Role and importance of mouthwashes in dental hygiene

The use of mouthwashes dates back to 2700 B.C. in China when people used to use salt water as a mouth rinse to treat gum diseases. The Greeks and Romans also used to use such preparations in olden times. Hippocrates too has been known to recommend the use of salt, vinegar and alum as a mouth rinse in earlier days. In 1870, “Listerine” was added in mouth wash preparation. Ayurveda recommends the application of coconut oil before brushing and sodium bicarbonate rinse is also used by people as per the literature survey.

There are large numbers of mouthwashes available in the market under different trade names are prescribed by dentists. Over the years, the use of such preparations seems to be on the rise not only in India, but also in western countries. The mouthwashes available the market has various components as their key ingredients, keeping in view their usage.

Beginning with Chlorhexidine mouthwash which is being considered as the most effective antibacterial agent. It is known to reduce plaque and gingivitis in humans by 55-60% as per studies conducted in the recent years. It is highly substantive i.e. not being cleared from mouth for several hours, thus providing a long time efficacy. It acts by altering the bacterial cell wall and interfering with adsorption of bacteria to teeth. It is also available in the form of toothpaste and spray-delivery system.

A dental hygienist should recommend the use of chlorhexidine as a mouth rinse, full strength (0.12%), twice daily for 30 seconds using 15 ml of the rinse by swishing and swashing it inside the mouth. It should be used in 1:1 dilution with water (0.06%) in an oral irrigator for supragingival irrigation once daily.

Some mouthwashes are also available over the counters that might also contain such as phenolic compounds, alcohols, essential oils, methyl salicylate which do reduce plaque and gingivitis up to 30 percent. These work on the same principle as the chlorhexidine mouthwash but are less costly than it.

Triclosan, another phenolic compound and some other quaternary ammonium compounds like Cetylpyridinium chloride are also commonly available in the mouthwashes these days.

In spite of having numerous merits there are a few demerits also attributed to them on being used for a prolonged period. Brown staining of teeth, alteration in taste, burning sensation, xerosis (oral dryness) and might also enhances the risk of oral cancer in rare cases. Though as per studies, mouthwashes seem to be appreciating as far as its antiplaque, antibacterial, anti-halitosis (i.e. anti bad breath) significance is concerned.

There is a general misconception among people that the use of mouth wash would eliminate the need for brushing and flossing, which is not true. They can always augment the use of brushing and flossing but can never substitute them. As they can never remove afirmly stuck sesame seed or let’s just say any piece of sweet that can cause decay of the tooth as a general example. However, the use of therapeutic mouth wash available these days are also known to be quite effective these days.

A survey had been conducted on the Second year BDS students of Rajasthan Dental College which revealed certain important facts pertaining to the use of mouthwashes.

The first and the most surprising fact was that still a very few people use mouth wash and are acquainted with their role in maintaining oral hygiene. Among the 100 people interviewed more than 50 percent were found to be not aware about periodontal diseases pyorrhoea and gingivitis and how to maintain oral hygiene.

Last but not the least, more and more people should be educated on the regular use of mouthwashes along with the proper brushing habits so as to maintain their oral health which is very substantial for all.

Written by:

c s bhan

Prof Chandra Shekhar Bhan
(Pharmacy academician)

Dr Sakshita Agnihotri
(Miro-biologist and Practising Dentist)

Role and importance of mouthwashes in dental hygiene