Specialty Therapeutic Oral Rinses

In addition to freshening breath and masking bad breath (halitosis) the way that cosmetic oral mouthwashes do, specialty therapeutic oral rinses are formulated with active ingredients that help prevent or treat specific oral health conditions. Available over the counter (OTC) or by prescription, therapeutic oral rinses have been proven to help prevent cavities, dry mouth, plaque and tartar buildup.

Dentists often recommend or prescribe specialized therapeutic oral rinses to patients who have oral health problems such as gum disease, gum inflammation (gingivitis) and dry mouth (xerostomia), or those who have undergone periodontal surgery. Therapeutic rinses also are recommended for individuals who can’t brush because of physical impairments or medical reasons. Other types of therapeutic oral rinses provide relief from oral pain. Topical antibiotic rinses, enzyme rinses and artificial saliva rinses also are available by prescription.

Ingredients in Specialty Therapeutic Oral Rinses

Depending on the specific oral health condition being addressed, ingredients in therapeutic oral rinses may include:

Antimicrobials (e.g., cetylpyridinium chloride, chlorhexidine and phenolic compounds), which decrease the amount of bacteria in your mouth to help control bad breath and reduce plaque and gum inflammation.
Astringents (e.g., citric acid and zinc chloride), which provide a pleasant taste and constrict oral tissues to create a protective layer of firm tissue between the under layers of tissue and the elements.
Anti-tartar agents (e.g., zinc citrate), which reduce the buildup of tartar (the sticky buildup of saliva, food and bacteria that becomes attached to teeth).
Cetlyperadium chloride, which serves as an antibacterial agent to help control the anaerobic bacteria – a type of bacteria that does not live or grow in an environment containing oxygen – in your mouth.
Fluoride, which strengthens teeth and prevents tooth decay.
Hexetidine, which helps relieve irritated and bleeding gums.
Micellized nutrients (e.g., micellized vitamin A, vitamin E and beta carotene), nutrients that have undergone cellular change, resulting in faster absorption through the cell membranes to increase the overall effectiveness of a product.
Pain-relieving agents (e.g., anodynes), which provide relief from pain and buffering agents, which may relieve soft-tissue pain, reduce acidity and dissolve film buildup on the lining of your mouth.
Xylitol, a natural sugar substitute, which has been shown to reduce tooth decay and even reverse existing dental caries.

Specialized Uses of Therapeutic Oral Rinses

Plaque control oral rinses are primarily used for preventing periodontal disease and are frequently recommended for patients with braces, canker sores, immune system deficiency and dry mouth.

Your dentist may suggest the use of a non-alcohol oral rinse if you wear dentures and have dry mouth. Dry mouth can aggravate problems associated with retaining and eating for denture-wearers, as well as contribute to tooth decay in patients with teeth. Therefore, the use of non-alcohol oral rinses is also helpful for patients with teeth.

Alternatives to Specialty Oral Rinses

Some dental experts do not regard oral rinses as necessary, or more effective, than merely gargling with water. In some cases, they view the use of therapeutic oral rinses as possibly masking or aggravating other more serious conditions, or of causing side effects. As such, they believe that daily use of toothpastes with anti-cavity, anti-plaque and anti-tartar properties, as well as regular flossing, is all that’s required for a beneficial oral hygiene regimen.

In their eyes, therapeutic oral rinses serve merely as an added “good measure,” helpful as an adjunct but not essential. This view, however, is slowly changing as dental professionals’ knowledge of pathogens and their understanding of oral disease increases and changes.

In cases where there are special oral concerns, some dental professionals might recommend gentler, more convenient and frequent-use alternatives to certain therapeutic oral rinses. For instance, if you suffer from dry mouth, OTC products such as sugar-free gums and mints that help stimulate the flow of saliva or moisturizing agents such as artificial saliva and saliva substitutes sprays, may be helpful.

If you suffer from ulcers, minor throat irritation or denture sores, rinsing with warm saltwater is a mild, economical and homemade alternative to an OTC or prescription therapeutic rinse that alleviates discomfort and aids healing. (If the area continues to be sore or irritated after a week of daily saltwater rinsing, consult your dentist.)

Note that some patients experience breakouts in their mouths and/or intraoral sensitivity when using products containing sodium lauryl sulfate, which is used in some oral health products. Some companies now make oral care products without this ingredient.

In addition to providing lubrication, mouth moisteners have been shown to be as effective in preventing tooth decay as sodium fluoride rinses used with the same frequency. A new proprietary OTC mouth moistener, which comes in spray form, is pleasant-tasting and fluoride-free so that it can be swallowed and used as often as you want with greater ease and convenience. In contrast, prescription fluoride rinses are potentially toxic, cannot be swallowed and are less convenient.

Availability and Use of Specialty Therapeutic Oral Rinses

Discuss your particular needs with your dentist and doctor, especially if you are undergoing medical/dental treatment or taking medications that might affect your oral health. Consult them on a regular basis, especially when your condition or medical treatment changes.

Your dentist and health professionals can recommend or prescribe the best oral rinse product for your individual oral health requirements. Your dentist also can provide you with information about instructions for use, frequency and duration of use, dosage amounts and any possible side effects you need to be aware of.

Before using any OTC oral rinse, you should read product labeling and instructions carefully. Always check the manufacturer’s label for precautions and age recommendations, and be sure to consult with your dentist, pharmacist or doctor for product suggestions, as well as usage and frequency directions, if you are uncertain which product is right for you. Specialty oral rinses are meant to serve as adjuncts to oral health care, not as replacements for regular oral hygiene measures prescribed by your dentist or doctor.

Cost of Specialty Therapeutic Oral Rinses

The cost of specialty therapeutic oral rinses varies depending on formulation, but can typically range from around $4 for an OTC anti-cavity rinse to around $35 for prescription therapeutic rinses used to help treat the oral hygiene needs of patients with medical conditions.

Cautions and Concerns

Some specialty therapeutic rinses contain high levels of alcohol (ranging from 18 to 26 percent), which can aggravate dry mouth syndrome and mouth sores, and be harmful to children, pregnant women and other alcohol-sensitive individuals. Certain prescription rinses can cause root sensitivity, staining, numbness, changes in taste sensation, sodium retention, mouth ulcers and mucosal erosions.

Some therapeutic rinses, such as chlorhexidine oral rinses – often used as an oral hygiene aid in patients undergoing chemotherapy – should only be used for short-term periods of six months or less.

Many anti-cavity rinses contain sodium fluoride, which if taken excessively or swallowed, can produce fluoride toxicity. Children six years old and younger should not use fluoride rinses; children older than six years should only use therapeutic oral rinses with dentist and doctor recommendation and under adult supervision.

If you or your child experiences any negative reactions when using a therapeutic oral rinse, stop using it immediately and notify your dentist and doctor.