Mouthwashes

What is a mouthwash?

Chemotherapeutic agent used as an adjunct to a patients home care system in their oral hygiene regime

When may a mouthwash be recommended?

• Oral conditions, e.g. lichen planus 

• Oral ulcerations 

• Xerostomia 

• Carious control 

• Cosmetic - fresh breath 

What are some general constituents of a mouthwash?

• Water

• Alcohol 

• Flavouring

• Colouring

• Sweeteners

• Active ingredients

What are active ingredients of mouthwash?

What are oxygenating agents function in mouthwash?

Cleanising effervescent

What are two examples of oxygenating agents in mouthwash?

• Sodium Perborate 

• Hydrogen peroxide 

What is the function of astringents in mouthwash?

Tissue shrinkage

What are three examples of astringents in mouthwash?

• Zinc chloride 

• Zinc Acetate 

• Citric acid 

What is the function of anodynes in mouthwash?

Help to alleviate pain

What are two examples of anodynes in mouthwash?

• Phenol derivatives

• Essential oils 

What is the function of buffering agents in mouthwash?

Reduce acidity and soreness

What are two examples of buffering agents in mouthwash?

• Sodium Perborate 

• Sodium Bicarbonate 

What is the function of deodorising agents in mouthwash?

Neutralise odours, e.g. from decomposing foods

What is an example of a deodorising agent in mouthwash?

Chlorine Dioxide 

What is the issue with deodorising agent in mouthwash?

Mask the underlying curse of odour

What are some functions of fluoride in mouthwash?

• Caries prevention 

• Prevention & management of demineralisation 

• Patients with conditions (xerostomia)

What is the function of pain relief substances in mouthwash?

Useful for the management of certain oral conditions. e.g. apthous ulcers

What does mouthwash contain that provides pain relief?

Mild local anaesthetic

What are some antimicrobials found in mouthwash?

• Bisbiguanides 

• Bispyridines 

• Pyrimidines 

• Halogens

• Phenols/Phenolic 

• Quaternary ammonium compounds 

• Herbal 

• Oxidising agents 

• Fluoride 

What is an example of antimicrobial bisbiguanides?

Chlorhexidine

What is an example of antimicrobial bispyridines?

Ocetedine

What is an example of antimicrobial pyrimides?

Hexetidine

What are two examples of an antimicrobial halogen?

Fluoride & iodine

What is an example of antimicrobial phenols/phenolic?

Phenol & Thymol 

What is an example of antimicrobial quaternary ammonium compound?

Cetylpyridium Chloride

What is an example of antimicrobial herbal?

Sanguinarine

How does a high concentration of chlorhexidine affect the cell membrane?

Causes lysis 

How does a high concentration of chlorhexidine interact with bacteria?

Incorporates into bacteria 

How does a high concentration of chlorhexidine affect the potassium & phosphates?

Extreme leakage of ions 

How does a low concentration of chlorhexidine affect the ions?

Causes cell content leakage loss of potassium & phosphates

How does a low concentration of chlorhexidine affect the bacteria?

Reduces replication

What are some indications of use for chlorhexidine?

• Gingival conditions 

• Compromised OH

• Ulcerations 

• Oral conditions 

What are three potential side effects of chlorhexidine?

• Staining 

• Tongue during and discomfort 

• Oral desquamation 

• Swelling of parotid 

What is an example of a branded phenolic compound mouthwash?

Listerine 

What is the effect of menthol in mouthwash?

Antibacterial

What is the effect of eucalyptus in mouthwash?

Anti-inflammatory

What is the effect of thymol in mouthwash?

Anti-septic 

What is a derivative of phenol?

Tricolsan