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PubMed2004

Formulation ingredients for toothpastes and mouthwashes.

In order to achieve the multi-claim products required for the dental care category, it is necessary for the formulator to use a variety of different ingredients. This places a number of demands on the development process. Innovations in the areas of pharmaceutical technology have contributed to the formulation of the products having superior efficacy as well as other attributes that may contribute to clinical response and patient acceptability. Improved clinical efficacy and tolerability, along with conditioning signals, should encourage patient compliance with oral hygiene further complementing professional efforts directed at disease prevention. The most effective way of preventing the development of dental disease is in controlling the production of dental plaque. It is formed by microbial action. The removal of plaque from the teeth and related areas is essential for the maintenance of a healthy mouth. In this paper we have presented the main components of toothpastes and mouthwashes. For the active ingredients, their supposed effect as therapeutic agents is also explained.

Anti-Infective Agents, Local↗
PubMed1976

Clinical reduction of gingivitis through the use of a mouthwash containing two quaternary ammonium compounds.

A commercially available antimicrobial mouthrinse was evaluated among students in Mexican boarding schools. The application was made daily for 3 months under the direct supervision of the project personnel. The observations indicated that the use of this mouthrinse decreased gingivitis substantially in comparison to the use of a control rinse which consisted of flavored water. It is concluded that this mouthwash, containing the known antimicrobial agents cetylpyridinium chloride and domiphen bromide, can be of clinical benefit if conscientiously applied as an adjunct in an oral hygiene regimen of regular toothbrushing with a dentifrice.

Adolescent↗
PubMed2001

Determinants of DNA yield and quality from buccal cell samples collected with mouthwash.

Buccal cells are becoming an important source of genomic DNA in epidemiological studies, but little is known about the effect of different sampling conditions on DNA quality and yield. We used a mouthwash protocol to collect six daily buccal cell samples from 35 healthy volunteers. Twenty-four individuals (six men and 18 women) correctly completed the protocol and were included in paired analyses to determine whether "swish" time (30 s versus 60 s), toothbrushing before collection, or lag time between collection and DNA extraction (1 day versus 5, 10, or 30 days at room temperature) would affect sample quality and yield. Total DNA, human-specific DNA (hDNA), degradation of DNA, and ability to amplify by PCR were determined. hDNA yield did not significantly vary by "swish" time. However, toothbrushing 1 h before sample collection reduced the amount of hDNA by nearly 40% (34 microg versus 21 microg; P = 0.06). Median hDNA yields for samples that were held for 1, 5, 10, and 30 days before extraction were 32 microg (range, 4-196), 32 microg (2-194), 23 microg (3-80), and 21 microg (5-56), respectively. The 10- and 30-day samples had significantly less hDNA than those processed after 1 day (P = 0.01). PCR success rates for beta-globin gene fragments of length 268 bp, 536 bp, and 989 bp were 94% or better, and high molecular weight DNA (>23 kb) was found in all but one sample. These results suggest that buccal cells should be collected before brushing teeth and processed within 5 days of collection to maximize hDNA yield.

Adult↗
PubMed2001

Cardiac asystole after mouthwash ingestion: a case report and review of the contents.

In the search for intoxication, alcoholic patients often ingest toxic alcohols or other products containing ethanol. We report a patient who presented with intoxication from Listerine and rapidly progressed to cardiac asystole. Several mouthwash products have a high concentration of ethanol and are easily obtained. We review the contents of this product and their possible toxicologic effects.

Acidosis, Lactic↗
PubMed2001

[Effects of saliva substitutes and mouthwash solutions on dentin].

Saliva substitutes are used by patients suffering from hyposalivation to alleviate the symptoms of severe xerostomia. Therefore, the objective of this study was to evaluate the effects of various saliva substitutes (Artisial; Glandosane; Oralube; Saliva medac; Oralbalance) on the lesion depth and the mineral content in sound bovine dentin in vitro. 96 dentine specimens were prepared from 24 freshly extracted bovine incisors and exposed for seven days to the various solutions. A carbonate-reduced mineral water (Hirschquelle) as well as the mouthwash solutions Meridol and biotène served as controls. After storage in the solutions, the specimens were cut perpendicularly to their surfaces, polished up to 4000 grit and mounted on plexiglass microscope slides. The slabs were ground to a uniform thickness of 110 mu m. Lesion depths and mineral content were evaluated from microradiographs of the prepared specimens by a dedicated software (TMR 1.24) After storage in Glandosane and biotène results indicated a significant mineral loss and increase in lesion depth (p<0.01; Kruskal-Wallis). All other solutions used did not have any effect on the integrity of the dentin samples. Thus, the use of both Glandosane as well as biotène cannot be recommended in dentate patients with severe xerostomia.

Animals↗
PubMedDate not supplied

Does using a mouthwash instead of water improve the oropharyngeal removal of inhaled flovent (fluticasone propionate)?

Rinsing the mouth with water is recommended to remove inhaled corticosteroid (ICS) deposited on the oropharyngeal mucosa. Given the lipophilicity of fluticasone propionate (FP), an ethanol-based mouthwash was hypothesized to be superior to water. This study's purpose was to compare the effectiveness of water versus Listerine (Warner Lambert, Lititz, PA) in removing FP from the oropharyngeal mucosa. Asthma patients were randomly assigned water or a Listerine-rinsing vehicle. A 440-microgram dose of FP was inhaled. After the second puff, patients rinsed for 30 seconds with 20 mL of the assigned agent and then repeated the process, spitting each "wash" into the same cup. At visit 2, patients used the alternate vehicle and repeated the procedure. Samples were frozen until analyzed using liquid chromatography/mass spectrophotometry (lower limit of detection 0.067 microgram/mL). Thirty-six patients (mean age, 44 years; 66% female) participated. Mean inhaler technique score was 11.3 (scale of 1-12). Eighty-three percent used the closed-mouth technique. The mean concentration of FP removed by Listerine was not statistically different than that removed by water, 1.67 micrograms/mL (range, 0.067-4.195 micrograms/mL) and 1.42 micrograms/mL (range, 0.067-5.107 micrograms/mL), respectively, and the total milliliter returned was assumed to be 40 mL. Regression analysis using sex, age, and inhaler technique showed no statistical relationship with the amount of FP removed. Therefore, Listerine was not more effective than water in removing FP from the oropharyngeal mucosa (p = 0.53). Thus, water is an adequate rinsing vehicle for removal of ICS deposited on the oropharyngeal mucosa. Other factors besides the rinsing vehicle are strong factors in determining the amount of drug removed.

Administration, Inhalation↗
PubMed1994

[Chemical plaque inhibitors. Their use in mouthwashes and toothpastes].

Despite the fact that many mouthrinses are available and much research is being devoted to better and new mouthwashes, as yet there is no form of chemical plaque control that can totally replace mechanical plaque removal. However, at this moment there is a promising compound. Triclosan, in combination with a copolymer, has already been added to a toothpaste and mouthrinse.

Anti-Infective Agents, Local↗
PubMed2006

The effect of a commercially available chlorhexidine mouthwash product on human osteoblast cells.

Chlorhexidine mouthwash (CMW) is used for decontamination of tooth, implant or prosthetic surfaces to treat or prevent local infection. A cell culture model was used to investigate cytotoxicity of CMW employing an MTT assay to record cell activity. Human osteoblast-like cells (HOS TE 85) were seeded. Dilutions of CMW (1:1 to 1:128) were made up with culture medium. Positive and negative controls were prepared. Cells were incubated, exposed to CMW, for 5 min to 4 h. Diluted tetrazolium salt solution was added. Plates were incubated for a further 4 h. Medium was removed, dimethylsulphoxide was added, and absorbance at 570nm read. Undiluted CMW caused total cytotoxicity, similar to positive control. Progessive dilution of CMW was associated with elevated cell survival. Cytotoxicity increased with longer time exposures. It was concluded that CMW can be cytotoxic in high concentrations and when applied for long time periods. Work is needed to determine effects on other cell types and clinical significance of these findings.

Analysis of Variance↗
PubMed1991

[Community trial for the evaluation of the fluoride mouthwash program among students in Palma de Mallorca].

It is presented the assessment of the weekly fluoride mouthwash program conducted among public primary school students in Palma de Majorca, Balearic Islands, Spain. It was carried out with students of 5th year (aged 10 years old) who had been participating in the program for four years. The prevalence of caries according to the CFLT index (Cavity Filling Lost Tooth) in those students who followed the program is compared with the rest of the 5th year students to whom the program was not applied. According to the CFLT index, the difference noticed between the two groups was 21.15%. This caused a 0.52% reduction of decayed pieces per child following the program. In the same way, the restoration index is 50% higher in the group of intervention than in that of control.

Child↗
PubMedDate not supplied

Comparison of a phenolic and a 0.2% chlorhexidine mouthwash on the development of plaque and gingivitis.

Chlorhexidine and phenolic mouthrinses have attracted considerable interest as adjuncts to oral hygiene. The aim of this study was to compare two well known proprietary mouthrinse products for their effects on plaque regrowth, the development of gingivitis and the formation of toothstaining. The study was a single-blind, randomized, placebo-controlled, triple cross-over experimental, gingivitis design. A group of 15 volunteers with a very high standard of oral hygiene and gingival health used each rinse for 19 days in the absence of normal toothcleaning. Each period was separated by a 21 day washout. Plaque scores were significantly different between the rinses, being lowest with chlorhexidine and highest with saline. The plaque area increased 3-fold with the phenolic rinse and 6-fold with the saline rinse compared to the chlorhexidine rinse. Similarly, gingivitis increments were lowest with chlorhexidine and highest with saline but differences between rinses did not reach significance. Staining was significantly different between rinses, primarily due to minimal staining associated with the saline rinse. Staining occurred with both the chlorhexidine and phenolic mouthrinses. It is concluded that the 0.2% chlorhexidine rinse offers greater oral hygiene benefits than the phenolic rinse. The question of indications and durations of use of mouthwash products should be addressed.

Adult↗
PubMed1988

Mucosal sensitivity to chlorhexidine mouthwash.

Mucosal sensitivity to chlorhexidine mouthwash is a rare occurrence and very few cases have been reported in the literature. The authors report 2 cases of oral sensitivity to chlorhexidine and discuss the side-effects, possible causes of sensitivity and the management of the cases.

Adult↗
PubMed1988

Reduction of oral toxicity of 5-fluorouracil by allopurinol mouthwashes.

5-Fluorouracil (5-FU) is the most effective drug in gastrointestinal cancer. Mucositis and bone marrow toxicity are the two major limiting side effects. In our effort to reduce mucositis we administered 'Allopurinol' mouthwash in 16 patients who had experienced oral mucositis during prior treatment with 5-FU. In all patients significant reduction of oral toxicity was noticed as well as prolonged pain relief. This observation must be tested by controlled clinical trial.

Allopurinol↗
PubMed1988

[Reduction of dental caries after two years with a combination of mouthwashes and topical fluorides].

The study's purpose was to evaluate the reduction of dental caries incidence by the association of two preventive methods. 246 students of both sexes aged from 7 to 11 years registered in "Escola de Educação Básica da Universidade Federal de Uberlândia" and living in the urbana area of Uberlândia, state of Minas Gerais, were examined. The sample was distributed into two groups: children from Group 1, which received a semestral topical application of Acidulated Fluor Phosphate at 1.23% and children from Group II, that besides the topical application above related (Group I) also received weekly mouthwashes of sodium fluoride aquesus solution at 0.2%. After two years of study DMFS index were tabled and statistically analysed. It was verified a reduction of 33.97% in the incidence of dental caries (in the permanent dentition). The difference between the Groups was significant at 5% level of confidence.

Brazil↗
PubMed1997

Use of tranexamic acid mouthwash to prevent postoperative bleeding in oral surgery patients on oral anticoagulant medication.

The clinical hemostatic effect of tranexamic acid mouthwash after oral surgery was evaluated in 47 patients receiving oral anticoagulant therapy. Surgery was performed after the anticoagulant medication was reduced in 15 patients (control group) and with no change in anticoagulant therapy in 32 patients (test group). The only statistical difference between the two treatment groups at baseline was the level of anticoagulation, which was significantly higher in the test group. There was no significant difference between the two treatment groups in the incidence of bleeding after oral surgery. The results indicated that a combination of local antifibrinolytic therapy and a local hemostatic agent is effective in preventing postoperative bleeding after oral surgery in patients treated with anticoagulants.

Administration, Oral↗
PubMed1997

Quantitative cultures of Candida from mouthwash fluid in HIV-infected patients: a longitudinal study.

The density of Candida colonization in mouthwash fluid of 59 HIV-seropositive patients and 21 controls was determined. No significant difference in colony-forming units was found. No correlation was found between the colonizing density of Candida albicans and the CD4 count among the patients. Twenty-seven of the HIV-seropositive patients were followed for almost 3 years. No difference was found between the number of Candida albicans colony-forming units at the first and second time of sampling. Vaccination with HIV IIIB GP 160 vaccine did not have any influence on the prevalence of Candida albicans.

Adolescent↗
PubMed2005

Cheilitis caused by contact allergy to cocamidopropyl betaine in '2-in-1 toothpaste and mouthwash'.

A 10-year-old girl presented with a 2-year history of severe cheilitis. Despite cessation of any lip-licking behaviour her symptoms continued to worsen, with only minimum relief from therapeutic measures. Patch testing proved strongly positive to cocamidopropyl betaine, which was noted to be present in the patient's '2-in-1 toothpaste and mouthwash'. Her cheilitis settled after avoidance of this product. Cocamidopropyl betaine, a surfactant, is a common allergen in hairdressers; however, this case highlights the importance of excluding a contact allergy to this product in patients with intractable cheilitis.

Betaine↗
PubMed1985

Alcoholics who drink mouthwash: the spectrum of nonbeverage alcohol use.

Nonbeverage alcohol (NBA), or substitutes for traditional forms of beverage alcohol, includes such substances as mouthwash, aftershave lotion and alcohol-based fuels. Literature pertaining to the prevalence, clinical significance and toxicity of this practice is reviewed, using illustrative cases from a series of 48 NBA consumers. It was found that 10-15% of alcoholics hospitalized in detoxication units have consumed NBA; half of these patients are regular consumers. Addiction to NBA itself may occur. Its use is primarily related to easy accessibility, rather than social or monetary factors. Polydrug misuse and antisocial personality disorder are more frequent in NBA users, but use is not pathognomic of end-stage alcoholism. The 48 NBA users reported surprisingly few toxic symptoms from acute ingestion, perhaps because tolerance to some substances in NBA may occur. Isopropyl alcohol was the exception, reproducibly causing symptoms suggestive of severe gastritis.

1-Propanol↗