Antimicrobial Efficacy of 3 Oral Antiseptics Containing Octenidine, Polyhexamethylene Biguanide, or Citroxx: Can Chlorhexidine Be Replaced?

Abstract

Background.Use of oral antiseptics decreases the bacterial load in the oral cavity.Objective.To compare the antimicrobial activity of 3 novel oral antiseptics with that of Chlorhexidine, which is considered the “gold standard” of oral hygiene.Design.Comparative in vitro study.Methods.Four common oral microorganisms (Streptococcus sanguinis, Streptococcus mutans, Candida albicans, andFusobacterium nucleatum) were tested under standard conditions and at different concentrations, by use of a broth dilution assay and an agar diffusion assay and by calculating the log10reduction factor (RF). The antimicrobial activity of each antiseptic was assessed by counting the difference in bacterial densities (ie, the log10number of colony-forming units of bacteria) before and after the disinfection process.Results.The oral antiseptics containing octenidine (with an RF in the range of 7.1–8.24 CFU/mL) and polyhexamethylene biguanide (with an RF in the range of 7.1–8.24 CFU/mL) demonstrated antimicrobial activity comparable to that of Chlorhexidine (with an RF in the range of 1.03–8.24 CFU/mL), whereas the mouth rinse containing Citroxx (Citroxx Biosciences; with an RF in the range of 0.22–1.36 CFU/mL) showed significantly weaker antimicrobial efficacy. Overall, octenidine and polyhexamethylene biguanide were more active at lower concentrations.Conclusion.Oral antiseptics containing the antimicrobial agent octenidine or polyhexamethylene biguanide may be considered as potent alternatives to chlorhexidine-based preparations.