Severe allergic reactions to hydrogen peroxide solution and compound chlorhexidine gargle are rare, and most medical professionals have limited understanding of such cases. This article reports a case of anaphylactic shock in a patient with a periodontal abscess following oral flushing with hydrogen peroxide and compound chlorhexidine gargle. Drawing on domestic and international literature, it provides a reference for the emergency management of serious adverse reactions caused by these agents.
Humans ; Anaphylaxis/chemically induced* ; Anti-Infective Agents, Local/adverse effects* ; Chlorhexidine/adverse effects* ; Hydrogen Peroxide/adverse effects* ; Mouthwashes/adverse effects*

Orthognathic surgery is frequently accompanied by intermaxillary fixation. Intermaxillary fixation impedes the maintenance of effective oral hygiene and prolonged fixation can result in periodontal disease. A potential shorter term effect is the generation of oral malodour. It is unclear, however, as to how the production of malodorous compounds in the oral cavity is altered post-surgery. Oral air concentration of sulphur containing compounds, short chain organic acids, ammonia, isoprene and acetone were measured using selected ion flow tube-mass spectrometry in a patient who had undergone orthognathic surgery with subsequent intermaxillary fixation. Total sulphide levels rose approximately 5-fold during fixation with metal ties, with smaller increases recorded for the other compounds measured with the exception of isoprene which remained close to baseline levels. Organic acid levels declined markedly once elastic ties had replaced metal ties, with a lesser reduction being observed in sulphide levels, with both declining further after the commencement of a chlorhexidine-containing mouthwash. These data suggest that bacterial generation of a variety of malodorous compounds increases markedly following intermaxillary fixation. This single case also suggests that the use of elastic ties and effective oral hygiene techniques, including the use of chlorhexidine mouthwash, may help ameliorate such post-surgical effects.
Adult ; Anti-Infective Agents, Local ; therapeutic use ; Breath Tests ; Chlorhexidine ; therapeutic use ; Halitosis ; drug therapy ; etiology ; Humans ; Jaw Fixation Techniques ; adverse effects ; instrumentation ; Male ; Mandibular Advancement ; Metals ; adverse effects ; Mouthwashes ; therapeutic use ; Orthognathic Surgical Procedures ; Spectrometry, Mass, Secondary Ion ; Sulfides ; analysis

OBJECTIVETo investigate the microbiological changes of subgingival microbials in patients with gingivitis and wearing fixed orthodontic appliances.

METHODS48 subjects (10 to 17 years old) with gingivitis, and wearing fixed orthodontic appliances, were divided randomly into three groups (placebo, NS and CH). Placebo group had normal saline mouthrinse; only and no oral hygiene instruction (OHI). The NS group had OHI and normal saline mouthrinse; The CH group had OHI and 0.12% chlorhexidine gluconate mouthrinse. Bacterial examinations were carried out on baseline, one week, one month and three months after scaling. The bacterial examination was carried out. The percentage of coccus, bacillus and spirochete was calculated.

RESULTSIn placebo group and NS group, the percentage of coccus increased up to the third examination then dropped down. The spirochete's percentage changed inversely. CH group maintained an increasing trend in coccus' percentage and decreasing trend in spirochete's percentage. The percentage changes of coccus and bacillus between placebo group and CH group are statistically significant (P < 0.05).

CONCLUSIONSDuring the three-month examination, the CH group had better microbiologic change than the other two groups.

Adolescent ; Child ; Chlorhexidine ; administration & dosage ; analogs & derivatives ; Female ; Gingivitis ; microbiology ; prevention & control ; Humans ; Male ; Malocclusion ; microbiology ; therapy ; Mouthwashes ; Orthodontic Appliances ; Orthodontics, Corrective ; adverse effects ; methods ; Periodontal Attachment Loss ; microbiology ; prevention & control ; Periodontal Diseases ; microbiology ; prevention & control ; Periodontal Pocket ; microbiology ; pathology ; Spirochaetales ; isolation & purification ; Spirochaetales Infections ; microbiology