Mouthwashes

how are mouthwashes used in conjunction with brushing?

used as adjuncts

what substance in mouthwash is anti plaque

cetylpyridinium chloride (cpc)

what are some characteristics of mouthwashes?

used to treat gingivitis, limited use in periodontitis, against bacterial plaque, has side effects

what is an important function of mouthwash?

suppress plaque or selected bacterial species that decrease caries, etc

what three things should mouthwashes not do?

be toxic, no long or short term effects, upset natural bacteria.

what are the nine types of mouthwashes?

quaternary ammonium compounds, phenolic antiseptics, hexetidine, chlorohexidine gluconate, povidone iodine, sanguinarine, oxygenating, delmopinol & fluoride

what type of mouthwash is cetlypyridinium chloride (cpc)?

quaternary ammonium compounds

what effect does quaternary ammonium compounds have on a cell wall?

makes it more permeable, causing a loss of contents

what is a branded example of quaternary ammonium compounds?

Colgate plax

what does a high concentration of phenolic antiseptics show a reduction in?

plaque

what substance is phenolic antiseptics less effective than?

chlorohexidine

what component can phenolic antiseptics penetrate through?

components of the bacterial cell wall

what is a branded example of phenolic antiseptics?

listerine - bactericidal

what can a high concentration of hexetidine cause?

ulcerations

what percentage of hexetidine in oraldene antibacterial and anti fungal?

0\.1%

how long can chlorhexidine gluconate bind to the oral cavity for?

up to 12 hours - form a protective layer

is chlorhexidine gluconate bactericidal?

yes

what can chlorhexidine gluconate cause after long term use? (2)

staining and taste disturbance

when is chlorhexidine gluconate usually used?

post-surgery

what can reduce the effectiveness of chlorhexidine gluconate long term? (3)

pus, blood & inflammation

is sanguinarine a natural or artificial type of mouthwash?

natural

what does sanguinarine have the ability to do against enzymes?

ability to suppress activity of plaque

what is sanguinarine less effective than?

chlorhexidine

what disease is sanguinarine linked to?

cancer

what is an example of an oxygenating mouthwash?

\
hydrogen peroxide

what does oxygenating mouthwashes have a beneficial effect on?

acute ulcerative gingivitis (AUG)

what does the release of oxygen from an oxygenating mouthwash affect?

anaerobic bacteria

what are some examples of what oxygenating mouthwashes are used for?

ulcers, irritated dentures, gingival inflammation & cheek burns

what structure helps with the release of oxygen in oxygenating mouthwashes?

enzymes

what does delmopinol inhibit the accumulation of?

plaque

what is delmopinol used as an alternative to?

chlorhexidine

what substance does delmopinol not interact with in toothpaste?

sodium laurel sulphate

what oral condition does delmopinol reduce?

gingivitis

what muttan is fluoride an inhibitor of?

streptococcus mutans - decreases acid production in plaque

why is fluoride recommended to children over 6 years of age?

less likely to swallow

what type of patients specifically benefit from fluoride mouthwashes?

orthodontic therapy, reduced salivary flow(cancer patients), spinal needs patients, acid erosion and attrition

what percentage of sodium fluoride is in duraphat?

0\.2% (1000ppm)

what percentage of sodium fluoride is in fluorigard?

0\.05% (225ppm)

what percentage of sodium fluoride is in aqua fresh?

0\.05% (225ppm)

what percentage of sodium fluoride is in chlorohex plus?

0\.05% (250ppm)

what percentage of sodium fluoride is in corsodyl?

0\.05% (250ppm)

how many parts per million of sodium fluoride is in pronamel?

450

what are the uses of anti-plaque mouthwashes?

* replace mechanical brushing
* after oral/periodontal surgery
* following root surface debridement & cervical hypersensitivity
* after orthodontic treatment
* plaque retentive factors (maligned teeth)

what can the alcohol and pH content in mouthwashes lead to long term?

oral cancer

what does evidence suggest alcohol does to the DNA in the oral cavity?

increases penetration of DNA, damage chemical in the lining of the oral cavity and oropharynx

what advise should be given to patients with high alcohol or tobacco intake when using mouthwashes with a high alcohol content?

reduce intake to reduce risk of oral cancer

what is bisguanide antiseptics?

effective anti-plaque and anti-gingivitis agent

what does bisguanide antiseptics do to the cell walls of bacteria?

increase permeability & coagulates cytoplasmic macromolecules

what are some side effects of mouthwashes?

disturbance in taste, extrinsic staining, desquamation parotid swelling,

what is the clinical application of mouthwashes?

used post op, plaque control, oral surgery patients, patients with intramural lesions, reduce drug induced gingival overgrowth, help with condition such as lichen planus