Podcast
Questions and Answers
What type of agents help alleviate pain?
What type of agents help alleviate pain?
Which agents are specifically mentioned as effective against anaerobic bacteria?
Which agents are specifically mentioned as effective against anaerobic bacteria?
Which of the following is an example of a deodorising agent?
Which of the following is an example of a deodorising agent?
What is the primary function of buffering agents?
What is the primary function of buffering agents?
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What is a benefit of adding fluoride to mouthwashes?
What is a benefit of adding fluoride to mouthwashes?
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Which antimicrobial is noted for its use in painful oral conditions?
Which antimicrobial is noted for its use in painful oral conditions?
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What is the role of astringents in oral care?
What is the role of astringents in oral care?
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Which one of the following is not classified as a type of antimicrobial mentioned?
Which one of the following is not classified as a type of antimicrobial mentioned?
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What effect do astringents such as Zinc Chloride and Zinc Acetate have on tissue?
What effect do astringents such as Zinc Chloride and Zinc Acetate have on tissue?
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Which of the following is an example of an anaesthetic included in some oral products?
Which of the following is an example of an anaesthetic included in some oral products?
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What is the primary role of a mouthwash in oral care?
What is the primary role of a mouthwash in oral care?
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In what situation might a mouthwash be recommended?
In what situation might a mouthwash be recommended?
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Which of the following is NOT a typical constituent found in mouthwashes?
Which of the following is NOT a typical constituent found in mouthwashes?
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What is a potential disadvantage of certain constituents in mouthwashes?
What is a potential disadvantage of certain constituents in mouthwashes?
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What type of action do oxygenating agents in mouthwashes typically have?
What type of action do oxygenating agents in mouthwashes typically have?
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Why is it important for clinicians to justify the recommendation of a mouthwash?
Why is it important for clinicians to justify the recommendation of a mouthwash?
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Which of the following is considered an active ingredient in mouthwashes?
Which of the following is considered an active ingredient in mouthwashes?
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What is a possible cosmetic benefit of using a mouthwash?
What is a possible cosmetic benefit of using a mouthwash?
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What may influence a patient’s choice in selecting a mouthwash?
What may influence a patient’s choice in selecting a mouthwash?
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What is the primary purpose of alcohol in mouthwash formulations?
What is the primary purpose of alcohol in mouthwash formulations?
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What is one of the primary side effects associated with prolonged use of Chlorhexidine?
What is one of the primary side effects associated with prolonged use of Chlorhexidine?
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What is the mechanism of action of Chlorhexidine at high concentrations?
What is the mechanism of action of Chlorhexidine at high concentrations?
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How long can Chlorhexidine remain active after application?
How long can Chlorhexidine remain active after application?
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Which of the following is a common formulation that contains Chlorhexidine?
Which of the following is a common formulation that contains Chlorhexidine?
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Which phenolic compound is known to reduce plaque by up to 30%?
Which phenolic compound is known to reduce plaque by up to 30%?
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What is a rare side effect of using Chlorhexidine mouthwash?
What is a rare side effect of using Chlorhexidine mouthwash?
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What is the primary action of phenolic compounds in oral care products?
What is the primary action of phenolic compounds in oral care products?
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Which essential oil is considered a natural antibacterial agent?
Which essential oil is considered a natural antibacterial agent?
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What indication might lead to the recommendation of using Chlorhexidine?
What indication might lead to the recommendation of using Chlorhexidine?
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What is one of the active ingredients found in Corsodyl mouthwash?
What is one of the active ingredients found in Corsodyl mouthwash?
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What is the original use of Triclosan?
What is the original use of Triclosan?
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Which of the following statements about Cetylpyridinium Chloride is true?
Which of the following statements about Cetylpyridinium Chloride is true?
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What is a known property of Sanguinarine?
What is a known property of Sanguinarine?
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Which of the following is a concern regarding the alcohol content in mouthwashes?
Which of the following is a concern regarding the alcohol content in mouthwashes?
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What is a notable characteristic of oxygenating agents like hydrogen peroxide?
What is a notable characteristic of oxygenating agents like hydrogen peroxide?
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Which mouthwash ingredient has a moderate plaque inhibitory effect?
Which mouthwash ingredient has a moderate plaque inhibitory effect?
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What potential risk is associated with alcohol-containing mouthwashes?
What potential risk is associated with alcohol-containing mouthwashes?
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Which of the following substances does not inhibit plaque effectively?
Which of the following substances does not inhibit plaque effectively?
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In what formulation is Dentyl found?
In what formulation is Dentyl found?
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What should be considered regarding the safety of Triclosan?
What should be considered regarding the safety of Triclosan?
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Study Notes
Mouthwashes
- Mouthwash is a chemotherapeutic agent used as an adjunct to a patient's home care oral regime.
- The aim of the presentation is to provide insight into the range of mouthwashes and their role in oral health.
- Learning objectives include: acknowledging the range of constituents in mouthwashes; appreciating the potential benefits of constituents on oral health; understanding potential disadvantages of certain constituents on oral health; analyzing information to advise patients accordingly.
- GDC learning outcomes are listed as 1.1.1, 1.1.8, 1.2.3, 1.9.1, 1.10.2, 1.10.3, 1.10.4, 1.10.5, 6.1, 6.2, and 6.3.
- Mouthwashes are not a replacement for mechanical plaque removal.
When Mouthwash May Be Recommended
- Recommended for those with difficulty with good oral hygiene (medically, physically, or mentally compromised).
- Recommended for oral ulceration and certain oral conditions like lichen planus, or aphthous ulcers.
- May be recommended after oral surgery or for those with xerostomia.
- Also recommended for caries control (fluoride component) and cosmetic purposes (fresh taste, fresh breath).
General Constituents of Mouthwash
- Water
- Alcohol (preservative)
- Flavoring
- Coloring
- Sweeteners
- Active Ingredients (detailed later)
Actions of Active Ingredients
- Antimicrobial
- Physical removal of plaque
- Crystalline impact
- Deodorizing
- Buffering agents
- Astringent
- Anodynes
Oxygenating Agents
- Cleansing effervescent, introducing O2.
- Examples: Sodium Perborate, Hydrogen Peroxide.
- Some antibacterial effect on anaerobic bacteria, but not broad spectrum.
Astringents
- Tissue shrinkage
- Examples: Zinc Chloride, Zinc Acetate, Citric acids
Anodynes
- Help alleviate pain.
- Examples: Phenol derivatives, Essential oils
Buffering Agents
- Reduce acidity and soreness.
- Examples: Sodium Perborate, Sodium Bicarbonate
Deodorising Agents
- Neutralize odors from decomposing food.
- Example: Chlorine Dioxide
Fluoride
- Addition of fluoride in mouthwashes benefits caries prevention and management of demineralization.
- Patients with conditions like xerostomia and dental sensitivity may benefit.
- Amounts vary in different products, with some containing a higher percentage (e.g., Duraphat). Refer to the lecture on Fluoride and tooth surface.
Pain Relief
- Some products, like Eludril, contain both an antimicrobial (like chlorhexidine) and a mild local anesthetic (like chlorobutanol).
- This combination may be beneficial for managing certain painful oral conditions.
Antimicrobials
- Bisbiguanides (e.g., chlorhexidine)
- Bispyridines (e.g., ocetedine)
- Pyrimidines (e.g., hexetidine)
- Halogens (e.g., fluoride and iodine)
- Phenols/Phenolic (e.g., phenol, thymol)
- Quaternary Ammonium Compounds (e.g., cetylpyridinium chloride)
- Herbal (e.g., sanguinarine)
- Oxidising agents
- Fluoride
General Considerations
- Active ingredient
- Indication for use
- Duration of use
- Side effects
- Cost
- Access
Chlorhexidine
- Broad-spectrum antimicrobial.
- Well-documented use in combating periodontal disease-related bacteria.
- Absorbed onto all oral surfaces, with good substantivity (released slowly and stays active for up to 24 hours).
Effects of Chlorhexidine
- Bactericidal (high concentration): cell lysis, incorporates into bacteria, extreme potassium and phosphate leakage, impacts cell membrane.
- Bacteriostatic (low concentration): cell content leakage, reduces replication, but bacteria can recover.
Chlorhexidine - Indications of Use
- Gingival conditions
- Compromised oral hygiene
- Ulcerations
- Oral conditions
Potential Side Effects
- Staining (significantly with prolonged use)
- Taste disturbances
- Tongue discomfort/burning
- Oral Desquamation
- Parotid swelling (rare side effect)
- Effects on certain toothpaste constituents
Corsodyl Mouthwash Range
- Contains chlorhexidine 0.06% (daily range)
- Contains chlorhexidine gluconate 0.2% (original)
Phenolic Compounds
- Not as effective as chlorhexidine.
- Poor oral retention.
- Has some anti-inflammatory effects.
- Reduces plaque by up to 30%.
- Works by altering bacterial cell walls.
- Works in association with essential oils.
- Common products: Listerine
Essential Oils
- Menthol (natural antibacterial)
- Eucalyptus (natural anti-inflammatory)
- Thymol (natural antiseptic)
- Often incorporated into phenolic compounds
Triclosan
- Derivative of phenol.
- Used in toothpastes and mouthwashes.
- Has a broad-spectrum antibacterial effect and some anti-inflammatory effects.
- Originally used as a hospital scrub in the 1970s.
Cetylpyridinium Chloride
- Moderate plaque inhibitory effect.
- Higher initial oral retention and equivalent antibacterial activity to chlorhexidine.
- Less effective in inhibiting plaque and preventing gingivitis.
- Found in products like Dentyl (oil and water based).
Hexetidine
- Antimicrobial found in products like Oraldene.
Sanguinarine
- Plant-based with effective anti-plaque properties.
Oxygenating Agents (Hydrogen Peroxide)
- Beneficial in certain conditions, for example AUG, as it inhibits anaerobic bacteria.
Mouthwashes and Alcohol Content
- Many mouthwashes contain alcohol (up to 26%).
- Caution is needed if accidentally swallowed
- Alcohol content can cause soft tissue discomfort and affect some restorative materials.
Recommended Reading (Citations)
- Links to various research articles and papers about mouthwash.
Image References (Citations)
- Links to image sources for the presentation.
Contact Information
- Presentation tutor's email address.
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Description
This quiz explores the different types of mouthwashes and their significance as a supplementary tool in oral hygiene. Participants will learn about the ingredients of mouthwashes, their benefits and potential drawbacks, and when they may be appropriately recommended. Gain valuable insights for advising patients effectively regarding mouthwash use.
