Abstract：
OBJECTIVE: To compare the effectiveness of chlorine dioxide, chlorhexidine and placebo sprays in improving oral hygiene among institutionalised elders.
BACKGROUND: Available evidence suggests that oral sprays may be an effective alternative delivery method for plaque control; however, few studies have evaluated antimicrobial agents other than chlorhexidine.
METHODS: A total of 228 elders across 11 nursing homes in Hong Kong were recruited into the clinical trial. Participants were randomly allocated into one of the following groups: 0.1% pH-balanced chlorine dioxide spray, 0.2% chlorhexidine spray or sterile water spray (placebo control), once daily. Dental plaque, gingival bleeding and other clinical oral health outcomes were assessed at baseline, 3 and 6 months. Participant acceptability of the interventions was assessed at the end of the clinical trial.
RESULTS: Review assessments were conducted for 135 elders at 6 months. Significantly greater reductions in plaque index scores were observed with the chlorhexidine spray (0.4) and chlorine dioxide spray (0.3) than the placebo spray (0.1). While significant reductions in gingival bleeding scores were observed within the chlorhexidine (7.4), chlorine dioxide (7.5) and placebo (5.3) sprays after 6 months, change scores were not significantly different between groups. Significantly greater increases in the levels of staining were observed in the chlorhexidine spray group (-0.1) than the chlorine dioxide (0.0) and placebo spray (0.0) groups.
CONCLUSIONS: Antimicrobial sprays were shown to be effective among institutionalised elders. Chlorine dioxide spray showed equivalent effects on dental plaque and gingival bleeding relative to the chlorhexidine spray over a 6-month period.
BACKGROUND: Available evidence suggests that oral sprays may be an effective alternative delivery method for plaque control; however, few studies have evaluated antimicrobial agents other than chlorhexidine.
METHODS: A total of 228 elders across 11 nursing homes in Hong Kong were recruited into the clinical trial. Participants were randomly allocated into one of the following groups: 0.1% pH-balanced chlorine dioxide spray, 0.2% chlorhexidine spray or sterile water spray (placebo control), once daily. Dental plaque, gingival bleeding and other clinical oral health outcomes were assessed at baseline, 3 and 6 months. Participant acceptability of the interventions was assessed at the end of the clinical trial.
RESULTS: Review assessments were conducted for 135 elders at 6 months. Significantly greater reductions in plaque index scores were observed with the chlorhexidine spray (0.4) and chlorine dioxide spray (0.3) than the placebo spray (0.1). While significant reductions in gingival bleeding scores were observed within the chlorhexidine (7.4), chlorine dioxide (7.5) and placebo (5.3) sprays after 6 months, change scores were not significantly different between groups. Significantly greater increases in the levels of staining were observed in the chlorhexidine spray group (-0.1) than the chlorine dioxide (0.0) and placebo spray (0.0) groups.
CONCLUSIONS: Antimicrobial sprays were shown to be effective among institutionalised elders. Chlorine dioxide spray showed equivalent effects on dental plaque and gingival bleeding relative to the chlorhexidine spray over a 6-month period.
摘要：
目的：为了比较二氧化氯的有效性，氯己定和安慰剂喷雾剂可改善住院老人的口腔卫生。
背景：现有证据表明，口腔喷雾剂可能是控制牙菌斑的有效替代给药方法；然而，很少有研究评估除氯己定以外的抗菌药物。
方法：在香港的11家疗养院中，共招募了228名老年人参加临床试验。参与者被随机分为以下一组：0.1％pH平衡的二氧化氯喷雾，0.2%氯己定喷雾剂或无菌水喷雾剂（安慰剂对照），每天一次。牙菌斑,在基线时评估牙龈出血和其他临床口腔健康结果，3和6个月。在临床试验结束时评估干预措施的参与者可接受性。
结果：在6个月时对135名老年人进行了回顾评估。与安慰剂喷雾剂(0.1)相比,氯己定喷雾剂(0.4)和二氧化氯喷雾剂(0.3)观察到菌斑指数评分显著更大的降低。虽然在氯己定（7.4）中观察到牙龈出血评分显着降低，二氧化氯（7.5）和安慰剂（5.3）喷雾后6个月，组间变化评分无显著差异.与二氧化氯(0.0)和安慰剂喷雾(0.0)组相比,在氯己定喷雾组(-0.1)中观察到染色水平显著更大的增加。
结论：抗菌喷雾剂在住院老人中被证明是有效的。在6个月的时间内，与氯己定喷雾剂相比，二氧化氯喷雾剂对牙菌斑和牙龈出血的影响相同。
背景：现有证据表明，口腔喷雾剂可能是控制牙菌斑的有效替代给药方法；然而，很少有研究评估除氯己定以外的抗菌药物。
方法：在香港的11家疗养院中，共招募了228名老年人参加临床试验。参与者被随机分为以下一组：0.1％pH平衡的二氧化氯喷雾，0.2%氯己定喷雾剂或无菌水喷雾剂（安慰剂对照），每天一次。牙菌斑,在基线时评估牙龈出血和其他临床口腔健康结果，3和6个月。在临床试验结束时评估干预措施的参与者可接受性。
结果：在6个月时对135名老年人进行了回顾评估。与安慰剂喷雾剂(0.1)相比,氯己定喷雾剂(0.4)和二氧化氯喷雾剂(0.3)观察到菌斑指数评分显著更大的降低。虽然在氯己定（7.4）中观察到牙龈出血评分显着降低，二氧化氯（7.5）和安慰剂（5.3）喷雾后6个月，组间变化评分无显著差异.与二氧化氯(0.0)和安慰剂喷雾(0.0)组相比,在氯己定喷雾组(-0.1)中观察到染色水平显著更大的增加。
结论：抗菌喷雾剂在住院老人中被证明是有效的。在6个月的时间内，与氯己定喷雾剂相比，二氧化氯喷雾剂对牙菌斑和牙龈出血的影响相同。
