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Your Go-To Guide to Therapeutic Mouthwash and Mouth Rinses


There’s no substitute for the two pillars of oral health: brushing and flossing.


But the more layers of defence against plaque, tartar, and gingivitis, the better. Mouthwash or mouth rinses can help patients to get even more out of regular brushing and flossing.


You might even call mouthwash the third pillar of oral health!


Adding mouthwash to an already-robust oral health regime has long-term benefits. It can be a crucial step in the battle against cavities, bad breath, gum disease, and dry mouth symptoms.


With that said, let’s take a deeper look at the many types of mouthwash that could help your patients achieve better oral health.


Cosmetic Mouthwash vs. Therapeutic Mouthwash: What’s the Difference?


As the term suggests, cosmetic mouthwash functions as a one-dimensional ‘band-aid’ for halitosis, or bad breath. Cosmetic mouthwash tastes pleasant enough and keeps your patients’ mouths feeling fresh for a brief time.


However, beyond temporarily freshening breath, cosmetic mouthwash has no chemical or biological function.Typically, cosmetic mouthwash does nothing to kill bacteria or address the root causes of halitosis.


Conversely, therapeutic mouthwash eats away at bacteria that cause bad breath, gingivitis, plaque, and cavities.


Therapeutic mouthwash contains active ingredients such as cetylpyridinium chloride, chlorhexidine, essential oils, fluoride, and peroxide. Cetylpyridinium chloride actively reduces bad breath, while chlorhexidine and essential oils control plaque and gingivitis. Fluoride prevents tooth decay, while peroxide is prevalent in whitening mouthwash.


Therapeutic mouthwash is available over-the-counter as well as by prescription. However, the chlorhexidine-based products can only be obtained with a prescription.


Common Clinical Applications for Therapeutic Mouthwash

  • Dry socket: also known as alveolar osteitis, commonly occurs after dental extraction procedures, especially extraction of the third molar. This results from a fibrin clotting that forms once a tooth is dislodged. Using chlorhexidine without antibiotics has proven effective against dry socket.
  • Halitosis: caused by volatile sulphur compounds that arise due to food breakdown, dental plaque, etc., can be controlled using mouthwash that contains antimicrobials. The active ingredients in antimicrobial mouthwash may include chlorhexidine, chlorine dioxide, cetylpyridinium chloride, and essential oils.
  • Plaque and gingivitis: when combined with daily brushing and flossing, antimicrobial mouthwash reduces plaque and gingivitis.
  • Tooth decay: fluoride ions cultivate remineralization and are available in some mouthwash.
  • Topical pain relief: local anesthetics are found in some pain-relieving mouthwash. Such anesthetics may include lidocaine, benzocaine/butamin/tetracaine hydrochloride, dyclonine hydrochloride, or phenol.
  • Whitening: extrinsic stain reduction can be achieved through the use of carbamide peroxide or hydrogen peroxide in mouthwash. Using 1.5-2% hydrogen peroxide-based mouthwash for 12 weeks provided similar whitening results to using 10% carbamide peroxide whitening gel for two weeks.
  • Dry mouth: mouthwash with fluoride helps prevent caries that stem from xerostomia, or a lack of saliva. Alcohol-free mouthwash is preferable since alcohol is a drying agent. Patients with dry mouth should use a mouthwash containing enzymes, cellulose derivatives, or animal mucins.

The Most Effective Way to Use Mouthwash

  1. First and foremost, patients should brush before using your mouthwash, waiting longer between brushing and mouthwash if they use toothpaste containing fluoride.
  2. It is best to use three to five teaspoons of mouthwash, which should be the volume of the mouthwash's bottle-cap or cup.
  3. Swish, don’t swallow! Instruct your patients to swish, gargle, and rinse for 30 seconds. And voila! It's time to spit it out.

While mouthwash is best used after brushing, it can be used as a quick fix for bad breath at any point of the day.


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