Importance of mouth rinse as an adjunct to brushing and flossing/interdental cleaning
The oral health of individual patients is the result of the interplay between a number of “dental behaviours” including dental office attendance, dietary habits and oral hygiene practices.
For decades Clinical Dentistry has recognized the fundamental role that oral hygiene plays in the effective and continued management of oral diseases between dental visits. Therefore the role of daily plaque removal by brushing and flossing/interdental cleaning is universally and routinely emphasized by Dental Professionals as an integral part of patient education during regular dental visits.
Brushing and flossing alone, in the absence of rinsing with antiplaque agents, can in theory control plaque growth purely by mechanical removal action on the accumulated plaque. However in reality many patients do not achieve the desired professional goal of an adequate and consistent control of dental plaque.
Experts in self-performed oral hygiene outcomes have indicated that the goal of effective plaque control can rarely be achieved solely by recommending mechanical means, since these rely heavily on the user training, motivation and manual dexterity.
Evidence from a systematic review shows that on average, only 42% of accumulated plaque is actually removed from teeth during a single brushing event.1
After more than 40 years of clinical research into the effects of antiplaque agents, there is now sufficient evidence supporting the use of adjunctive antibacterial mouth rinses, such as chlorhexidine and essential oil based mouth rinses, to significantly improve gingival health beyond what can be achieved with unsupervised use of mechanical cleaning means alone.2–6
Today up to 69% of your patients are not currently adding a mouth rinse to their oral care routine.7 Could they benefit from a third step to their oral hygiene routine?
Within the context of mechanical plaque removal, there are a number of oral hygiene and health issues that the use of a mouth rinse can potentially help to address.
Although Dental Professionals routinely advise patients on good oral care habits, this advice is not always followed as it should be. Patients are often advised to brush for a certain length of time, however the patient’s perception of the length of time spent brushing is not always accurate.1
References
1. Slot DE et al. The efficacy of manual toothbrushes following a brushing exercise: a systematic review. Int J Dent Hygiene 2012; 10: 187–197.
2. Gunsolley JC. A meta-analysis of six-month studies of antiplaque and antigingivitis agents. J Am Dent Assoc 2006; 137(12): 1649–1657.
Stoeken JE et al. The long-term effect of a mouthrinse containing essential oils on dental plaque and gingivitis: a systematic review. J Periodontol 2007; 78(7): 1218–1228.
3. Van Leeuwen et al. Essential oils compared to chlorhexidine with respect to plaque and parameters of gingival inflammation: a systematic review. J Periodontol 2011; 82(2): 174–194.
4. Van Strydonck et al. Effect of a chlorhexidine mouthrinse on plaque, gingival inflammation and staining in gingivitis patients: a systematic review. J Periodontol 2012; 39(11): 1042–1055.
5. Boyle P et al. Quantitative review of mouthwash and prevention of plaque and gingivitis. IADR General Session March 22, 2013, Seattle, USA. Abstract 2492.
6. NHS The Health and Social Care Information Centre. 5: Preventive behaviour and risks to oral health - a report from the Adult Dental Health Survey 2009. 2011.
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