Mouthwash refers to a liquid which is held in the mouth passively or swilled 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.
Mouthwashes are antiseptic solutions intended to reduce the microbial load in the oral cavity.
Some mouthwashes have analgesic, anti-inflammatory or anti-fungal action.
Some rinses act as saliva substitutes to neutralize acid and keep the mouth moist in dry mouth.
There are cosmetic mouthrinses temporarily control or reduce bad breath and leave the mouth with a pleasant taste.
Rinsing with a mouthwash after brushing with a fluoride toothpaste can reduce the availability of salivary fluoride.
Common use involves rinsing the mouth with about 20-50 ml of mouthwash, with swishing or gargling for about half a minute and then discharged.
It is suggested not drinking water immediately after using mouthwash, and
should not be used immediately after brushing the teeth so as not to wash away the beneficial fluoride residue left from the toothpaste.
Chlorhexidine mouthwash effectiveness is that it strongly adheres to surfaces in the mouth and thus remains present in effective concentrations for many hours.
Many mouthwash solutions aim to control the Volatile Sulfur Compound (VSC)-creating anaerobic bacteria that live in the mouth and excrete substances that lead to bad breath and unpleasant mouth taste.
Only a limited set of microbes cause tooth decay, with most of the bacteria in the human mouth being harmless.
Mouthwashes prevent cavity causing bacteria from growing.
Alcohol added to mouthwash acts as a carrier agent for ingredients such as menthol, eucalyptol and thymol which help to penetrate plaque.
Up to 27% alcohol, and it is possible to fail a breathalyzer test after rinsing.
The added alcohol is a drying agent, which encourages bacterial activity in the mouth, releasing more malodorous volatile sulfur compounds, and may temporarily worsen halitosis.
Currently available evidence suggests an association of alcohol-containing mouthwashes with the development of oral cancer, and it is inadvisable to recommend the long-term use of alcohol-containing mouthwashes.
In painful oral conditions
analgesic mouthrinses can ease pain, and arebcommonly used before meals to reduce discomfort.
Betamethasone is sometimes used as an anti-inflammatory, corticosteroid mouthwash, for severe forms of aphthous stomatitis.
Cetylpyridinium chloride containing mouthwash is used for halitosis.
Cetylpyridinium chloride mouthwash has less anti-plaque effect than chlorhexidine.
Cetylpyridinium chloride mouthwash
may cause staining of teeth, or oral burning sensation or ulceration.
Chlorhexidine digluconate is a chemical antiseptic and is used in a 0.12–0.2% solution as a mouthwash.
Chlorhexidine is sometimes used to prevent dental caries and to treat gingivitis periodontal disease.
Chlorhexidine mouthwash alone is unable to prevent plaque.
Chlorhexidine is not a substitute for regular toothbrushing and flossing, but
is more effective with tooth brushing and flossing.
Chlorhexidine mouthwash rinsing before a tooth extraction reduces the risk of dry socket.
Chlorhexidine mouthwash uses includes prevention of oral candidiasis in immunocompromised persons,[
treatment of denture-related stomatitis, mucosal ulceration/erosions and oral mucosal lesions, and general burning sensation.
Chlorhexidine binds to tannins, so it’s prolonged use in persons who consume coffee, tea or red wine is associated with staining of teeth, and can also cause taste disturbance or alteration.
Mouthwashes based on essential oils have been found effective in reducing halitosis.
Anti-cavity mouth rinses use fluoride to protect against tooth decay.
For most people using fluoridated toothpastes they do not require fluoride-containing mouth rinses.
Fluoride mouthwashes are sometimes used in individuals who are at high risk of dental decay, due to dental caries or people with xerostomia.
Due to their sweetness flavoring agents including sweeteners such as sorbitol, sucralose, sodium saccharin, and xylitol, stimulate salivary function and helps
restore the mouth to a neutral level of acidity.
Xylitol rinses act as a bacterial inhibitor.
Hydrogen peroxide as an oxidizing mouthwash kills anaerobic bacteria, and also has a mechanical cleansing action.
Hydrogen peroxide, froths as it comes into contact with debris in mouth, and
is used in the short term to treat acute necrotising ulcerative gingivitis.
Hydrogen peroxide prolonged use may cause hypertrophy of the lingual papillae.
Sliva substitutes containing enzymes and proteins such as Lactoperoxidase, Lysozyme, Lactoferrin have been used in mouthrinses to reduce oral bacteria adhering acid produced by bacteria.
Oral lidocaine is useful for the treatment of mucositis symptoms induced by radiation or chemotherapy.
Methyl salicylate containing mouthwash
functions as an anti-septic, anti-inflammatory, analgesic, flavoring, and fragrance.
Methyl salicylate containing mouthwash
has less anti-plaque action than chlorhexidine, but does not stain teeth.
Potassium oxalate mouthwash controls and reduces dentine hypersensitivity when used in conjugation with toothbrushing.
Sanguinarine containing mouthwashes are marketed as anti-plaque and anti-malodor, and is a toxic alkaloid herbal extract.
Sanguinarine containing mouthwash use is strongly associated with development of leukoplakia.
Sodium bicarbonate mouthwash is sometimes used to remove viscous saliva and to aid visualization of the oral tissues during examination of the mouth.
Salt water mouth wash is made by dissolving 0.5–1 teaspoon of table salt into a cup of water.
Salt water mouth wash has a mechanical cleansing action and an antiseptic action.
Salt water mouth wash as it is a hypertonic solution in relation to bacteria, resulting in lysis.
Hot salt water mouthwashes increase blood flow, and also encourages the draining of pus from dental abscesses.
Hot salt water mouth washes, are routinely used after oral surgery.
Hot salt water mouth washes keep food debris out of healing wounds and prevent infection.
Hot salt water mouth washes use in dental extractions, should start about 24 hours after a dental extraction.
Sodium lauryl sulfate (SLS) is a foaming agent in many mouthwashes.
Triclosan is a non-ionic chlorinate bisphenol antiseptic used in some mouthwashes.
Triclosan has moderate, broad spectrum anti-bacterial action, some anti-fungal action and significant anti-plaque effect, especially when combined with copolymer or zinc citrate.
Triclosan does not cause staining of the teeth.
Astringents like zinc chloride provide when used in combination with other anti-septic agents can limit the build-up of tartar.