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This article will focus on the antiplaque efficacy of mouthwashes. An antiplaque agent inhibits the formation of plaque and also reduces gingivitis. There is good evidence that chlorhexidine digluconate, used in the correct concentrations, is the gold standard agent against which all others should be measured. It does, however, have some unwanted side-effects. One of the major problems for antiplaque mouthwashes is that they have a much reduced effect on established plaque within the oral environment. Although they can flow into the biofilm channels and kill bacteria in the superficial layers of dental plaque, they cannot penetrate the biomass and inhibit the pathogenic bacteria adjacent to the tooth surface and gingival margin. There is no evidence that they prevent the progression of periodontitis.
CPD/Clinical Relevance: The evidence supporting the use of ‘over the counter’ antiplaque mouthwashes is evaluated. This provides guidance for dentists and dental care professionals of when it is appropriate to recommend mouthwash use to their patients.
Article
There are various reasons why a patient may wish to use a mouthwash. These include:
A member of the dental profession might consider recommending the use of a mouthwash as an antiplaque agent, to deliver topical fluoride, to combat oral malodour or for a patient with a dry mouth. For members of the public the array of mouthwashes available and the claims made by manufacturers can be confusing. A newspaper article raised the question ‘Mouthwash or hogwash: experts argue that not only is a mouthwash useless, it can also be harmful to your health' (Times newspaper 15 September 2008). The aim of this series of papers is to review the available evidence for the efficacy of ‘over the counter’ mouthwashes and to give guidance for dentists and dental care professionals of when it is appropriate to recommend mouthwash use to their patients.
Evidence regarding mouthwashes may be divided into:
This narrative review will be split into three parts. The first part will focus on antiplaque efficacy of mouthwashes. The second part will address caries prevention, antihalitosis efficacy and dry mouth relief. The third part will cover safety of mouthwashes.
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