Mouthwashes are an integral part of our daily hygiene routines and the fight against certain diseases for most of us. While some mouthwashes are mainly made to serve cosmetic purposes, some of them, what we know as therapeutic mouthwashes, provide an effective fight against diseases with the medical agents they contain. Chlorhexidine mouthwash is one of them. It is a mouthwash recommended by doctors, especially for the treatment of various gum diseases.
Now, we will examine with you what chlorhexidine mouthwash is, how it is used, and how it works.
What is chlorhexidine mouthwash?
Chlorhexidine is a germicidal agent used against bacteria and fungi. It is invented in the 40s and it has never used as a mouthwash in those early times. It was used as a disinfectant for skin and open wounds. It is a very strong germicidal that kills almost 100% of bacteria in vitro, which means when it is tested under laboratory conditions.
It is provenly an effective agent killing the microbes living and multiplying on the surfaces. In our time, it is commonly used for the treatment of gingivitis, ulcers, and mouth infections in the form of mouthwash. Let’s dive into the details together everything about chlorhexidine mouthwash!
How does this germicidal agent work?
Since chlorhexidine is a strong germicidal agent, when it touches with germs, it destroys their cellular membrane*. Under that layer, there are organelles in a liquid called cytoplasm. With the destruction of this membrane, they disperse. So, its higher concentrations destroy bacteria that way. In lesser concentrations, it can show bacteriostatic effects. This means it prevents bacteria from growing and multiplying.
How to use chlorhexidine mouthwash?
You need to take the recommended amount and rinse with it. It is generally prescribed in dosages like these depending on your situation:
For ulcers and oral hygiene problems:
- Rinse twice a day with 10 ml of %0.2 solution, for about 1 minute, or soak your dentures in solution for about 15 minutes.
For treatment of gingivitis:
- Rinse twice a day with 5 ml of %0.12 solution for about 30 seconds.
- Rinse twice a day with 10 ml of %0.2 solutions for about 1 minute.
Of course, you have to ask your doctor about dosage. It’s important to use the correct amount, neither much nor less than the required, appropriate for your own situation. Other than that, you should spit it out and never swallow it. It is not recommended to brush your teeth or rinse your mouth with water after use. It’s better to keep it in your mouth for a while for maximum effect. If you have to brush, it’s better to brush before using it.
Is chlorhexidine mouthwash safe?
Yes, chlorhexidine mouthwash is safe, if you follow the instructions and your doctor’s advice. This is valid for the majority of medicines. If you overdose or overuse you can get harm from it. However, although rare, sometimes allergic reactions and unexpected side effects can be observed. If you encounter these, you should stop using them and consult your doctor immediately. Other than these situations, chlorhexidine mouthwash is safe to use.
Are there any side effects?
Like the majority of medical products, chlorhexidine mouthwashes also have side effects. Some of the chlorhexidine side effects are the effects of strong antimicrobials.
This kind of strong germicide destroys all the bacteria indiscriminately, consequently, it can harm the microbial balance in your mouth. If you destroy them, some bad bacteria can more easily accumulate in your mouth and this can cause various problems from infections to plaque build-up. So, some of the side effects are related to this, and some others can be allergic reactions to chlorhexidine mouthwash.
We can group these side effects into two groups according to their frequency of occurrence:
|Common side effects||Rare side effects|
|Periodontitis||Mouth or Tongue tip irritation|
|Yellow teeth||Swollen or itching tongue|
|Change in taste||Severe dizziness|
|Increased plaque and tartar buildup||Rash on skin or mouth|
|Dry mouth||Breathing difficulties|
What is chlorhexidine mouthwash used for?
It is largely used for the treatment of gingivitis. It is effective in reducing the symptoms of gingivitis, such as gingival bleeding, and gingival swelling. It kills the germs that cause problems and turns your mouth into an unsuitable environment for them. Thanks to these effects, it is a very effective medicine in treating many oral diseases. Let’s explore them in detail.
After tooth extraction: Researches show that chlorhexidine mouthwash is effective in preventing dry socket. You should start using it after 24 hours in order to prevent the blood clot to prolapse.
For inflammations: If you’re experiencing any gum problems related to wisdom teeth, like inflammation or gum infections, chlorhexidine mouthwash can help you.
After wisdom teeth removal: Just like we said in tooth extraction, it is safe and effective against possible infections that can occur in the area as well as osteitis.
After oral surgery: Again, it can prevent any infections to occur in the area of surgery.
For thrush: Besides it is an antibacterial mouthwash, it is also an antifungal agent. So it is quite effective against fungal infections.
For mouth ulcers: It makes the healing process quicker and also prevents mouth ulcers get infected.
For canker sores: Chlorhexidine can make canker sores heal quicker and it also can reduce pain.
When to use chlorhexidine mouthwash?
In order to maximize its effectiveness, it is important to know when to use chlorhexidine mouthwash.
First of all, it’s better to use it after brushing your teeth, not before. You may wonder why? Because chlorhexidine needs to stay in your mouth for a while to have maximum effect. Brushing your teeth or gargling with water after use will reduce the effect.
Also, if you apply your mouthwash to a clean mouth, it can affect more areas more easily because there is no food debris and similar things to cover your mouth.
How long should I use chlorhexidine mouthwash?
It depends on your situation. For gum disease, it is generally used for several weeks, after that it starts to cause staining and plaque.
For mouth ulcers, you have to use it until two days after your symptoms are gone. It’s always best to consult with a professional. They can advise you about the best usage for your own situation.
Can I use chlorhexidine mouthwash every day?
No. It is not recommended for daily use, as it may make things worse. It can be used for up to four weeks under the supervision of a doctor in patients with severe gum disease. However, if it is used longer than this time, it may cause problems such as yellowing of the teeth and plaque formation. Plaque and tartar formation is one of the main causes of gingival disorders. Therefore, you can create a backfire while trying to treat your gum disease.
Tips on chlorhexidine mouthwash usage
There are some types that will increase the effect if you pay attention while applying the Mouthwash. We have mentioned some of them before. We can summarize them as follows, all to better kill bacteria:
- Don’t dilute it with water
- Don’t rinse your mouth with water after use
- Don’t brush your teeth after use
- Don’t eat after using it at least for half an hour
- It can’t replace your oral hygiene habits so keep brushing and flossing
- Follow the instructions given by your doctor, and don’t overuse them.
-Bescos R, Ashworth A, Cutler C, Brookes ZL, Belfield L, Rodiles A, Casas-Agustench P, Farnham G, Liddle L, Burleigh M, White D, Easton C, Hickson M. Effects of Chlorhexidine mouthwash on the oral microbiome. Sci Rep. 2020 Mar 24;10(1):5254. doi: 10.1038/s41598-020-61912-4. PMID: 32210245; PMCID: PMC7093448. Link
Poppolo Deus F, Ouanounou A. Chlorhexidine in Dentistry: Pharmacology, Uses, and Adverse Effects. Int Dent J. 2022 Jun;72(3):269-277. doi: 10.1016/j.identj.2022.01.005. Epub 2022 Mar 12. PMID: 35287956; PMCID: PMC9275362. Link
Halabi D, Escobar J, Alvarado C, Martinez N, Muñoz C. Chlorhexidine for prevention of alveolar osteitis: a randomised clinical trial. J Appl Oral Sci. 2018;26:e20170245. doi: 10.1590/1678-7757-2017-0245. Epub 2018 May 7. PMID: 29742264; PMCID: PMC5933829. Link