CITROX Interview

CITROX®: a valuable adjunct for improving oral hygiene

A microbiologist with over 30 years of research experience, Prof. David Williams currently leads the Microbial Diseases Research Group of the School of Dentistry at Cardiff University. As an expert in oral microbiology, he has studied the effects of a number of mouthwash formulations on inhibiting microbes in the oral cavity. One of these was the unique combination of Citrox and chlorhexidine, featured in CURAPROX’s new Perio Plus+ mouthrinse.

Is there a move in the market towards more natural healthcare products?

Healthcare products that contain natural ingredients have become very popular among consumers, many of whom favour these over synthetic alternatives. This may be due to consumer concerns over possibly negative side effects from the use of artificial substances. As such, some patients have begun seeking natural remedies to treat a wide range of illnesses, including oral diseases such as dental caries, gingivitis and periodontitis.

There are now a variety of oral hygiene products on the market that contain natural antimicrobial ingredients, like Citrox. Unlike conventional antibiotics—which typically target one specific site—the active agents in Citrox can attack multiple sites of a microbial cell, leading to improved deactivation, and making the agent effective at inhibiting microorganisms known to cause infections in the oral cavity. I have demonstrated these results in my own laboratory experiments, which also tested Citrox’s ability to eradicate bacteria in biofilms.[i] These studies—among many others—have helped open up avenues for further research into additional applications of Citrox throughout the healthcare industry. For instance, my research is now assessing whether Citrox can prevent biofilm formation on catheters.

What is Citrox’s potential as a mouthrinse ingredient specifically?

As most practitioners are aware, many oral diseases are caused by a build-up of bacterial plaque. Rather than create a completely sterile environment, mouthrinses help reduce the number of bacteria within the mouth, thus minimising the likelihood of a patient acquiring infection. Oral bacteria multiply rapidly, so it is important for patients with acute dental problems, or at a higher risk of contracting dental disease, to use a suitable mouthrinse to limit plaque accumulation.

Mouthrinses containing Citrox may serve as valuable adjuncts for improving oral hygiene, as our research has shown that a combination of chlorhexidine and Citrox was demonstrably more effective at inhibiting bacteria, compared with using either of these ingredients alone.

Why would you recommend Perio Plus+?

The laboratory study my colleagues and I conducted explored a range of different microorganisms, including bacteria and fungi, all of which had varying susceptibilities to the tested mouthrinses. One of these mouthrinses was Perio Plus+, which combines chlorhexidine with Citrox in one unique formula. It was clear that this product was the most effective agent tested against the microorganisms. If these laboratory findings translate to a clinical setting, then Perio Plus+ products could be highly beneficial in helping protect teeth and gums from oral diseases.

Do you see any further applications for Citrox?

Citrox has a plethora of applications within the dental industry and beyond. In the future, it could have value as an antimicrobial ingredient in toothpastes and other dental care products, or it might be used to treat periodontitis, as a solution that is injected into the gingival pockets to protect against bacteria. Citrox could be implemented as an ingredient in disinfectant handwash or for the removal and prevention of biofilms in dental unit waterlines. It is also exciting to think that Citrox may have value in treating chronic wounds. The agent may even become commonplace as an antibacterial solution in food processing or in food storage to preserve meat. If a natural ingredient like Citrox is proven to eradicate biofilm, its future applications are extensive. Only time will tell how far reaching the effects of using Citrox could be in multiple industries, including dentistry.

According to research led by professor David Williams at Cardiff University, a combination of Citrox and chlorhexidine was demonstrably more effective at inhibiting bacteria, compared with using either of these ingredients alone. (Photograph: David Williams)

[i] Malic S, Emanuel C, Lewis MA, Williams DW. Antimicrobial activity of novel mouthrinses against planktonic cells and biofilms of pathogenic microorganisms. Microbiology Discovery. 2013 Oct 4;1:11. doi: 10.7243/2052-6180-1-11.