An update on mouthwashes: advice for dental practitioners

Area of Science:

• Oral Health
• Microbiology
• Pharmacology

Background:

• Mouthwashes are clinically effective against plaque biofilms and gingival inflammation due to antimicrobial properties.
• A wide array of mouthwash products with multiple active ingredients necessitates careful selection based on oral disease type and usage techniques.

Purpose of the Study:

• To update dental professionals on optimal mouthwash selection and application techniques.
• To review current evidence and guidelines for using mouthwashes in clinical practice.
• To highlight potential risks and benefits associated with various mouthwash constituents.

Main Methods:

• Literature review of current professional guidelines and high-level evidence.
• Analysis of active ingredients in mouthwashes and their efficacy for specific oral conditions.
• Evaluation of adjunctive mouthwash use and potential risks.

Main Results:

• Adjunctive fluoride mouthwashes are effective for dental caries prevention when used with brushing and interdental cleaning.
• Chlorhexidine, essential oils, and cetylpyridinium chloride mouthwashes show efficacy in early plaque-induced periodontal disease management.
• Insufficient evidence currently exists to guide mouthwash selection based on oral microbiome testing for systemic health.

Conclusions:

• Mouthwash selection should be guided by evidence-based guidelines, considering specific oral conditions and patient needs.
• Potential risks include allergies, tooth staining, and oral microbiome dysbiosis; benefits must outweigh these risks.
• Personalized preventive care advice requires clinicians to weigh the benefits against risks of mouthwash use.