Stain drives me crazy! Unfortunately, even with the staining and calculus issues CHX remains the “gold standard.” Chlorhexidine is a broad-spectrum biocide effective against Gram-positive bacteria, Gram-negative bacteria and fungi. Chlorhexidine inactivates microorganisms with a broader spectrum than other antimicrobials (e.g. antibiotics) and has a quicker kill rate than other antimicrobials (e.g. povidone-iodine). It has both bacteriostatic (inhibits bacterial growth) and bactericidal (kills bacteria) mechanisms of action, depending on its concentration. Chlorhexidine kills by disrupting the cell membrane. Upon application in vitro, chlorhexidine can kill nearly 100% of Gram-positive and Gram-negative bacteria within 30 seconds. Since chlorhexidine formulations can destroy the majority of categories of microbes, there is limited risk for the development of an opportunistic infections too. I tend to not keep my patients on chlorhexidine for too long; just long enough for healing after SRPs. I find that the staining issues also can lead to patient non-compliance. For this issue, I recommend every other day CHX/Listerine. And good to know, Hygenius, about alcohol free causing less stain! This is great news, thank you!

The alcohol free is less staining. I have noticed over the years that people that do not effectively remove plaque have more staining. The way I understand chlorhexidine it kills plaque bacteria and hardens it into calculus and then the calc takes on more plaque and starts to stain. Most of it is very fine sheet calculus with stain.