Editing Chlorhexidine (section)

=== Dental use ===
[[File:Perichlor, 0.12% chlorhexidine glucomate solution medication.jpg|thumb|Perichlor brand 0.12% chlorhexidine gluconate solution]]

Use of a chlorhexidine-based mouthwash in combination with normal tooth care can help reduce the build-up of plaque and improve mild [[gingivitis]].<ref name="coch2017">{{cite journal | vauthors = James P, Worthington HV, Parnell C, Harding M, Lamont T, Cheung A, Whelton H, Riley P | title = Chlorhexidine mouthrinse as an adjunctive treatment for gingival health | journal = The Cochrane Database of Systematic Reviews | volume = 3 | issue = 3 | pages = CD008676 | date = March 2017 | pmid = 28362061 | pmc = 6464488 | doi = 10.1002/14651858.CD008676.pub2 | doi-access = free }}</ref> There is not enough evidence to determine the effect in moderate to severe gingivitis.<ref name="coch2017" /> Its use as a mouthwash has a number of [[adverse effect]]s including damage to the mouth lining, tooth discoloration, [[Calculus (dental)|tartar]] build-up, and impaired taste.<ref name=coch2017/> Extrinsic tooth staining occurs when chlorhexidine rinse has been used for four weeks or longer.<ref name="coch2017" />

Mouthwashes containing chlorhexidine which stain teeth less than the classic solution have been developed, many of which contain [[chelation|chelated]] [[zinc]].<ref name="pmid16451475">{{cite journal | vauthors = Bernardi F, Pincelli MR, Carloni S, Gatto MR, Montebugnoli L | title = Chlorhexidine with an Anti Discoloration System. A comparative study | journal = International Journal of Dental Hygiene | volume = 2 | issue = 3 | pages = 122–126 | date = August 2004 | pmid = 16451475 | doi = 10.1111/j.1601-5037.2004.00083.x }}</ref><ref>{{cite journal | vauthors = Sanz M, Vallcorba N, Fabregues S, Müller I, Herkströter F | title = The effect of a dentifrice containing chlorhexidine and zinc on plaque, gingivitis, calculus and tooth staining | journal = Journal of Clinical Periodontology | volume = 21 | issue = 6 | pages = 431–437 | date = July 1994 | pmid = 8089246 | doi = 10.1111/j.1600-051X.1994.tb00741.x }}</ref><ref>{{cite journal | vauthors = Kumar S, Patel S, Tadakamadla J, Tibdewal H, Duraiswamy P, Kulkarni S | title = Effectiveness of a mouthrinse containing active ingredients in addition to chlorhexidine and triclosan compared with chlorhexidine and triclosan rinses on plaque, gingivitis, supragingival calculus and extrinsic staining | journal = International Journal of Dental Hygiene | volume = 11 | issue = 1 | pages = 35–40 | date = February 2013 | pmid = 22672130 | doi = 10.1111/j.1601-5037.2012.00560.x }}</ref>

Chlorhexidine is a [[cation]] which interacts with [[anionic]] components of [[toothpaste]], such as [[sodium lauryl sulfate]] and [[sodium monofluorophosphate]], and forms salts of low solubility and reduced antibacterial activity. Hence, to enhance the antiplaque effect of chlorhexidine, "it seems best that the interval between toothbrushing and rinsing with CHX [chlorhexidine] be more than 30 minutes, cautiously close to two hours after brushing".<ref>{{cite journal | vauthors = Kolahi J, Soolari A | title = Rinsing with chlorhexidine gluconate solution after brushing and flossing teeth: a systematic review of effectiveness | journal = Quintessence International | volume = 37 | issue = 8 | pages = 605–612 | date = September 2006 | pmid = 16922019 }}</ref>