Restorative & Materials · patient case question
For a patient with oral mucositis using chlorhexidine, which change is appropriate?
Patient case: Wear, erosion and a burning mouth
demo: 31-year-old female
chief: Sensitive front teeth that look increasingly thin, and occasional pain that comes and goes.
history: She drinks four cans of soda daily and has a history she is reluctant to discuss regarding eating patterns. She is otherwise well.
meds: None.
findings: Marked erosion of the lingual surfaces of the maxillary teeth with intact buccal surfaces. Smooth, shiny, saucer-shaped cervical lesions on the buccal aspects of several premolars. Parotid regions appear full bilaterally.
Show answer and explanation
Correct answer: A. Substitute a bland or povidone-iodine rinse for alcohol-containing chlorhexidine
- A. Correct. Alcohol-containing chlorhexidine stings intensely on ulcerated mucosa and worsens dryness, so compliance collapses. Alcohol-free formulations, bland saline or sodium bicarbonate rinses, or povidone-iodine are better tolerated. Comfort and continued gentle hygiene matter more than antiseptic potency here.
- B. A higher concentration increases irritation and staining without benefit in mucositis.
- C. Stopping hygiene invites secondary infection. Gentle mechanical cleaning with a soft brush continues throughout.
- D. Hydrogen peroxide is irritating to ulcerated mucosa and disrupts healing granulation tissue.
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