This document summarizes various types of antiseptics, disinfectants, and other agents used in dentistry. It describes common antiseptics like alcohols, aldehydes, bis-biguanides, and halogens that are used to destroy microorganisms. It also discusses dentifrices used for cleaning teeth, mouthwashes, demulcents that protect mucous membranes, emollients that soften skin, protective agents that cover wounds, and hemostatic drugs and measures used to control bleeding. The document provides examples of specific substances in each category and their applications in dentistry.
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Anti-septics & disinfectants
• Antiseptics: Destroy m.o. & used on living things
• Disinfectants: Destroy m.o. & used on non-living things
A. Alcohols: ethyl-alcohol, isopropyl-alcohol (50-70 %)
• Precipitate proteins & enzymes, kill many m.o.
• Used for preparing clean skin for injection and wiping tables
• Also used as vehicle for other antiseptics: iodine, etc
• Inactivated by biological material: pus, blood, etc
• Does not kill spores
B. Aldehydes: Formaldehyde (2-8%), glutaraldehyde (2%)
• Denature proteins & effective against bacteria, fungi & viruses
• Not inactivated by biological materials
• Used for disinfection of dental instruments
• Glutaraldehyde is more effective; less volatile & irritant, & lacks
unpleasant smell of formaldehyde
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Anti-septics & disinfectants (Cont.)
C. Bis-biguanides: Clorhexidine
• Affect cell membrane & cause lysis. Kill most m.o.
• 0.2 & 1 % with gluconate for oral rinses & in toothpastes
• 1-4 % solution in water & 0.5 % sol in isopropyl alcohol for
cleaning skin, mucosa & hands before surgery
• 5 % solution for disinfection of instruments
D. Halogens: Denature proteins & enzymes; kill most m.o.
• Chlorine: (Na hypochlorite & organic chloramines)
• 2 % sol for irrigation of root canal, cleaning instruments
• Inactivated by organic matter
• Iodine: (KI solution & tincture)
• Not inactivated by organic matter
• Stains skin & may causes allergy
• Pavidone: 1% solution for mouth wash. 10% cream for skin
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• Iodoform: (Liberates iodine when applied to tissues)
• 10% iodoform with benzoin, etc (Whitehead’s varnish)
• Dressing of dry socket & after removing molars & cysts
E. Oxidizing agents: (Hydrogen peroxide & Na perborate)
• Release O2 & kill mo; may cause local irritation
• Used as mouth wash in ulcerative gingivitis
F. Phenols, cresols & related compounds:
• Phenol & cresol: Disinfectants for floors & wash rooms
• Irritate skin, not used now as antiseptic
• Parachlorophenol: Less irritant
• 1% as anti-septic & 35% for root canal treatment
• Hexachlorophene: Less irritant, used as powder & cream on skin.
Very effective against G (+) m.o.
Anti-septics & disinfectants (Cont.)
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Anti-septics & disinfectants (Cont.)
G. Cationic surface active agents:
• Cetrimide & cetrimide + chlorhexidine (Savlon)
• Used as general purpose antiseptics
• Oxidizing agents: Potassium permanganate
• Liberates oxygen and oxidises bacterial protoplasm
• Used as anti-septic and disinfectant in different concentrations
• Dental uses of antiseptics & disinfectants (summary):
• Cold sterilization of instruments (when heat not possible)
• Disinfection of surgeon’s & assistant’s hands
• Preparation of skin & mucosa before surgery
• Irrigation of root canal & inhibition of dental plaque
• Treatment of mouth ulcers
• Protection of dentists & assistants from viral (HBV, HCV &
HIV), bacterial & fungal infections
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Dentiferices
• Substances used with tooth-brush to clean teeth
• Available as: gels, pastes, powders
• Usual contents:
a. Abrasives: Ca & Mg carbonate, phosphates or silicates
b. Binders: Gum, cellulose, seaweed or mineral colloid
c. Foaming agents: Na lauryl sulfate/sarcosinate or soap
d. Flavoring & sweetening agents
• Additional substances:
a. Fluoride to prevent caries
b. Strontium Chloride for sensitive teeth
c. Anti-septics to prevent periodontal disease
d. Coloring agents to make tooth paste look attractive,
particularly for children
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Mouth washes
• Aqueous solutions used in the mouth as:
• Refreshing, deodorant, antiseptic or for control of dental
plaque
• Also used for the treatment of mouth ulcers
• Antiseptics commonly used in mouth washes are:
chlorhexidine, povidone-iodine, cetylpiridinium
chloride
• Also contain sweetening, coloring & surface active
agents
• Contents of a simple mouth wash: NaCl, sodium
bicarbonate, peppermint & chloroform water
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Demulcents
• Sticky viscid preparations
• Applied on membranes & skin
• Make a covering & protect from irritants
a. Acacia (gum arabic): Used for inflammation of mouth
b. Glycerine: Used for inflammation of mouth & throat
c. Benzoin (Compound tincture benzoin)
1-2 drops poured on boiling water, its fumes inhaled &
good for laryngitis & croup
d. Methylcellulose, OH-methylcellulose, polyvinyl-alcohol
Usually applied on eye & control irritation from dust &
contact lenses
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Emollients
• Emollients are bland, fatty or oily substances
• Applied locally to skin & mucous membranes
• Form a protective layer, make skin soft & moist
• Prepared as cream or ointment
• Also used as vehicle for active ingredients, to prolong their action
• Draw backs:
• Moisture under protective layer favors growth of m.o.
• Liquid emollients may be aspirated, cause pneumonia
• Examples:
• Cocoa butter, theobroma oil, coconut oil, olive oil
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Protectives
• Inert & insoluble substances
• Cover & protect epithelial surfaces, ulcers & wounds
• May also have astringent & adsorbent properties
• Usually prepared as paste for covering, lining or coating
a. Chemical:
Aluminium hydroxyl gel, collodion, absorbable gelatin,
dimethicone, Zn oxide, Zinc carbonate, Ca carbonate
b. Mechanical:
Film dressing: Acrylic adhesive coated on a plastic film
Hold well to normal skin, but not on wet wound surface
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Hemostatics (topical)
• Local measures for control of bleeding:
Pressure packing, sutures, refrigerants & drugs
• Drugs: (local hemostatics or styptics)
• Absorbable gelatin sponge (gelfoam): Water-insoluble, sterile
sponge. Moistened with saline or thrombin sol.
Left in place after closure of surgical incision.
Digested by tissue enzymes & absorbed in 4-6 weeks
• Absorbable gelatin powder: Applied locally on ulcer, wound or cut,
covered with dressing.
• Thrombin: Sterile powdered protein, prepared from prothrombin
• Used for control of bleeding from cuts or injuries
• Not to be injected, can cause blood coagulation
• Oxidized cellulose: Sterile cotton gauze oxidized chemically.
Absorbed with in a week
• Adrenaline (1:1000 sol): Constrict blood vessels & control bleeding
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Hemostatics (systemic)
• Measures for control of bleeding in bleeding disorders:
• Human plasma:
In Hemophilics & other coagulation factor deficiencies
• Platelet concentrate:
In thrombocytopenia, disseminate intravascular coagulation,
thrombocytopenic purpura
• Anti-hemophillic factor (coagulation factor VIII):
In classical hemophillia (hemophillia A)
• Factor IX complex (Pooled human plasma protein fraction
containing factors II, VII, IX & X):
In hemophillia B & other coagulation factor deficiencies: factors
II, VII & X
• Vitamin K: anti-dote for warfarin
• Protamine: anti-dote for heparin