Chlorhexidine Mouthwash – What it is and What it is Not

As your Fort Collins pediatric dentist I thought it important to discuss the current topic of Chlorhexidine in mouthwash. With the recent interest in oral health during pregnancy and infant oral health, Chlorhexidine Mouthwash has received a lot of interest in the dental and medical communities. So what is this stuff and should my family be using it?

Chlorhexidine, or more specifically, 0.12% Chlorhexidine Gluconate is a very large aromatic salt that has antimicrobial properties. In other words it kills bacteria and other microorganisms. It is found in soap, water line cleaners and a host of other products, but it is also available in a prescription mouth wash. The mouthwash contains Chlorhexidine, 11% alcohol, and a sweetener and goes by the brand names of Peridex, Periogard or DentiCare. The rinse is somewhat unique in that about 30% of the rinse sticks to the soft tissues of the mouth and is released slowly into the saliva over time. This “substantivity” makes the rinse very effective at killing bacteria in the mouth and reducing counts for long periods of time. Studies show that rinsing with Chlorhexidine twice daily for two weeks will reduce bacteria counts in the mouth for 3 to 6 months!

A recent study of pregnant women showed that twice a day rinsing with good oral hygiene, reduced bacteria and carried over to show reduced cavity rates in their children. Chlorhexidine has some side effects but only with long term use; those may be staining of calculus and a metallic taste alteration that is temporary. It is best to use this product after a good dental cleaning, and since it is a prescription your dentist will need to write for it or sell you a bottle. Also, since Chlorhexidine is positively charged and fluoride toothpaste is negatively charged, you should use the rinse at least 30 min before or after brushing.

Who should use a Chlorhexidine rinse? For adults, especially expectant mothers, a short two week course can make a huge difference on caries control and gum inflammation. Of course, using the rinse after a discussion with your dentist is essential. For children, Chlorhexidine use is still off label, meaning its use has not been approved for pediatrics, but a large number of practitioners have used it for children as young as two years old. The latest research out of UCLA recommends a regimen of swabbing the rinse onto baby teeth once a day for a week and repeating every month for six months. After fillings, this is a great way to suppress bacterial growth and give the fluoride toothpaste a chance to remineralize weakened enamel. That’s the latest on Chlorhexidine.