Mouthwash

Patients were told to "spit don't rinse" after toothbrushing as part of a National Health Service campaign in the UK.

Surrogate alcohol use such as ingestion of mouthwash is a common cause of death among homeless people during winter months, because a person can feel warmer after drinking it.

Chemo­thera­peutic agents, including mouthwashes, could have a key role as adjuncts to daily home care, preventing and controlling supra­gingival plaque, gingivitis and oral malodor.

[21] Minor and transient side effects of mouthwashes are very common, such as taste disturbance, tooth staining, sensation of a dry mouth, etc.

Prescription mouthwashes are used prior to and after oral surgery procedures, such as tooth extraction, or to treat the pain associated with mucositis caused by radiation therapy or chemotherapy.

Current guidelines suggest that saline solution is just as effective as magic mouthwash in pain relief and in shortening the healing time of oral mucositis from cancer therapies.

[28] Later, in the Greek and Roman periods, mouth rinsing following mechanical cleansing became common among the upper classes, and Hippocrates recommended a mixture of salt, alum, and vinegar.

[29] The Jewish Talmud, dating back about 1,800 years, suggests a cure for gum ailments containing "dough water" and olive oil.

[30] The ancient Chinese had also gargled salt water, tea and wine as a form of mouthwash after meals, due to the antiseptic properties of those liquids.

He experimented with samples by adding vinegar or brandy and found that this resulted in the immediate immobilization or killing of the organisms suspended in water.

[33] In 1892, German Richard Seifert invented mouthwash product Odol, which was produced by company founder Karl August Lingner (1861–1916) in Dresden.

[39] Research in the field of microbiotas shows that only a limited set of microbes cause tooth decay, with most of the bacteria in the human mouth being harmless.

[43][44] Alcohol is added to mouthwash not to destroy bacteria but to act as a carrier agent for essential active ingredients such as menthol, eucalyptol and thymol, which help to penetrate plaque.

[48] In addition, alcohol is a drying agent, which encourages bacterial activity in the mouth, releasing more malodorous volatile sulfur compounds.

[50] Many newer brands of mouthwash are alcohol-free, not just in response to consumer concerns about oral cancer, but also to cater for religious groups who abstain from alcohol consumption.

[52] Cetylpyridinium chloride mouthwash has less anti-plaque effect than chlorhexidine and may cause staining of teeth, or sometimes an oral burning sensation or ulceration.

[56] A randomized clinical trial conducted in Rabat University in Morocco found better results in plaque inhibition when chlorohexidine with alcohol base 0.12% was used, when compared to an alcohol-free 0.1% chlorhexidine mouthrinse.

[56] In the short term, if toothbrushing is impossible due to pain, as may occur in primary herpetic gingivostomatitis, chlorhexidine mouthwash is used as a temporary substitute for other oral hygiene measures.

[56] Chlorhexidine is rarely associated with other issues like overgrowth of enterobacteria in persons with leukemia, desquamation, irritation, and stomatitis of oral mucosa,[53][60] salivary gland pain and swelling, and hypersensitivity reactions including anaphylaxis.

[66] Ayurvedic literature claims that oil pulling is capable of improving oral and systemic health, including a benefit in conditions such as headaches, migraines, diabetes mellitus, asthma,[27] and acne, as well as whitening teeth.

[65] When compared with chlorhexidine in one small study, it was found to be less effective at reducing oral bacterial load,[68][69] and the other health claims of oil pulling have failed scientific verification[65] or have not been investigated.

[77][78] Fluoride-containing mouthwashes are used as prevention for dental caries for individuals who are considered at higher risk for tooth decay, whether due to xerostomia related to salivary dysfunction or side effects of medication, to not drinking fluoridated water, or to being physically unable to care for their oral needs (brushing and flossing), and as treatment for those with dentinal hypersensitivity, gingival recession/ root exposure.

Flavoring agents include sweeteners such as sorbitol, sucralose, sodium saccharin, and xylitol, which stimulate salivary function due to their sweetness and taste and helps restore the mouth to a neutral level of acidity.

[82] There is evidence that lidocaine anesthetic mouthwash has the potential to be systemically absorbed, when it was tested in patients with oral mucositis who underwent a bone marrow transplant.

[84] A randomized clinical trial found promising results in controlling and reducing dentine hypersensitivity when potassium oxalate mouthwash was used in conjugation with toothbrushing.

[85] A 2005 study found that gargling three times a day with simple water or with a povidone-iodine solution was effective in preventing upper respiratory infection and decreasing the severity of symptoms if contracted.

[53] Sanguinarine is a toxic alkaloid herbal extract, obtained from plants such as Sanguinaria canadensis (bloodroot), Argemone mexicana (Mexican prickly poppy), and others.

[97] It is not recommended for use in the prevention of oral mucositis in head and neck cancer patients receiving radiotherapy or chemoradiation, due to a lack of efficacy found in a well-designed, randomized controlled trial.

It is sometimes use for herpetiforme ulceration (an uncommon type of aphthous stomatitis), but prolonged use may lead to oral candidiasis, as the fungal population of the mouth overgrows in the absence of enough competing bacteria.

[24] A 4.8% tranexamic acid solution is sometimes used as an antifibrinolytic mouthwash to prevent bleeding during and after oral surgery in persons with coagulopathies (clotting disorders) or who are taking anticoagulants (blood thinners such as warfarin).