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Peridex

My doctor uses Peridex, and recommends for every patient because he claims if he uses it everyone can. I have been able to recommend for when needed but with patients who don’t bleed I find it unnecessary. Is that ethical? Also, any contraindications for pregnant women?



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Peridex (CHX) is indicated for patients with gingivitis or perio. I don’t see any reason for a healthy patient to be using it. In most cases, it should only be used for 1-2 weeks at a time. It can cause staining, calculus build-up, change in taste sensation, and inhibits fibroblast formation (healing) with long-term use. It’s not best practice to use “cookie cutter” treatment recommendations (i.e. everyone should use Peridex). Simply put, not everyone needs it or would benefit from the use of CHX rinse.
 
According to Drugs.com:
Teratogenic Effects:
Pregnancy Category B
Reproduction studies have been performed in rats and rabbits at chlorhexidine gluconate doses up to 300mg/kg/day and 40mg/kg/day, respectively, and have not revealed evidence of harm to fetus. However, adequate and well-controlled studies in pregnant women have not been done. Because animal reproduction studies are not always predictive of human response, this drug should be used during pregnancy only if clearly needed.
 
Nursing Mothers
It is not known whether this drug is excreted in human milk. Because many drugs are excreted in human milk, caution should be exercised when Peridex is administered to nursing women. In parturition and lactation studies with rats, no evidence of impaired parturition or of toxic effects to suckling pups was observed when chlorhexidine gluconate was administered to dams at doses that were over 100 times greater than that which would result from a person’s ingesting 30ml (2 capfuls) of Peridex per day.
 
So basically, the effects to pregnant woman and nursing mothers have not been studied (it would be unethical to do so).

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