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Mouthwashes — the finishing touch!

Now that we have brushed our teeth for two minutes with an ADA approved soft toothbrush, with a pyrophosphate free fluoride ADA approved toothpaste, as well as cleaned our inter-dental spaces with appropriate ADA approved dental floss, the question becomes can we get “kiss-ably close”! The final class of dentifrices we can recommend to get more than a peck on the cheek is to try an ADA approved mouthwash!

There are two distinct mouth washes, “cosmetic” mouthwashes that just freshen our breath, and the “therapeutic” mouthwashes that do something positive for our mouth. Let’s briefly discuss “halitosis” and other mouthwashes.

The major contributor to halitosis is the presence of “volatile sulfur compounds”. These volatile sulfur compounds arise from the breakdown of foods, as well as dental plaque and the bacteria associated with oral disease. Hydrogen sulfide (paper mill smell or rotten eggs) and dimethyl sulfide (smell of the ocean) account for about 90% of the volatile sulfur compounds found in breath and are produced by anaerobic bacteria. High protein foods, such as eggs, meat and fish when broken down by the bacteria cause the highest concentration of volatile sulfur compounds. These bacteria can live in all of the corners of the mouth, between teeth and in the “nooks and crannies” of the tongue.

Cosmetic mouthwashes: are best defined by what they don’t do. They simply leave the mouth with a pleasant taste, but don’t deal with the causes of bad breath, kill the bacteria that cause bad breath; or help reduce plaque, gingivitis or cavities.

Therapeutic mouthwashes: rinse for at least 60 seconds, then spit out.

  • Control plaque and gingivitis (chlorhexidine, povidone iodine, cetylpyridium chloride -CPC- and essential oils) Using these mouthwashes significantly reduced plaque and reduced bacterial indicators of gingivitis. Cetylpyridium chloride is an antiseptic that kills off the offending bacteria and remains in the oral cavity 3-5 hours. CPC was developed to control plaque and gingivitis without essential oils ie “medicine breath”. Chlorhexidine products (Peridex) are prescription only. Chlorhexidine may cause staining of the teeth, which is easily removed by a dental hygienist.
  • Strengthen teeth (fluoride) For added protection against tooth decay, usually contains about 0.05% of Sodium Fluoride (NaF). Fluoride strengthens the enamel on the teeth.
  • Whitener (peroxides) bleaching agent, usually hydrogen peroxide or carbamide peroxide. This helps to whiten teeth and remove stains over time. These products may also cause tooth sensitivity.
  • Alcohol levels can be as high as 20%. Best to avoid these with alcoholics as well as teenagers because of potential abuse. May also cause increase in tooth sensitivity by dissolving away the mucus layer that protects teeth.
  • Xerostomia: “dry mouth”– be sure to use sugar free products, as well as alcohol free dental rinses. Dental rinses containing alcohol may cause increased dryness. Because of reduced salivary flow, sugar free products are needed to decrease chance of tooth decay. (such as Biotene® or Oasis® mouth rinse)

Your Thompson Pharmacist is always there to help make over the counter dental recommendations!

At Thompson Pharmacy it’s all for YOU!