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PubMed2005

Optimal rinsing time for intra-oral distribution (spread) of mouthwashes.

AIM: To investigate the intra-oral spread of an erythrosine mouthwash in relation to the rinsing period. MATERIAL AND METHODS: Thirty subjects were randomly divided into two equal groups and asked to rinse with 10 ml erythrosine mouthwash for cumulative periods of 15, 30 and 60 s (Group I) and 30, 60 and 90 s (Group II). Each rinsing session was followed by new plaque measurements. After rinsing plaque was finally assessed using the erythrosine mouthwash applied by means of a cotton swab. RESULTS: In Group I there was a difference observed between the 15 s rinsing period and those of 30 and 60 s. Explorative analysis for Group I suggested that differences in both jaws and approximal sites on both vestibular and lingual surfaces appeared to have contributed to the overall difference seen between 15 and 30 s rinsing periods. Also, pre-molars and front teeth seem to have contributed to this observed difference. No differences were noted between rinsing sessions and cotton swab application for Group II or Groups I+II combined. CONCLUSIONS: Rinsing for 30 s appeared to be sufficient for all plaque-covered surfaces of the dentition to come into contact with the mouthwash.

Dental Plaque↗

PubMed1975

Clinical evaluation of the effect of a proteolytic enzyme mouthwash on plaque and gingivitis in young adults.

One hundred and thirty-one young adults were used in a controlled study to determine whether a proteolytic mouthwash produced from B. subtilis could help remove existing plaque, decrease the rate of plaque accumulation or reduce the clinical signs of gingivitis. These subjects were stratified by means of the Gingival Index and the Shaver-Schiff Plaque Index into severe or mild groups. These groups were further divided in a random fashion into treatment and placebo groups. The treatment group rinsed with a proteolytic mouthwash consisting mainly of neutral and alkaline proteases and amylase. A placebo mouthwash was used by the control group. The results of this investigation indicate that there is no statistically significant reduction either in existing plaque or in the rate of plaque accumulation when this proteolytic enzyme mouthwash is used. Furthermore, in the treatment group the degree of gingivitis as measured by the GI was not reduced.

Adolescent↗

PubMed2004

An in vivo study of the plaque control efficacy of Persica: a commercially available herbal mouthwash containing extracts of Salvadora persica.

AIM: This study compared the oral health efficacy of Persica mouthwash (containing an extract of Salvadora persica) with that of a placebo. DESIGN: In a double-blind, cross-over trial, participants were randomly allocated to use either the Persica mouthwash or a placebo for a three-week period. Plaque accumulation, gingival bleeding and the salivary concentrations of mutans streptococci (MS) were measured before and immediately following the experimental period. After an eight-week 'washout' period, the study was repeated with participants using the alternative mouthwash. PARTICIPANTS: Twenty-eight healthy students (aged between 18 and 42 years) volunteered to take part in this investigation. RESULTS: Compared with the pre-treatment values, both placebo and experimental groups demonstrated significantly reduced gingival bleeding (p < 0.01). Plaque scores were not significantly reduced following use of either Persica or the placebo. However, the use of Persica, but not the placebo, resulted in significant reduction in the carriage of MS (p < 0.05). CONCLUSION: Use of Persica mouthwash resulted in improved gingival health and lower carriage rate of cariogenic bacteria when compared with the pre-treatment values. The placebo (vehicle control) also improved gingival health significantly. Neither the Persica nor the placebo reduced the accumulation of dental plaque.

Adolescent↗

PubMed2003

Alcohol-containing mouthwash and oropharyngeal cancer: a review of the epidemiology.

BACKGROUND: There has been concern that the use of alcohol-containing mouthwash may increase the risk of developing oropharyngeal cancer, or OPC. The authors examine the epidemiologic literature relating to this issue. TYPES OF STUDIES REVIEWED: The authors identified all nine English-language epidemiologic studies of OPC that made reference to mouthwash. The findings and major strengths and limitations of each study are described. In addition, the authors reanalyzed data from one of the studies. RESULTS: The results of six of the studies reviewed are negative and provide no support for the hypothesis that use of alcohol-containing mouthwash increases the risk of OPC. One of the three studies with positive results was a case series and included a follow-up case-control study, the results of which were negative. The authors reanalyzed the study with the most positive results. This analysis found that the study results were just as positive for nonmucosal cancers developing in the mouth as they were for the usual type of OPC. The authors concluded that this study's positive finding resulted from recall bias. CLINICAL IMPLICATIONS: It is unlikely that the use of mouthwashes that contain alcohol increases the risk of developing OPC.

Alcohol Drinking↗

PubMed2006

Toxicity screening of mouthwashes in the pollen tube growth test: safety assessment of recommended dilutions.

This study investigated whether mouthwash dilutions, recommended by the manufacturers, may contribute to oral mucosa irritation. Twenty frequently used mouthwash brands were examined by the pollen tube growth test, an alternative in vitro method for assessment of the irritating potential of ingredients of cosmetic formulations. The test is based on the photometric quantification of pollen tube growth inhibition. This parameter is expressed by IC50 values that characterize the cytotoxic potential of a product. The IC50s clearly revealed that none of the tested mouthwashes should cause acute irritation if used in the recommended dilution. However, at least 4 of the mouthwashes evaluated in this study could probably irritate the oral mucosa acutely if used undiluted (original concentration).

Humans↗

PubMed1978

Effect of an antiseptic mouthwash on plaque accumulation.

This study was undertaken to determine the effect of sodium peroxyborate monohydrate bitartarate on plaque accumulation in comparison with "no oral hygiene" and "brushing once before breakfast." Fifteen male resident students between the ages of 18 to 22 years volunteered for the study. 1. In all three stages of the study regeneration of plaque were observed in all individuals within 24 hours after thorough prophylaxis. 2. The tendency to plaque accumulation varied from person to person, from tooth to tooth in the same individual, and even on different surfaces of the same tooth. 3. The plaque scores and the range of plaque scores were lower on the first 2 days with the use of mouthwash when compared with tooth brushing on the corresponding days. 4. A reduction of 30.62% was observed with the use of mouthwash when it was compared with "no oral hygiene." 5. Plaque accumulation was 17.7% more with mouthwash than with use of the toothbrush. 6. A negligible reduction in efficacy (0.38%) was observed with this mouthwash in comparison with 1% H2O2, used under pressure.

Adolescent↗

PubMed1992

A report of acute ethanol poisoning in a child: mouthwash versus cologne, perfume and after-shave.

The ingestion of ethanol-containing products, such as cologne, perfume and after-shave, in children under six years of age is common, but serious poisoning is rarely reported. Thus, it has been recently suggested that children ingesting up to 3.5 ounces of these products may be safely observed at home as long as they remain asymptomatic. While it may be assumed that products with a significantly lower alcohol content represent a much smaller poisoning hazard, mouthwashes are a relatively frequent cause of serious poisoning in children. In the following case report, 75 milliliters of mouthwash caused hypoglycemia, coma and manifestations of tonic seizure activity. Because of the palatable nature of mouthwash, wine and liquor, it appears that children are more apt to drink large quantities, consuming dangerous amounts of ethanol. The apparent safety of cologne, perfume, and after-shave may be due to a lack of palatability as well as the irritant nature of high concentrations of ethanol. This case suggests that consumer items such as mouthwash should be packaged in child-resistant containers.

Alcoholic Intoxication↗

PubMed1999

Phase I study of transforming growth factor-beta3 mouthwashes for prevention of chemotherapy-induced mucositis.

The purpose of this study was to establish the safety and tolerability of recombinant transforming growth factor-beta3 (TGF-beta3; CGP 46614) mouthwashes intended for prevention of chemotherapy-induced mucositis. Local effects were especially analyzed by objective and subjective measurements of mucositis. Secondary aims were analysis of potential systemic exposure and development of anti-TGF-beta3-antibodies. Eleven breast cancer patients received chemotherapy with 1.5 g/m2 cyclophosphamide i.v., 80 mg/m2 epirubicin i.v., and 1.0 g/m2 5-fluorouracil i.v. (n = 8) or 1.6 g/m2 carboplatin i.v., 480 mg/m2 thiotepa i.v., and 6 g/m2 cyclophosphamide i.v. divided over 4 days (n = 3). TGF-beta3 mouthwashes (10 ml; provided by Novartis, Basel, Switzerland) were administered for 4 days, four times a day, starting 1 day before chemotherapy. The dose was escalated in following patients from 25 microg/ml (n = 3) to 50 microg/ml (n = 3) and 100 microg/ml (n = 5). Clinically, the mucosa was scored objectively and according to WHO criteria. The percentage of viable oral epithelial cells was determined by trypan blue dye exclusion. Morphology of cells was assessed in buccal smears. Plasma samples were collected for determination of TGF-beta3 levels and anti-TGF-beta3-antibodies. Adverse events were recorded by the patient in a diary. Mouthwashes with TGF-beta3 were well tolerated. Three patients scored for mucositis > grade 0 (WHO grading criteria). The percentage of viable oral epithelial cells in patients treated with 1.5 g/m2 cyclophosphamide i.v., 80 mg/m2 epirubicin i.v., and 1.0 g/m2 5-fluorouracil i.v. was stable, whereas in patients treated with 1.6 g/m2 carboplatin i.v., 480 mg/m2 thiotepa i.v., and 6 g/m2 cyclophosphamide i.v. divided over 4 days, an increase was observed. The morphology of buccal cells showed a transient shift from mature to immature cells in the first week. Neither systemic absorption of TGF-beta3 nor development of TGF-beta3-antibodies was observed. TGF-beta3 mouthwashes were well tolerated and deserve further study in preventing chemotherapy-induced mucositis.

Administration, Oral↗

PubMedDate not supplied

[Efficacy and safety of mouthwash diclofenac in oral or periodontal surgery].

BACKGROUND: In a multicentre clinical study was evaluated the efficacy and safety of a mouthwash containing diclofenac 0.074% in patients undergone to oral or periodontal surgery. METHODS: Multicentre clinical open study. The patients rinsed for 1 min twice a day with diclofenac mouthwash for 7 days. After the baseline measurements of all parameters, spontaneous pain and burning were evaluated daily, while redness and oedema after 3 and 7 days of treatment. Seventy-nine patients (48 F, 31 M), mean aged 42.5 years+/-13.1 SD, with pain intensity at the end of anaesthesia effect equivalent to 54.8 mm+/-15.1 SD of a visual analogue scale were evaluated for efficacy. RESULTS: Spontaneous pain was significantly reduced by diclofenac mouthwash, versus baseline, in the first day of treatment. After a week of treatment, intensity was reduced more than 88% (p<0.01). Burning, redness and oedema too evidenced a similar behaviour, with absence of the sign respectively superior to 87%, 72% and 91 % (p<0.01). The physician's and patient's final judgement overlapped, recording a resolution/improvement in 94.1% of cases, particularly improvement in 77.2% for the physician and in 70.9% for the patients. Palatability was judged pleasant/acceptable in all cases. CONCLUSIONS: Diclofenac mouthwash is endowed by very good efficacy and safety in the treatment of inflammatory condition of the buccal cavity following oral or periodontal surgery.

Adolescent↗

PubMed2003

Tranexamic acid mouthwash--a prospective randomized study of a 2-day regimen vs 5-day regimen to prevent postoperative bleeding in anticoagulated patients requiring dental extractions.

This prospective randomized study analyses the use of a prescribed 4.8% tranexamic acid post-operative mouthwash over 2 days vs 5 days to prevent bleeding in patients taking warfarin who require dental extractions. Eighty-five patients therapeutically anticoagulated with warfarin for various conditions, ranging in age from 21 to 86 years and requiring dental extractions, were randomly divided into two groups. Group A postoperatively received a 4.8% tranexamic acid mouthwash to be used over a 2-day period. Group B received the same mouthwash and instructions postoperatively, to be taken over 5 days. All procedures were performed on an ambulatory basis under local anaesthetic by the same surgeon. Patients were reviewed 1, 3, and 7 days postoperatively to assess bleeding. Eighty-two of the 85 patients encountered no postoperative problems. Two patients in group A and one in group B had minor postoperative bleeds that required minor ambulatory intervention to control. This study shows that a 2-day postoperative course of a 4.8% tranexamic acid mouthwash is as equally effective as a 5-day course in controlling haemostasis post-dental extractions in patient's anticoagulated with warfarin.

Administration, Topical↗

PubMedDate not supplied

Toxicity screening of mouthwashes in the pollen tube growth test: safety assessment of recommended dilutions of twenty brands.

The question of whether mouthwash dilutions, recommended by the producers, contribute to irritation of the oral mucosa was examined. Twenty frequently used mouthwash brands were examined by the pollen tube growth test, an alternative in vitro method for the irritation assessment of ingredients of cosmetic formulations. The test is based on the photometric quantification of pollen tube growth inhibition. This parameter is expressed by IC50 values which characterize the cytotoxic potency of a product. The IC50s clearly revealed that none of the tested mouthwashes should cause acute irritation if used at the recommended dilution. However, 4 to 5 of the mouthwashes could probably irritate the oral mucosa acutely, when used in the form of the original producer concentrations.

Animal Testing Alternatives↗

PubMed1991

Effect of amine fluoride (AmF)/stannous fluoride (SnF2) toothpaste and mouthwashes on dental plaque accumulation, gingivitis and root-surface caries.

The aim of the study was to assess the effect of a toothpaste and mouthwashes containing amine fluoride (AmF) and stannous fluoride (SnF2) on dental plaque, gingivitis and root-surface caries. Forty-four adults participated in a five-month double-blind study. The following combinations of toothpastes and mouthwashes were used: (1) AmF/SnF2 toothpaste and AmF/SnF2 (Meridol) mouthwash (20 patients, mean age 45.7 years), (2) sodium fluoride (NaF) toothpaste and NaF mouthwash (24 patients, mean age 48.8 years). The mean values for dental plaque (Silness-Löe index) were clinically and statistically significantly reduced in both groups, the difference being greater in the AmF/SnF2 group. Sulcus-bleeding index values were clinically and statistically significantly decreased in both groups. There was no marked difference between the groups. The root caries index (RCl, Katz) had decreased by the end of the experiment by 10% in the NaF group and by 47.4% in the AmF/SnF2 group.

Amines↗

PubMed1991

[Prophylactic effect of allopurinol mouthwash against stomatitis induced by the chemotherapy (PMUE regimen) for gastrointestinal malignancies].

For prevention of the chemotherapy-induced stomatitis we administered allopurinol mouthwash to 15 out of 38 patients who underwent PMUE regimen. The severity of stomatitis was graded on five scales according to the criteria of Japan Society For Cancer Therapy. The incidence of stomatitis was defined as patients number with stomatitis above Grade 2/all patients number. Six of 23 patients which were not given allopurinol mouthwash (control group) developed stomatitis of Grade 1 (three patients), Grade 3 (two), or Grade 4 (one). Only one patient given allopurinol mouthwash (AMW group), however, suffered from Grade 1 stomatitis. The incidence of stomatitis was 13.0% for a control group and 0% for an AMW group. The average graded toxicity was 0.07 for the AMW group significantly lower than 0.57 for the control group. There was no significant difference between the two groups in other clinical adverse effects or abnormal laboratory data. These results suggested that allopurinol mouthwash regimen was well tolerated and effective for prevention of the chemotherapy induced stomatitis.

Allopurinol↗

PubMedDate not supplied

The effect of alcoholic and nonalcoholic mouthwashes on heat-treated composite resin.

Studies show that mouthwashes containing alcohol soften the surface of composite resin restorations. The present study determined weight change over time in heat-treated composite resin soaked in alcohol and nonalcohol-containing mouthwashes. The results indicate that samples soaked in mouthwashes containing alcohol gained significantly more weight than samples soaked in nonalcoholic mouthwashes.

Absorption↗

PubMed1978

Ultrasonic method for direct and simultaneous determination of alcohol and soluble solids content of mouthwash.

A technique for the determination of certain soluble species in solution by the changes they produce in the speed of propagation of ultrasonic waves in the solution was applied to measure the alcohol and soluble solids levels of mouthwashes. The simultaneous determination of these two quantities is made possible by measuring the wave velocity at two different temperatures. The method gives accurate, precise results for the general range of mouthwash compositions in use with appropriate calibration. The advantages of this method over other current methods are precision, speed, and convenience. It is not a suitable regulatory method, however, because calibration must be done with known variations of the particular mouthwash composition to be analyzed.

Ethanol↗

PubMed2002

Sucralfate mouthwash for prevention and treatment of 5-fluorouracil-induced mucositis: a randomized, placebo-controlled trial.

A randomized, double-blind, placebo-controlled trial was conducted to evaluate the effectiveness of a sucralfate mouthwash in preventing and alleviating oral mucositis induced by 5-fluorouracil (5FU). A total of 81 patients with colorectal cancer were enrolled. Patients were studied during their first cycle of chemotherapy with 5FU and leucovorin (LV) daily for 5 days every 4 weeks (Mayo Clinic schedule). Patients were randomly allocated to receive either a sucralfate suspension or a placebo suspension that was identical in appearance. Patients were instructed to use the suspension as a mouthwash four times daily from the beginning of the chemotherapy cycle. All patients received oral cryotherapy. Patients graded the severity of their own symptoms on a daily basis, and this was the primary outcome measure. There was no difference in the frequency or severity of oral mucositis between the sucralfate- and the placebo-treated group. Some mucositis was reported by 79% of the patient group. Assessment of mucositis by trial staff underestimated the incidence of this problem. Results of this trial do not support the hypothesis that a sucralfate mouthwash can prevent or alleviate oral mucositis induced by 5FU. Patient reporting of mucositis is a more sensitive instrument for assessment of mucositis than review by medical staff.

Administration, Oral↗

PubMed1988

The effect of chlorhexidine and benzydamine mouthwashes on mucositis induced by therapeutic irradiation.

A variety of mouthwashes are frequently used in the management of irradiation-induced mucositis. Benzydamine has recently been introduced for alleviating this condition. Its efficacy as a mouthwash was compared with chlorhexidine in two groups of patients receiving radiotherapy for oral carcinoma. Mucositis and pain were recorded over a 6 week period and oral carriage of Candida species, coliforms and Staphylococcus aureus was assessed using an oral rinse technique. There was no significant difference in the mucositis scores, overall pain scores or the yeast and bacterial species isolated between the two treatment groups. However, 58% (7 out of 12) and 92% (12 out of 13) patients reported oral discomfort when rinsing the mouth with chlorhexidine and benzydamine, respectively. In both groups, the most common coliform isolated was Klebsiella pneumoniae and the carriage of yeasts was significantly greater than that of coliforms. These results indicate that, although the individual patient acceptance of chlorhexidine is better than benzydamine, there is little difference between the two mouthwashes both in controlling pain and mucositis or in the oral carriage of the micro-organisms studied.

Aged↗

PubMed2000

Chlorhexidine spray versus chlorhexidine mouthwash in the control of dental plaque after periodontal surgery.

BACKGROUND/AIMS: This clinical trial aimed at comparing 2 different means of delivering chlorhexidine digluconate (CHX) in the oral hygiene phase during the 2 weeks following periodontal surgery. METHOD: 40 patients were randomly divided into 2 groups: A (using CHX mouthwash) and B (using CHX spray). Professional oral hygiene was carried out immediately before surgical operation. For 7 days after surgery, group A used CHX mouthwash and group B CHX spray on the teeth involved in the surgical procedure, while mechanical oral hygiene was maintained only on the teeth not involved surgically. After suture removal, on the 7th day, patients were allowed to perform mechanical oral hygiene also on surgical sites. Plaque index (PI) and stain index (SI) were evaluated on the 7th and 14th days after the operation. RESULTS: In both groups, PI increased similarly with respect to the baseline in surgically involved teeth, being 0.25+/-0.41 (SD) and 0.15+/-0.26, respectively, in A and B, on day 7, and 0.14+/-0.23 (A) and 0.10+/-0.22 (B), on day 14. There was no significant difference between A and B on either day 7 or 14. On the contrary, SI increased significantly in respect to the baseline over the 14 days in group A at both involved and not involved sites, while it did not differ from the baseline in group B. CONCLUSIONS: The present results indicate that the efficacy of CHX spray in the post-surgical control of dental plaque is not different from that of CHX mouthwash. Tooth staining, on the contrary, was significantly lower in the group using CHX spray. The observed effects might be related to the way of delivering CHX and to the total dose administered, about 80% lower in group B in respect to A. Further studies are needed to validate the preliminary findings of the present study.

Adult↗