Effectiveness of 0.06% Chlorhexidine-based Mouthwash against Certain Oral Microflora among Patients Undergoing Fixed and Removable Orthodontic Treatment

Abstract

This study was conducted to evaluate the effectiveness of 0.06% chlorhexidine-based mouthwash available in local pharmacies when they were prescribed for use by patients undergoing orthodontic treatment. Fifteen patients undergoing fixed or removable orthodontic treatment were selected. Swabs were taken from five patients with ligature brackets, five patients with self-ligating, and the other five patients with removable orthodontic appliances. The concentration of the chlorhexidine-based products was 0.06%, and the culture method, as a fundamental microbiological technique, was chosen, which is based on the cultivation of microorganisms on specific nutrient media. The morphological and tinctorial analyses were also used to study the structure and shape of cells or tissues, as well as their staining with special dyes for subsequent microscopic examination. Further, the disk diffusion method (Kirby-Bauer Method) is based on measuring the zone of inhibition of microbial growth around disks impregnated with antibacterial agents placed on a nutrient medium. The collected data were analysed using Microsoft Excel and Statistica 10.0 software. Descriptive statistics were used to summarise the obtained results for each group. Oral microorganisms were identified in patients treated with conventional ligature brackets, self-ligating brackets, and removable orthodontic appliances. Differences in the composition and distribution of oral microorganisms were observed among the three studied groups, including variations in the prevalence of Gram-positive/negative cocci, Gram-positive/negative rods, spore-forming bacteria, and Candida species. 0.06% chlorhexidine-based mouthwash demonstrated high antibacterial activity when compared to chlorhexidine-free mouthwash; thus, it proved to be more effective in reducing the oral microflora growth. The mean inhibition zone diameters were 20.80 mm, 16.57 mm, and 19.67 mm in Groups 1, 2, and 3, respectively. It was concluded that the correct selection of antibacterial products and patient motivation to maintain oral hygiene play a critical role in preventing the accumulation of pathogenic microflora, particularly in patients undergoing orthodontic treatment, where the biofilm accumulation is significantly increased.