Study finds limited effectiveness of chlorhexidine for oral procedures.

LEIOA, Spain: The human oral cavity is populated by a variety of bacteria. Surgical procedures in the mouth thus pose the risk of bacteria passing into the bloodstream, causing bacteraemia. This is generally transient; however, it is not yet clear how bacteria in the blood are associated with the origin and evolution of infectious processes. Previous studies have shown that chlorhexidine mouthwashes have an antimicrobial effect on saliva and bacterial plague. However, a research team from the University of the Basque Country has now found that chlorhexidine mouthwashes have only an insignificant prophylactic effect regarding oral procedures.

To assess the effectiveness of chlorhexidine in preventing bacteraemia after a tooth extraction, the research group conducted a systematic review and meta-analysis of randomised controlled clinical trials. The study included eight clinical trials with a total of 523 patients. Of these, 267 were treated with chlorhexidine, among whom 145 cases of bacteraemia were recorded. The control group consisted of 256 patients, in which 156 cases of bacteraemia were found. The results therefore indicate that 12 per cent of bacteraemia cases could be prevented with chlorhexidine-based prophylaxis.

The results point to the relative and not particularly significant effectiveness of chlorhexidine with respect to preventing bacteria in the mouth from passing into the bloodstream during dental extractions. “Yet, given its low cost and the absence of adverse reactions and complications, we would recommend a mouthwash with chlorhexidine before a procedure of this type is carried out,” concluded the research group.

The study, titled “Does chlorhexidine reduce bacteremia following tooth extraction? A systematic review and meta-analysis”, was published on 23 April 2018 in PLOS ONE.