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MOUTH WASH - benefits, side effects. Best time to use mouth wash?

Oral care is a part of your day to day routine. Brushing your teeth highly recommended to be the first thing you perform after getting up from bed.

Whether you believe it or not, MOUTH WASH is an important part of oral hygiene.
Dentists all round the world focus on regular use of mouth wash on regular basis.

DID YOU KNOW?
You might be using mouth wash at the wrong time!
Stick till the end of the post in order to know when you should use a mouth wash! & WHY !!!

MOUTH WASH - benefits, side effects. Best time to use mouth wash

BENEFITS OF MOUTH WASH

So far not just one but multiple studies have been conducted to identify the benefits of adding mouth wash as apart of our daily regimen.

It has been found that, on adding mouth wash in to the regular routine of tooth brushing and tongue cleaning, reduced bad breathe in 2 to 4 weeks.

More benefits was seen when mouth wash for a longer period.
 
Bad breath can be due to many reasons. It might be due to accumulation of plaque, gingivitis or left over food between the teeth.

People using mouth wash were found to have 33% less chances to plaque and 26% less chances of gingivitis as compared to people not using mouth wash

So in order to summarize the benefits of mouth wash-

  • reduce and prevents plaque
  • reduce and prevents gingivitis
  • prevents supragingival calculus
  • reduce and prevents bad breath

One of the research studies found that a combination of Chlorhexidine + sodium fluoride + zinc chloride mouth rinse was found to be significantly more effective in the reduction of gingivitis and supragingival calculus
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Side Effects of Mouth Wash

Nothing in this world comes with benefits alone. This is nothing different when it comes to medical world.

Not everyone faces these side effects. And most importantly these do not come with one time usage. The frequency of these side effects have been found to be around 1%.
 
Staining of teeth is one of the most common side effect seen in many users. Also this is what has defamed mouth washes over time. 

  • staining of teeth 
    • it was found more at 4 to 6 weeks or more of regular use
  • taste disturbance
  • irritation
  • ulcerations/eruptions
  • burning sensation
    • on tongue and oral muscosa

Research Studies-
1. In a study, comparing effect in 51 randomised control trial, involving a total of 5,345 patients, it was found that chlorhexidine mouth wash reduced gingivitis, plaque in four to six weeks use of with a similar effect at six months.
A range of other adverse effects were reported including taste disturbance/alteration, oral mucosa symptoms including soreness, irritation, mild desquamation and mucosal ulceration/erosions, and a general burning sensation or a burning tongue or both.

2. A study conducted by T Hoffmann and his team observed the effect of 0.06% CHX (Chlorhexidine) vs 0.1% CHX vs water 10ml on using it 2 times a day. Reduction with CHX for plaque was 33% and for gingivitis 26%. CHX rinsing groups demonstrated significantly more staining.

MOUTH WASH - benefits, side effects. Best time to use mouth wash?

BEST TIME to use MOUTH WASH

One of the common practices done by people is use of mouth wash immediately after brushing teeth.

Toothpastes contain certain detergents, certain anionic thickners such as carbomer and anionic emulsifiers such as acrylates/C10-30 alkyl acrylate crosspolymer.

Most Mouth wash solutions contain chlorhexidine.

When you use mouth wash after brushing, chlorhexidine combines with the ingredients of toothpaste and forms an insoluble salt. This is the inactivates the chlorhexidine.

Hence, Mouth wash should not be used within atleast 30 minutes of brushing your teeth.

Due to a similar reason, it is also recommended that activities such as eating, drinking, smoking and mouth rinses using normal water must be avoided for atleast 1 hour after mouth wash.

Chlorhexidine has been found to have a residual effect on surfaces. This means the antibacterial capacity of chlorhexidine containing mouth wash can remain over teeth for some time and is not short lived.

This is the reason, why mouth wash is one of the recommended oral care routine before sleep.

CONCLUSIONS

In medical field where every action has a benefit and a side effect, it is always wise to calculate the benefit vs risk ratio in order to understand the importance of a product 

MOUTH WASH should be apart of your daily routine.

MOUTH WASH should be used atleast 30 minutes after brushing your teeth.

AND

Avoid rinsing your mouth with water after using mouth wash.


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SOURCES-
  1. Effectiveness of three oral hygiene regimens on oral malodor reduction: a randomized clinical trial by Ei Ei Aung and others Trials. 2015.
  2. Chlorhexidine mouthwash reduces plaque and gingivitis by David Herrera. Evid Based Dent. 2013 Mar.
  3. Chlorhexidine mouthwash plaque levels and gingival health by Derek Richards. Evid Based Dent. 2017.
  4. Clinical controlled study on plaque and gingivitis reduction under long-term use of low-dose chlorhexidine solutions in a population exhibiting good oral hygiene by T Hoffmann and others in Clin Oral Investig. 2001 Jun
  5. Efficacy of Listerine, Meridol and chlorhexidine mouthrinses as supplements to regular tooth cleaning measures by M Brecx and others in J Clin Periodontol. 1992 Mar.
  6. Do active ingredients in non alcoholic chlorhexidine mouth wash provide added effectiveness? Observations from a randomized controlled trial by K Santhosh and others Odontostomatol Trop. 2010 Jun.
  7. The effect of chlorhexidine dentifrice or gel versus chlorhexidine mouthwash on plaque, gingivitis, bleeding and tooth discoloration: a systematic review by S C Supranoto and others in Int J Dent Hyg. 2015 May
  8. Plaque bacteria counts and vitality during chlorhexidine, meridol and listerine mouthrinses by L Netuschil et al. Eur J Oral Sci. 1995 Dec.
  9. The effect of 3 mouthrinses on plaque and gingivitis development by J Maruniak and others J Clin Periodontol. 1992 Jan.
  10. Chlorhexidine mouthrinse as an adjunctive treatment for gingival health
    Patrice James and others in Cochrane Database Syst Rev. 2017
  11. Chlorhexidine Mouthwash- A Review by Shrada.B.Kumar in J. Pharm. Sci. & Res. Vol. 9(9), 2017, 1450-1452

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