Chlorhexidine

Added to Handbook: Prior to June 2004
Updated: May 2019

PURPOSE

To provide guidelines on the use of chlorhexidine by dental hygienists.

BACKGROUND

Chlorhexidine has been shown to be an effective anti-plaque and anti‑gingivitis chemotherapeutic agent. Topical oral preparations of therapeutic chlorhexidine and chlorhexidine salts are listed on the federal Food and Drugs Act Prescription Drug List. The federal Act is enacted through provincial legislation. The BC legislation is the Drug Schedules Regulation to the Pharmacy Operations and Drug Scheduling Act of British Columbia, which lists chlorhexidine as a “Schedule I – Prescription” drug.
 
Schedule I drugs require a prescription for sale and are provided to the public by a pharmacist following the diagnosis and professional intervention of a “practitioner”. Specific practitioners who may prescribe a Schedule I drug for sale are defined by provincial legislation. This includes dentists and physicians.
 
Chlorhexidine is routinely used in dental settings as a pre-procedural rinse, for irrigation, and/or for topical application. Chlorhexidine oral rinses may be provided by a dental office to a client for home use as a mouth rinse or for site specific irrigation. Chlorhexidine oral rinses may also be purchased by clients for home use.

POLICY

A written prescription by a dentist or physician is required for the sale of chlorhexidine to a client by a pharmacy. A prescription note must be recorded in the client's record.
 
In-office use of chlorhexidine by dental hygienists must be supported by a prescription or annotation documented in the client's chart by the prescriber. Documentation for the prescribed use of chlorhexidine should specify whether it is intended for a single appointment or for ongoing appointments (e.g. as a pre-procedural rinse). Following a prescription, the use of chlorhexidine products in-office by a dental hygienist must be documented in the client’s chart including product, concentration, and volume. Any chlorhexidine preparations given to a client for home use must also follow a documented prescription.

If the ability to obtain a prescription for in-office use of chlorhexidine poses a barrier, dental hygienists should select appropriate alternative products that are supported by evidence of effectiveness.
 
Dental hygienists are expected to provide client-centered care based on each client’s individual needs. Client-centered care includes planning interventions and selecting products for use that are evidence-based.

 

REFERENCES