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Hello everyone, The pages in this blog were originally from a school assignment designed to be a notebook full of information for my patients. I've found that my patients and I don't always have enough time to answer questions and use the notebook as in depth as we'd like. That is why I have begun uploading the pages onto this blog for anyone to be able to read and educate themselves about their dental health anytime they'd like. Most of the information from the notebook was made available by the American Dental Hygiene Association, and various other professional sources. Please feel free to email me with any questions you have. ~Cherie

Tuesday, June 30, 2009

mouthwash

Mouth rinses serve a variety of purposes.

     Whether it's to mask bad breath, fight cavities or prevent the buildup of plaque, the sticky material that contains germs and can lead to oral diseases, mouth rinses serve a variety of purposes.

     Though they may leave your mouth with a clean, fresh taste, some rinses can be harmful, concealing bad breath and unpleasant taste that are signs of periodontal diseases which cause inflammation and degeneration of the supporting structures of the teeth and tooth decay.

What are the differences in rinses?
Rinses are generally classified by the U.S. Food and Drug Administration (FDA) as either :

  • Cosmetic
  • Therapeutic
  • A combination of the two

Cosmetic rinses are commercial over-the-counter (OTC) products that help remove oral debris before or after brushing, temporarily suppress bad breath, diminish bacteria in the mouth and refresh the mouth with a pleasant taste. 

Consumer Reports tested 15 OTC mouthrinses, all worked for at least 10 minutes
 but none worked at the end of two hours.

 

 

Therapeutic rinses have the benefits of their cosmetic counterparts, but also contain an added active ingredient that helps protect against some oral diseases. Therapeutic rinses are regulated by the FDA and are voluntarily approved by the American Dental Association (ADA). 

     Therapeutic rinses also can be categorized into types according to use: 

  1. antiplaque/antigingivitis rinses 
  2. anticavity fluoride rinses.

Should I use a rinse?
    That depends upon your needs. Most rinses are, at the very least, effective oral antiseptics that freshen the mouth and curb bad breath for up to three hours. Their success in preventing tooth decay, gingivitis (inflammation of the gingival gum tissue) and periodontal disease is limited, however.

     Rinses are not considered substitutes for regular dental examinations and
 proper home care. 

    Dentists stress a regimen of brushing with a fluoride toothpaste followed by flossing, along with routine trips to the dentist, should be sufficient in fighting tooth decay and periodontal disease.

Which type should I use?
     This depends upon your needs. 

     While further testing is needed, initial studies have shown that most over-the-counter antiplaque rinses and antiseptics aren't much more effective against plaque and periodontal disease than rinsing with plain water. Most dentists are skeptical about the value of these antiplaque products, and studies point to only a 20 to 25 percent effectiveness, at best, in reducing the plaque that causes gingivitis.

     Anticavity rinses with fluoride, however, have been clinically proven to fight up to 50 percent more of the bacteria that cause cavities. 

     Nevertheless, many dentists consider the use of fluoride toothpaste alone to be more than adequate protection against cavities.  Many recommend Act mouth rinse.

     Dentists will prescribe certain rinses for patients with more severe oral problems such as caries, periodontal disease, gum inflammation and xerostomia (dry mouth). 

     Patients who've recently undergone periodontal surgery are often prescribed these types of rinses. Likewise, many therapeutic rinses are strongly recommended for those who can't brush due to physical impairments or medical reasons.

 

Pros of using mouthwashes:

Pros are:

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improved health of gums

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germ killing effects

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fresh taste

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cavity prevention,

Cons  of using mouthwashes:

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altered taste

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tooth staining

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drying of oral tissues in the mouth

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burning sensation

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ulcers

 

 

What are the proper steps when using mouth rinses?

  

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Before using a mouth rinse, brush and floss teeth.

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Measure the proper amount of rinse recommended on the container or by a dentist.

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Close lips and, keeping teeth slightly apart, swish liquid around the mouth.

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Thirty seconds is the suggested rinsing time.

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Finally, spit liquid from mouth thoroughly.

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Do not rinse, eat, or smoke for thirty minutes after using a mouthwash. Doing so will diminish the effects of the mouthwash

 

 

When and how often should I rinse?
     If it's an anticavity rinse, dentists suggest the following steps, practiced after every meal:

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 brush

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 floss

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 then rinse.

      Teeth should be as clean as possible before applying an anticavity rinse to reap the full preventive benefits of the liquid fluoride. 

    The same steps can be followed for antiplaque rinses.  If ever in doubt, consult your dentist or follow the instructions on the bottle or container. Be sure to heed all precautions listed.

What is the proper way to rinse?

  1. First, take the proper amount of liquid as specified on the container or as instructed by your dentist into your mouth. 
  2. Next, with the lips closed and the teeth kept slightly apart, swish the liquid around with as much force as possible using the tongue, lips, and sucking action of the cheeks. 
  3. Be sure to swish the front and sides of the mouth equally. Many rinses suggest swishing for 30 seconds (one minute for the fluoride rinses)
  4. Finally, rinse the liquid from your mouth thoroughly.
  5. Choose one that is based on your individual needs. For example, if they have a dry mouth, but want a nice taste, they should look for a non-alcohol mouthwash so their tissues stay moist. “If you often have cavities, you should use a fluoride rinse.
  6. It is best to consult your dentist about the best mouth rinse to meet the needs of your mouth.

Are there any side effects to rinsing?
   Yes, and they vary depending on the type of rinse. Habitual use of antiseptic mouthwashes containing high levels of alcohol, which is most of your over the counters products (ranging from 18 to 26 percent) may produce:

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a burning sensation in the cheeks, teeth and gums. 

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it can cause intoxication if swallowed, used excessively, or used by children. 

For a child weighing only 26 pounds, 5 to 10 ounces of many OTC rinses 
containing alcohol can be potentially lethal.

     Many prescribed rinses with more concentrated formulas can lead to: 

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ulcers

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sodium retention

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root sensitivity

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stains

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soreness

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numbness

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changes in taste sensation 

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painful mucosal erosions. 

    Most anticavity rinses contain sodium fluoride, which if taken excessively or swallowed, can lead over time to fluoride toxicity. Because children tend to accidentally swallow mouthwash, they should only use rinses under adult supervision. 

If you experience any irritating or adverse reactions to a mouth rinse, discontinue its use immediately and consult your dentist.

Can I make a home-made rinse?
Yes. You can prepare at home three widely used alternatives to brand name cosmetic rinses:

  1. saline solution rinse
    1/2 tsp. salt + 8 oz water
  2. for a stronger solution
    1/2 tsp. salt + 4 oz water.
  3. sodium bicarbonate
    1/2 tsp. baking soda + 8 oz. water.

What are the ingredients in rinses that make them work?
     Most over-the-counter rinses contain five standard components:

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an active bacteria- fighting ingredient such as quaternary ammonium compounds, boric and benzoic acid

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phenolic compounds;

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a flavoring agent such as saccharin or glycerin

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astringents like zinc chloride to provide a pleasant-tasting sensation and shrink tissues

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ethyl alcohol, ranging from 18 to 26 percent; and water. Journal of the American Dental Association" indicated that mouthwashes "containing more than 25% alcohol could increase the risk of oral and pharyngeal cancers by about 50%.  Also the more alcohol content of the mouthrinse, the more sloughing.  The more sloughing, the more food for bacteria, leading to higher levels of bacteria which  increases sulfur levels  of bad breath.  Listerene has  triple the alcohol content of American beer, which is a 50% increase over table wine and about the same as fortified wines. Avoid alcohol based mouthrinses,  the alcohol actually makes periodontal disease WORSE.

     Rinses can also contain buffers to reduce acidity, dissolve mucous films and alleviate soft tissue pain. Anticavity rinses usually contain 0.05 percent sodium fluoride, or 0.1 percent stannous fluoride, as approved by the FDA.

Active ingredients in antiplaque rinses vary. Certain rinses contain Chlorhexidine (the most effective plaque-fighting drug yet tested, available only by prescription). Heavy metal salts or herbal extracts like sanguinaria, derived from the bloodroot plant.

Commonly-used Rinses

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Antiplaque/antigingivitis Rinses

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Therapeutic Antiseptics

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Phenol products: Listerine1 (Dr Peterson does not recommend this product due to its alcohol content and it can stain teeth)., Chloraseptic, BreathRX

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Chlorhexidine products2.: Peridex1.2., PerioGuard1.2., Corsodyl1.2.

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Sanguinaria products: Viadent (we do NOT recommend this product)

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Cosmetic antiplaque rinses: Plax (Dr. Peterson does not recommend, it is not approved by ADA) , Close-up Anti-Plaque, Oral-B Antibacterial

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Therapeutic Anticavity Fluoride Rinses Act1., Fluorigard1., Act ., Oral-B Anticavity Rinse1.

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Cosmetic Breath Freshening Mouth Rinses Cepacol, Lavoris, Scope, Signal, Clear Choice, Rembrandt Mouth Refreshing Rinse

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Others

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Topical antibiotic rinses2.3.

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Enzyme rinses2.3.

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Artificial saliva rinses1.2.

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Rinses that control tartar (The hard, crusted calcium deposits that form on teeth)3.

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1. approved by the American Dental Association
2. available by prescription only
3. still undergoing tests

^^ JADA, Vol 127, Sept 96, pg 1282.

http://www.dentalgentlecare.com/mouthrinses.htm

 

 


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