Consensus statement¹

Rinsing with water after brushing with fluoride toothpaste can reduce the benefit of fluoride toothpaste.

There is a theoretical benefit in keeping the intra-oral levels of fluoride elevated by replacing a post-brushing water rinse with a fluoride rinse.

Non-fluoride rinses should preferably be used before brushing or at a different time to brushing with fluoride toothpaste.

Mouth rinses containing fluoride can be used after brushing with fluoride toothpaste.

For the general population, including children aged 12 years and above:

• Brush twice daily with a fluoride toothpaste; do not rinse excessively with water; use one of the three recognised post-brushing approaches to enhance fluoride retention

For children at high risk of caries:

• Rinsing should be supervised until an age where parents/carers are confident that children will not drink the rinse
• Mouth rinses should not be used before the age of 6 years. (However, studies in Japan have indicated that 4–5-year-olds can rinse under supervision. In addition, children with newly erupting teeth may gain a long-term benefit from using mouth rinses)
• Use 10 ml twice daily of mouth rinse up to 100 ppm fluoride, or 10 ml once daily of mouth rinse up to 226 ppm fluoride
• Avoid the risk of approaching the lethal dose of fluoride by using an appropriate bottle size

The panel also encouraged future research with a range of mouth rinse products to explore the effects of the interplay between the frequency of use of mouth rinse agents and fluoride concentration.

Adapted from Pitts et al. 2012. The consensus statement also included a population-based approach to dental health, and the use of a slurry of toothpaste and water post-brushing; not discussed here.

References

1. Pitts N et al. Post-brushing rinsing for the control of dental caries: exploration of the available evidence to establish what advice we should give our patients. Br Dent J 2012; 212(7): 315–320.