Extensive oral mucosal ulcerations caused by misuse of a commercial mouthwash

This case report describes severe mucosal injuries following misuse of an undiluted over-the-counter mouthwash with a high alcohol content (70%), oil of peppermint and arnica. The mouthwash was to be diluted 5:1 with water. The patient used undiluted solution to better treat her self-diagnosed "contagious gum infection." She experienced burning sensation with each rinse and developed severe mucosal injuries subsequently. Her oral condition improved within 48 hours following discontinuation of use of the mouthwash and application of a mixture of Benadryl Elixir, Maalox Plain, and 2% viscous Lidocaine. A detailed history and review of a patient's medical condition will help to differentiate self-induced mucosal injuries from those caused by an allergic reaction or skin diseases.