I have been asked this question by 90% of my patients!
Well, mouth rinses on the market are all different because of their effects, but at the same time they all have similar ingredients. The difference, is about the time it takes for the mouthwash to make the impact; and whether the product is alcohol based or non-alcohol based. Therefore, any product approved by the health authorities is fine. This article is to explain the correct use of mouthwashes.
As a dental professional, I believe in encouraging and educating my patients to use mouthwashes correctly, or to discourage incorrect use. Sometime mouthwashes simply do not need to be used at all.
I never recommend the use of mouth rinses just for the sake of adding something to my patient’s routine. My recommendation to use therapeutic rinses is only based on individual needs and oral health after a thorough assessment by a dental professional. Mouth rinses should be used wisely. Despite the beneficial effects, they can have disadvantages as well, such as dryness of the mouth, allergic reactions and burns to moth tissues.
So, lets learn what is it mouth wash? When and why you need it?
Before adding a mouthwash to your oral care routine, it is important to understand what a particular mouthwash does exactly, and whether or not you really need it. Studies have shown that oral rinses can reduce plaque, gingivitis or periodontitis when used in addition to tooth brushing, as opposed to only brushing your teeth.
The different levels of impact or in other words, different concentrations and ingredients are meant to treat gum disease, reduce sensitivity, reduce cavities, whiten the teeth; or help with saliva production. Kids and adults’ mouth rinses have differences as well. Therefore, it is important to follow the instructions labelled on the product. Individuals with periodontal disease are recommended to use mouth rinse twice a day. If you know your gums are healthy then the use of mouth rinse is not required as often.
Remember that both alcohol-based and non-alcohol-based mouth rinses have the same final results. Therefore, neither of them is superior to the other.
***See the links below to learn the differences between the products available on the market; and to see which one is best for you to use.
There are two main types of mouthwashes: cosmetic and therapeutic.
Cosmetic mouthwashes may temporarily control bad breath and leave a pleasant taste, but have no chemical or biological application beyond their temporary benefit. To be precise, if a product does not eliminate bacteria associated with bad breath, its benefit is considered to be solely cosmetic.
Most of the mouthwashes on the market are therapeutic and have active ingredients, intended to help control or reduce conditions like bad breath, gingivitis, periodontitis, plaque, and tooth decay. The right mouthwash or mouth rinse for you, is the one that meets your dental hygiene needs to improve health of your teeth and gums. You should always ask your hygienist or dentist what type of mouth wash they would recommend for you based on your needs. Therapeutic mouthwashes usually come in a variety of flavours, so you would probably be able to find your desired taste of what you need.
Here are the main ingredients that are usually used in therapeutic mouthwashes:
- Cetylpyridinium chloride (CPC) – generally mediates an antiseptic activity and protective action against dental plaque and reducing gingivitis. It is diminishing the growth of pathogenic bacteria, and inhibits the production of virulence factors. It acts by penetrating the cell membrane, causing cell components to leak, which eventually leads to cell death.
- Chlorhexidine– is a chlorinated phenolic disinfectant used commonly in mouthwash for its action against bacteria. Chlorhexidine is bound to the oral mucosal surfaces and gradually releases over a period of time. It reduces numbers of bacteria beneath and top of your gums. It is not recommended to use Chlorhexidine on a regular basis, due to its strong active ingredients. This type of mouth rinse has a long-lasting activity for about 12 hours. We recommend to use Chlorhexidine -based rinses for treatment of periodontal disease, some infections in the mouth tissues or after dental surgeries. Only a medical professional, i.e. a dentist or a dental hygienist can prescribe this type of mouth rinse for you; and should tell you how long you need to use it.
- Essential oils (EOs)-has their therapeutic properties and implication in dentistry since ancient times. EOs are very common ingredients in different mouthwashes and they help in antifungal, antibacterial, antibiofilm and antiseptically treatments. EOs also accelerate wound healing and prevent swollen and bleeding gums. Most essential oils as ingredients of a mouthwash, may sound like chemicals’ names (e.g. Eucalyptol, Thymol, Menthol, etc.) but all of them are secondary metabolites or extracts of different plants that have passed clinical trials and are approved by health authorities. The mechanisms of action of EOs are dependent on their chemical composition but mostly they are adhesive to tissues and disrupt bacteria outer walls that kills them.Here are examples of the most valuable essential oils that you can use for your mouth problems. Keep in mind that you can used them only as rinses, DO NOT SWALLOW, because they can be very allergenic and cause discomfort or heath problems.You can make natural mouth rinses with just water and essential oils. Add one to two drops of the essential oil to a quarter-full cup of water, and gargle with it.
- Clove oil – Is anti-inflammatory and antifungal. Can be used to decrease your tooth or gum pain by simply apply with a cotton tip on the painful area.
- Peppermint oil – Effective in killing bacteria that lead to gum disease and cavity development. Helps with bad breath and mouth candidiasis.
- Tea Tree (Melaleuca) – Kills oral bacteria, kills influenzas viruses, diminish tooth decay and relieve bleeding gums. Perfect ingredient for periodontal disease treatment.
- Oregano oil – Contains anti-inflammatory properties to help reduce bacterial and fungal infections in the mouth.
- Thyme oil – Helps with candida and general oral infections.
- Cinnamon oil – is antibacterial, antifungal and antiseptic. It is an effective cleanser for every oral health care need, such as relief for a sore throat!
- Lavender oil – reduce pain and anxiety. Helpful in reduction of bruxism.
- Fluoride- Fluoride is a mineral that works by making your teeth stronger and more resistant to decay caused by acid or bacteria. The most common fluoride compound used in mouth rinse is neutral sodium fluoride. Fluoride mouth rinses range from 0.05% to 0.2% (225-1,000 ppm) in concentration. Mouthwashes with these concentrations are considered therapeutic; and depending on the concentration level we recommend them for children, adults or patients with special needs. After a fluoride mouth rinse treatment, the fluoride in the mouth rinse is retained in the saliva which helps prevent tooth decay. Fluoride also exist in different products that we use every day in our diet. Excessive doses can result in brown or yellow coloring of the teeth.
- Peroxide – It is a very effective oral debriding agent and an oral wound cleanser. Peroxide is an effective antimicrobial for chronic oral wounds and periodontal disease. Peroxide gels and liquids are used in dentistry to help with the under-gum treatment; and is sometimes recommended as a mouth rinse for home use in certain cases. For home use you can dilute 50/50 with water or there are some peroxide-based mouth rinses on the market, off-the-shelf ready for use.
The technique to use mouth rinses is simple.
- Most of the time it is not recommended to delude mouth rinses, but some companies may recommend that you dilute them with water. Remember, if the label does not tell you to dilute, then you may not get the full benefit of the mouth wash if the germ-killing ingredients are at a lower level!
- Get a small amount of about 30ml in your mouth;
- Gargle for 30-60 seconds, in order to ensure that your mouthwash can impact the bacteria at the back of the tongue; and
- Spit out. You can rinse your mouth with normal water afterwards, if the taste of the mouthwash is unpleasant. Concentrated rinses take about a minute to kill bacteria in your mouth.
You can learn more about the differences between mouthwashes available in Canada and find detailed information about the products on the market through the links below:
https://www.cda-adc.ca/en/oral_health/seal/products/results.asp?id=6&type=1
https://www.colgate.com/en-us/products/mouthwash
https://crest.com/en-us/products/compare/crest-mouthwash
***Remember whatever oral rinse you choose, be sure to follow the instructions and avoid swallowing.