Mouthwashes, Creams, Ointments

Types of mouthwashes

- steroid: reduce inflammation & swelling > OLP, aphthous ulcers (canker sores), oral mucositis (due to chemotherapy or radiation therapy).

- analgesic: relief from pain > toothaches, mouth ulcers, gum irritation, oral injuries.

- antiseptic: prevent & treat infections, reduce plaque formation, control bad breath: gum disease, thrush, ulcers, post-surgical oral care.

- antimicrobial: kills/inhibits the growth of MOs > bacterial, fungal, or viral infections in the mouth.

Chlorhexidine (CHX)

antiseptic, Corsodyl

0.2% rinse 1m 10ml BD, spit out, until lesions resolved

usually no >14d

- active against bacteria (-cidial/-static) & candida, prob mem disruption

may cause staining

Benzydamine hydrochloride

analgesic, Difflam

0.15% rinse/gargle 15ml 1 1/2h, spit out, usually no >7d

Hydrogen peroxide (H2O2)

antiseptic, Peroxyl

6% rinse 2m 15ml diluted in half glass warm water TDS until lesions resolved

might be in some whitening MW's, used for ANUG, gum disease

Sodium Fluoride

Colgate® FluoriGard Fluoride Rinse, LISTERINE® TOTAL CARE Anticavity Fluoride MW

- helps remineralize enamel, making it more resistant to acid attacks from plaque bacteria

- inhibits the growth of acid-producing bacteria

- 0.05% rinse OD 10ml 1m, spit out, diff time than brushing

used for high risk of decay

Sodium Chloride

- contain a saltwater solution that helps hydrate oral tissues, promote healing, & create an env less conducive to bacterial growth

- dilute w/ equal vol warm water, spit out

used for ulceration

Cetylpyridinium chloride (CPC)

antiseptic, ammonium compound

may cause staining

Desensitizing

- contain ingredients like potassium nitrate, arginine, strontium chloride, which help block the transmission of pain signals from the tooth surface to the nerve. (help occlude tubules)

Arginine: Colgate Pro-Relief Sensitive MW

Whitening

Colgate Optic White Whitening Mouthwash > contains 2% H2O2

- often contain hydrogen peroxide or carbamide peroxide, which help break down & remove stains on the teeth

- not as effective as professional whitening treatments.

- sensitivity?

Alcohol-free

no alcohol > burning may help

- prefer to avoid alcohol due to sensitivity, dry mouth, or preference

- use alternative solvents such as water or glycerin to dissolve active ingredients

Triamcinolone rinse

steroid

(only LUDH & antifungal therapy)

Triamcinolone Acetonide 0.1%

used in OLP

Betamethasone

steroid

1 tablet 10ml water MW QD

used for moderate LP, ulceration

Doxycycline

Antibiotic, dispersible tablet

- dissolve in water, rinse 2m QD for 3d at onset of ulceration

used for periodontitis, ulceration

SDCEP - Doxycycline is not licensed for use in children under 12 years & doxycycline dispersible tablets are not licensed for oral ulceration in adults or children??

Betamethasone sodium phosphate (Betnosol)

steroid

used for moderate LP, ulceration

Beclamethasone diproprionate (Clenil modulate)

steroid

metered inhalation CFC-free

1-2 puffs onto ulcers x2 daily

used for moderate LP (spray), ulceration

SDCEP - Clenil Modulite® inhaler is not licensed for oral ulceration?

Budesonide (Rinocort spray)

steroid

used for mod LP

Lidocaine spray/ointment

anaesthetic w/ analgesic properties

> ointment 5% rub gently on affected areas sparingly, not before meals

> spray 10% apply as nec w/ cotton bud, not before meals

used in ulceration etc...

Hydrocortisone oromucosal tablets

steroid

1 tablet dissolved next to lesion QD

used for ulceration

Nystatin suspension

antifungal

(if f/m contraind) 1ml after food x4d

cream also

- prod from Strep noursei

- polyene class of antifungal drugs

- binds to ergosterol in fungus cm, suff quantities form pores & cell death

used for candida, MRG, AC

Miconazole gel

antifungal

pea-sized after food x4d

NO WARFARIN/STATIN

- chemically syn antifungal drug

- imidazole class of antifungal drugs

- blocks synthesis of ergosterol

- contains daktarin - potential allergy to Daktacort cream

cream: 2%, x2d

used for candida, MRG, AC

Fluconazole

50mg x1d 7d

NO WARFARIN/STATIN

- triazole class of antifungal drugs

- inherits both human & fungal cytochrome p450, interferes w/ ergostol synthesis in fungi

used for candida, MRG, AC

Fuscidic acid cream

staph a

2%, x4d

used in AC