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Chlorhexidine : Changing the Mouthwash Game

  • July 7, 2020
Chlorhexidine : Changing the Mouthwash Game 2

Whether it is to refresh your breath after a garlic-ridden meal, or as a part of your daily morning routine, we have all felt the need to use chlorhexidine ormouthwash at least once in our lives. Although mouthwash has been around for a long period of time, it’s integration into our everyday lives has been a part of only about a few decades in total. Mouthwashes help you achieve that minty fresh breath that you’ve been advertised by countless dental infomercials. But that’s not all! The proper use of mouthwash has earned its spot high on the top tiers of dental hygiene regimen in every dentist’s books. Today, a thorough swish-a-sloshing has been linked to numerous therapeutic benefits that target your overall health.

Brushing and flossing may give you a good dental clean-up but it is important that you engage in swilling mouth rinses that give your mouth that extra wall of protection. According to the American Dental Association (ADA), there is no one-fits-all kind of mouthwash- you need to be aware of the right mouthwash to use for optimal results.


Chlorhexidine gluconate is a chemical antiseptic, used in a 0.12 to 0.2% solution as a mouthwash to decrease bacteria and help relieve halitosis (bad mouth odor). It is a highly effective germicidal mouthwash with moderate anti-plaque and anti-fungal properties. It is usually adjudged as a prescription mouthwash, effective for the prevention, and further progression of gum disease and can only be prescribed by your dentist. It is most potent when used in adjunct to thorough brushing and flossing for optimal plaque control. The addition of CHX in mouthwash has been approved by the Council of Dental Therapeutics of the American Dental Association.

How does it work?

Chlorhexidine digluconate (CHX) mouthwash is a bactericidal ingredient that fatally damages bacteria in about 30 seconds. At physiologic pH, chlorhexidine salts dissociate and release positively charged CHX cations. As a result, the cationic molecule begins binding to the negatively charged bacterial cell walls, causing fatal leakage of their cytoplasm, and subsequent death. At low concentrations, chlorhexidine is bacteriostatic in nature. CHX is most effective against gram-negative rods that are responsible for gingivitis.

Chlorhexidine also forms a protective layer over the gums and teeth, helping to prevent plaque build-up for up to 12 hours. A study suggests that CHX helps reduce the proliferation of bacterial species associated with periodontal disease (gum disease), such as Enterobacteria, Porphyromonas gingivalis, Fusobacterium nucleatum, as well as a broad spectrum of bacterial species Actinomyces and Streptococcus, including Streptococcus mutans, which is considered the main etiological factor of dental caries. It is considered the gold standard against which other anti-plaque and gingivitis agents are measured.

When can you use it?

Chlorhexidine mouthwash is mostly indicated or prescribed:

  • For plaque-induced gingivitis
  • After a thorough tooth cleaning/scaling and root planing session
  • For immunocompromised people in the prevention of oral candidiasis (thrush)
  • For the treatment of denture-related stomatitis
  • To treat mucosal ulcerations, erosions, and lesions
  • For treating general burning sensation in the mouth
  • Before tooth extraction to lower the risk of dry socket

How do I use it?

Strictly follow the instructions given by your dentist or on your prescription label. Do not use chlorhexidine in quantities higher or lower or for longer than is recommended.

  • Rinse your mouth with chlorhexidine gluconate twice daily after brushing your teeth.
  • Measure your dose (about ½ ounce) using the cup provided with the medication. Swish the medicine in your mouth for at least 30 seconds, then spit it out. Do not swallow the mouthwash.
  • Do not dilute the oral rinse with water. Avoid rinsing your mouth with water or other mouthwashes right after using chlorhexidine gluconate.
  • After using chlorhexidine, wait for at least 30 minutes before rinsing your mouth with water, brushing your teeth, eating, or drinking.
  • The dosage is based on your medical and dental condition, so avoid sharing CHX with your peers even if they exhibit similar symptoms as you.
  • It may take up to 6 weeks for results to show up.

What are the potential risks?

Chlorhexidine use may cause some of these side-effects:

  • Staining: Chlorhexidine readily binds to hard and soft tissues in the mouth. With the consumption of excessive caffeine or other deeply-pigmented foods, CHX binds to tannins and may cause brownish stains on the teeth, tongue, and existing tooth fillings. While it is easy to get rid of these stains with a thorough cleaning, you may not be prescribed chlorhexidine if you have a lot of anterior white fillings.
  • Alteration in taste: Some people may also experience taste disturbance or alteration with the use of chlorhexidine.
  • Tartar formation: Occasionally, chlorhexidine use can counterintuitively increase tartar build-up.
  • Other side-effects: You may also experience irritated throat, dry mouth, burning sensation, or itchiness. Contact your doctor if you exhibit these symptoms.

Common brand names

Chlorhexidine is available in the U.S. under different brand names such as:

  • Paroex (GUM)
  • Peridex (3M)
  • PerioGard (Colgate)
  • Hibiclens

How much does it cost?

The lowest cost of common chlorhexidine mouthwash comes around $5.69, 60% off the average retail price of $14.49.

The American Academy of Dentistry (ADA) affirms that a mouth rinse is not to be used as a substitute for brushing and flossing, instead, in conjunction with them. Look for a mouthwash that has the ADA Seal of Acceptance on its packaging as it confirms that the product has been deemed safe and effective to use.

Numerous studies conducted in favor of the importance of oral health dictate that there is a well-established link between your oral health and your general health. In fact, the Academy of General Dentistry (AGD) affirms that about 90% of all systemic conditions manifest symptoms in the mouth in the form of oral disease. It is important to take care of your oral health for your overall health. With the right mouthwash, you will be one step closer to achieving a healthy mouth and set stunning pearly whites that you have always wanted!

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