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Mouthwashes for xerostomia
and related conditions
These include products that contain
substances to stimulate salivary flow and help
to buffer acids, such as xylitol, green tea and
Spilanthes acmella.19 Xylitol also reduces the
oral population of cariogenic bacteria, Porphyromonas gingivalis and candida. Green tea 20
and chitosan21 are also valuable for reducing
inflammation. Mouthwashes for xerostomia
may also contain ingredients that lubricate
and retain moisture, such as hyaluronate,
coconut oil and aloe vera. Examples of rinses
for xerostomia include brands such as Spry,
Synedent, Moisyn, Hydris, Mighteaflow
by Camellix and AO Hydrating rinse by
PerioScience.
Rinses with supersaturated calcium
and phosphate ion, such as SalivaMax by
Forward Science, are valuable for patients
with xerostomia and mucositis resulting from
radiation therapy or chemotherapy. Fluoride
rinses are also valuable for dry-mouth patients,
because they are at high risk for caries.

Current research on mouthwash
A recent longitudinal study found that
twice-daily use of over-the-counter mouthwash
was associated with increased risk of developing
prediabetes or diabetes in overweight and
obese individuals age 40-65. 21 It's been
proposed that mouthwash has antibacterial
effects in the oral cavity, yet oral bacteria
play an important role in the salivary nitrate/
nitrite/nitric oxide pathway, and reduced levels
of nitric oxide are associated with insulin
resistance as well as adverse cardiovascular
effects such as hypertension and impaired
vascular function.
Research has been conducted on the efficacy
of mouthwashes with other novel ingredients,
such as sea buckthorn oil,22 honey,23 coenzyme
Q1024 and pomegranate extract.25 Pomegranate
extract was tested against Aggregatibacter
actinomycetemcomitans, Porphyromonas gingivalis
and Prevotella intermedia; it showed inhibition

SEPTEMBER 2019 // dentaltown.com

of all three strains of periodontopathogens.
Sunstar has introduced GUM ActiVital
Mouthrinse, which contains pomegranate
extract and coenzyme Q10.

Conclusion
Mouthwash is a valuable, user-friendly
adjunct to brushing and interdental mechanical plaque control that can reduce gingivitis
and prevent caries. Rinses for xerostomia can
relieve symptoms and have a protective effect,
which reduces complications of a dry mouth.
Using mouthwash can significantly contribute
to achieving and maintaining optimal oral
health for a wide range of patients. ■
References
1.
"Mouthwash." (n.d.) Medical Dictionary for the Dental
Professions (2012). Retrieved July 24 2019 from https://
medical-dictionary.thefreedictionary.com/mouthwash
2.
Lax, A. (27 October 2005). Toxin: The Cunning of Bacterial
Poisons. Oxford University Press. ISBN 978-0-19-157850-2
3.
https://www.speareducation.com/spear-review/2012/12/a-briefhistory-of-mouthwash
4.
https://www.mouthhealthy.org/en/az-topics/m/mouthwash
5.
"Subgingival Delivery by an Oral Irrigation Device." Braun,
R.E., and Ciancio, S.G. J Periodontol. 1992; 63:469-472.
6.
"Retention of Chlorhexidine in the Human Oral Cavity After
Mouth Rinses." Bonesvoll, P.; Lökken, P.; Rölla, G.; Paus, P.N.
Arch Oral Biol. 1974; 19:209-212.
7.
"Efficacy of 0.2% Tempered Chlorhexidine as a Preprocedural
Mouth Rinse: A Clinical Study." Shantipriya Reddy, MGS
Prasad, Sanjay Kaul, K. Satish, Sabana Kakarala, Nirjhar
Bhowmik. J Indian Soc Periodontol. 2012 Apr-Jun; 16(2):
213-217. doi: 10.4103/0972-124X.99264
8.
"Meta-Analysis of the Effect of an Essential Oil-Containing
Mouthrinse on Gingivitis and Plaque." Araujo, MWB,
Charles, C.A., Weinstein, R.B., et al. J Am Dent Assoc. 2015;
146:610-622.
9.
"Can Chemical Mouthwash Agents Achieve Plaque/Gingivitis
Control?" Van der Weijden, F.A., Van der Sluijs, E., Ciancio
S.G., Slot, D.E. Dent Clin North Am. 2015; 59:799-829.
10. "The Effect of Cetylpyridinium Chloride-Containing Mouth
Rinses as Adjuncts to Toothbrushing on Plaque and Parameters
of Gingival Infl ammation: A Systematic Review." Haps, S, Slot,
D.E., Berchier, C.E., Van der Weidjen, G.A. Int J Dent Hyg.
2008; 6:290-303.
11. "Hyaluronan-Containing Mouthwash as an Adjunctive
Plaque-Control Agent." Rodrigues, S.V., Acharya, A.B.,
Bhadbhade, S., Thakur, S.L. Oral Health Prev Dent. 2010;
8(4):389-94.
12. "Clinical Efficacy of Turmeric Use in Gingivitis: A Comprehensive Review." Stoyell, K.A., Mappus, J.L., Gandhi, M.A.
Complement Ther Clin Pract. 2016 Nov; 25:13-17. doi:
10.1016/j.ctcp.2016.08.004. Epub 2016 Aug 2.
13. "Phloretin-Induced Cytoprotective Effects on Mammalian Cells:
A Mechanistic View and Future Directions." De Oliveira,
M.R. Biofactors. 2016 Jan-Feb; 42(1):13-40. doi: 10.1002/
biof.1256. Epub 2016 Jan 30.
14. "Ferulic Acid May Target MyD88-Mediated Pro-Infl ammatory
Signaling-Implications for the Health Protection Afforded
by Whole Grains, Anthocyanins, and Coffee." McCarty, M.F.,
and Assanga, S.B.I. Med Hypotheses. 2018 Sep; 118:114120. doi: 10.1016/j.mehy.2018.06.032. Epub 2018 Jun 28.
PMID:30037596

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Dentaltown September 2019

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