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References

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Marinho VC, Higgins JP, Logan S, Sheiham A Fluoride mouthrinses for preventing dental caries in children and adolescents. Cochrane Database Syst Rev. 2003;
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Mouthwashes: do they work and should we use them? part 2: anticaries, antihalitosis and dry mouth relief efficacy of mouthwashes

From Volume 43, Issue 7, September 2016 | Pages 631-640

Authors

Penny Hodge

BDS, PhD, FDS RCS(Ed)

Specialist Periodontist/Honorary Senior Lecturer, University of Glasgow, 378 Sauchiehall Street, Glasgow G2 3JZ, UK

Articles by Penny Hodge

Abstract

This article will review the anticaries, antihalitosis and dry mouth relief efficacy of mouthwashes. Fluoride mouthwashes may provide an additional benefit to toothpaste and gel in children with a high risk of dental caries, but toothpaste alone may be a more acceptable mode of delivery. There may be a beneficial effect of fluoride mouthwashes on caries levels in older adults, particularly those at higher risk of root caries. The available data of the antihalitosis effect of mouthwashes neither supports nor contra-indicates their use. The key area where a mouthwash may be of use in the treatment of patients with a dry mouth is through the anticaries effect of fluoride.

CPD/Clinical Relevance: The evidence supporting the use of anticaries, antihalitosis and dry mouth relief mouthwashes is evaluated. This provides guidance for dentists and dental care professionals of when it is appropriate to recommend the use of a mouthwash in these situations.

Article

The first part of this review focused on the antiplaque efficacy of mouthwashes. The second part will cover the evidence regarding mouthwashes marketed for caries prevention, the treatment of halitosis and for dry mouth relief. The final part will address the controversy surrounding the safety of alcohol-containing mouthwashes.

A topical fluoride intervention should be effective in preventing dental caries (Figure 1), safe, easy to use and acceptable to the patient.

The evidence for using mouthwashes for caries prevention can be divided into:

A series of seven Cochrane systematic reviews on the subject of the effectiveness of the main topical fluoride modalities (toothpaste, gels, mouthwashes and varnish) on reducing dental caries increment were conducted between 2002 and 2004.1 Regarding the results of these reviews:

These findings had weaker support in another systematic review.7 The authors concluded that there was limited evidence for the caries preventive effect of daily or weekly sodium fluoride mouthwashes, compared with placebo, in permanent teeth of schoolchildren and adolescents with no other fluoride exposure. In addition, there was inconclusive evidence of an additional benefit of fluoride mouthwashes in children who were also exposed to other sources of fluoride, eg toothpastes.

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