Elderly patients now retain their teeth for a longer time and are increasingly susceptible to oral disease, including periodontal disease. Poor oral hygiene is a common finding in elderly populations, especially among the institutionalised elderly. Chemical control of plaque and gingivitis
is effective as a complement or alternative to mechanical removal. Chlorhexidine (CHX) has proven efficacious for controlling plaque accumulation and gingival inflammation3, even in elderly and special-needs populations. Chlorhexidine can be applied in varnish form at high concentrations, and this method has demonstrated its capacity to control mutans streptococci and dental caries6.
Although CHX varnishes have been associated with favourable short-term effects on plaque accumulation and gingival inflammation, only a few studies have assessed their medium- or longterm effects, with contradictory results. The effect of CHX varnish was reported to be of short duration in patients with overdentures or fixed prostheses. On the other hand, a 3-monthly application of 10% CHX varnish improved the gingival health of adolescents at 3 months9 and 6 months after treatment. Root dentine has been proposed to act as a CHX
depot, slowly releasing CHX for up to 6 monthsafter one application of Cervitec. Moreover,
Cervitec treatment reduced gingival inflammation indicators in orthodontic patients by reducing the
levels of inflammatory mediators. With this background, it was considered of interest to determine
whether CHX–thymol varnish could benefit patients with chronic gingival inflammation and be of particular value in the elderly, whose ability to perform routine oral hygiene practices is often
compromised.
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