Medicines, a list of the most important drugs needed in a basic health care. At physiologic pH, chlorhexidine salts dissociate and release the positively charged chlorhexidine cation. The bactericidal effect is a result of the binding of this cation to the negatively charged bacterial cell walls. At low concentrations of chlorhexidine, this results in a bacteriostatic effect; however, at relatively higher concentrations, membrane disruption results in cell death. Chlorhexidine is active against Gram-positive and Gram-negative organisms, facultative anaerobes, aerobes, and yeasts. Chlorhexidine is often used as an active ingredient in various mouthrinses in periodontal medicine as one of the most efficient antiplaque agent. It has been shown to have an immediate bactericidal action and a prolonged bacteriostatic action due to adsorption onto the pellicle-coated enamel surface. If it is not deactivated, chlorhexidine lasts longer in the mouth than other mouthrinses, which is partly why it is still considered to be the most preferred antiplaque agent till today. The clinical efficacy of chlorhexidine as a component is well documented by many clinical trials however, continuous use of chlorhexidine for prolonged periods has also been seen to lead to staining of the tissues in the oral cavity, this being one of the most important limitation of long term use of chlorhexidine. This brief communication gives an overview of the drug with its structure, drug characteristics including dynamics and kinetics, mode of action, indications and potential adverse effects.

Keywords: Chlorhexidine (CHX), cationic bisbiguanide, periodontal medicine.