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Is there a benefit for the routine use of an antibacterial mouth rinse prior to dental appointments?

Dental CareThis question was submitted by a general dentist: Is there any evidence of benefit for the routine use of an antibacterial mouth rinse (ie. chlorhexidine gluconate 0.12%) prior to dental appointments?  Would there be any contraindications to this practice?

Drs. Gordon Schwartz from Gumdocs and Suham Alexander provided this quick initial response. 

 

 

The intended aim of having patients use a pre-procedural antibacterial mouth rinse is to reduce or limit the exposure of patients and dental staff to microorganisms that are found in aerosols in the dental office as well as to decrease contamination of equipment and operatory surfaces whilst performing routine dental procedures. Air-water syringe and handpiece sprays are most concentrated within 2 feet of the patient in the same vicinity as the operator/assistant.

Presently, there is no scientific evidence to suggest that a pre-procedural rinse prevents any clinical infections in dental patients or personnel. The study cited below by Feres et al compared the effectiveness of 0.05% cetylpyridinium chloride (CPC) and 0.12% chlorhexidine gluconate (CHX). Both are equally effective in reducing the number of viable bacteria in aerosols in comparison to the negative control groups (water and no rinse at all). It should be noted, however, that the presence of bacteria alone is not indicative of an infection or that one will be caused by contact with the aerosol. 

There are fewer side-effects (mild taste changes and burning feeling) associated with CPC compared to CHX (strong taste, mucosal irritation, staining of the teeth/tongue, metallic taste). Additionally, the lower cost of CPC can be beneficial for practices that employ pre-procedural rinses.

Overall, the use of a pre-procedural rinse may be costly and unnecessary for each and every patient. Rinses may be more beneficial to use in patients at higher risk for infection or before certain procedures such as ultrasonic scaling, dental prophylaxis or where rubber dams cannot be utilized as well as for surgical procedures.

References

Feres M, Figueiredo LC, Faveri M, Stewart B and de Vizio W. The Effectiveness of a Preprocedural Mouthrinse Containing Cetylpyridinium Chloride in Reducing Bacteria in the Dental Office. JADA 2010; 141(4): 415-22.

http://www.cdc.gov/oralhealth/infectioncontrol/faq/preprocedural_mouthrinse.htm 

USAF Dental Evaluation & Consultation Service – Reducing Bacteria Using Preprocedural Mouth Rinses (6/10)

 

 

3 comments

  1. It is considered prudent and good practice to offer patients a pre-extraction rinse especially with poor oral hygiene.chx 0.12% is appropriate.

  2. American Biotech Labs in Utah produces a silver colloidal solution whialmost ch is a patented silver solution (10ppm) which has very effective antimicrobial activity. I have been using it daily as a mouth rinse (2ml nightly) and then ingesting it for the last 4yrs. I can vouch for its safety and effectiveness. It is also available in professional strength (24 ppm) which I use to disinfect tooth preps prior to placing restorations or sealants. The great thing is that it is non-toxic but more effective
    They also have silver in gel form for treating surface wounds. My family and I have used it on several occasions with “miracle healing”. Wounds have healed within a week with very little scarring and almost immediate pain relief. You have to try it to believe it. Just recently they introduced a tooth gel consisting of silver and xylitol What a great combination.

    Dave Okamura North York

  3. Recent research has shown that regular mouthwash use may have an unwanted effect of interfering with helpful bacteria with a resultant raise in blood pressure. Mouthwash use may also interfere with protective stomach secretions. See Dr. Gabe Mirkin “Mouthwashes raise blood pressure” (November 23, 2014).

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