Chlorhexidine digluconate and Gluconate mouthwash and spray for wounds

The chlorhexidine is an antiseptic used as a mouthwash or as a gel disinfectant for wounds and skin. It can be used as an aqueous solution, soap-based, as gluconate or digluconate. Many brands such as Lacer, Perio Aid, or Bexident include it in their composition. So let’s look at its properties, side effects, and whether it really works to prevent and eliminate stains on teeth.

It is worth mentioning that although it is well-known as a mouthwash or rinse, it also has a commercial form for treating and disinfecting wounds, making it suitable for topical use, that is, on the skin.

Moreover, it also has many uses as a surgical disinfectant, being employed in dentistry, surgery, and interventions where antisepsis is necessary for the utensils and materials required for interventions on humans and animals.

What is Chlorhexidine and What Is It Used For

It is a biguanide, an antiseptic substance with properties to eliminate bacteria and fungi. Its uses include as a mouth disinfectant, to treat wounds, and to keep the skin clean and healthy.

It is included in the list of Essential Medicines by the World Health Organization (WHO). With many uses in dentistry as a mouthwash and in dermatology as a gel or spray.

It comes in different concentrations depending on the type of infection or pathology to treat, these are 0.2%, 0.12%, and 0.10%. In many online stores and pharmacies, you can buy it as “chlorhexidine digluconate” or “gluconate”, with higher concentrations such as 4% in aqueous solution used to wash hands before surgery, and 5% for producing antisepsis on the utensils to be used in operating rooms.

Types of Chlorhexidine

• Digluconate.
• Chlorhexidine gluconate

According to its chemical structure, it is very common to use it in these forms. Although in some references it is mentioned without gluconate or without digluconate, the common form is that it is present in these chemical forms that act as both an oral and topical antiseptic. It also has applications as a disinfectant in the wine industry, used with tartaric acid, another additive for wine production.

Digluconate and Chlorhexidine Gluconate

It is composed of two molecules that form a single substance, gluconic acid and chlorhexidine.

Gluconic acid appears by the oxidation of glucose by microorganisms such as enzymes, fungi, or bacteria and is commercially available in liquid form.

By combining these two substances (gluconate and chlorhexidine), it has better properties for human health. It acts as an oral antiseptic in low concentrations or as a high-level disinfectant when concentrations exceed 4%.

Chlorhexidine can also be used for dogs and pets, employed in the same way, either to wash the oral cavity, teeth, and gums without the animal swallowing it, or for use by veterinarians.

Commercial Forms

• Mouthwash.
• Gel.
• Spray for wounds.
• Soap-based.

Because it can be diluted in alcohol and other substances beneficial for connective tissue (gums, teeth, skin, etc.), it is ideal to make a mixture and produce different medicinal products.

Chlorhexidine Mouthwash

It is a mouth rinse that eliminates germs from teeth and gums. Chlorhexidine as mouthwash provides freshness, cleans, and acts as a treatment against dental plaque.

While providing relief from oral discomfort, it also gives a slight bitter taste that is pleasant and refreshing.

This form of presentation (mouthwash) is very well known.

Chlorhexidine mouthwash works to treat gum inflammation and abscesses, gingivitis, as well as mouth ulcers and abscesses. It eliminates bacterial plaque and serves as an adjunct for treating gingivitis and other oral conditions. It is also effective in cases of periodontitis and dental implants.

It acts as an oral antiseptic and is used as a mouthwash. You must rinse your mouth with it and then spit it out. Never swallow the liquid, as it is toxic and irritating to mucous membranes due to its potency.

In its commercial mouthwash version, chlorhexidine is sold at concentrations of 2%, 0.2%, and 0.12%.

The most well-known brands of this product are OralB, Lacer, Bexident, and Perio Aid.

Gel

With a slightly different formulation but similar functionality, chlorhexidine gel works as a mouthwash or rinse.

This presentation is thicker than the liquid form, working in the same way.

The action of chlorhexidine gel is identical to that of mouthwash, but the difference is that it must be applied directly to the affected area. Whether on the tooth, molar, or gums with infection symptoms.

Since it is a thicker and more compact product, it works less effectively for rinsing or gargling, but its results are just as good.

At the same time as being sold as gel, chlorhexidine gel dressings or bioadhesives are also available. For example, Lacer sells them to apply directly to the infected area.

Spray for Skin and Wounds

In spray form, it can be used for both the mouth and other areas of the body, being useful for treating mouth infections as well as disinfecting scratches and bruises.

Chlorhexidine spray for wounds is a topical solution that serves to disinfect wounds, preventing them from getting infected by microbes and thus maintaining the healing time without the danger of germs causing pus or delaying healing.

The antiseptic chlorhexidine spray prevents infection by pathogens and, if present, eliminates them. It inhibits the growth and reproduction of microbes, whether they are bacteria or fungi.

Thanks to this form of presentation, it is very easy to use. It works well when applied to the skin, keeping it free from infections for several hours.

Soap Solution

Sometimes referred to as gel, although chlorhexidine soap solution is a disinfectant solution that works as a hand soap to eliminate germs.

Its composition and molecular form improve dermal absorption, providing emollients that promote skin hydration.

It is usually accompanied by a moisturizing substance to increase its effectiveness and benefits for the skin. These substances included in the formula may be hyaluronic acid, aloe vera, or provitamin B5, substances that act as skin nutrients and moisturizers, which while hydrating, strengthen the cellular system after disinfection.

In many cases, the soap solution can be bought as liquid chlorhexidine soap, most often corresponding to the same disinfectant product for human and animal use.

Does it work as an antiseptic?

Yes. One of the properties of chlorhexidine is antisepsis, that is, the action to inhibit the growth of microorganisms, germs that cause infections in humans and other animals.

It works well as an antibacterial and antifungal, so you can use it as a general antimicrobial and as a treatment to disinfect the skin and oral cavity, whether you use it in spray form or in its other commercial forms such as mouthwash or gel.

The use as an oral antiseptic is very effective, halting the proliferation of bacteria on the teeth, the so-called dental plaque, but also other types of microorganisms that damage and prevent proper tissue healing.

Chlorhexidine antiseptic spray is very effective for the skin. A single application on the skin surface is enough to prevent the proliferation of common germs in small wounds and scratches.

Uses as an aqueous solution or gel

Any of these presentations work well, but the uses of aqueous chlorhexidine should be differentiated, as this is somewhat different from the gel or mouthwash.

The action of the “aqueous” version is as a topical antiseptic, meaning aqueous chlorhexidine is for the skin. It reacts with both gram+ and gram- microorganisms, producing the alteration of bacterial permeability. This way, it penetrates and destroys the pathogens. This is ideal for keeping the skin and the tissue of wounds and scars clean and healthy, as well as for disinfecting hands before surgery.

It is very common to find it in aqueous solutions or as a main ingredient in mouthwashes that have some differences from regular mouth rinses.

In this format, it is commonly found in concentrations ranging from 0.5% to 2%.

Side effects of chlorhexidine

• Discoloration of teeth.
• Loss of dental enamel.
• Change in tongue color.
• Effects on the appearance of dental fillings.
• Inflammation of salivary glands.
• Increased tartar.
• Transient taste alteration.
• Skin or tongue irritation.
• Itching.
• Partial depigmentation of the treated area.

Occasional use typically does not trigger adverse reactions, although continuous use has a much higher chance of producing chlorhexidine side effects.

If you need to rinse your teeth for several consecutive days, you should know that after the 7th day, tooth discoloration and staining of the tongue’s dorsal surface may appear.

Dental fillings can also be affected by continued use of chlorhexidine digluconate. After 6 months, color changes in the teeth are visible in half of the cases.

To avoid side effects with chlorhexidine, it is necessary to undergo a dental cleaning. In the case of fillings, they will need to be replaced if this color change occurs.

Taste alteration varies from person to person. The more frequently you use the antiseptic, the greater the likelihood of losing the sense of taste. However, after discontinuing use, the taste buds will return to normal after a few days.

As for the appearance of tartar, it is advisable to have it removed every 6 months if the use is continuous. Although the use of chlorhexidine can inhibit tartar formation, this type of subgingival bacterial plaque usually resists the action of oral antiseptics, making it necessary to remove it by a dentist.

Chlorhexidine in children can cause inflammation of the salivary glands and blockage of the parotid duct.

Stain on Teeth

One of the most common side effects of chlorhexidine is the appearance of stains on the teeth.

When used frequently and for a long period, small areas on the teeth may develop a different color. This adverse reaction typically disappears a few days after discontinuing use. If the stain does not go away, a visit to the dentist will be necessary for a dental cleaning.

Generally, chlorhexidine stains disappear on their own after a few weeks. However, if used for more than 6 consecutive months as a mouthwash, they may become permanent. With occasional use, staining is unlikely to occur.

Contraindications

• Minors under 18 should use it with caution and not continuously.
• Breastfeeding.
• Pregnancy.
• Allergy.
• Permanent damage to ocular mucous membranes.
• Skin disease.
• Deep wounds that penetrate the superficial layers of the skin.
• Treatment with Disulfiram.
• Use of metronidazole and nitroimidazole medications.

Allergic reactions to oral chlorhexidine are rare, though it’s always good to keep this contraindication in mind.

If you want to apply it topically, although it is a functional antiseptic, the wound must be superficial. If it penetrates deep dermal tissues, it can cause damage, as can mucous membranes.

Another contraindication for chlorhexidine is its use with disulfiram and treatments for alcoholism. Many mouthwashes and rinses contain alcohol, which is counterproductive for detoxification therapy.

Absorption through the digestive tract is minimal; however, adverse effects may occur.

It can also interact with metronidazole.

Pregnancy and Breastfeeding

Regarding the use of chlorhexidine during pregnancy, there are no clinical studies proving its safety or the advisability of avoiding it, so it should be avoided to prevent possible harm to the fetus.

Similarly, during breastfeeding, it is not clear whether it can cross the mammary barrier and be excreted in breast milk. In this case, as with pregnancy, it is also recommended to avoid using chlorhexidine gluconate or digluconate during breastfeeding.

Can it be used with a dental irrigator?

It is entirely feasible and actually advisable to use an oral antiseptic, although the frequency of using a dental irrigator may be higher. The action of these two dental health aids is essential, though each case should be considered. If there are wounds in the mouth, the use of the irrigator may need to be postponed.

However, using dental irrigators with chlorhexidine and/or a toothbrush is very practical and healthy for maintaining optimal oral hygiene.

How to Use Chlorhexidine

• Mouthwash or chlorhexidine Lacer: 10 ml. undiluted in water, directly into the oral cavity. Hold the liquid in your mouth for 1 minute and spit it out without swallowing.
• Gel: Apply chlorhexidine gel directly to the area to be treated, gums, gingival sulcus, or areas with inflammation. For best effects, you can use the cannula that comes with the container. Repeat 2 to 3 times a day.
• For wounds and on the skin: Apply once or twice a day. Do not exceed the dose within 24 hours.

To enhance the effects and improve its effectiveness, it is advisable not to consume any liquids or food for the 15 minutes following the use of chlorhexidine mouthwash and rinse presentations.