From the Guidelines
The first mouthwash recommended is 0.2% chlorhexidine digluconate mouthwash, such as Corsodyl mouthwash, 10 mL twice daily. This is based on the most recent and highest quality study available, which suggests using an antiseptic oral rinse twice daily to reduce bacterial colonization of the mucosa 1. The study recommends 0.2% chlorhexidine digluconate mouthwash as an option, and it can be diluted by up to 50% to reduce soreness. Some key points to consider when using this mouthwash include:
- Using 10 mL of the mouthwash twice daily
- Diluting the mouthwash by up to 50% if soreness occurs
- Considering alternative antiseptic oral rinses, such as 1.5% hydrogen peroxide mouthwash, if chlorhexidine is not suitable
- Monitoring for secondary infections, such as bacterial or candidal infections, and treating accordingly 1. It's also important to note that the study suggests using a topical anaesthetic preparation, such as viscous lidocaine 2%, as an alternative for severe oral discomfort, but this is not a replacement for the antiseptic oral rinse 1.
From the FDA Drug Label
Directions ... Oral Debriding Agent (oral rinse): Adults and children 2 years of age & over: mix with an equal amount of water swish around in the mouth over the affected area for at least 1 minute and then spit out use up to 4 times daily after meals and at bedtime or as directed by a dentist or doctor The recommended first mouthwash is hydrogen peroxide mixed with an equal amount of water, swished around in the mouth for at least 1 minute, and spat out, used up to 4 times daily after meals and at bedtime or as directed by a dentist or doctor 2.
- Key considerations:
- For adults and children 2 years of age & over
- Children under 12 years of age should be supervised
- Children under 2 years of age: consult a dentist or doctor
From the Research
Recommended First Mouthwash
The choice of the first mouthwash depends on various factors, including the individual's oral health needs and preferences. Based on the available evidence, here are some options to consider:
- Hydrogen peroxide mouthwash: A study published in 2022 3 found that hydrogen peroxide mouthwash was effective in reducing gingival index and plaque index in patients with gingivitis.
- Chlorhexidine mouthwash: Chlorhexidine is a widely used and effective mouthwash ingredient. A study published in 2019 4 compared the efficacy of different chlorhexidine-based mouthwashes and found that they were effective in reducing plaque and gingival bleeding.
- Prebiotic mouthwash: A study published in 2022 3 found that a prebiotic mouthwash was effective in reducing gingival index and plaque index in patients with gingivitis.
- Chitosan chlorhexidine mouthwash: A study published in 2020 5 found that a combination of chitosan and chlorhexidine was effective in reducing plaque indices in patients with dental plaque.
Key Considerations
When choosing a first mouthwash, consider the following factors:
- Oral health needs: If you have gingivitis or periodontitis, a mouthwash containing chlorhexidine or hydrogen peroxide may be effective.
- Sensitivity: If you have sensitive teeth or gums, a mouthwash with a lower concentration of active ingredients may be more suitable.
- Taste and preference: Choose a mouthwash with a flavor you like to ensure you use it regularly.
Comparison of Mouthwashes
Here is a summary of the efficacy of different mouthwashes:
- Hydrogen peroxide mouthwash: Effective in reducing gingival index and plaque index 3, 6
- Chlorhexidine mouthwash: Effective in reducing plaque and gingival bleeding 3, 4, 6
- Prebiotic mouthwash: Effective in reducing gingival index and plaque index 3
- Chitosan chlorhexidine mouthwash: Effective in reducing plaque indices 5