Mouth rinses serve a variety of
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. Or so we think.
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. Your dentist will tell you, most mouth
rinses just don't wash.
What are the differences in
Rinses are generally classified by the U.S. Food and Drug Administration (FDA)
as either :
|a combination of the two.
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.
Reports tested 15 OTC mouthrinses, all worked for at least 10
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
Up To Top
Therapeutic rinses also can be categorized into types
according to use:
- antiplaque/antigingivitis rinses
- anticavity fluoride
Should I use a
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.
Up To Top
Which type should I
Again, that 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.
many dentists consider the use of fluoride toothpaste alone to be more than
adequate protection against cavities. We 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
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
What are the
proper steps when using mouth rinses?
Before using a mouth rinse, brush and floss
Measure the proper amount of rinse
recommended on the container or by a dentist. |
Close lips and, keeping teeth slightly apart,
swish liquid around the mouth. |
Thirty seconds is the suggested rinsing time.
Finally, spit liquid from mouth thoroughly.
Do not rinse, eat, or smoke for thirty
minutes after using a mouthwash. Doing so will diminish the
effects of the mouthwash|
Up To Top
When and how often should I
If it's an anticavity rinse, dentists suggest the following steps, practiced
after every meal:
Teeth should be as clean as possible
before applying an anticavity rinse to reap the full preventive benefits of the
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.
Up To Top
What is the proper way to rinse?
- First, take the proper amount of liquid as specified on the container or as
instructed by your dentist into your mouth.
- 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.
- 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)
- Finally, rinse the liquid
from your mouth thoroughly.
- 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.
- It is best to
consult your dentist about the best mouth rinse to meet the
needs of your mouth.
Up To Top
Are there any side effects to
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:
sensation in the cheeks, teeth and gums.
|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:
|changes in taste
|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.
Up To Top
Can I make a home-made
Yes. You can prepare at home three widely used alternatives to brand name
- saline solution rinse
1/2 tsp. salt + 8 oz water
- for a stronger solution
1/2 tsp. salt + 4 oz water.
- sodium bicarbonate
1/2 tsp. baking soda + 8 oz. water.
Up To Top
What are the ingredients in rinses that make them
Most over-the-counter rinses contain five standard components:
bacteria- fighting ingredient such as quaternary ammonium compounds, boric and
|a flavoring agent such as saccharin or glycerin
|astringents like zinc chloride to provide a pleasant-tasting sensation
and shrink tissues
|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
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.
Up To Top
DA Affirms Benefits of
ADA-Accepted Antimicrobial Mouth Rinses and Toothpastes,
Fluoride Mouth Rinses
Recently, the ADA’s Council on Scientific
Affairs highlighted the oral health benefits of other
ADA-Accepted products such as antimicrobial mouth rinses and
toothpastes that can help prevent and reduce plaque and
gingivitis, and fluoride mouth rinses that can provide extra
protection against tooth decay over that provided by fluoride
toothpaste alone. Gingivitis is an inflammation of the gums
caused by the accumulation of plaque along the gum line.
It is important to note that the ADA’s daily
oral hygiene recommendations have not changed—people should
still brush twice a day with an ADA-Accepted fluoride
toothpaste; clean between their teeth daily with an ADA-Accepted
floss or ADA-Accepted interdental cleaner; eat a balanced diet
and limit between meal snacks; and visit their dentist regularly
for professional cleanings and oral examinations.
rinses and toothpastes
Antimicrobial mouth rinses and toothpastes reduce
the bacterial count and inhibit the bacterial activity in dental
plaque that can cause gingivitis, an early, reversible form
of periodontal (gum) disease. ADA-Accepted antimicrobial mouth
rinses and toothpastes have substantiated these claims by
demonstrating significant reductions in plaque and gingivitis.
Fluoride mouth rinses
Fluoride mouth rinses are used to help
reduce and prevent tooth decay. Clinical studies have
demonstrated that use of a fluoride mouth rinse in addition to
fluoride toothpaste can provide extra protection against
tooth decay over that provided by fluoride toothpaste alone.
The use of fluoride mouth rinse is not recommended for children
six years of age and younger because they may swallow the rinse.
Consumers should always check the manufacturer’s label for
precautions and age recommendations and talk with their dentist
about the use of fluoride mouth rinse. ADA.org 6/07
Listerine No Replacement For Floss, Despite Claim By Ads
NEW YORK -- An advertising campaign that says
the mouthwash Listerine is as
effective as floss at fighting tooth and gum decay is false and
and poses a public health risk because it can undermine the
dental professionals, a judge has ruled.
U.S. District Judge Denny Chin said in a decision signed
Thursday and made
public Friday that he will order Pfizer, the maker of
Listerine, to stop the
"Dentists and hygienists have been telling their patients for
floss daily," Chin wrote. "They have been doing so for good
benefits of flossing are real -- they are not a `myth.' Pfizer's
message that Listerine can replace floss is false and
The judge ruled after McNeil-PPC Inc., a subsidiary of Johnson &
filed a lawsuit saying that false claims in the advertising
began last June posed an unfair threat against its sales of
Pfizer in print ads had featured a Listerine bottle balanced
equally on a
scale opposite a floss container with the words: "Listerine
clinically proven to be as effective as floss at reducing plaque
gingivitis between the teeth."
The campaign also featured a television commercial titled the
"Big Bang." In
it, the commercial announces that Listerine is as effective as
that clinical tests prove it, though it does add that there is
replacement for flossing.
The judge said "substantial evidence" demonstrates that
important in reducing tooth decay and gum disease and that it
replaced by rinsing with a mouthwash.
The judge also noted that the authors of articles on which
Pfizer based its
advertising campaign had emphasized that dental professionals
continue to recommend daily flossing and cautioned that they
were not suggesting that mouthrinse be used instead of floss.
|Phenol products: Listerine1 (Dr Peterson does not recommend
this product due to its alcohol content and it can stain teeth).,
Chloraseptic, BreathRX |
|Chlorhexidine products2.: Peridex1.2.,
|Sanguinaria products: Viadent
(we do NOT recommend this product)|
|Cosmetic antiplaque rinses: Plax (Dr. Peterson does not recommend, it
is not approved by ADA) , Close-up Anti-Plaque, Oral-B Antibacterial|
|Therapeutic Anticavity Fluoride Rinses Act1.,
Fluorigard1., Act .,
Oral-B Anticavity Rinse1.
|Cosmetic Breath Freshening Mouth Rinses Cepacol,
Lavoris, Scope, Signal,
Clear Choice, Rembrandt Mouth Refreshing Rinse |
There is a range of
mouthwashes available to the consumer. Some of these are purely
cosmetic, while others have been clinically proven to improve
oral hygiene and reduce plaque, a major cause of periodontal
diseases. The efficacy of cetylpyridinium chloride as a
mouthwash prior to toothbrushing does little to reduce plaque
levels or improve oral health. Solely using mouthrinses as
the only method of oral hygiene will be detrimental to their
periodontal health.1 Chlorhexidine preparations have
the slight advantage over essential oils with respect to plaque
reduction. Unlike essential oil mouthwashes chlorhexidine
preparations can stain teeth, are generally indicated for
shorter-term use and can alter taste perceptions for up to
several hours post rinsing. The percentage reduction from
control of EO mouthwash and chlorhexidine groups after twice
daily rinsing for six weeks 2: Overall plaque index at six
weeks Chlorhexidine 0.1 percent was 54 percent and
Chlorhexidine 0.2% was 77 percent. Both agents have a range of
uses in the management of oral conditions where plaque levels
could be problematic. Mouthwash can be used after
mechanical methods to further reduce plaque levels because
mechanical plaque removal alone may not achieve these low
scores on a regular basis.
but a main
in man. J.
~We have NO financial interest in any of these
| Bad Breath Help | Our Services | Home |