A review of chlorhexidine and its use in special populations.

The purpose of this paper is to review the mechanism of the action, safety, and side-effects of chlorhexidine, and to provide guidelines for its use in special populations. Chlorhexidine has been used orally since 1959, primarily for the control of dental plaque. Chlorhexidine is a safe material, with low toxicity potential when used correctly. The most conspicuous side-effects are the development of yellow-brown stains on the teeth, tongue, and at the margins of anterior restorations, and an alteration in taste sensation. The use of chlorhexidine is indicated in developmentally disabled, medically compromised patients, and in dependent elderly populations, since these groups are often physically unable to remove plaque by mechanical means. Clinicians should not prescribe chlorhexidine indiscriminately for all patients, however, until analyzing its efficacy, safety, and side-effects.