Takenaka Shoji, Sotozono Maki, Ohkura Naoto, Noiri Yuichiro
Division of Cariology, Operative Dentistry and Endodontics, Faculty of Dentistry & Graduate School of Medical and Dental Sciences, Niigata University, Niigata 951-8514, Japan.
Antibiotics (Basel). 2022 May 28;11(6):727. doi: 10.3390/antibiotics11060727.
Antimicrobial mouthwash improves supragingival biofilm control when used in conjunction with mechanical removal as part of an oral hygiene routine. Mouthwash is intended to suppress bacterial adhesion during biofilm formation processes and is not aimed at mature biofilms. The most common evidence-based effects of mouthwash on the subgingival biofilm include the inhibition of biofilm accumulation and its anti-gingivitis property, followed by its cariostatic activities. There has been no significant change in the strength of the evidence over the last decade. A strategy for biofilm control that relies on the elimination of bacteria may cause a variety of side effects. The exposure of mature oral biofilms to mouthwash is associated with several possible adverse reactions, such as the emergence of resistant strains, the effects of the residual structure, enhanced pathogenicity following retarded penetration, and ecological changes to the microbiota. These concerns require further elucidation. This review aims to reconfirm the intended effects of mouthwash on oral biofilm control by summarizing systematic reviews from the last decade and to discuss the limitations of mouthwash and potential adverse reactions to its use. In the future, the strategy for oral biofilm control may shift to reducing the biofilm by detaching it or modulating its quality, rather than eliminating it, to preserve the benefits of the normal resident oral microflora.
作为口腔卫生日常护理的一部分，抗菌漱口水与机械清除方法联合使用时，可改善龈上生物膜的控制情况。漱口水旨在抑制生物膜形成过程中的细菌黏附，而非针对成熟生物膜。漱口水对龈下生物膜最常见的循证效应包括抑制生物膜积聚及其抗牙龈炎特性，其次是其防龋活性。在过去十年中，证据的力度没有显著变化。依赖细菌清除的生物膜控制策略可能会导致多种副作用。将成熟的口腔生物膜暴露于漱口水会引发多种可能的不良反应，例如耐药菌株的出现、残留结构的影响、渗透受阻后致病性增强以及微生物群的生态变化。这些问题需要进一步阐明。本综述旨在通过总结过去十年的系统评价来重新确认漱口水对口腔生物膜控制的预期效果，并讨论漱口水的局限性及其使用可能产生的不良反应。未来，口腔生物膜控制策略可能会转向通过分离生物膜或调节其质量来减少生物膜，而非消除它，以保留正常口腔常驻微生物群的益处。
