The use of antiseptics in pediatric dentistry

Antiseptici su antimikrobna sredstva namijenjena koži i sluznicama zbog čega se još nazivaju i topikalnim ili lokalnim antiinfektivnim ili antimikrobnim sredstvima. Mogu djelovati bakteriostatski ili baktericidno te fungicidno i virucidno. Upotrebljavaju se u prevenciji i terapiji različitih infektivnih oralnih bolesti. Za razliku od antibiotika, nedovoljno su selektivni i ne smiju se apsorbirati jer bi oštetili stanice i tkiva domaćina. Potvrda njihove koristi u stomatologiji došla je tek kada je dokazano da bakterijski plak predstavlja glavni etiološki čimbenik u nastajanju karijesa, bolesti pulpe i parodonta. Antiseptici su neizostavni u preventivnim i terapijskim postupcima u dječjoj stomatologiji. Ti postupci odnose se na kemijsku kontrolu plaka i eliminaciju patogenih mikroorganizama, a samim time i na prevenciju karijesa i gingivitisa. Odnose se i na njihovu primjenu u endodonciji u postupcima vitalne i devitalizacijske pulpotomije te pulpektomije. Stomatološki antiseptici mogu se u odgovarajućim koncentracijama primjenjivati na sluznicu usne šupljine, na površinu zuba i u zub radi redukcije broja mikroorganizama. Uspješnost liječenja ovisi o pravilnom odabiru antiseptika, a za to je potrebno poznavati antimikrobni spektar pojedinog antiseptika i indikacije za njegovu pravilnu primjenu. Uspješnost ovisi i o učinku njegova djelovanja, odnosno o postizanju dostatne koncentracije i dostatnog vremena djelovanja antiseptika na mjestu primjene (3). Antiseptics are antimicrobial substances applied to skin and mucous membranes, so they are often called topical or local anti-infective or antimicrobial agents. They may be bacteriostatic or bactericidal, fungicides and virucides. They are used to prevent and treat various infective oral diseases, but unlike antibiotics they are not selective enough and cannot be absorbed because they could damage host’s cells and tissue. The importance of their use in dentistry was confirmed when it was proven that bacterial plaque is the main etiological factor in the formation of dental caries, as well as in pulp infections and periodontal diseases. Antiseptics are indispensable in preventive and therapeutic procedures in pediatric dentistry. These methods relate to a chemical plaque control and elimination of pathogenic microorganisms, and thus help in the prevention of caries and gingivitis. Furthermore, they are applied in endodontics such as vital and devitalizing pulpotomy and pulpectomy. Antiseptics can be applied in dentistry, in appropriate concentration, to oral mucosa, teeth surface and into the teeth in order to reduce the number of microorganisms. The success of the treatment depends on the correct choice of the antiseptic, which requires the knowledge of the antimicrobial spectrum and indications for adequate use of each antiseptic. The success also depends on its performance, i.e. on using the appropriate concentration and appropriate time of application of the antiseptic on the treated area (3).