Locally acting drugs 2

Dentifrices

They are therapeutic mechanical aids which are available

as either tooth powder or tooth paste.
Many ingredients may be added to the dentifrices to
acquire certain functions e.g.
1- Abrasives.
2- Detergents to have cleaning actions
3- Antiseptics: methanol, cinnamon, boric acid.
Detergents

Antiseptics
 Obtundents
• They are agents which are used to either diminish the
dentine sensitivity or to make the excavation painless.
Ex: camphor, silver nitrate, absolute alcohol
• Its use in the present is decline due to availability of
local anesthetic agents e.g.
xylocaine for painless excavation
 :Mechanism of action
1. Paralyzing the sensory nerve ending e.g. camphor
2. Precipitating proteins e.g. silver nitrate
3. Destroying the nervous tissue e.g. absolute alcohol
 Demulcents & protective
Demulcents are viscid agents used to protect and lubricate
.mucous membrane
Members
Acacia (Gum acacia)

Glycerin

Tragacanth (Gum tragacanth )

:Members
:Acacia (Gum acacia) -1
protect mucous membrane from irritation by coating
its surface with a gummy layer , used to treat catarrhal
.infections of the mouth
:Glycerine -2
is used a protective to skin& demulcent, antiseptic to
.mucous membrane
:Tragacanth (Gum tragacanth ) -3
is applied on mucous abrasions
arising from friction to form
a gelatinous mass
 Astringents
These substances precipitate proteins in superficial
cells and thereby form a protective layer against
.irritants and bacterial invasions

Types
Metallic Vegetable
astringents astringents
1-Metallic astringents:
Zinc sulphate & zinc chloride are used as
mouth washes.
Silver nitrate is an antiseptic and astringent.

2- Vegetable astringents: Tannic acid is used

in dentistry in powder form as a haemostatic.
 Mummifying agents
(Astringents + Antiseptics)
They are agents used to harden and dry tissues of
the pulp and root canal, used when it is not
possible to remove the pulp and contents of root
.completely
Examples: liquid formaldehyde & tannic acid
 Bleaching agents
 They are agents used to remove
pigmentation of the teeth.
 They include:
1. Reducing agents as sodium
thiosulphate (hyposulphate)
2. Oxidizing agents as perhydrol (30%
hydrogen peroxide) and chlorinated
lime powder (Liberates chlorine).
 Mouth washes
• Definition: They are solutions used to rinse the mouth.

• Superficial infections of the mouth are often helped by

warm mouth washes which have a mechanical cleansing
effect and cause some local hyperemia.

• A warm saline mouth wash, can be prepared either by

dissolving half of a teaspoonful of salt in a glassful of
warm water or by diluting compound sodium chloride
mouthwash with an equal volume of warm water.
• It is prepared to reduce plaques, gingivitis , dental caries
and stomatitis, it also reduced bad breath.
Mouth wash generally contain

4 groups of excipients:
Alcoh Surfac Flavor Colorin
ol tants s g agents
1- Alcohol is used as solubilizing agent for some flavoring
agents as well as a preservative
2- Surfactants are non specific substances which are used
to help in the solubilization of flavors and in the removal of
debris by producing foaming reaction.
3- Flavors are used to overcome disagreeable taste
4- Coloring agents are used to give a pleasing color to
mouth wash.
 Antiplaque/Antigingivitis
 Dental plaque is the soft,
nonmineralized bacterial deposit
that forms on teeth that are not
adequately cleaned.

 Plaque bacteria produce

inflammation –inducing substances
and release endotoxin & bacterial
antigens, which causes damage, so,
the dental plaque is the common
denominator in caries and
periodontal diseases.
 Anti plaque measures
: Agents acting against the microflora

Agents interfering with bacterial attachement

.Mechanical removal of plaque

Agents acting against the microflora per se
:Chlorhexidine (antiplaque of choice)

:Antibiotics

:Oxygenating agents

Fluorides

Quaternary ammonium compounds

Phenolic compounds
:Chlorhexidine (antiplaque of choice)

• Electrostatic forces attract positively charged

chlorhexidine to the negatively charged
bacterial cell wall leading to disorientation of
bacterial lipoprotein structure and destruction of
its osmotic barrier
• It can be used as a mouth wash, spray or gel
as an adjunct to other oral hygiene measures
.
•Patients should be advised to use chlorhexidine at least 30
min. after tooth brushing as calcium salts used as filler agents
in most toothpaste will affect the binding of chlorhexidine.
•Side effects:

1. mucosal irritation
2. taste disturbances
3. reversible brown staining of teeth and tongue
4. parotid gland swelling
Antibiotics:
• Systemic penicillin and erythromycin have resulted in
emergence of resistant bacteria
• Topical non-absorbable such as vancomycin, bacitracin are
used in mouth washes.
• Topical tetracycline rinse can reduce the amount of plaque
formed during a nonbrushing period and can inhibit the

development of gingivitis
 Oxygenating agents:

Hydrogen peroxide mouth rinses reduce plaque formation and gingivitis

and arrest ulcerative gingivitis.
 Fluorides

Acts as antibacterial at high concentrations

 Quaternary ammonium compounds

As benzethonium chloride that is active against gram positive bacteria.

 Phenolic compounds

Phenols exert antibacterial and anti-inflammatory effects

Phenols and its derivatives such as thymol have some limitations in use;
due to bad taste, poor water solubility and allergy
 Agents interfering with bacterial attachment

They act either by attacking plaque matrix components or

altering the tooth surface.

Mechanical removal of plaque

 Dental protective
They are used as:
1- Protective linings for cavities in
order to prevent staining or chemical
irritation of the dentine
2- Varnishes over synthetic fillings
to protect them from secretions until
setting iscomplete.
3- To help in pulp healing.

Examples: zinc oxide, Ca hydroxide