Does your dentist or dental hygienist ask you to rinse before your dentist appointment begins? Your appointment should always start with a pre-procedural mouthrinse. Why rinse first? This step can significantly reduce the number of microorganisms (bacteria) that are introduced during a dentist appointment through splatter or aerosols. A simple 30-second rinse can reduce contamination on dental equipment, dental personnel and surfaces in the operatory.
Basis for Pre-Procedural Rinse
While no scientific evidence exists that a pre-procedural rinse prevents infections in patients or dental health care workers, the Centers for Disease Control and Prevention (CDC) states that it does reduce the level of microorganisms in the mouth that can enter the patient's bloodstream during a dental visit. During a professional cleaning, scaling and polishing instruments, such as slow-speed handpieces, prophy (polishing) cups and ultrasonic scalers, create splatter and aerosols that allow microorganisms to leave the mouth and contaminate clinical surfaces, instruments and personnel in the treatment room.
Aerosols are fine mists that contain bacteria. The mist is expelled from the mouth when the ultrasonic scaler and other water-based dental instruments are used. The water component used to cool the instrument and flush debris contains bacteria from the mouth and can easily contaminate people and surfaces outside of the treatment zone. Additionally, when the hygienist is polishing the teeth, splatter occurs when the motion of the slow-speed handpiece and polishing cup picks up paste and saliva. All dental health care workers must wear protective equipment at all times during treatment and thoroughly disinfect the treatment room after the patient is dismissed. However, even with the best infection control practices, microorganisms can remain.
Components and Indications of Pre-Procedural Rinses
Which rinses are best? The CDC recognizes several that reduce microbes. These rinses can contain chlorhexidine gluconate, povidone iodine, essential oils and alcohol. Chlorhexidine, a prescription rinse, and povidone iodine, available over-the-counter, are used mainly in periodontal offices for procedures that require deep scaling or surgery. Rinses that contain essential oils and alcohol are used as well. For patients who are sensitive to alcohol or essential oils, alcohol- and oil-free choices are best. A study published in the Journal of the American Dental Association (JADA) in 2010 showed that a pre-procedural rinse containing 0.05 percent of cetylpyridinium chloride (CPC) was as effective as chlorhexidine for reducing microbes in the mouth before treatment. Colgate Total® Advanced Pro-Shield™ mouthwash is an alcohol-free formula that contains CPC and has been clinically shown to reduce cross-contamination by 77 percent. This mouthwash contains 0.075 percent CPC, and patients have reported a pleasant taste and a noticeable reduction in plaque and gingivitis after a few weeks of use.
Why not put your mind at ease by reducing the risk of cross-contamination? The fact that a pre-procedural rinse can reduce bacteria in the mouth and keep the patient and dental personnel safer is an excellent reason to rinse before treatment. A rinse that is effective and acceptable to patients is critical for compliance. The next time you visit your dentist, ask for a pre-procedural rinse if one is not offered. You will be doing the right thing for you and for your dental office.