From the Guidelines
The recommended dosage of chlorhexidine (CHX) mouthwash for antimicrobial purposes is 0.2% concentration, used as a 10 mL rinse twice daily. This recommendation is based on the guidelines provided by the British Journal of Dermatology 1, which suggests using 0.2% chlorhexidine digluconate mouthwash, 10 mL twice daily, to reduce bacterial colonization of the mucosa.
Key Considerations
- The dosage and usage of chlorhexidine mouthwash may vary depending on the specific condition being treated and the patient's individual needs.
- It is essential to follow the recommended dosage and usage instructions to minimize the risk of side effects and maximize the effectiveness of the treatment.
- Chlorhexidine mouthwash can be used in combination with other oral care products, such as toothpaste and floss, to maintain good oral hygiene.
Important Details
- The mouthwash should be used twice daily, with 10 mL of the 0.2% concentration solution.
- The solution should be swished around the mouth for the recommended time before being spit out.
- It is crucial to avoid eating, drinking, or rinsing the mouth for at least 30 minutes after using the mouthwash to allow the active ingredients to work effectively.
- Chlorhexidine mouthwash can cause side effects such as tooth staining, altered taste sensation, and increased calculus formation, especially with prolonged use 1.
Additional Guidance
- Patients should be advised to use chlorhexidine mouthwash after brushing and flossing, ensuring that any toothpaste has been thoroughly rinsed out, as some ingredients in toothpaste can inactivate chlorhexidine.
- Alcohol-free formulations of chlorhexidine mouthwash are available for patients who prefer to avoid alcohol or experience sensitivity.
- The duration of use should generally be limited to 1-2 weeks unless otherwise directed by a healthcare provider.
From the FDA Drug Label
DOSAGE AND ADMINISTRATION Paroex ® (Chlorhexidine Gluconate Oral Rinse USP, 0.12%) therapy should be initiated directly following a dental prophylaxis. Patients using Paroex ® should be reevaluated and given a thorough prophylaxis at intervals no longer than six months. Recommended use is twice daily, oral rinsing for 30 seconds, morning and evening after toothbrushing. Usual dosage is 15 mL (½ FL OZ) of undiluted Paroex ®. The recommended dosage and usage of chlorhexidine mouthwash for antimicrobial purposes is:
- Twice daily
- 15 mL (½ FL OZ) of undiluted solution
- Oral rinsing for 30 seconds, morning and evening after toothbrushing 2
From the Research
Recommended Dosage and Usage of Chlorhexidine Mouthwash
- The recommended concentration of chlorhexidine (CHX) mouthwash for antimicrobial purposes is between 0.12% to 0.2% 3.
- Concentrations above 0.2% may increase the risk of unwanted side effects, such as tooth staining 3.
- CHX mouthwash is more effective compared to gels, especially when used in short time spans for the prevention of gingivitis and maintenance of oral hygiene 3.
- The use of CHX mouthwash should be weighed alongside its potential adverse effects, including extrinsic staining of teeth, antimicrobial resistance, and rare but fatal allergic reactions 4.
Clinical Applications of Chlorhexidine Mouthwash
- CHX mouthwash is useful in various areas of dentistry, including oral surgery, periodontics, and general dentistry 3.
- It is recommended as an adjunct to mechanical debridement in patients with peri-implant mucositis and peri-implantitis 3.
- CHX mouthwash may also be used to manage dental plaque, reduce clinical symptoms of gingivitis, and reduce aerosolisation of bacteria 4.
- However, its effectiveness in managing or preventing periodontitis, dental caries, and other oral diseases remains less certain and requires further research 4.
Guidelines for the Use of Chlorhexidine Mouthwash
- Current guidelines suggest the use of CHX mouthwash as an adjunct to mechanical oral hygiene measures for the management of periodontal diseases 5.
- The use of mouthwashes, including CHX, should be based on individual patient needs and risk assessment, taking into account potential risks and benefits 5.
- Dental practitioners should keep abreast of the evidence base on the current and emerging mouthwashes and follow international guidelines on their use 5.