The Oral Cavity: The oral cavity is one of the most complex parts of the human body that consists of teeth, periodontal tissue (tissues surrounding the teeth), tongue and mucosa as well as secretory organelles. In addition the mouth harbours a wide range of microbial community and remains highly prone to infectious diseases. Hundreds of bacterial species are involved in dental caries; e.g., streptococci species, lactobacillus species etc.
Bacterial accumulation on teeth results in the formation of dental plaque, which when left untreated could lead to gingivitis, which is inflammation of the gums characterized by redness, swelling, and bleeding on probing. If left untreated, gingivitis can lead to the development of periodontitis, which results in irreversible damage to the gums and underlying support tissues.
All about Mouthwash: We all know that the most important part of oral healthcare happens at home. Mechanical cleaning with brushing and flossing has been the corner stone of good oral hygiene and health. Many people find it difficult to comply with this daily regimen. Insufficient and/or inadequate brushing and flossing could lead to plaque build-up. As these methods may be insufficient to achieve optimum results, a common strategy to control of plaque build-up and gingivitis, is to use mouthwash formulations.
A mouthwash is defined as a non-sterile aqueous solution which is used mostly for its deodorant, refreshing and/or antiseptic effect. Mouthwashes are meant to reduce oral bacteria, remove any food debris, temporarily reduce and overall provide a pleasant and refreshing taste in the mouth.
Through the years a lot of different substances have been used as mouthwashes. For example, in the middle ages, people rinsed their mouth with household products like vinegar and rose water. In this day and age, production of mouthwashes is a big industry almost at the same level as the manufacturing of toothpastes.
Components of mouthwash
|Antimicrobials||cetylpyridinium chloride, chlorhexidine, gluconate, sanguinarine, phenolic compounds||Reduce amount of bacteria in the mouth and attack the build-up of plaque on the teeth. Remove tooth-decay causing germs and bacteria from the mouth.|
|Deodorizing and oxidizing agents||sodium bicarbonate and chlorine dioxide respectively||Help to mask and neutralize bad odors|
|Oxygenating agents||hydrogen peroxide||Help in eradicating anaerobic micro-organisms (ones that live in the absence of oxygen) by adding oxygen to the area.|
|Fluoride||sodium fluoride||Strengthens teeth and prevents tooth decay. Often added to water filtration systems and toothpaste as a means of further protection against tooth decay|
|Pain-relieving agents||Anodynes||Provide pain relief.|
|Buffering agents||benzoic acid||Relieve soft-tissue pain, reduce acidity and dissolve build-up of film on the lining of the mouth|
|Anti-tartar agents||zinc citrate||Reduce tartar build-up in the mouth|
|Flavoring agents||eucalyptol or menthol||Flavor the mouthwash to give a pleasant taste in the mouth|
|Preservatives||sodium benzoate||Prolong the stability or the shelf life of the mouthwash and prevent formation of microbes.|
One issue to be aware of is that many mouthwashes contain alcohol, which has been a controversial issue for various reasons. The first is that many mouthwashes are manufactured in bright colors, with flavors which mask the antiseptic and alcohol in them. One school of thought is that this makes them more appealing to children who may want to try and drink them. The alcohol content makes the mouthwashes particularly dangerous for children and they must be kept out of their reach. Some parents simply choose not to use mouthwashes which contain alcohol as they put the health of their children first.
Types of mouthwash
Fluoride mouthwash: This kind of mouthwash contains fluoride compounds such as 0.05% sodium fluoride, which provides extra fluoride to the people who need it. Using it daily may give additional protection against tooth decay since fluoride mouth rinse can strengthen the teeth and prevent tooth decay.
Antiseptic mouthwash: An antiseptic mouthwash kills bacteria and can also make the breath fresher. Antiseptic mouthwashes are used before and after surgery to remove bacteria and prevent infections. This kind of mouthwash is also recommended for some patients with some kind of mouth infection such as gum disease or thrush. Because an antiseptic mouthwash could affect the sense of taste and possibly stain the teeth, one should consult a dental professional about frequent use.
Alcohol-free mouthwash: With the recent medical reviews and articles about what alcohol does to the body and how it negatively affects the curing of bad breath, many companies have now begun producing alcohol-free products. Regular mouthwash can cause a burning sensation in the oral cavity tissue whereas alcohol free mouthwash does not. Alcohol-free mouthwash should not contain chemicals such as benzalkonium chloride (allergen), sodium lauryl sulfate, saccharin, or alcohol. On the other hand, it should have sodium benzoate, sodium bicarbonate, and other ingredients that actually help eliminate bacteria from the mouth.
Anti-plaque mouthwash: Development of plaque creates acid that slowly eats away at your teeth and if you let it hang around for several days, it hardens into tartar, which you''ll need a professional to remove. Anti-plaque mouthwashes can help to control plaque build-up and prevent gingivitis.
Natural mouthwash: Natural herbal mouth rinses are made of natural, plant-based ingredients and typically do not contain alcohol, sugar, artificial sweeteners, artificial colors etc. Natural mouthwashes use vegetable juices such as red cabbage, purple carrot, beet, tomato and annatto to add color. They are sweetened with vegetable glycerin, stevia or xylitol, none of which foster bacteria growth. Essential oils, such as anise, cinnamon, clove, eucalyptus, fennel, lavender, rosemary and spearmint are used to flavoring agents to freshen the breath and reduce bacteria in the mouth.
Candida is a naturally occurring fungus that can cause a medical condition known as thrush when there is too much of it present in the mouth. The fungus could cause swelling in the mouth and painful sores. Anti-fungal mouthwash is most commonly used to treat this condition, which usually improves the condition within a couple of weeks.
Whitening mouthwash: There is some anecdotal evidence that using hydrogen peroxide as a mouth rinse when diluted by at least 50 percent water can help whiten your teeth, but more research needs to be conducted in this area to conclusively prove this.
Mouthwash for kids: Older children who wear braces are especially good candidates for fluoride mouth rinses because the rinse can help prevent teeth from acid-producing plaque bacteria which may buildup under the brackets. Young children should not use mouthwash because of the risk involved in swallowing the product. Children between 6 and 12 years of age should only use a mouthwash under close adult supervision. And children under the age of 6 years should especially avoid fluoride rinses since excess fluoride exposure in children could lead to fluorosis, a condition that leaves spots or streaks on the teeth.
• Mouthwash reaches back of the mouth and teeth where a toothbrush or floss typically cannot, thus enhances the effects of brushing and flossing
• Causes reduction in gingivitis, plaque and other dental and gum problems.
• Combats germs in reachable areas in the mouth and prevents cavities and tooth decay.
• Loosens and dislodges food debris trapped in between spaces, thereby acting as floss.
• A popular product for oral hygiene, mouthwashes come in an assortment of flavors which act as breath fresheners.
Risks involved with Mouthwash
• Irritates canker sores in the mouth: If the alcohol content of your mouthwash is too high, it may actually end up irritating the canker sore more than helping it.
• Masks bad breath: Mouthwash can lead to fresher breath, but it could be short-lived. It has been seen that if a patient has poor oral hygiene and doesn’t brush effectively, there is no amount of mouthwash which could mask the effects of poor oral health.
• Linked to oral cancer: The issue about alcohol in mouthwash is that some research has suggested that it can be a contributing factor to mouth cancer. Some mouthwashes can contain as much as 25% alcohol and in 2009, The Telegraph newspaper reported on research which concluded that the increased possibility of cancer after using certain types of mouthwashes was four or fivefold.
• Linked to increased risk of stroke and heart attack.
Points to Remember
• Always consult your dentist before using a mouthwash to ensure that there are no other health issues affecting to your oral hygiene. For example if you are using a mouthwash to combat halitosis or mouth ulcers, the mouthwash could simply be masking a more serious, underlying problem.
• People with voice problems should avoid mouthwashes that contain alcohol or other irritating ingredients.
• Licorice is a commonly used herb in the Ayurvedic medicine. Licorice has anti-ulcer and antibacterial properties which are effective to treat mouth ulcers.
• You should always rinse for the amount of time stated on the product no matter what type of mouthwash you choose. Avoid using mouthwash in excess of the recommended amount or frequency.
• Mouthwashes or rinses should not take the place of daily tooth brushing and flossing, which are essential to remove particles of food on and between teeth. In other words, mouthwash should be used after you finish your tooth brushing and flossing routine.
• No mouthwash is capable of killing the bacteria that causes gum disease.
• The use of mouthwash is not recommended for little children especially those below 6 years of age, because these kids are more inclined to swallow the mouthwash instead of spitting them out after rinsing.
When you walk down the mouthwash aisle in a drug store, choosing the best brand from a vast array of mouthwash brands could be quite a daunting task. Since your dentist deals with teeth on a regular basis, and knows which products will work best for you, be sure to ask for a recommendation at your next scheduled appointment.