## 4 Discussion
CHX penetrates the bacterial wall, damaging the bacterial cell and inhibiting enzymes related to the cytoplasmic membrane, and causes an overflow of low-molecular-weight cytoplasmic components, such as potassium ions [38]. This is the bacteriostatic stage which can be reversed if CHX is removed, but if it persists, the antimicrobial action continues to the bactericidal stage, where cytoplasmic coagulation and precipitation occur, and complexes such as adenosine triphosphate and nucleic acids are formed. Oral surfaces are negatively charged; therefore, CHX, a cationic molecule, adheres well to these surfaces and exhibits good interference with bacterial adhesion [39]. Good binding to the oral surface allows it to last longer in the mouth. CHX exhibits a prolonged action and can be released through a period of 8-12 h in the mouth [19; 40]. CHX has antifungal, antimicrobial (anaerobes and aerobes), and antiviral (RNA, DNA, and lipophilic-enveloped viruses) activities [41]. This study showed that the anti-adhesive effect is mostly related to the type of mouthwash used. CHX DG showed the lowest inhibition of adhesion, whereas Perio Plus showed the highest inhibition. The Curasept acted similarly to Perio Plus. _A. actinomycetemcomitans_ was most inhibited, whereas _V. parvula_ was least inhibited. Some differences were observed but not with commercial products. There is unclear evidence of whether mouthwash with CHX DG concentrations below 0.1% has an antiplaque effect. Some authors claim that CHX DG 0.05% with herbal extract has a similar antiplaque effect as CHX DG at concentrations of 0.1%, while others claim that CHX DG at concentrations below 0.1% has an unclear antiplaque effect [42; 43]. It is generally recommended to rinse twice daily with 20 mg of CHX DG mouthwash at concentrations of 0.12-0.2% [44]. In addition to the DG concentrations of CHX, it is necessary to be aware of toothpaste components. The effect of CHX DG can be reduced with ingredients such as sodium lauryl sulfate, cocamidopropy1 betaine (CAPB), calcium and anionic surfactants, and sodium dodecyl sulfate in toothpaste. To avoid a reduction in the effect, the recommendation is to wait 30 min after brushing before using the mouthwash [45]. Fluoride toothpaste should be switched with CAPB paste because it provides better enamel remineralisation as a surfactant with a 30 min delayed rinse [46]. In addition to mouthwash, CHX DG can be used as a gel or dendrimice, although mouthwash should be the first choice, especially in non-brushing models. Researchers have shown that CHX mouthwash reduces _S. mutans_ better than CHX gels and varnishes, even at higher concentrations, but when used alone, it does not have a clinical impact on significant caries reduction [47]. This study found that the cell viability was dependent on the bacteria, alloys, and exposure. The viability of the wires was greatest in _V. parvula_ and smallest in _S. mutans_. CHX DG decreased the viability of _S. mutans_ and _V. parvula_ on SS and NiTi and decreased the viability of _A. actinomycetemcomitans_ only on NiTi. Perio Plus is the only alcohol solution used in this study. When comparing mouthwash 0.2% CHX DG with a non-alcohol base and essential oils containing alcohol, both showed similar results on gingival health; however, because of the side-effects of alcohol-based mouthwash, such as reduced salivation and burning mouth, it is recommended to use the non-alcohol-based one [48]. In contrast, a 7-day study using CHX DG showed a decrease in the pH of the saliva which is associated with enamel demineralisation and caries. CHX DG showed a shift to an acidic environment; therefore, mouthwash application should be cautiously considered [49]. Alcohol is probably not the only reason for the greater effectiveness of Perio Plus, but rather a combination of different substances with a potential antimicrobial effect. In addition to CHX DG, Perio Plus also contains several other components with an antimicrobial effect, such as xylitol, citric acid, and Polysorbate 20.