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chlorhexidine chx chlorhexidine gluconate digluconate chg acetate disinfectant antiseptic skin disinfection sterilize surgical instruments dental plaque yeast infection skin irritation teeth discoloration allergic reaction microorganism spores ototoxic cationic rendering functional cleansing group synthetic surface tension matter zwitterionic stuff production block reagent hydrophobic micelle detergent surfactant compound emulsifying building hydrophilic surfaces anionic agent component