Genotoxicity of chlorhexidine mouthwash in gingivitis patients' cells

| Posted in: Science Health Sciences

Journal name: Journal of Indian Society of Periodontology
Original article title: Genotoxic assessment of chlorhexidine mouthwash on exfoliated buccal epithelial cells in chronic gingivitis patients
The Journal of Indian Society of Periodontology (JISP) publishes original scientific articles on periodontology (the study of supporting structures of teeth) and oral implantology. It is a bimonthly open-access journal with special issues for specific occasions.
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Original source:

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Author:

Saif Khan, Asad Ullah Khan, Sadaf Hasan


Journal of Indian Society of Periodontology:

(A bimonthly open-access journal)

Full text available for: Genotoxic assessment of chlorhexidine mouthwash on exfoliated buccal epithelial cells in chronic gingivitis patients

Year: 2016 | Doi: 10.4103/jisp.jisp_9

Copyright (license): CC BY-NC-SA


Summary of article contents:

Introduction

Chlorhexidine (CHX) is widely recognized as the gold standard among chemical plaque control agents and is commonly prescribed as a mouthwash in clinical practice. Despite its effectiveness in managing dental plaque and associated conditions such as chronic gingivitis, there have been numerous studies indicating its potential cytotoxic and genotoxic effects on various eukaryotic cells. This study investigates the genotoxic impact of 0.2% CHX mouthwash on buccal epithelial cells by using micronuclei as a biomarker for DNA damage in chronic gingivitis patients. The research involved comparing patients utilizing CHX alongside mechanical plaque control measures with those relying solely on mechanical methods.

Genotoxic Effects of Chlorhexidine

The results of the study indicated a significant difference in the mean number of micronucleated cells and micronuclei between the control group and those using CHX. Specifically, the mean number of micronucleated cells ranged from 0.41 ± 0.71 in the control group to 11.7 ± 1.87 in patients who used CHX for 24 weeks. Similarly, the mean number of micronuclei showed a dramatic increase from 0.48 ± 0.80 in the control group to 14.5 ± 2.49 in the longest usage subgroup. These findings suggest a clear trend indicating that prolonged exposure to CHX correlates with an increase in genotoxicity, as evidenced by the rise in both parameters with extended duration of use.

Conclusion

The study underscores the potential genotoxic effects of chlorhexidine mouthwash on buccal epithelial cells, raising concerns regarding the long-term use of CHX as a chemical plaque control agent. The results advocate for a reevaluation of its use, emphasizing the need for alternative antiplaque agents that offer similar efficacy without the associated risks of genotoxicity. Patient education on proper oral hygiene techniques and adherence to mechanical plaque control methods could effectively mitigate the need for prolonged chemical intervention, thereby lowering the potential health risks associated with CHX usage.

FAQ section (important questions/answers):

What is the main purpose of this study on chlorhexidine?

The study aimed to assess the genotoxic effects of 0.2% chlorhexidine mouthwash on buccal epithelial cells in chronic gingivitis patients, using micronuclei as a biomarker for DNA damage.

What were the findings regarding the use of chlorhexidine?

The study found that the mean number of micronucleated cells and micronuclei significantly increased with the duration of chlorhexidine mouthwash use, indicating its genotoxic potential.

How were the buccal epithelial cells collected for the study?

Buccal epithelial cells were collected using a soft toothbrush to gently scrape the buccal mucosa, with cells suspended in a buffer solution for analysis.

What are micronuclei and why are they important in this study?

Micronuclei are small DNA-containing structures separate from the nucleus and indicate chromosomal damage. They are used as biomarkers for studying genotoxicity in cells, such as those in buccal epithelium.

What conclusion does the study reach about chlorhexidine's effects?

The study concludes that chlorhexidine mouthwash is genotoxic to buccal epithelial cells, with increased genotoxicity observed alongside longer durations of use, prompting reconsideration of its long-term applications.

Glossary definitions and references:

Scientific and Ayurvedic Glossary list for “Genotoxicity of chlorhexidine mouthwash in gingivitis patients' cells”. This list explains important keywords that occur in this article and links it to the glossary for a better understanding of that concept in the context of Ayurveda and other topics.

1) Table:
In the context of a study, a table presents organized data clearly and concisely, allowing for easy comparison and analysis of results. It summarizes findings such as the number of micronucleated cells across different groups, aiding in understanding the impact of chlorhexidine on genotoxicity in buccal epithelial cells.

2) Study (Studying):
A study refers to a systematic investigation aimed at discovering new knowledge or validating existing information. In this context, the study investigates the genotoxic effects of chlorhexidine mouthwash on human buccal epithelial cells, providing crucial data on its implications for oral health and risk assessment.

3) Blood:
Blood is a vital fluid that circulates in the body, carrying oxygen and nutrients to cells while removing waste. The relevance of blood in this study lies in potential comparisons with blood lymphocytes, establishing a broader understanding of chlorhexidine's genotoxic effects beyond just oral cells.

4) Relative:
The term 'relative' signifies the comparison between different groups or measures. In the study, it helps convey the relationship between the duration of chlorhexidine use and the corresponding increase in genotoxicity in buccal cells, showing how effects magnify with time.

5) Death:
Death refers to the cessation of biological functions that sustain a living organism. In toxicological studies, such as this one, cell death or cytotoxicity is a critical endpoint, indicative of harmful effects of substances like chlorhexidine, influencing safety assessments for clinical practices.

6) Transformation (Transform, Transforming):
Transformation in a biological context often pertains to the change of a cell or tissue, which can lead to cancer. In this study, monitoring for signs of transformation in buccal epithelial cells due to chlorhexidine exposure serves to evaluate its potential carcinogenicity.

7) India:
India is the geographical context of the study, where chronic gingivitis patients were assessed. Cultural and regional factors may influence dental health practices and the prevalence of conditions like gingivitis, making the findings pertinent to public health and dental care policies specific to the region.

8) Inflammation:
Inflammation is a biological response to harmful stimuli, involving immune activation. In chronic gingivitis, inflammation is a key characteristic. Understanding how chlorhexidine affects inflamed tissues offers insight into its therapeutic benefits and possible adverse effects on gum health.

9) Observation:
Observation refers to the systematic noting and recording of experimental outcomes. In this study, the detailed observation of micronuclei presence in epithelial cells forms the basis of establishing chlorhexidine's genotoxic effects, grounding the study in empirical evidence.

10) Disease:
Disease denotes a pathological condition of a bodily part or system resulting from various factors, like infection or toxic exposure. Chronic gingivitis, the focus of this study, is influenced by plaque accumulation and requires effective management, which chlorhexidine aims to address.

11) Account:
An account is a detailed report or narrative concerning an event or phenomenon. In the study context, giving an account of findings related to chlorhexidine use essentially communicates the implications of its genotoxicity to both scientific community and public health.

12) Glass:
Glass surfaces are utilized in laboratories for the preparation and observation of specimens. The study involved microscopy on glass slides to view buccal cells, highlighting the fundamental role of glass in experimental methodologies and accuracy in medical research.

13) Water:
Water serves as a crucial solvent and medium for many biological and chemical processes. In this study, autoclaved distilled water was used for preparing buffer solutions, emphasizing the importance of compatibility and purity in laboratory experiments for reliable results.

14) Gold (Golden):
Gold, in this context, symbolizes the highest standard of something, particularly referring to chlorhexidine being the 'gold standard' in chemical plaque control. This status asserts its comparative efficacy against other agents in managing oral hygiene, framing its value in clinical dentistry.

15) Accumulation (Accumulating, Accumulate):
Accumulation refers to the gradual gathering or amassing of substances. In dental health studies, the accumulation of plaque/gingival biofilm is a precursor to diseases like gingivitis. Understanding how chlorhexidine affects plaque accumulation is vital for evaluating its mouthwash effectiveness.

16) Discussion:
The discussion section of a study interprets and analyzes the findings, placing them in context with existing literature. It allows researchers to explore implications, limitations, and future research directions regarding chlorhexidine's genotoxicity and overall oral health effects.

17) Substance:
A substance is a form of matter with a specific composition and properties. The term is critical in toxicology to assess the risk associated with compounds. In this study, chlorhexidine is the substance of interest in evaluating its safety and health effects.

18) Pesticide:
Pesticides are substances used to eliminate pests, commonly researched for their toxicological effects on health. While not directly related to the study focus, pesticides share the concept of environmental exposure, drawing parallels regarding chemical effects on human tissues, including buccal cells.

19) Toxicity:
Toxicity measures the degree to which a substance can harm living organisms. In the study, establishing the toxicity of chlorhexidine toward buccal epithelial cells is essential for assessing its safety profile and guiding clinical recommendations for dental hygiene products.

20) Swelling:
Swelling is a common inflammatory response characterized by an increase in volume, often related to tissue injury or infection. Its relevance here links to the adverse effects of chlorhexidine, drawing attention to safety concerns for long-term oral treatments.

21) Dividing:
Dividing refers to the process of cellular replication. In studies of genotoxicity, understanding how agents like chlorhexidine affect dividing cells is crucial for assessing their potential impact on proliferation and cancer risk in epithelial tissues.

22) Science (Scientific):
Science embodies the systematic study of the structure and behavior of the physical and natural world through observation and experimentation. The study exemplifies scientific inquiry by investigating chlorhexidine's effects, demonstrating the essence of research in advancing dental health knowledge.

23) Cancer:
Cancer signifies uncontrolled cell growth leading to tumors. The investigation of substances like chlorhexidine for genotoxicity directly relates to cancer risk assessment, ensuring that dental products do not contribute to malignant transformations in buccal epithelial cells.

24) Cotton:
Cotton is used in a medical context for various hygienic purposes, including the handling of tissues in laboratory settings. Its mention implies an aspect of the methodology, underscoring the importance of maintaining sterile conditions during sample collection and analysis.

25) Chang:
Chang likely refers to researchers whose work contributes to the understanding of chlorhexidine's cytotoxic and genotoxic effects. Citing relevant studies by researchers like Chang builds a foundation for the current study, linking past findings with existing knowledge.

26) Visit:
Visit refers to clinical appointments where patients receive care or treatment. The relevance of visits encompasses follow-up for chronic gingivitis patients, emphasizing the importance of regular dental checks in monitoring both health status and treatment efficacy.

27) Hela (Helá):
HeLa refers to a widely used immortal cell line derived from cervical cancer cells. This term indicates the research context where such cells may be relevant for experimenting with cytotoxicity and genotoxic effects of substances like chlorhexidine, linking basic research to clinical applications.

28) Line:
Line may refer to cell lines used in experiments to study various drug effects. In the context of this study, it underscores the relevance of tissue culture methodologies for understanding the cellular impacts of chlorhexidine in a controlled research setting.

29) Male:
Male refers to one of the two primary biological sex categories. In the study, gender distribution among chronic gingivitis patients is essential for understanding demographic variations, which may influence the study results and their applicability across different populations.

Other Health Sciences Concepts:

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Discover the significance of concepts within the article: ‘Genotoxicity of chlorhexidine mouthwash in gingivitis patients' cells’. Further sources in the context of Health Sciences might help you critically compare this page with similair documents:

Statistical analysis, Chlorhexidine mouthwash, Dental plaque, Mechanical plaque control method, Cellular proliferation, Genotoxic effect, Buccal epithelial cells, Giemsa stain, Oral carcinogenesis.

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