Mouthwashes: Implications for Practice

Area of Science:

• Oral Health
• Microbiology
• Pharmacology

Background:

• Current global guidelines suggest specific mouthwashes as adjunctive oral care for managing dental caries, gingivitis, and periodontal disease.
• Fluoride mouthwashes are recommended for caries management, while chlorhexidine is suggested for periodontal diseases, based on moderate evidence.
• Gaps in the literature exist, particularly concerning the robust evidence for natural mouthwashes and their adjunctive use.

Approach:

• This review summarizes current international guidelines on the adjunctive use of mouthwashes for common oral conditions.
• It critically evaluates the evidence base supporting the use of various mouthwash ingredients, including fluoride, chlorhexidine, essential oils, and cetylpyridinium chloride.
• The review also considers potential risks and the need for further in vivo research.

Key Points:

• Mouthwash use should always be adjunctive to mechanical oral hygiene measures.
• Evidence supports fluoride for caries and chlorhexidine for periodontal disease, but robust data for other agents like natural mouthwashes is lacking.
• Potential risks include allergic reactions, oral dysbiosis, antimicrobial resistance, and environmental effects.

Conclusions:

• Mouthwashes may offer limited value for individuals with good oral health or low caries risk.
• Further clinical trials are essential to establish the efficacy and safety of various mouthwash formulations.
• Dental practitioners must stay updated on emerging evidence and guidelines for informed patient recommendations.