3 crucial features of an effective antimicrobial mouthwash

(925 words)

Recent articles like ‘Can mouthwashes douse the spread of Covid 19?’ published in MedScape on June 12 and Dr Challacombe’s June ’20 paper presented  at the Royal Society of Medicine both suggest an oxidising mouthwash can reduce microbial load, which in turn could possibly halt the spread of Covid 19.

Ideally, a dental mouthwash should be potently antimicrobial yet safe and gentle on teeth, gums and the oral mucosa.

It should require a short contact time to make it convenient to rinse but allowing sufficient time to kill the target bacteria or virus.

Many types of mouthwash are available with a variety of active ingredients.

For instance, Fluoride is used for caries prevention and Chlorhexidine to help in the management of periodontal diseases.

Unfortunately, these popular mouthwashes do not target viruses that are the focus of the move towards a pre-treatment rinse for dental patients to reduce the risk of aerosol-generating procedures.

OraWize+ is an oxidising mouthwash – the oxidative action of its active ingredient – Hypochlorous acid, is potently antibacterial and anti-viral.

This physical degradation of bacteria and viruses means that there is no risk of bacterial resistance developing from the widespread use of OraWize+.

Many types of mouthwash also contain a variety of preservatives or carrier substances.

There is a great deal of concern over the level of alcohol in some mouthwashes. Some common brands contain over 20% alcohol.

Alcohol is a known carcinogen, and repeated use of alcohol-containing mouthwashes has been shown to have the potential to increase the risk of oropharyngeal cancer.

Other components found in mouthwashes include Benzoic acid, parabens, palm oil, surfactants, sodium phosphate, glycerine and artificial sweeteners.

Most of these products are “GRAS” – generally accepted as safe but their environmental impact and potential effects on health are a concern for many patients.

Patients may be alarmed to find out that a very common mouthwash contains Nonoxynol-9 which is primarily used in contraceptive gels! While not a risk to health, it may lead to some difficult questions in the surgery!

OraWize + is free from any preservatives or additives.

Other issues with mouthwashes include their pH and the risk of enamel or dentine erosion with repeated use. OraWize+ has a neutral pH and is tooth safe.

As dentists start to provide pre-treatment mouthwashes to large numbers of patients, it will be essential to recognise potential allergy risks or adverse reactions to other drugs the patient may be taking.

For instance, Povidone-Iodine should not be used by children or patients who are pregnant or breastfeeding or have a known allergy to Iodine. Patients with thyroid problems and those taking Lithium-based medicines should also avoid Iodine.

OraWize+ has no known drug interactions and is safe to use in pregnancy.

If we are asking patients to gargle with antimicrobial mouthwashes, the risk of accidental ingestion or inhalation is ever-present.

Some mouthwashes recommended as a pre-treatment rinse should not be ingested.

For instance, Hydrogen peroxide can cause tissue burns and vomiting if ingested. It is also a respiratory irritant, so it may not be sensible to use during the current pandemic.

 Measures should be put in place to ensure that patients and staff do not splash hydrogen peroxide into their eyes when rinsing or gargling.

OraWize+ is also the ideal solution for irrigation during dental procedures. Being non cytotoxic shows it can be used as a safer alternative to bleach during treatments like endodontics. Studies show that it is as effective against endodontic pathogens as bleach but infinitely safer. Delivered via and irrigating syringe it can provide a low volume irrigant as an adjunct to hand scaling and can be used to gently irrigate periodontal pockets, dry sockets and surgical sites.

OraWize+ is biocompatible: as such it’s active ingredient will rapidly break down into a saline solution if ingested. OraWize+ is potently antimicrobial yet safe to rinse, tooth and tissue friendly and contains no additives that could be harmful to patients or the environment.

In summary, OraWize+ is:

  • proven to be as effective as hypochlorite when used as a dental irrigant;
  • tested to stringent European standards including BS EN 14476
  • pH neutral so will not cause dentine or enamel erosion;
  • pre-mixed, ready to use before, during and after treatment.
  • free from acrid taste and unpleasant odour.

 

Dental practices can purchase OraWize + in 5L, 1L and 250ml bottles from

360 Dental, Denka, Trigiene Dental, The Dental Directory, Aroschem, Next Dental and direct from the CleanCert website

 

References:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5986684/

https://www.endoexperience.com/documents/NaOCl-safeuseetcBritDentJ2007.pdf

https://www.sciencedirect.com/science/article/pii/S1045105620300233

The Guideline for the Diagnosis and Treatment of Novel Coronavirus Pneumonia (the 5th edition)

 

About the author

Jason Bedford BDS is a specialist endodontist who works at 3 practices around the West Midlands. He also acts as a clinical consultant for CleanCert Innovations LTD, a company operating at the forefront of clinical infection control for over 10-years. He used to be Clinical Director at The Dental Directory and Dentex corporate groups.

The active ingredient in CleanCert products is stabilised Hypochlorous acid (HOCl), a potent natural biocide proven effective against a wide range of pathogens.

If you’d like to learn more about how CleanCert Innovations is easing the pressure on dental practices, please call our customer helpline on:
08443 511115 or Email: Technical@CleanCert.co.uk

If you are looking to purchase OptiZil  hand sanitizer and hard surface disinfectant, OraWize+ oxidising mouthwash, or CleanCert biofilm remover, you can buy the products from 360 dental, Trigiene Dental, Denka, Aroschem, The Dental Directory and direct from the CleanCert website:

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