Mouthwash:

Mouthwash, mouth rinse, oral rinse or mouth bath, is a liquid which is held in

the mouth passively or swilled around the mouth by contraction of the perioral
muscles and/or movement of the head, and may be gargled, where the head
is tilted back and the liquid bubbled at the back of the mouth. A solution, often
containing antiseptic, astringent, and breath-sweetening agents, is used for
cleansing the mouth and teeth, and for gargling.

There are two main types of mouthwash:

cosmetic mouthwash : breath freshening and whitening.

therapeutic mouthwash : reduce or control plaque, gingivitis, bad breath, and

tooth decay.

Ideal Properties of Oral Rinse

Safe to use over long periods of time •

Palatable to user •

Inexpensive •

Highly soluble; stable in storage •

Effective •

Broad spectrum •

Adequate bioavailability to bacteria •

Minimal side effects •

Adequate retention to kill bacteria •

Categorization of Active Ingredients in Oral Chemotherapeutics

 Antiseptic agents - Usually broad spectrum; kill or prevent propagation of

plaque microorganisms.
 Antibiotics - Broad or narrow spectrum; inhibit or kill specific or groups of
bacteria, or modulate host inflammatory response.
 Modifying agents - Agents that alter the structure and/or metabolic
activity of bacteria.
 Antiadhesives - Products that interfere with the ability of bacteria to
attach to the acquired pellicle.

General Common Contraindications

Contraindicated in patients with physical or cognitive challenges who cannot

:follow rinsing instructions

 Alcohol in oral rinses

o has also been implicated with xerostomia, but this relationship
remains unsubstantiated—that is, alcohol is not significantly
associated with either the perception of oral dryness or actual
reduction in salivary flow. Xerostomic individuals do not appear to
have an increased dry mouth problem from using alcohol containing
rinses.
o Recovering alcoholics .
o Individuals taking certain antibiotics (e.g., metronidazole) with which
gastrointestinal upset may occur as an interaction effect.
o Small children, because ingestion can result in intoxication, illness, or
fatalities .
Clients being treated with head and neck radiation and clients with
mucositis, who should use bland oral rinses such as sterile water or normal
saline; there remains a lack of research in the area.

 Sodium, found in substantial amounts in some oral rinses (e.g., Cepacol,

Plax, Viadent), leads to sodium absorption through the oral mucosa from
frequent rinsing. People on sodium-restricted diets (e.g., those with
hypertension, renal disease, or congestive heart disease) should be
aware that some brands of mouthwash may be a significant source of
sodium; they should consult their physicians regarding the potential
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