Over the past two decades there has been a dramatic increase in over-the-counter sales of mouthrinses. In particular, teenagers and young adults are purchasing these products as mouthrinsing has become part of the normal grooming process. From a health promotion point of view, this is a welcome trend since most of the mouthrinses sold contain therapeutic agents to control various oral health conditions such as caries, plaque/ gingivitis, tooth wear and halitosis.

  • Mouthrinses containing fluoride are very effective in the control of dental caries and are especially useful for those wearing orthodontic bands.
  • If your dentist recommends that you use a fluoride mouth rinse, use it at a different time to brushing with fluoride toothpaste in order to maximise the caries-preventive benefits of fluoride.
  • Some fluoride mouthrinses are formulated to help control tooth wear.
  • Mouthrinses for the control of gingivitis are also available.
  • Many people use mouthrinses to freshen their breath.
  • Alcohol-free mouthrinses are available and may be as effective as their alcohol-containing counterparts.ntaining fluoride to control dental caries

Rinses Containing Fluoride to Control Dental Caries

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Fluoride mouthrinses have been used for many decades for the control of dental caries. Initially, these were used mainly within public health programmes such as daily, weekly or fortnightly mouthrinsing programmes using 0.05% or 0.2% sodium fluoride. Over the last two decades, over-the-counter sales of mouthrinses containing fluoride (usually 0.05% NaF) have increased. This is a welcome development since a high proportion of sales are to teenagers and young adults who are the most prone to frequent snacking on sweet foods and drinks between meals.

Some school-based mouthrinsing programmes continue in the Republic of Ireland. Indeed, one of the longest running school-based programmes in the world is conducted in non-fluoridated areas of Co. Waterford. This programme commenced in the late 1960s and has been shown to be effective in the control of dental caries.

tooth wearRinses Containing Fluoride to control Tooth Wear (Erosion)

Such products are new to the market; they endeavour to hold the fluoride content of the rinse in contact with the tooth surface for a longer period of time, encouraging the formation of a harder enamel surface.

Rinses to Control Plaque and Gingivitis

For a number of people, toothbrushing does not sufficiently controlplaque and gingivitis, hence the use of mouthrinses specifically formulated for this purpose. The most effective rinses contain chlorhexidine. This type of rinse is generally recommended for people who have acute gum problems. Long term use (more than 3-4 weeks) is not advised because it affects the oral flora. Also, the teeth may develop a brownish stain. Should this happen however, a dentist will be able to remove the stain without too much difficulty. The modes of action and effectiveness of mouthrinses in general are continually being reviewed. The popular pre and post-brush rinses with co-polymer and triclosan and other products such as those containing essential oils do control plaque and improve gum health. In general, however, these are not as effective as rinses with chlorhexidine, but they have the benefit of not staining the teeth.

Rinses Containing Alcohol

Some mouthrinses contain a significant amount – up to 27% volume – of alcohol. Alcohol provides an antibacterial effect, acts as a carrier of flavor and adds “zing” to the mouthrinse. Alcohol consumption is also a known risk factor for oral cancer. Due to concerns regarding the possible carcinogenic effect of alcohol in mouthrinse, sporadic studies have been carried out over the last three decades to investigate the issue.

However, the claim of “sufficient evidence” has been disputed by Cancer Research UK and a science brief issued in 2009 by the American Dental Association states that “studies published to date looking at alcohol-containing mouthrinses and oral cancer have neither established nor refuted a causal relationship between the use of these products and the development of oral cancer."

Some alcohol-free mouthrinses are available on the market and some research suggests that they are as effective as their alcohol-containing counterparts.