| Ye Zhangying, Professor of Zhejiang University, Pei Luowei from Electrolytic Water Technology Channel
Editor, |, Electrolytic Water Technology Channel
At present, oral diseases are characterized by high incidence, a wide range of affected people and popularity, making them one of the most common diseases in the world.
The most common oral diseases include oral ulcers, periodontal disease, and dental caries, etc. Periodontal disease mainly refers to periodontitis and gingivitis, which are common infectious oral diseases. In developed countries, 15% of people suffer from periodontal disease, while in China, 2/3 of people suffer from periodontal disease, of which 97% are adults. This type of periodontal disease is the main reason for people over 35 to lose their teeth.
In addition, the incidence of dental caries is 45%, making it the second largest oral disease after periodontal disease. Dental caries is a progressive lesion of the hard tissue of the teeth caused by the combined effects of multiple factors in the oral cavity, and bacteria are a necessary condition for the occurrence of dental caries, and the typical pathogen is Streptococcus mutans.
In general, mutans Streptococcus is most important for early biofilm formation and is known to cause dental caries through a process of adhesion to tooth surfaces, proliferation, and acid production. To prevent and treat dental caries and periodontal disease, the number of bacteria must be reduced and eliminated by preventing bacterial colonization.
Data show that conventional toothbrushing can only remove 40% to 50% of the plaque on the tooth surface (30% on the adjacent surface), and is basically powerless to remove the plaque on the surface of the oral soft tissue. Mouthwash can penetrate into all parts of the oral cavity, including the gum margins and tooth gaps that are difficult for a toothbrush to reach, and is a good auxiliary measure to control plaque.
A dental clinic in Busan, South Korea, used hypochlorous acid/HOCL as an oral rinse to evaluate its feasibility and compared its effects with 0.9% saline and 0.005% chlorhexidine on removing bad breath, killing harmful microorganisms in the oral cavity, and removing dental plaque. The main contents are as follows:
- Materials and methods
Researchers selected 15 patients with oral diseases without any systemic diseases and divided them into 3 groups: group X1: saline gargle group 5 cases (control group), group X2:0.005% chlorhexidine gargle group 5 cases, group X3: hypochlorite water gargle group 5 cases. Use 15ml of mouthwash each time and gargle for 1min.
Halitosis removal test, O 'Leary index and Snyder test were used to evaluate the gargling effect, and the amount of bacteria and motor activity were measured by phase contrast microscope. Specific test methods are as follows:
Halitosis removal experiment: In order to determine the change of halitosis before and after the use of mouthwash, a special sensor was used to measure the halitosis value.
O'leary Index: After staining each subject's teeth with a plaque stain, a plaque control score (O'Leary Index) is used, where 1 point is awarded if plaque is found to be attached to four tooth surfaces (mesial, distal, buccal, and tongue), and 0 points are awarded if not, and the degree of plaque attachment is calculated as a percentage;
Snyder test: The acid production rate of oral bacteria was determined by colorimetry using Snyder test. 0.2ml saliva was injected into a test tube containing 5ml culture medium and cultured for 72 hours, and the change of tooth color was observed every 24 hours. A yellow tooth color after 24 hours is identified as highly active; Moderate activity was determined after 48 hours. Low activity was determined after 72h. No color change within 72 hours is considered inactive. 3 points are given to those with high range of motion; Moderate activity, 2 points; Low activity, 1 score; For inactivity, 0 points.
Phase contrast microscopy: A sterile probe is used to collect suprgingival and subgingival plaque on the lingual surface of the left and right posterior teeth of the mandible. They are then placed on a slide and a drop of saline is released on top of them. A phase contrast microscope was used to observe the movement of microorganisms in the mouth at 4300x magnification.
- Experimental Results
Halitosis
The normal values for patients in the three groups were 0~50 BBV. There was no significant difference in the halitosis value between the normal saline group and the chlorhexidine mouthwash group, but the halitosis value in the hypochlorous acid mouthwash group was significantly lower, indicating that hypochlorous acid mouthwash can significantly reduce halitosis.
Table 1 Comparison of oral disease parameters
O'Leary Index Comparison
The O'Leary index of the normal saline mouthwash group was higher, while that of the hypochlorous acid mouthwash group was lower than that of the chlorhexidine mouthwash group. In the quantitative results in Table 1, there are significant differences among the three groups, indicating that hypochlorous acid water is more effective in removing dental plaque.
Figure 1 Comparison of O'Leary Index
Caries activity compared with the Snyder test
In the comparison of dental caries activity, there were significant differences among the three groups (P<0.05). In the Snyder test of the normal saline mouthwash group, the subject's tooth color turned yellow after 24 hours, indicating that they were in the high-risk group; The teeth of the chlorhexidine mouthwash group turned yellow after 48 hours, showing medium to low activity; the subjects in the hypochlorous acid mouthwash group did not have any color change during 72 hours, showing no activity, indicating that hypochlorous acid mouthwash can Prevent dental caries to a certain extent.
Note: The activity test of dental caries mainly tests the acid-producing ability or quantity of cariogenic bacteria such as Streptococcus mutans and Lactobacillus, which can predict the prevalence of new dental caries.
Figure 2 Comparison of Snyder test results
Observing oral bacteria with phase contrast microscopy
By observing the bacterial activity of Streptococcus mutans, filamentous bacteria and spirochetes, it was found that there were significant differences between the three groups (P<0.05). All bacteria in the saline mouthwash group showed active movement, while the chlorhexidine mouthwash group showed active movement. Group movement was reduced, but all bacteria still showed activity. The movement of bacteria was significantly reduced in the hypochlorous acid water mouthwash group. In particular, Streptococcus mutans was significantly reduced, as were the bacterial filaments and spirochetes that cause periodontal disease. Compared with other groups, the bacterial activity in the hypochlorous acid mouthwash group decreased significantly, especially the activity of filamentous bacteria (Figure 3) (Table 1).
Figure 3 Results of observing the chlorhexidine and slightly acidic hypochlorous acid water groups using a phase contrast microscope
Circles: represent cocci, squares: represent filamentous bacteria, triangles: represent spiral bacteria
Experimental results
The above data shows that gargling with slightly acidic hypochlorous acid water can significantly reduce dental plaque, eliminate bad breath, reduce the activity of dental caries, reduce the acid-producing ability of bacteria, and thus reduce the incidence of oral diseases.
Compared with chlorhexidine and saline, slightly acidic hypochlorous acid water is a better choice for mouthwash.
According to the available data, BLUEWAV recommends the frequency and concentration of gargling with slightly acidic hypochlorite water as follows:
Frequency of use: Gargling is recommended at least twice a day. In some special cases, such as the prevention and treatment of acute mucositis associated with radiotherapy for head and neck tumors, it is recommended to gargle at least four times a day after every meal.
Concentration: The pH value of slightly acidic hypochlorous acid water is between 5.0 and 6.5, and the concentration is generally between 50 mg/L and 100 mg/L, which can be used directly without dilution and is suitable for skin and mucosa. For children and adults over 12 years old, it is recommended to use 20 ml each time; Children aged 6-12 years are advised to use 10 ml at a time and continue gargling for 30 seconds before exhaling.
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