Using Chlorhexidine as an Endodontic Irrigant?

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Dr. Allan Deutsch from EndoMessageBoard.com
 comments:

“For most of my endodontic career there was only one irrigant, and that was sodium hypochlorite. It was and still is the workhorse of endodontic treatment the world over. It dissolves tissue and kills most of the bacteria present in the root canal—but not all of it. The one bug that it does not kill too well is E. faecalis. This bacteria is becoming increasingly associated with failed root canal treatment. So, if your instrumentation doesn’t remove E. faecalis, you may have a doomed root canal treatment from the very beginning.

Luckily for us, over the last ten years a lot of research has been done on chlorhexidine and its antibacterial properties. Most of you are probably familiar with chlorhexidine as the active ingredient in the mouthwash “Peridex.” Peridex is a 0.12 percent solution of chlorhexidine. Unfortunately the 0.12 percent solution is not strong enough for use as an endodontic irrigant. At this low concentration, the chlorhexidine would take several hours to kill the bacteria in the canal. This length of time is not a practical option when treating patients. The research has shown, however, that a 2 percent solution of aqueous chlorhexidine will kill the bacteria in one to two minutes. This length of time is certainly acceptable for practical endodontic treatment.”

What do you think about Using Chlorhexidine as an Endodontic Irrigant? Leave your comments below.

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7 Responses to “ Using Chlorhexidine as an Endodontic Irrigant? ”

  • dr preeti January 22nd, 2009

    peridex is 0.12% chlorhexidine, not strong enough to be an endodontic irrigant……
    can u suggest some formulation which contain 2% chlorhexidine and therefore is a good endo irrigant???

  • Randall G. Cohen, DDS January 27th, 2009

    I used to use chlorhexidine 4% (from Hibiclens or Dial hand scrub) as an endodontic lubricant, then irrigate with chlorox and let it sit for 10 minutes in the canal. I think this is about as much as you could do without risking periapical tissue damage.

  • Alfred dela Cruz February 27th, 2009

    I like to use 2% Chlorhexidine like Consepsis as my last rinse. I leave it in for about 5 mins. Also, it’s worth mentioning to be sure to thoroughly rinse the canal of sodium hypochlorite as it mixed with the chlorhexidine will precipitate a black-brown residue. Try mixing it on a mixing pad and you’ll see what I mean. So I use warm to med-hot sodium hypochlorite whilte alternating with irrigation with 17% EDTA. As the last irrgant, I suction off the edta and or hypochlorite and blot with coarse or med paper points before placing the chlorhexidine. I feel the residual or latent antibacterial properties really help with faster apical bone formation and also less post op pain.

  • Randall Morera April 13th, 2009

    What about the the periapical tissue damage that causes the 2% Chlorhexidine solution? how do you deal with that? thanks for the answer!!

  • Andrew Gomes August 28th, 2010

    I know most of the doctors including endodontist use sodium hypo, I use lidocaine for canal irrigation,works very good. No complain .To me if the seal is very good ,enough condensation it works really good very few failure .

  • Jonathan October 26th, 2010

    I have heard that combining CHX and NaOCl makes a carcinogenic compound. Any truth to this?

  • dr kunal shah February 11th, 2011

    can anyone suggest company name for chx 2% apart from consepsis( ultradent), im practising in india,
    As a intra- appointment dressing medicament mixure of ca(oh)2 paste and chx drops works out effectively…