Tuesday, January 24, 2012

Mouth Rinses, Who Should Use Them and Why

Various types of mouth rinses are available over the counter in the market.  It can be very confusing when deciding which one is the right one for you.  This post gives an overview of the general types of mouth rinses and introduces the most abundantly available, yet most ignored type of mouth rinse!  Curious to see what it is?  Please read on.....

There are basically four kinds of Mouth rinses Available in the Market:

1)   Prescription rinses (Chlorihexidine Gluconate) – It is usually prescribed after oral surgery or deep cleaning and should be used for a short time only. This rinse is also prescribed to help reduce occurrence of canker sores.  It should only be used when a canker sore is present or when one is coming on.  Discontinue once sore is gone as this rinse can cause staining of the teeth.  Peridex is the most common brand name.  Chlorihexidine  Gluconate is actually an antiseptic rinse but it is listed separately as it is not sold over the counter.

2)   Fluoride rinses – These are recommended for people who are prone to tooth decay.   The fluoride in the rinse bonds with the tooth enamel and help to strengthen the enamel, thus helping to prevent further decay. Fluoride rinses are not antiseptic rinses at all.  Meaning, they do not kill germs! They only strengthen the teeth.

3)   Antiseptic or antimicrobial rinses – These rinses actually help to kill bacteria in the mouth.  Two main types are available over the counter:

a.  Alcohol basedListerineand Scope are the two best known and most widely used in this category.
b.  Non-alcohol based – Crest Pro Health is probably the best known, but there are many non-alcohol rinses, such as Breath Rx and Closys for general use and the following for specific use:
                                                i.    Biotene is a non-alcohol rinse specially formulated for people who have dry mouth due to low salivary flow.
                                              ii.    Herbal rinses are also non-alcohol based.  Studies have shown that they are quit effective in killing oral bacteria.  Many people like herbal rinses as they do not contain many of the harsh chemicals contained in other alcohol and non-alcohol rinses.
                                            iii.    Baking soda mixed with water is also a very effective germ killing mouth rinse.  Baking soda is a natural germ killer.  This product is not sold commercially, but can be made easily at home by mixing 1teaspoon of baking soda with 4 oz. of water. Store in a jar with a tight fitting lid. Swish twice a day for 30 sec.

4)   Pure water rinse – We recommend that after every meal, with that last drink or two of water, rinse the mouth vigorously to help remove food particles from around and in between the teeth. Also, after drinking coffee or other acidic beverages, swish with water to help keep gums and teeth healthy.  Try to get into the habit of swishing any time you take a drink of water.  It’s ok to swallow the food that is dislodged during swishing.  After all, the food is in your mouth anyway. 

Should I use a mouth rinse every day,and if so what kind?

There are many reasons for using a mouth rinse, therefore, the kind of rinse and duration of use should be determined on an individual basis. 

Common reasons for using an antiseptic mouthrinse such as Scope or Breath Rx:

1)      Bleeding gums – This is usually indicative of gingivitis.  Gingivitis is inflammation of the gums caused by bacterial plaque.  Plaque is where oral bacteria live.  This plaque settles in the space between the teeth and gum and unless this plaque is brushed or flossed away the bacteria in the plaque multiply and thrive in this warm, dark environment.  Bacteria themselves are not the real culprit.  It is a common misconception that bacteria in our mouths kind of “chomp” away at our teeth making cavities.  What is really happening is this: Bacteria ingest the carbohydrates in our mouth, digest these carbs, and then secret acid as a waste product. It is this acid waste product that eats away tooth enamel and irritates the gums causing inflammation and bleeding. Usually, brushing and flossing daily is enough to keep the gums clean and healthy as well as the teeth.  If brushing and flossing are not enough to kill oral bacteria an antiseptic mouth rinse is recommended.  However, mouth rinse is not a substitute for flossing and brushing!

2)      For individuals who have extensive dental work,such as crowns and fillings – Sometimes the tissue around crowns and large inter proximal fillings tends to bleed easily, and even with daily brushing and flossing the tissue remains somewhat inflamed. Antiseptic mouth rinse before or after brushing can help kill the bacteria that live around the junctions of crowns and fillings and teeth.

Common reasons for using Biotene, a mouth rinse formulated specially for dry mouth:
Low salivary flow– Some people have very dry mouth due to lack of adequate salivary flow.  Without saliva flowing over the teeth and washing away the bacteria the bacterial plaque and acid secretion multiplies causing decay and inflammation of the gums. Many conditions lead to low salivary flow such as:

1)    Radiation therapy which effects the salivary glands adversely, causing a reduction in saliva;
2)    Sjogren’s disease which inhibits the fluid flow in the salivary glands, causing the mouth to become very dry;
3)    and anti-seizure medication;

Common reasons for using chlorihexidinegluconate (commonly known as Peridex):

1)    Dental surgery – Frequently after surgeries the Dr. will prescribe chlorihexidine gluconate, a very heavy duty germ killer,to help the gums heal more quickly.  This rinse is by prescription only and is used for a short duration of time, which is which is determined by the dentist or hygienist;

2)    Deep cleaning – Frequently after a deep cleaning for the treatment of periodontal disease, the hygienist prescribes chlorihexidine gluconate which enables the gums to heal more quickly; 

Common reasons for using a fluoride rinse such as ACT: 

Individuals at high risk for decay:
a)      Anyone with low salivary flow
b)      Anyone who is prone to decay

Common reasons for using pure water swishing as mouth rinse on regular basis:

a)      Healthy gums
b)      Strong teeth
c)      Fresh breath

We hope this has answered some general questions regarding use of the mouth rinses.  Please consult with your dentist or hygienist if you have any questions about whether or not you should incorporate mouthrinse in your oral hygiene routine and if so which one is the right product for you.  We always recommend the simple use of water or baking soda and water swishing on regular basis as we think this simple practice, if adopted routinely would improve oral health to a great extent.