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Cetylpyrinidium Chloride (CPC)
Mechanism of Action:
CPC is one kind of Quartenary Ammonium Compounds (QACs) which contains the positively-charged pyridine ion (active site). The CPC interacts with negatively-charged bacteria, causing interference of the bacteria's osmoregulation and homeostasis at low concentrations and causes disintegration of membranes followed by leakage of cytoplasmic contents at high concentrations.

Active Ingredients:
Pyridine (positive ion), Chloride (negative ion)

Side Effects:
- Tooth and tongue staining
- Temporary taste alteration
- Slight burning sensation in gums

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D3 Stannous fluoride sodium hexametaphosphate

Mechanism of action

Has antibacterial and anti inflammatory reaction by inhibiting the growth of bacteria

Antiplaque and antigingivitis

Reduce the dentinal hypersensitivity by occluding the dentinal tubules with stannous ion that preventing the stimulation of free nerve ending

Anticalculus effect by inhibiting hydroxyapatite effect

Anticaries effect as stannous fluoride sodium hexametaphosphate has negative charge that can be absorbed at the positive sites of enamel surfaces, thereby forming a protective layer on enamel against erosive and acidic factors

Active ingredients

0.4% stabilized stannous fluoride

Sodium hexametaphosphate

Side effects

temporary staining of the teeth may occur but by brushing may control these stains, which can be removed by the dental professional

Rare of allergic reaction to fluoride or any ingredients of stannous fluoride but seek immediate medical attention if having the symptoms such as rash, itching/swelling (especially of the face, tongue or throat), severe dizziness and trouble breathing

Vomiting

Diarrhoea

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D3: stannous-fluoride sodium-hexametaphosphate

MOA:
Stannous fluoride- Chemical precipitation of stannous ion can occlude dentinal tubules and prevent stimulation of nerve endings
-Antibacterial activity against species associated with plaque, gingivitis, cavities and malodor
-Reduces plaque
-Reduces gingival inflammation and bleeding -Protects against hypersensitivity
-Remineralizes enamel and protects against demineralization

SHMP- hydrolyzes in aqueous solution, particularly under acidic conditions, to sodium trimetaphosphate and sodium orthophosphate
-Inhibits calculus formation
-Protects against new stain formation
-Removes extrinsic stain

ACTIVE INGREDIENTS:  Stannous fluoride, sodium hexametaphosphate

SIDE EFFECTS: no significant side effects, only concern is prolonged using of phosphate salts might upset balance of phosphates and other chemical in body, and possible allergic reaction

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D3- stannous fluoride sodium hexametaphosphate

Active ingredient
- stannous fluoride
-sodium hexametaphosphate

MOA
-Antibacterial and anti inflammatory reaction by inhibit bacterial growth
- Reduce plaque and gingivitis
-anticalculus effect by inhibiting hydroxyapatite effect
-Whitening effect by give effect on chemical mechanism of chromogen adsorption and desorption
-Reduce dentine hypersensitivity

Side effect
-Allergic reaction to fluoride
-temporary staining of the teeth may occur
- Vomiting
- Diarrhoea

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M1: Chlorhexidine Mouthrinse

Mechanism of action:
-Positively charged Chlorhexidine molecule bind to negatively charged phospholipids of bacteria’s cell wall.

-in low concentration, the integrity of cell wall is affected.  It binds to the cell wall causing it to rupture. The rupturing of cell wall causes fluid to leak leading to lysis and cell death. (bacteriastatic)

-in high concentration, it will cause the cytoplasm to solidify. (bactericidal)

-Protein bound chlorhexidine release slowly to maintain a potent sustained release. It allows longer duration of antimicrobial action against broad spectrum of bacteria and fungi. This helps to reduce bacteria count and prevents dental plaque.

-Chlorhexidine inhibit the adherence of microorganisms to a surface thereby preventing growth and development of biofilms

Active ingredients:
-chlorhexidine digluconate

Side effects:
1.      Tooth / teeth staining
2.      Increased tartar
3.      Mouth / throat irritation
4.      Dry mouth
5.      Change in taste of food / drinks
6.      Rare: allergic reaction (mouth / skin rash, itching, dizziness, breathing difficulty)

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4Name : Muhammad Hasanal Afiq bin Yahya
No Matrik : A163516
stannous fluoride sodium hexametaphosphate
Mechanism of action
Chemical precipitation of stannous ion – occludes dentinal tubules – prevents the stimulation of free nerve endings
Active ingredient
0.4% stabilized stannous fluoride
Bemefits
• Whitens by extrensic stain removal
• Helps prevent stains
• Inhibits calculus
Side effects
• May upset the balanced of phosphate in body
• Can cause tooth hypersensitivr
• Flourosis

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D2-Triclosan copolymer dentrifice

Mechanism of action:

-is a phenolic agent with broad-spectrum antibacterial activity

-it disrupts bacterial cytoplasmic membranes by blocking fatty acid biosynthesis

-Triclosan can selectively inhibit Gram negative anaerobic bacteria implicated in gingivitis and periodontal diseases,while leaving species associated with oral health relatively unaffected

Active ingredients:
-Triclosan

-Copolymer of polyvinylmethyl and maleic acid:to increase substantivity and anticalculus benefits

-Tetrasodium pyrophosphates: anticalculus

-Alcohol
-Zinc citrate:additional antiplaque and anticalculus

Side effects of active ingredients:
-bacterial resistance
-allergy

-can be accidentally swallowed particularly by young children

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D3 STANNOUS-FLUORIDE-SODIUM-HEXAMETAPHOSPHATE

ACTIVE INGREDIENTS

0.4 % stabilized Stannous fluoride

Sodium hexametaphosphate

MOA

Antibacterial and antiinflamatory action - inhibits bacterial growth by interfering the metabolic pathways thus reducing bacterial acid formation, inhibition of bacterial cohesion & adhesion

Antiplaque & antigingivitis

Dentinal hypersensitivity - reacts with enamel or dentin surfaces to produce solid complexes or insoluble precipitates that wholly or partially occlude the tubuli

Anticaries effect - fluoride’s ability to foster remineralization of partially demineralized tooth enamel using calcium and phosphate & react with enamel to form thin fluorophosphate complex that coats and protect tooth

Anti calculus effect - inhibit hydroxyapatite crystal growth

Whitening effect - effects on chemical mechanism of chromogen adsorption and desorption

SIDE EFFECTS

temporary staining of teeth but can be remove by brushing

vomiting & diarrhea due to fluid imbalace

May cause allergic reaction but rarely occur

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M1 - Chlorhexidine mouthrinse

Mechanism of action:
- Has broad-spectrum biocide effect against Gram-positive bacteria, Gram-negative bacteria and fungi.
- Has both bacteriostatic and bactericidal mechanisms of action depending on its concentration.
- Chlorhexidine as a positively-charged molecule binds to the negatively-charged sites on the cell wall of bacteria or fungi, which destabilizes the cell wall and interferes with osmosis. In low concentration, once the cell wall is damaged, chlorhexidine then crosses the cell and attacks the cytoplasmic membrane, resulting in leakage of components thus leading to cell death. In high concentration, chlorhexidine causes the cytoplasm to congeal or solidify.

Active ingredient:
- Chlorhexidine digluconate

Side effects:
- The most common side effects:
- An increase in teeth or other oral surfaces staining,
- An increase in calculus formation,
- An alteration in taste perception.

- Other reported side effects:
- Oral mucosal symptoms: stomatitis, gingivitis, glossitis, ulcer, dry mouth, hypesthesia, glossal edema, paresthesia.
- Sialadenitis

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Mira Fareena Binti Mohd Faizal (A162713(

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Mira Fareena Binti Mohd Faizal (A162713(

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D2 - Triclosan/ copolymer dentrifice

Active Ingredients

·      Triclosan

·      Co-polymer

Mechanism of action

Anti-microbial effect

Þ   Enhance inhibitory effects on bacterial metabolism in dental plaque

Þ   Has broad spectrum antibacterial activity that disrupt bacterial cytoplasmic membrane by blocking fatty acid synthesis

Þ   Active against Gram positive and Gram negative bacteria

Anti-inflammatory effect

Þ   Triclosan in certain concentration range able to inhibit both cyclo-oxygenase and lipoxygenase pathway.

Side effects

o   No reports of adverse effects on the oral hard or soft tissues that could be attributed to the use of triclosan/copolymer toothpaste.

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Mohamad Izzuddin Naim Bin Mustafa Yusof A163003

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Mohamad Izzuddin Naim Bin Mustafa Yusof A163003

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MOA:

CPC is a well-known, broad-spectrum antimicrobial agent.

It acts by penetrating the cell membrane, causing cell components to leak, which eventually leads to cell death.

It is a cationic surface-active agent and has a broad antimicrobial spectrum, and kills gram-positive pathogens and yeast.

The cation charged allow it to react to cell membrane surface and make it leak out.

Active ingredient:
-Cetylpyridium chloride
- N-hexadecylpridinium

Side effect:
- stain of tooth
-stain of the tongue

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M1-Chlorhexidine

Moa:

Broad-spectrum biocide effective against Gram-positive bacteria, Gram-negative bacteria and fungi. It is both bacteriostatic and bactericidal, kills by disrupting the cell membrane. Binds to the proteins present in human tissues such as skin and mucous membranes with limited systemic or bodily absorption, leading to prolonged activity.

Chlorhexidine binds to the mouth tissue, oral mucosa and teeth. It is then released over time to kill bacteria and fungi.⁵ This helps to reduce the bacterial count and prevents dental plaque.

Ingredients:

Contains 0.12% of the medicinal ingredient, chlorhexidine gluconate and the non-medicinal ingredients: alcohol, FD&C Blue # 1, flavour, glycerin, PEG 40-sorbitan diisostearate, saccharin sodium and USP Purified water

Side effect:

No serious systemic reactions associated but most common adverse reactions are: Teeth and oral mucosa staining, increase in calculus formation, an alteration in taste perception

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M2 - Essential oils

1. Active ingredients:
- Eucalyptol
- Thymol
- Menthol
- Methyl salicylate

2. MOA:
- Ability to alter the cell surface of specific microorganism
- Eliminate their enzymatic activity
- May penetrate the dental biofilm and cause bactericidal effects
- Inhibits the endotoxins of gram negative pathogens
- Effective in controlling inflammation and supragingival biofilm

3. Side effects:
- Burning sensations in the mouth
- Rash
- Allergic reaction

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Julia Izzaty binti Mohd Juffry (A162684) 

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Julia Izzaty binti Mohd Juffry (A162684) 

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M1 - Chlorhexidine

MOA

broad spectrum against Gram-positive bacteria, Gram-negative bacteria, fungi

Bacteriostatic & bactericidal

binds to negatively charged sites on cell wall of bacteria and destabilises it causing interference with osmosis (low concentration)

Damage cytoplasmic membrane of bacteria causing leakage of bacterial components leading to its death (low concentration)

Solidify cytoplasm (high concentration)

Inhibit adherence of microorganisms to a surface - preventing growth and development of biofilm

Active ingredients - Chlorhexidine gluconate

Side effects

staining - teeth, restorations, tongue

Alteration of taste

Increased calculus formation

Mouth/throat irritation - ulceration, geographic tongue, glossitis, gingivitis,dry mouth

Allergic reaction

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M2: Essential oil mouthwash

Active ingredients:
Menthol, thymol, methyl salicylate, and eucalyptol

MOA:
- Essential oil mouthwashes disrupts bacterial cell walls and inhibiting their enzymic activity.
- They prevent bacterial aggregation, slow multiplication and extract endotoxins.
- Membrane damage is also proposed to be the main mechanism of action.
- Solubility of EOs in the phospholipid bilayer of cell membranes plays an important role in their antimicrobial activity.
- Terpenoids in EOs have been found to interfere with the enzymatic reactions of energy metabolism.

Side effects:
- burning sensation in mouth
- altered taste
- nausea

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D1: Chlorhexidine

Mechanism of action: Chlorhexidine is a broad-spectrum biocide that is both bacteriostatic and bactericidal depending on its concentration. Chlorhexidine which is a positively charged molecule kills the bacteria by binding to the sites on the bacterial cell wall which is negatively charged. The cell wall then destabilizes and the cell wall will rupture that causes fluid to leak out leading to lysis and death of the cell.

Active ingredient:

·      Chlorhexidine gluconate

·      Chlorhexidine acetate

Side effects:

·      Staining of tooth, restorations & tongue

·      Change in taste of food & drinks

·      Mouth irritation

·      Dry mouth

·      Increase calculus formation

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TRICLOSAN-COPOLYMER

1. MODE OF ACTION
- Triclosan (2,4,4’-trichloro-2’hydroxy-
diphenyl ether) is a phenolic agent with
broad-spectrum antibacterial activity
that disrupts bacterial cytoplasmic mem-
branes by blocking fatty acid biosynthesis.

2. INGREDIENTS
- Phenol which is substituted at C-5 by a chloro group and at C-2 by a 2,4-dichlorophenoxy group

3. SIDE EFFECTS
-Animal studies have linked triclosan to lower testosterone levels and less sperm production, allergies and asthma. Bowel inflammation has also been indicated.

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Wafa Nadhirah (A163642) Cetylpyridinium chloride mouthrinse

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Wafa Nadhirah (A163642) Cetylpyridinium chloride mouthrinse

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Mechanism of action - Antimicrobial

Consist of a cationic surface active agent surfactant that can be absorbed readily to oral surfaces. As it has both hydrophilic and hydrophobic groups, the hydrophilic positive charged region of cetylpyridinium chloride molecules causes the compound to interact with microbial cell surfaces.Therefore, it leads to a disruption of bacterial membrane integrity which cause the leakage of bacterial cytoplasmic components, interference with cellular metabolism, inhibition of cell growth, and finally, cell death.

It can also inhibit the synthesis of insoluble glucan by streptococcal glucosyltransferase, adsorbed to pellicle-covered enamel, and the inhibition of bacteria co-adhesion and also bind to the streptococcus mutans biofilms.Therefore it can lead to retention in the mouth and has prolonged antmicrobial activity.

Active ingredients

- Cetylpyridinium chloride

Side effects-

Tooth staining

Patient with xerostomia, may experience mild dysgeusia and tingling of the mucosa

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M2: Essential oil

1. MOA
- Disrupt bacterial cell wall and inhibit their enzymatic activity.
- Prevent bacterial aggregation, slow multiplication and extract endotoxins.
- Mainly act on the bacterial membrane where interaction of antimicrobial compounds with the membrane can affect the transport of nutrients and ions, the membrane potential, and the overall permeability of the cell.

2. Active ingredient
- Eucalyptol
- Menthol
- Methyl salicylate
- Thymol

3. Side effects
- Burning sensation
- Headache
- Neurotoxicity
- Dermatitis

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D1: Chlorhexidine dentifrice
MOA:
CHX which is a bi-cationic, positively charged molecule, attaches to the negatively charged sulfates and phosphate ions on the bacterial cell wall. CHX gets adsorbed on the bacterial cell wall and alters the integrity of the bacterial cell membrane.
With increased concentration of CHX, there is progressive damage to the cell membrane.
CHX binds to the phospholipids in the inner membrane and there is leakage of low molecular weight compounds, like potassium ions
There is coagulation and precipitation of cytoplasmic components by formation of phosphate complexes which include adenosine triphosphate and nucleic acids, causing bacterial cell death

Active ingredient: Stannous fluoride, sodium fluoride

Side effects:
Tooth/tongue staining
Alteration in taste
Increased calculus formation
Allergy reactions

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D1: Chlorhexidine

1) Active ingredient
= Chlorhexidine gluconate

2) MOA
= In oral application,  CHX binds to the oral mucosa, teeth and mouth tissues. It is then released over time to kill bacteria and fungi. It has the ability to adhere to soft tissue and hard tissue and maintain a potent  sustained release.
= CHX is a positively charged molecule that binds to the negatively charged sites of the bacterial cell, it destabilizes the cell wall and interferes with osmosis. The bacterial uptake of the CHX is very rapid, typically working within 20s.

IN LOW CONCENTRATION, it affects the integrity of the cell wall. once the cell wall damaged, CHX then crosses into the call itself and attacks the cytoplasmic membrane. Damage to the cytoplasmic delicate semipermeable membrane allows for leakage of components leading to cell death.

IN HIGH CONCENTRATION, CHX causes the cytoplasm to congeal or solidify, precipitation of bacterial cytoplasm.

3) Side effects
- brown staining of the teeth, restorative materials and dorsum of tongue
- supragingival calculus formation
- alteration in taste
- mucosal erosion
rarely,
- desquamative soft tissue lesion after prolonged application
- parotid swelling

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Dentrifice - Chlorhexidine
MOA: the bactericidal effect is a result of the binding of this cationic molecule to negatively charged bacterial cell walls.  At low concentration of chlorhexidine, this cause bacteriostatic effect at high concentration membrane disruption will cause cell death.
Active ingredient : sodium benzoate,  hydrochloride, hydroxyethylcellulose
Side effect : increase in calculus of teeth,  staining of teeth,  change in taste

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D2 ( Triclosan-copolymer)
1. MOA
- cytoplasmic membrane disruption of the bacterial and inhibition of the oxygenase or lipoxygenase pathway.
it involve in membrane destabilisation, efflux mechanisms, the inhibition of fatty acid synthesis and the formation of biofilms. The early work on triclosan highlighted its effect on the bacterial membrane structures, particularly its distruptive effects on lipids and proteins.
2. Active ingredient:
- 5-chloro-2-(2,4-dichlorophenoxy)phenol
- copolymer: PVM-MA copolymer (2% copolymer and 0.3 % triclosan in dentrifices)
-copolymer helps in retention and uptake of triclosan.
3. side effect:
- microbial resistance , it has antibiotic resistance.
- it may also associated with allergies or hay fever

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(A162838)
D2: Triclosan Copolymer tooth paste
1. Mechanism of action:
- Antimicrobial effect. Triclosan is a phenolic agent with broad spectrum antibacterial activity that disrupts the bacterial cytoplasmic membranes by blocking fatty acid biosynthesis. Effective against both gram-positive and gram-negative bacteria.
- Anti-inflammatory effect. Triclosan is known to inhibit inflammatory mediators production by human gingival fibroblasts by inhibiting the cyclo-oxygenase and lipoxygenase pathways.

2. Active ingredient:
Triclosan (2,4,4'-trichloro-2'hydroxy-diphenyl ether)
Copolymer: PVM-MA copolymer

3. Side effect:
- Antibiotic resistance
- Gut inflammation and endocrine disruption in animal studies.

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D1: Chlorhexidine (dentifrices)

1. MOA:
a) On tooth surface
- CHX gets attached to the salivary protein and desquamated epithelial cells. It then blocks acidic group of salivary glycoprotein. This will lead to reduction of glycoprotein adsorption on tooth surface, thus preventing formation of pellicle.

- CHX prolongs antiseptic release as it prevents adsorption of bacterial cell wall on tooth surface, thus preventing plaque formation.

- CHX will also compete with calcium ion, blocking agglutination of plaque therefore prevents binding of mature plaque

b) On bacterial cell membrane
- CHX (positively charge) adheres to bacterial cell membrane by binding to phospholipids in inner cell membrane (negatively charge).
- CHX binds to cell wall causing it to rupture
- Rupturing of cell wall causes fluid leakage leading to lysis and cell death

2. Active ingredient
- Chlorhexidine gluconate

3. Side effects
- Staining of tooth surface, restoration and tongue
- Increased calculus formation
- Taste alteration (may be temporary)

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D1: Nur Aliyyah Binti Md Saleh (A163028)

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D1: Nur Aliyyah Binti Md Saleh (A163028)

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Chlorhexidine

MOA: Chlorhexidine is both bacteriostatic (in low concentration) and bactericidal (in high concentration). It can disrupt microbial cell membranes. The reaction of positively charged chlorhexidine molecule with negatively charged phosphate groups on the microbial surface will destroy the integrity of the cell which results in leakage of intracellular substance. In higher concentration, the chlorhexidine will later enter the cell, causing precipitation of cytoplasmic components and ultimately causes cell death.

Active ingredients: Chlorhexidine gluconate

Side effects: usage of chlorhexidine might causes an unpleasant sensation to the mouth. It can also cause stating to teeth and restorations. In some patients, they might have an allergic reaction to the usage of chlorhexidine.

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Cetylpyridium Chloride mouthrinse (CPC)

MOA:
Wide spectrum antimicrobial agent which its molecules have both hydrophilic and hydrophobic groups. The positively charged hydrophilic region enables the compound to interact and integrate with microbial cell surfaces. This results in disruption and rupture of the bacterial cell wall, causing bacterial cytoplasmic component leakage, interference with cellular metabolism, inhibition of cell growth, and eventually cell death.

Besides, it also inhibits the synthesis of insoluble glucan by streptococcal glucosyltransferase, adsorb to pellicle-covered enamel and inhibit co-adhesion of bacteria.

Active ingredients:
Cetylpyridium Chloride
(Quaternary Ammonium COmpound)
(N-hexadecylpyridinium as the cation and chloride as the anion)

Side effects:
- transient staining
- temporary taste alteration
- slight burning sensation in the gingiva
- promote formation of calculus on some users' teeth

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M1: Chlorhexidine mouthrinse

1. MOA:

Chlorhexidine is a positively-charged molecule that binds to the negatively-charged sites on the cell wall; it destabilizes the cell wall and interferes with osmosis.

The bacterial uptake of the chlorhexidine is very rapid, typically working within 20 seconds.

In low concentrations it affects the integrity of the cell wall.

Once the cell wall is damaged, chlorhexidine then crosses into the cell itself and attacks the cytoplasmic membrane (inner membrane).

Damage to the cytoplasm's delicate semipermeable membrane allows for leakage of components leading to cell death.

In high concentrations, chlorhexidine causes the cytoplasm to congeal or solidify

2. Active ingredients:
- Chlorhexidine gluconate

3. Side effects:
The most common side effects associated with Chlorhexidine gluconate oral rinses are:

1. an increase in staining of teeth and other oral surfaces;

2. an increase in calculus formation; and

3. an alteration in taste perception.

4. Oral irritation and local allergy-type symptoms have also been reported

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Dentrifice (chlorhexidine)
MOA: binding of this cationic molecule to negatively charged bacterial cell walls. At low concentrations of chlorhexidine it gives in a bacteriostatic effect while at high concentrations, membrane disruption results in cell death.
Active ingredient:
Thymol, menthol, eucalyptol, methyl salicylate
Side effects:
- burning of sensation in the mouth.
- tooth discolouration.

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Chlorhexidine

1. MOA:  It prevents pellicle formation by blocking acidic groups on salivary glycoproteins, hence reducing adherence of glycoprotein on tooth surface

2. Active ingredients: Chlorhexidine gluconate, alcohol, glycerin, saccharin sodium

3. Side effects: Staining of teeth, alteration in taste perception, increase in subgingival calculus

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D1: Chlorhexidine

MOA:
- has bacteriostatic and bactericidal effect.
- kills bacteria by disrupting the cell membrane
- the positively charged chlorhexidine molecule attracted to the negatively charged phospholipids in the bacteria cell wall causing the the cell wall to rupture which then causes the fluid to leak leading lysis and death of the bacteria

Active ingredients: chlorhexidine gluconate

Side effects:
- increase in staining of teeth and other oral surfaces
- alteration in taste perceptions
- dry mouth
- mouth or throat irritation

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D1 : Chlorhexidine (dentifrice)

MOA :
The bactericidal effect is result from the binding of cationic molecule to the negatively charged bacterial cell walls. At low concentrations, chlorhexidine is results in bacteriostatic effect by increasing the cell membrane permeability and leakage of intracellular components. At high concentration, membrane disruption results in cell death.

Active ingredients :
- chlorhexidine gluconate
- chlorhexidine acetate

Side effects :
- tooth discoloration
- dry mouth
- stomach irritation or nausea (if ingested)
- acute respiratory distress syndrome (if aspirate into lungs)

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M1: CHLORHEXIDINE (CHX)

MOA: it is bacteriostatic in nature and bacteriocidal in high concentration.
- It is bi-cationic positively charged molecule, attached to negatively charged sulfates and phosphate ions on the bacterial cell wall.
- This allows CHX to get adsorbed on the bacterial cell wall, which then allows CHX to alter the integrity of the bacterial cell membrane, making damage to the cell membrane of bacteria.
- CHX then binds to the phospholipids in the inner membrane and causes leakage of low molecular weight compounds.
- Cytoplasmic components coagulates and precipitates due to the formation of phosphate complexes, which then causes bacteria cell death.

Active Ingredient
0.12% chlorhexidine gluconate

Side effects
1. Tooth and tongue staining
2. Unpleasant taste in mouth
3. Dry mouth
4. Increased in formation of calculus
5. Decreased/altered taste sensation

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M2: Essential Oil
1. MOA

Allowing antibacterial agents to act on bacteria biofilm and penetrating into biofilm wall to kill numbers of plaque bacteria

Decrease plaque formation and bacterial adhesion

Work as anti- plaque and an anti- gingivitis agent to decrease gingival inflammation so destructive periodontal disease will not develop

2. Active ingredients:

eucalyptol 0.092%

thymol 0.064%

methyl salicylate 0.060%

menthol 0.042%

3. Side effect:

burning sensation

objectionable taste

tooth staining

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Cetylpyrinidium Chloride
Mechanism of Action:
The polar end of the CPC binds to the negatively charged membrane of the bacteria. A non-polar region of the CPC end penetrates the membrane and causes an imbalance in the osmotic regulation of the bacteria which activates loss of cytoplasmic contents and ultimately, death.

Active Ingredients:
Pyridinium (positive ion), Chloride (negative ion)

Side Effects:
- Tooth and tongue staining
- Gum irritation
- Aphthous ulcers

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Essential oil mouthrinse (M2)
MOA: It kills micro-organisms by disrupting their cell walls and inhibiting their enzymic activity. They prevent bacterial aggregation, slow multiplication and extract endotoxins.
Active ingredients : Thymol,menthol,eucalyptol,methyl salicylate.
Side effects: May cause burning sensation in the mouth and cause headaches .

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M1: Mouthrinse (Chlorhexidine)

Active Ingredient:

Thymol, menthol, eucalyptol

Mechanism of Action:

Chlorhexidine has both bacteriostatic and bactericidal mechanism of action and it kills by disrupting the cell membrane through cell wall lysis and precipitation of cytoplasm. At physiologic pH, chlorhexidine dissociates and release positively charged cation. The binding of this cationic molecule to negatively charged bacterial cell wall result in the bactericidal effect. While at low concentrations of the chlorhexidine, it will result in a bacteriostatic effect.

Side Effects:

1. Allergic reaction

2. Staining

3. Alteration in taste

4. Oral mucosa irritation

5. Dry mouth

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D(2) - Triclosan-copolymer

1. MOA
- It inhibits enoyl-(acyl carrier protein) reductase which allows it to kill bacteria by inhibiting the fatty acid biosynthesis pathway, disrupting lipid synthesis and eventually kill the cell.

2. Active ingredients
- 0.3% triclosan
- 2.0% copolymer and fluoride

3. S/E
- mitochondrial dysfunction
- endocrine disruption
- affect immune response
- affect ROS production
- affect cardiovascular function

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Cetylpyridium Chloride (CPC)

Mechanism of action :  At low concentrations, CPC affects the cell by interfering with its osmoregulation and its homeostasis by K+ and pentose leakage which might initiate autolysis by activation of intracellular latent ribonucleases.  At high concentrations, CPC leads to disintegration of the membranes with subsequent leakage of cytoplasmic contents. Damage of proteins and nucleic acids as well as cell wall lysis by autolytic enzymes are the consequences .

Active ingredients :
Monoactive quaternary ammonium compound consist of positively charged pyridine as a hydrophilic headgroup in combination with a hexadecane chain as a lipophilic side chain.
Side effects :
-Genes of microorganisms which can make multiple antibiotic resistance proteins and multidrug resistance proteins were mainly upregulated in CPC-treated (Salmonella Heidelberg).
-  Overuse may have potential risks of inducing resistance toward due to its widespread use.
- Brown stains between the teeth.

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Dr Madihah's Homework: Mechanism of action, active ingredients and side effects of selective chemical products

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Dr Madihah's Homework: Mechanism of action, active ingredients and side effects of selective chemical products

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Dentifrice:
•Chlorhexidine

•Triclosan-copolymer

•Stannous-fluoride- sodium hexametaphosphate

Mouthrinse:
•Chlorhexidine

•Essential Oils

•Cetylpyridium chloride

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Essential oil mouth rinse
Moa:Cell wall distruption and inhibition of bacterial enzyme.
Active ingredient: menthol, eucalyptol, methyl salicylate, thymol
Side effects: headaches, asthma attack, irritation and burning.

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D[3] Triclosan-Copolymer

Mechanism of action

Active predominantly against Gram-positive bacteria inhibiting the fatty acid biosynthetic pathway by inhibiting  enoyl-acyl carrier protein (ACP) reductase, which in turn disrupts lipid synthesis and eventually kills the cells

Active Ingredient

1. Triclosan

2. Copolymer

Side effects

1. Bacterial resistance

2. negative impact on fertility

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D3 : Stannous-fluoride-sodium-hexametaphosphate

Mechanism of Action :
-For the MOA, it is provided by both active ingredients. For Stannous fluoride (has bacteriostatic and bactericidal properties) it provides antibacterial activity agaisnt species associated with plaque, gingivitis, cavities, and malodor. Also reduced plaque, gingival inflammation and gingival bleeding. Furthermore, it protects agaisnt hypersensitivity. It also has the effect of  remineralization of enamel and protects agaisnt demineralization. As for the Sodium hexametaphosphate ingredient, it inhibits calculus formation, protects agaisnt new stain formation, and serves to removes extrinsic stains.

Active ingredients :
-0.454% stabilized Stannous Fluoride
-Sodium hexametaphosphate

Side effects :
-fluorosis in cases of overdose (children)
-Allergic reaction
-temporary staining