Names | |
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Preferred IUPAC name 1-Hexadecylpyridin-1-ium chloride | |
Other names Acetoquat CPC; Pyrisept EXADECYL-PYRIDINIUM, CHLORIDE | |
Identifiers | |
3D model (JSmol) | |
3578606 | |
ChEBI | |
ChEMBL | |
ChemSpider | |
ECHA InfoCard | 100.004.177 |
PubChem CID | |
UNII |
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CompTox Dashboard (EPA) | |
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Properties | |
C21H38ClN | |
Molar mass | 339.99 g·mol−1 |
Appearance | Solid |
Melting point | 77 °C (171 °F; 350 K) |
Pharmacology | |
B05CA01 ( WHO ) | |
Hazards | |
Lethal dose or concentration (LD, LC): | |
LD50 (median dose) | 36 mg/kg (rabbit, iv) [1] 400 mg/kg (rabbit, oral) [1] 6 mg/kg (rat, ip) [1] 30 mg/kg (rat, iv) [1] 200 mg/kg (rat, oral) [1] 250 mg/kg (rat, sc) [1] 10 mg/kg (mouse, ip) [1] 108 mg/kg (mouse, oral) [1] |
Except where otherwise noted, data are given for materials in their standard state (at 25 °C [77 °F], 100 kPa). |
Cetylpyridinium chloride (CPC) is a cationic quaternary ammonium compound used in some types of mouthwashes, toothpastes, lozenges, throat sprays, breath sprays, and nasal sprays. It is an antiseptic that kills bacteria and other microorganisms. It has been shown to be effective in preventing dental plaque and reducing gingivitis. [2] [3] It has also been used as an ingredient in certain pesticides. Though one study seems to indicate cetylpyridinium chloride does not cause brown tooth stains, [4] at least one mouthwash containing CPC as an active ingredient bears the warning label "In some cases, antimicrobial rinses may cause surface staining to teeth," [5] following a failed class-action lawsuit brought by customers whose teeth were stained. [6]
The name breaks down as:
OTC (over the counter) products containing cetylpyridinium chloride include oral wash, oral rinse, and ingestable products, such as lozenges [8] and over-the-counter cough syrup. [9]
The United States' federal Food and Drug Administration's monograph on oral antiseptic drug products reviewed the data regarding CPC and made this conclusion:
The agency believes that the information contained in its adverse reaction files, 30 years of safe marketing of an OTC mouthwash containing cetylpyridinium chloride (NDA 14- 598), and the safety data evaluated by the Oral Cavity Panel are sufficient to conclude that 0.025 to 0.1 percent cetylpyridinium chloride is safe as an OTC oral antiseptic when labeled for short-term use (not to exceed 7 days). [10]
The National Library of Medicine Toxicology Data Network (TOXNET) reviewed the range of toxicity of CPC and stated "Significant toxicity is rare after exposure to low concentration products that are typically available in the home." [11]
The fatal dose in humans ingesting cationic detergents has been estimated to be 1 to 3 g. [11] Therefore, a person using a typical oral ingestible product that provides 0.25 mg CPC per dose would need to take 4,000 doses at one time to reach the estimated fatal dose range.
A review found that mouthwashes containing CPC "provide a small but significant additional benefit when compared with toothbrushing only or toothbrushing followed by a placebo rinse" in reducing plaque and gingivitis-inflammation. [3] In combination with chlorhexidine and zinc lactate, CPC has been found to be effective in treating halitosis. [12]
CPC mouthwashes inactivate viruses, including the virus that causes COVID-19, by breaking their lipid envelope. [13]
Cetylpyridinium chloride is known to cause tooth staining in approximately 3 percent of users. [14] The Crest brand has noted that this staining is actually an indication that the product is working as intended, as the stains are a result of bacteria dying on the teeth. [15] Crest stated that because of the low incidence of staining, there was no need to label Pro-Health mouthwash as a potential tooth stainer. [16] However, after numerous complaints [17] and a federal class-action lawsuit, [6] which was later dismissed, [18] the mouthwash now contains a label warning consumers of its potential to stain teeth. [5]
In a small percentage of population, CPC can alter or eliminate the sense of taste. The effect generally goes away a few days after discontinuing use of the product.
The LD50 of cetylpyridinium chloride has been measured at 30 mg/kg in rats and 36 mg/kg in rabbits [ broken anchor ] when the chemical is administered by intravenous infusion but 200 mg/kg in rats, 400 mg/kg in rabbits, and 108 mg/kg in mice when administered orally. [19]
There is in-vitro evidence that cetylpyridinium chloride interferes with mitochondrial function at levels "that may be relevant to human exposures." The research was published in Environmental Health Perspectives" volume 125 no. 8. [20]
The molecular formula of cetylpyridinium chloride is C21H38NCl. In its pure form it is a solid at room temperature. It has a melting point of 77 °C when anhydrous or 80–83 °C as a monohydrate . It is soluble in water but insoluble in acetone, acetic acid, or ethanol. It has a pyridine-like odor. It is combustible. Concentrated solutions are destructive to mucous membranes. Its critical micelle concentration (CMC) is ~ 0.0009–0.0011M, [21] and is strongly dependent on the salt concentration of the solution.
Some products are formulated instead with the bromide salt cetylpyridinium bromide, the properties of which are virtually identical.[ citation needed ]
Mouthwash, mouth rinse, oral rinse, or mouth bath is a liquid which is held in the mouth passively or swirled around the mouth by contraction of the perioral muscles and/or movement of the head, and may be gargled, where the head is tilted back and the liquid bubbled at the back of the mouth.
A toothbrush is a special type of brush used to clean the teeth, gums, and tongue. It consists of a head of tightly clustered bristles, atop of which toothpaste can be applied, mounted on a handle which facilitates the cleaning of hard-to-reach areas of the mouth. They should be used in conjunction with something to clean between the teeth where the bristles of the toothbrush cannot reach - for example floss, tape or interdental brushes.
Toothpaste is a paste or gel dentifrice used with a toothbrush to clean and maintain the aesthetics and health of teeth. Toothpaste is used to promote oral hygiene: it is an abrasive that aids in removing dental plaque and food from the teeth, assists in suppressing halitosis, and delivers active ingredients to help prevent tooth decay and gum disease (gingivitis). Owing to differences in composition and fluoride content, not all toothpastes are equally effective in maintaining oral health. The decline of tooth decay during the 20th century has been attributed to the introduction and regular use of fluoride-containing toothpastes worldwide. Large amounts of swallowed toothpaste can be poisonous. Common colors for toothpaste include white and blue.
Bad breath, also known as halitosis, is a symptom in which a noticeably unpleasant breath odour is present. It can result in anxiety among those affected. It is also associated with depression and symptoms of obsessive compulsive disorder.
Teeth cleaning is part of oral hygiene and involves the removal of dental plaque from teeth with the intention of preventing cavities, gingivitis, and periodontal disease. People routinely clean their own teeth by brushing and interdental cleaning, and dental hygienists can remove hardened deposits (tartar) not removed by routine cleaning. Those with dentures and natural teeth may supplement their cleaning with a denture cleaner.
Crest is an American brand of toothpaste and other oral hygiene products made by American multinational Procter & Gamble (P&G) and sold worldwide. In many countries in Europe, such as Germany, Bulgaria, Serbia, Ukraine, Belarus, Russia, Poland, Hungary, Latvia, Romania, Estonia and Lithuania, it is sold as Blend-A-Med, the name of an established German toothpaste acquired by P&G in 1987. In France, Spain, Italy, Israel, Sweden, Finland, Colombia, Belgium, the Netherlands, Brazil, the United Kingdom, the Republic of Ireland, Australia, Nigeria, Greece, Uruguay and Argentina, P&G markets similar toothpaste formulations under the Oral-B brand.
Chlorhexidine is a disinfectant and antiseptic with the molecular formula C22H30Cl2N10, which is used for skin disinfection before surgery and to disinfect surgical instruments. It is also used for cleaning wounds, preventing dental plaque, treating yeast infections of the mouth, and to keep urinary catheters from blocking. It is used as a liquid or a powder. It is commonly used in salt form, either the gluconate or the acetate.
Fluoride therapy is the use of fluoride for medical purposes. Fluoride supplements are recommended to prevent tooth decay in children older than six months in areas where the drinking water is low in fluoride. It is typically used as a liquid, pill, or paste by mouth. Fluoride has also been used to treat a number of bone diseases.
Dental plaque is a biofilm of microorganisms that grows on surfaces within the mouth. It is a sticky colorless deposit at first, but when it forms tartar, it is often brown or pale yellow. It is commonly found between the teeth, on the front of teeth, behind teeth, on chewing surfaces, along the gumline (supragingival), or below the gumline cervical margins (subgingival). Dental plaque is also known as microbial plaque, oral biofilm, dental biofilm, dental plaque biofilm or bacterial plaque biofilm. Bacterial plaque is one of the major causes for dental decay and gum disease.
Sodium perborate is chemical compound whose chemical formula may be written NaH2BO4, Na2H4B2O8, or, more properly, [Na+]2[B2O4(OH)4]2−. Its name is sometimes abbreviated as PBS.
Gleem is an American brand of oral hygiene products, including toothpastes and electric toothbrushes, owned by Procter & Gamble. It was introduced as a toothpaste in the United States in 1952 and discontinued in 2014. Procter & Gamble later revived Gleem toothpaste as a flavor variant of Crest toothpaste. In 2019, Procter & Gamble expanded the brand to include a line of electric toothbrushes.
The miswak is a teeth-cleaning twig made from the Salvadora persica tree. The miswak's properties have been described thus: "Apart from their antibacterial activity which may help control the formation and activity of dental plaque, they can be used effectively as a natural toothbrush for teeth cleaning. Such sticks are effective, inexpensive, common, available, and contain many medical properties".
Dentin hypersensitivity is dental pain which is sharp in character and of short duration, arising from exposed dentin surfaces in response to stimuli, typically thermal, evaporative, tactile, osmotic, chemical or electrical; and which cannot be ascribed to any other dental disease.
Tooth brushing is the act of scrubbing teeth with a toothbrush equipped with toothpaste. Interdental cleaning can be useful with tooth brushing, and together these two activities are the primary means of cleaning teeth, one of the main aspects of oral hygiene. The recommended amount of time for tooth brushing is two minutes.
Oral hygiene is the practice of keeping one's oral cavity clean and free of disease and other problems by regular brushing of the teeth and adopting good hygiene habits. It is important that oral hygiene be carried out on a regular basis to enable prevention of dental disease and bad breath. The most common types of dental disease are tooth decay and gum diseases, including gingivitis, and periodontitis.
Dentyl Dual Action, previously known as Dentyl Active, and originally as Dentyl pH, is a brand of mouthwash, an oral hygiene product designed to reduce the presence of bacteria responsible for tooth decay, gingivitis and halitosis. Traditional mouthwash formulations typically use alcohol or other antimicrobial ingredients to kill bacteria.
Gingivitis is a non-destructive disease that causes inflammation of the gums; ulitis is an alternative term. The most common form of gingivitis, and the most common form of periodontal disease overall, is in response to bacterial biofilms that are attached to tooth surfaces, termed plaque-induced gingivitis. Most forms of gingivitis are plaque-induced.
Tooth discoloration is abnormal tooth color, hue or translucency. External discoloration is accumulation of stains on the tooth surface. Internal discoloration is due to absorption of pigment particles into tooth structure. Sometimes there are several different co-existent factors responsible for discoloration.
Oral disease is one of the most common diseases found in dogs. It is caused by the buildup of various anaerobic bacteria in the mouth which forms plaque, eventually hardening into tartar on the teeth along the gum line, and is related to the development of gingivitis. Since small and toy breeds have a much smaller jaw but contain the same number of teeth, crowding allows higher bacterial build up and puts them at higher risk of developing periodontal disease.
The product does have a small print warning on the back label that reads: "In some cases, antimicrobial rinses may cause surface staining to teeth," but consumers have complained the warning label is buried in the product information.
Rossman's lawsuit seeks class-action status. It accuses P&G of violating the Michigan Consumer Protection Act by not putting a warning on the label.
The company's Crest Pro-Health Rinse, launched with much promise in April 2005, is discoloring the teeth of about 3 percent of its users, the company said, because it is doing its job.
Tooth discoloration could actually be one indication, in some people, that the product is working: after the rinse kills germs in your mouth, the dead germs can collect on the tooth surface and create the appearance of a brown stain.
Brinker said P&G doesn't see a need for a warning label because the number of those affected is very small.
But NBC's Today show reported Wednesday that the complaints have led to a consumer lawsuit alleging fraud and to further study by the Food and Drug Administration, which approved the product.
A U.S. District Court judge has dismissed a proposed class-action lawsuit filed against Procter and Gamble charging that the company's Crest Pro-Health mouthwash causes staining and browning of teeth
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