ANTISEPTICS USED IN DENTISTRY
Kyaw Htoo Lwin
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Asepsis
• Asepsis is the state of being free from disease-
causing microorganisms such as pathogenic
bacteria, viruses, pathogenic fungi and parasites.
• Asepsis is absence of pathogenic microorganisms.
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Antiseptics
• Antiseptics are substances which destroy or
prevent the growth of microorganisms, applying
to living tissue.
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Disinfectants
• Disinfectants are powerful germicides which are
too corrosive or toxic to be applied to tissues but
which are suitable for application to inanimate
objects.
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Properties Desirable in Antiseptics
• Agents should have high germicidal efficacy
• Agents which can destroy or kill microorganisms in obviously
superior to one that merely inhibit the growth of microorganisms
• A wide antimicrobial spectrum is also desired
• Antiseptic which has low surface tension is much more effective
for topical application
• Agent the lethal action in the presence of organic matter such as
blood, sputum and pus
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Properties Desirable in Antiseptics
• Agents must have high therapeutic index the relationship
between the concentration that is effective against
microorganisms and that produce such as harmful effects as local
tissue irritation and interference with the processes of healing
and tissue repair
• Agents should not be allergenic and toxic to tissues
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Classification of antiseptics based on chemical compounds
1. Halogens and halogen containing compounds
2. Phenols and phenol derivative agents
3. Oxidizing agent
4. Biguanides compounds
5. Alcohols
6. Aldehydes
7. Acids
8. Quaternary ammonium compounds
9. Nitrofurazone
10. Heavy metals and their salts
11. Dyes
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1.Halogens and halogen containing compounds
Iodine
• Most bacteria are killed within one minute by exposure of 1:20000
solution of iodine
• 15 mins to kill wet bacterial spores and dry spores require hours
and higher concentration
• Indications
• Disinfection of the skin
• Treatment of wounds and abrasions
• Application to mucous membrane (2% solution of iodine in
glycerine)
• Disadvantages
• Iodine burns usually by using 7% tincture.
• Irritating when applied to absorbed or raw surfaces
• Staining of skin, clothes and hypersensitivity rashes
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1.Halogens and halogen containing compounds
Iodophore
• The most widely used iodophore is povidone-iodine
• Its low concentration the immediate bactericidal action is only
moderated to that of iodine solution
• Very little staining of the skin and burning sensation
• E.g. Betadine, Septidine
Cholorophore
• Chlorine is present in the form of hypochlorite
• It is useful for skin and wound infection and irrigation solution for
abscess cavities
• They are bactericidal and virucidal
• They are corrosive to stainless steel equipment 9

1.Halogens and halogen containing compounds
Iodoform
• Ribbon gauze impregnated with whit head’s varnish and pack into
intra oral wounds such as dry socket
• Protective dressing for exposed bone surface
• Antiseptic dressing for dry socket
• Prevent the entering the food debris into the dry socket
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2.Phenols and phenol derivative agents
• Phenolic compounds are more bactericidal than phenol itself
• It is widely used for disinfecting inanimate objects
• It is superiors to and cheaper than phenol
• Should not be used as burned or denuded skin
• Not be used as an occlusive dressing, wet pack and internal
use
• Should be used with caution in neonates and infants (brain
damage)
• Camphorated Paramonochlorophenol (CMCP) – used in root
canal treatment but inferior to sodium hypochlorite.
• Thymol – antibacterial and antifungal effects and usually
contains in the dental cartridge as funigicide. E.g. Listerine
mouthwash
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3.Oxidizing agent
• Hydrogen peroxide is used as oxidizing agent
• Can be used as mouth wash in acute necrotizing
ulcerative gingivitis and give bactericidal effect on
anaerobic organisms
• Irrigating solution used in root canal treatment
• Irrigating for suppurating wounds are used
• Can use as bleaching agent
• Prolong use of hydrogen peroxide can cause black hairy
tongue but it disappear after the drug is discontinued
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4.Biguanides compounds
• Chlorhexidine is one of a member of biguanides
• Useful as preoperative preparation of surgeon and patient
also useful in disinfection of wounds
• It is easily contaminated by pathogen
• Chlorhexidine mouthwash – contains chlorhexidine
gluconate and effective in treatment of apthous ulcer and
stomatitis and effect in inhibiting the formation of plaque
on tooth and used successfully in prophylaxis of dental
caries
• Untoward effects – black hairy tongue, changes in taste,
loss of appetite, candidiasis, staining of the teeth, burning
sensation of oral mucosa and lead to mucositis
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5.Alcohols
• Bactericidal to all common pathogenic bacteria
• Cannot kill the spores
• Ethanol is used in alcohols
• Skin disinfection – to prevent bed sores in bed ridden
patient
• As alcohol sponge to reduce fever
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6.Aldehydes
• Formaldehyde and glutaraldehyde are used in aldehyde
group
• Effective against bacteria, fungi and viruses
• To disinfect inanimate objects such as surgical
instruments and gloves
• Can be used to sterilize turberculum sputum.
• Can not be applied safely to mucous membrane and skin
• In high concentration usually use as disinfected, not
antiseptic
• Glutaraldehyde is less toxic than formaldehyde
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7.Acids
• Acetic acid – 5% concentration (bactericidal) , lower
concentration is bacteriostatic.
• Benzoic acid – food preservative
• Boric acid – non irritating and do not kill bacteria
• Lactic acid – corrosive to tissues after prolonged contact
Uses
- Surgical dressings as a topical antimicrobial agent
- Burn therapy and vaginal douche
- Irrigation of lower urinary tract
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8.Quaternary ammonium compounds
• More effective against gram positive than gram negative
microorganisms
• More useful as anti-plaque agent which contains
predominantly gram positive bacteria
• Burning sensation of the oral mucosa
• Brownish discoloration of teeth and tongue
• Can cause recurrent apthous type ulceration
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9.Nitrofurazone
• Wide spectrum antibacterial agent
• Urinary antiseptic
• Furazolidine – shigella, salmonella and trichomonas
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10.Heavy metals and their salts
• Mercury bichloride - disinfectant for instruments or
unabraded skin
• Silver Nitrate - precipitation protein, interfere with
essential metabolic activities of
microbial cells
• Silver Sulfadiazine - 1% cream for burns
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11.Dyes
• Gentian violet
• Effective against gram positive bacteria and fungi
• Gram negative bacteria and acid fast bacteria are
resistant
• Permanent pigmentation of skin
• Acriflavin
• Orange red to red crystalline powder
• Incompatible with eusol and other chlorine preparation
• Effective against gram positive bacteria
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Thank You !!!
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