As the mouth provides a window into an individual’s general health status, prevention is the foundation of successful dentistry and an integral component of health and well-being. Undisturbed dental plaque biofilms are often seen as the precursor to tooth decay and gum problems. Studies have shown that gingivitis will develop within 10–21 days if all oral hygiene practices are stopped and plaque is allowed to accumulate undisturbed, left untreated it can lead to severe gum problems and even gum disease.
Plaque biofilm contains more than 600 different micro-organisms, contributing to the oral cavity’s overall dynamic environment that frequently undergoes rapid changes in pH, nutrient availability and oxygen tension. According to Jorgsen and Slot, “under suitable conditions, periodontal pathogens colonise the subgingival environment, incorporating into a tenacious biofilm, impacting both caries and periodontal disease” (2000). The plaque bacteria (Streptococcus mutans) demineralise the tooth surface by producing acid through the metabolisation of carbohydrates and therefore attack the minerals in the enamel, the cementum and the dentin (Duckworth, 1993). When considering the oral environment, about 20 per cent is occupied by tooth surfaces, those areas targeted for tooth brushing and flossing. The removal of interproximal plaque is considered to be an integral part of the maintenance of gum and oral health and for preventative measures. “Brushing and flossing/interdental cleaning displaces and dislodges plaque bacteria that can cause gingivitis and periodontal disease from the tooth surface” (Barnett ML (2006) and around the gingival margin.
It also helps to remove food particles from Interdental spaces.
Floss, tape, tooth picks, wire-free and Interdental brushes currently represent the primary methods available for interproximal cleaning. No one method suits all patients and it is difficult for any of these methods to access the posterior dentition. Interdental products coated with stabilised chlorine dioxide however may be considered a breakthrough in superior interdental cleaning. The unique advanced technology has been shown to eliminate bacteria associated with gum problems, tooth decay and plaque and allows oxygen to get below the gum to destroy volatile sulphur compounds (VSC).
Whilst both periodontal disease and tooth decay are associated with bacterial plaque, international researchers have known for some years that VSC, the family of gases which are primarily responsible for oral malodour, are also linked with a pathological role in the production of periodontitis, gingivitis and tooth sensitivity. The late eminent American periodontist, Professor Perry Ratcliff claimed that the link between oral malodour and periodontitis has implications for treatment and that extremely low concentrations of volatile sulphur compounds, the family of gases which are primarily responsible for oral malodour (by-products of the bacterial action and the putrefaction in the oral cavity of oral debris such as stagnating food, rotting skin cells, bacteria toxins and other sulphur containing substrates) are also highly toxic to the tissues in the mouth.
Dental plaque biofilm is not limited to tooth surfaces. About 80 per cent of the remaining surfaces including the oral mucosa, tongue and saliva, serve as reservoirs of pathogenic bacteria able to relocate and colonise on the teeth and gums. Ideally, the agent should be efficacious in reducing bacterial activity and have breath freshening properties which enhance usage compliance. Producing an antimicrobial effect throughout the entire mouth, brushing with a toothpaste containing stabilised chlorine dioxide can help to eliminate VSC and bacteria that accumulate in the gutters around the teeth, whilst the oral rinses can reach areas easily missed during tooth brushing and Interdental cleaning.
The challenge is to eliminate or control VSC and bacteria that cause tooth decay and gum disease in a way that does not introduce substances or cause bacteria to build an immune resistance. Researchers for years have sought an ideal plaque control agent. Stabilised chlorine dioxide has proven to be effective at this, as it works closely with the natural oral pH. It is very gentle on the delicate tissues of the mouth and when exposed to the acidic areas, where plaque has formed, the chlorine dioxide is released. Once released, it neutralises the production of acid in the mouth, helps to eliminate the VSC that cause bad breath and to effectively control plaque-causing bacteria, that may damage soft tissue. It acts as an oxidising agent, decreasing the ability of negative micro-organisms/ bacteria in the oral cavity to multiply. Research has also shown that stabilised chlorine dioxide can demonstrate efficacy at lowering concentration of VSC in periodontal pockets (Perry R Ratcliff and Paul W Johnson, 1999) by changing the molecular structure on contact. It is essential that dental care professionals understand the science behind products in order to consider how a particular technology or product potentially contribute to the process of oral health care.
Oral hygiene products with stabilised chlorine dioxide (like UltraDEX) can offer outstanding oral health benefits and be a significant aid in the fight against tooth decay, plaque, gum problems and other major oral hygiene conditions, when used as part of an oral hygiene regime. Bacteria cannot become resistant to it. The active ingredient not only provides a valuable aid for dental health and function, but also based on its high patient compliance; it helps encourage patients to become an active participant in their own oral healthcare.