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Author: Admin | 2025-04-28
Listen to the article on our podcast!In daily interactions with patients, discussions about mouth rinses are commonplace—whether focusing on preventing caries or aiding in gingival and periodontal health. For dental hygienists, the challenge lies in navigating the myriad of options available on the market to select the most suitable mouthwash for an individual’s oral health needs.This article aims to provide dental professionals with a comprehensive guide to choosing the optimal mouthwash by examining the efficacy of various active ingredients and considering factors such as dry mouth that may influence selection. The purpose of mouth rinses is to delay biofilm growth in the oral cavity, especially on the teeth and surrounding periodontal tissues. By understanding the role of active ingredients in mouth rinses and their implications on oral health, dental professionals can make informed decisions to enhance patient care and satisfaction.Mouth rinse categoriesThe American Dental Association (ADA) has systematically classified oral rinses into two primary subcategories—cosmetic and therapeutic—due to their varying active ingredients and properties.1 These distinctions guide dental professionals and consumers in understanding the intended use and benefits of various mouth rinse formulations.Therapeutic mouth rinses are available over the counter (OTC) and by prescription. These mouth rinses provide patients with antimicrobial agents to kill bacteria associated with gingivitis, periodontal disease, and dental decay.Cosmetic mouth rinses are also available OTC and include ingredients that offer temporary benefits. The primary function of cosmetic mouth rinses is to provide temporary relief, such as leaving patients with fresh breath or relieving dry mouth after use. While effective, cosmetic mouth rinses contain active therapeutic ingredients but often don’t remove harmful bacteria needed to maintain a healthy oral biome.Composition of mouth rinsesTable 1 gives a breakdown of ingredients, uses, side effects, and mechanism of action in mouth rinses.Water or alcohol solvents: The typical composition of therapeutic and cosmetic mouth rinses consists of antimicrobial properties, with water or alcohol acting as solvents. Alcohol solvents, such as ethyl alcohol and glycerin, are the most commonly used active ingredients in both therapeutic and cosmetic mouth rinses found on the market today.2 Mouth rinse products contain ingredients with a nonalcohol solvent option for patients who may have contraindications to the alcohol component of certain mouth rinses.Other active ingredients: These ingredients include sweeteners, preservatives, coloring or cooling agents, surface-acting and thickening agents, and added flavoring (plant-based).2-4 Active ingredients most commonly listed in mouth rinses include—but are not limited to—fluoride, chlorhexidine (CHX), cetylpyridinium chloride (CPC), hydrogen peroxide, sodium chlorite, xylitol, and natural flavors such as menthol, mint, green tea, and eucalyptus.2-4Fluoride: Fluoride is the first and most common active ingredient in most therapeutic and cosmetic mouthwashes. Fluoride is one of the most effective ingredients in mouth rinses due to its ability to lower pH levels, rebuild enamel, and increase the mineralization of the teeth.4,5 The clinical effectiveness is due to its chemical solubility in the oral cavity with each use. Fluoride’s primary function is to lower pH in the oral cavity and chemically assist in stabilizing and binding the fluoride to the
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