Not all mouthwashes are created equally. Different mouthwashes contain different ingredients and have different purposes. Some simply freshen your breath. Others help fight cavities and may reduce symptoms of gum disease. Some are available over the counter at your local drug store. Others, such as a chlorhexidine rinse, require a prescription from your dentist. How do you know which type of rinse is right for you?
Mouthwash: An Overview
As the American Dental Association points out, there are two broad categories of mouthwash: cosmetic and therapeutic. Cosmetic mouthwashes contain ingredients that help to mask bad breath, but don't contain ingredients that actually do anything to improve the health of your mouth or to treat the root cause of the bad breath.
In contrast, therapeutic mouthwashes contain active ingredients that kill bacteria, helping to lower the risk for or improve symptoms of gingivitis, or contain ingredients, such as fluoride, that help reduce the risk for cavities and strengthen your tooth's enamel.
An antibacterial mouthwash can contain one of several ingredients, such as cetylpyridinium chloride or chlorhexidine gluconate. Mouthwashes that contain cetylpyridinium chloride, such as Colgate Total Advanced Health mouthwash, is available over-the-counter. It kills 99 percent of germs on contact, reduces plaque and helps prevent gingivitis. A chlorhexidine rinse is only available with a prescription from a dentist and is also intended to kill the bacteria that causes gum disease and to help reduce plaque.
Why Your Dentist Might Prescribe a Chlorhexidine Rinse
Generally, dentists prescribe chlorhexidine mouthwashes to patients who have gingivitis, the mildest, earliest form of gum or periodontal disease. The mouth rinse isn't meant to be used on its own to treat gum disease. Instead, you're supposed to use it along with brushing and flossing to help clean and improve the health of your gums and teeth.
A review of 30 separate studies, published in the Journal of Clinical Periodonotology (JCP), examined the effectiveness of using a mouthwash with chlorhexidine compared to control mouthwashes or placebos. The review found that using mouthwashes that contained chlorhexidine gluconate, along with regular oral hygiene practices, led to a noticeable reduction in plaque and a considerable improvement of the gingivitis, compared to patients who used either the placebo or control rinses.
How to Use Chlorhexidine Mouthwash
Since chlorhexidine rinses are only available by prescription and should only be used under your dentist's supervision, it's important to follow the directions. As the University of Michigan Health Library points out, you are usually directed to use the rinse twice a day after brushing your teeth. Even though your symptoms might clear up before you finish the product, it's important to keep using it for as long as your dentist prescribed.
Side Effects and Who Shouldn't Use Chlorhexidine Mouthwash
Mouthwashes that contain chlorhexidine gluconate aren't right for everyone. For example, people who are allergic to the active ingredient should avoid it, since there is a risk for a severe reaction. The mouth rinse is also not recommended for use by teens or children, since it can cause irritation or burns.
Another thing to know about chlorhexidine gluconate is that it might stain your teeth, tongue and inside your mouth. The review in JCP found that patients who used mouth rinses with chlorhexidine had a significant increase in staining. Another study, published in Dental Clinics of North America, found smoking or drinking wine or other dark-colored beverages while using the mouthwash further increased staining on the teeth.
If your dentist recommends a prescription mouthwash to help treat gingivitis or to reduce plaque, it's a good idea to follow his or her instructions. Don't worry too much about staining, as your dentist can help you find ways to reduce or remove the stains and improve the appearance of your smile after the treatment is over.