Chlorhexidine Usage in Dentistry Under Threat
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- Published: Monday, 20 January 2025 09:32
- Written by Peter Ingle
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A dental and hospital staple for decades is the subject of multiple press articles raising concerns about its safety. A bill to ban its use is currently under consideration in the Lords.
As the world becomes familiar with Ultra Processed Foods (UPFs), ‘Biocides’ may be the next bad health buzzword. Like UPF’s they are all around us including in soaps, shampoos and some dental products. Papers including the Mail, Sun and Mirror have repeated claims that so-called ’biocides’ wipe out ‘good’ bacteria in the microbiome and can cause disease. A number of the reports led their stories with headlines such as: “Urgent warning issued to anyone who buys soaps, shampoos and dental products.”
Many familiar popular products including mouthwashes, toothpastes and hand sanitisers include antibacterial ingredients which are now being described as biocides. The reports explain that Chlorhexidine, for decades a staple in many dental practices, can eliminate 90% of protective bacteria in the oral microbiome, and increase high blood pressure.
The Consumer Products (Control of Biocides) Bill has now been read a second time and committed to a Committee of the Whole House. It sets out to ban biocides from non-medical over-the-counter products unless strictly justified by evidence.
Baroness Natalie Bennett, former leader of the Greens, who is tabling the bill states in its foreword: "What was your morning like? Maybe, singing cheerfully, you jumped into the shower, reaching for the antibacterial body wash, on special this week, with its loud label claiming "kills 99% of bacteria". Afterwards you brushed your teeth with the heavily advertised new antibacterial toothpaste and used chlorhexidine-containing mouthwash.” She gives further examples and then says: "Before you go to breakfast, you have subjected your microbiome – the tens of thousands of species of microbes that make you a microbial holobiont – to a barrage of biocides, in other words poisons. We know that the microbiome is essential to life; our gut microbiome, about which we know most (although still very little) has significant impacts on mental and physical health. Exactly what impact that barrage has on it we have little information, yet, but it cannot be good."
If GDPUK readers are concerned by the tone of the foreword, Baroness Bennett’s colleagues appear to have accepted much of it at face value. Chlorhexidine is only one on the list of biocides under scrutiny. Triclosan, once touted as a game changing addition to toothpastes, and Benzalkonium chloride which is found in some hand sanitisers and handwash products, also feature.
Supporters of the bill believe a general ban is necessary to stop a "whack a mole" situation where individual named biocides are removed from products only to be replaced by a new chemical which may later turn out to be just as harmful.
Professor Andrew Seaton, President of the British Society for Antimicrobial Chemotherapy, and Consultant in Infectious Diseases at NHS Greater Glasgow and Clyde, said: "Outside of healthcare, the benefits of biocides are at best speculative, but harms are potentially significant and irreversible. The indiscriminate use of biocides has the potential to drive antimicrobial resistance (AMR) by directly disrupting both the human microbiome as well as our fragile environmental ecosystem."
Opponents to the bill say that there are already effective measures in place to restrict and control levels of biocidal components in cosmetics, including the UK cosmetics legislation 2009/1223. The use of products in medicines is overseen by the MHRA, and also the GB Biocidal Products Regulations. In addition, making currently over the counter items prescription based, would add a further strain to the NHS, including the time for extra GP appointments and prescriptions.
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