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Surface ultrastructure of intact and in situ chlorhexidine-treated human buccal cells. A method for scanning electron microscopy.

Air-dried and ethanol-fixed buccal epithelial cell smears from five subjects were observed by scanning electron microscopy. The mucous pellicle was precipitated as a smooth haze covering the cells, and outlines of bacteria were found embedded within it. Rinsing the preparations under running water gradually diminished the mucous pellicle but not the cell-adherent bacteria. A more complete dissolution of the pellicle was accomplished by washing the buccal epithelial cells before smearing. After a chlorhexidine mouthrinse the buccal cells appeared distorted, with only a few adherent bacteria. Three days after the rinsing, the denatured appearance still persisted on many cells, however, simultaneously with the emergence of undenatured epithelial cells with adherent bacteria. The method introduced in this study is useful to investigate the bacteria-mucus-epithelial cell interactions. A possible mode of antibacterial activity of chlorhexidine in vivo may be that it destroys bacterial adhesins. The substantivity of chlorhexidine in the oral cavity may be linked to the turnover rate of the oral epithelial cells.