This article first appeared in the February 2016 issue of Maple Leaf Times. We have reproduced it for the information of those of you who missed it when it was published.
Q: I currently brush my teeth twice a day and floss once a day, is there still a need to use a mouth rinse? If I have to choose one, what type of mouth rinse should I use?
A: It always brings a smile to my face when patients practice good home care. Research has shown that plaque is the primary cause of gum inflammation and gum (periodontal) disease. Hence the mainstay of prevention of periodontal disease is plaque control, which is mainly achieved through mechanical methods. This means tooth brushing the smooth surfaces of the teeth, and flossing or using interdental brushes between teeth.
Normally, regular effective brushing and flossing is good enough; hence it is not absolutely essential to use a mouth rinse. At Specialist Dental Group, we always encourage patients to practice the rule of 2-2-2; brush your teeth for 2 times a day, for at least 2 minutes each and visit your dentist 2 times a year.
Nonetheless, we understand that some people may have difficulty brushing and flossing adequately, secondary to disease or disability. In such cases, a mouth rinse may be recommended. Mouth rinses act as vehicles for delivery of chemical agents. You should visit a dentist to find out whether a mouth rinse should be included into your home care routine. The dentist would then recommend the type of mouth rinse to use, based on your oral health needs.
Here is a list of some of the most common types of mouth rinses and their benefits/limitations.
Mouth rinses with fluoride
These contain fluoride to help prevent dental caries. Due to the fluoride content, they will also help in remineralizing and strengthening teeth. These mouth rinses are usually recommended for patients at a high caries risk e.g. patients with xerostomia, poor or limited dexterity, multiple exposed root surfaces or enamel defects.
Antiseptic mouth rinses
These are antiplaque agents that kill or inhibit bacterial plaque from proliferating. Different brands in the market contain different active ingredients e.g. chlorhexidine, essential oils, cetylpyridinium chloride. These antiseptic mouth rinses have plaque-inhibitory actions and help to reduce gingivitis (gum inflammation). However chlorhexidine mouth rinses are usually recommended by dentists only for short-term use post-operatively. It may bring about altered taste sensation and teeth staining when used daily on a long term basis.
Herbal mouth rinses
Natural ingredients like aloe vera and plant extracts such as peppermint and tea tree oil have also been used in mouth rinses to help freshen breath and reduces gum inflammation. Unfortunately, there are few scientific data available on the beneficial effects on reducing plaque accumulation and gingivitis. Hence, more research is needed to validate the beneficial effects of these mouth rinses.
Desensitizing mouth rinses
These are oral rinses that contain ingredients such as potassium nitrate and sodium fluoride. Potassium nitrate numbs the nerves in teeth while sodium fluoride coats the tooth enamel to strengthen it. Both help to provide relief from the discomfort of teeth sensitivity. These mouth rinses can be used with desensitizing toothpastes to alleviate tooth sensitivity. However, results are often not immediate and it takes regular usage over time to be effective.
A common home remedy can be made from a mixture of salt in warm water. It is helpful especially when one is suffering an oral infection or injury, before dental treatment is available. The salt water mixture draws water out from one’s oral tissues, washing out micro-organisms. However this only provides symptomatic relief and is not a cure for your oral condition, so do consult your dentist to fix the underlying problem.
Remember, a mouth rinse should only be used as a complement to one’s home care routine and not as a replacement to regular effective brushing and flossing.
Dr Daylene Leong is Dental Specialist in Periodontics with Specialist Dental Group®. She received her training in the specialty area of Periodontology from the University of Michigan, USA. Dr Leong is a Diplomate of the American Board of Periodontology and a Fellow of the Academy of Medicine, Singapore. She has a special interest in periodontal regeneration, gingival aesthetic and plastic surgery and dental implants.