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    Examples

    Mode of Action

    Effective against

    Recommended use

    Short or long term

    Side effects

    Chlorhexidine

    Savacol.

    Curasept

    Cationic bis-guanide that kills microbes.

    Broad spectrum antimicrobial. Studies have shown that spraying toothbrush with chlorhexidine can reduce bacterial load

    Most effective mouthwash for reducing plaque and gingivitis. Don’t use after fluoride or lauryl sulphate containing toothpastes as these limit its effect.

    Use twice daily for short term

    Can cause staining of teeth, increased calculus, taste alteration, burning mouth. Not recommended for those undergoing chemotherapy, xerostomia and ulcers

    Benzydamine hydrochloride

    Difflam

    Thought to effect the production of pain initiators, disrupt inflammatory cycle and stabilise cell membranes

    Anti-inflammatory, anti-microbial and anaesthetic

    Often used with Chlorohexidine.

    Well tolerated for chemotherapy patients and ulcerative conditions

    Long term if it doesn’t contain alcohol or chlrohexidine

    Often contains alcohol and chlorhexidine

    Cetylpyridinium chloride, sodium benzoate, ticlosan

    Plax, Oral B Pro health

    CPC -Disrupts cell membranes and metabolism of bacteria

    SB- breaks down fats which weakens plaque attachments

    T- potentiates effect of mouthwash

    Reduce plaque weight and thus reduce gingivitis although this is contradicted in other studies. So I would conclude that although there is some effect it is not clinically significant

    Just an addition to normal cleaning routine.  I am not sure that it is a clinically significant addition to oral care especially if it replaces any of the time that you would use for brushing or flossing

    Long term. As an adjunct to brushing and before brushing

    Unknown but avoid if it contains alcohol for long term use.

    Oxygenating mouthwashes

    Peroxyl

    Kill microbes that are dependant on absence of oxygen

    Bacteria

    Good for ulcers, around erupting wisdom teeth, on a pikster into deep periodontal pockets

    Often contain alcohol

    Can reduce staining of chlrohexidine if used before

    alcohol

    some commercial mouthwashes, check label

    It is a solvent, preservative and antiseptic

    antimicrobial (bacteria, fungi and viruses)

    Do not use high alcohol concentration mouthwashes > 20%

    Don’t use long term

    Implicated in oral cancer. Ulceration, xerostomia, pain and epithelial detachment at high concentrations and prolonged use

    Iodine

     

    Effects cell membrane and penetrates

    Bacteria, fungi and viruses, protozoa

    Effective in reducing plaque and gingivitis

    Reduces severity and duration of radiation gingiviis

    Some allergies exist, do not swallow. Care in use with thyroid patients

    Peroxidase

    Biotene

    4 enxymes (lysozyme, lactoferin, glucose oxidase and lactoperioxidase) act on the bacterial metabolism

    Bacteria

    Effective in halitosis, dry mouth and gingival irritations

    Xerostomia and after radiation therapy. Where ever saliva flow is reduced

    Low PH (5.5) which means it is slightly acidic which is not ideal

    fluoride

    Neutrafluor 220, neutrafluor 900

    Reduces bacterial activity and also increases enamel resistance to acid attack

    Bacteria

    Can be daily or weekly use. Spit out excess

    Useful when there is a high caries incidence, chemotherapy patients and radiation therapy patients

    Not recommended in children under 6 because of risk of swallowing

    Chlorine dioxide

    Closys

    Breaksdown cell membranes of bacteria and also effects fungi and viruses

    Fungi, bacteria and viruses

    Very effective in halitosis and periodontal disease

    Applicable in many cases. originally for bad breath but has recently been very helpful in gum disease

    No side effects. Does not contain alcohol. However the manufacturers are very secretive about how they stabilize this product without preservatives or alcohol

    essential oils..

    thymol, eucalyptol, menthol and methyl salicylate

    Listerine

    Needs to be in an alcohol solution.

    Claim to destroy bacterial cells, inhibit their enzymes, anti-inflammatory and are anti-oxidants

    Bacteria

    Adjunct to brushing

    Some studies find them effective but without the alcohol there is no point

    Don’t use if you have dry mouth, mucositis, dental erosion, or allow children to use them

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     


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