What is a mouthwash
When we talk about oral hygiene to clients its necessary to provide them with evidenced based information, which will make the hygienist not only appear professional but competent as well. The oral self care education should begin with plaque control which can be managed with the many dental products available in the market today, some of which have shown to be significantly effective. Such examples of those are antimicrobial mouth rinses. Considering the fact that 80% of bacterial plaque is located on the oral mucosa, antimicrobial mouth rinses prove to be useful in maintaining a healthy environment within the oral cavity.
Plaque is considered a bacterial biofilm that is organized in colonies creating an independent surviving system that makes it impossible for the immune system to fight and destroy. Plaque consists of different types of microbial flora that interact with each other to create what is called biofilm. Plaque maturation is associated with poor oral hygiene, compromised immune system, and lack of capability to perform oral self care among other things.
Quantity of plaque is the number one factor to determine the aggressiveness of periodontal disease development. There are two different types of microorganisms that populate plaque biofilm: gram negative and gram positive. Gram negative bacteria are significantly found in large numbers at periodontal disease sites. They live in anaerobic ( not needing oxygen ) environment and are proven to be an important factor in periodontitis development. The quantity of gram negative bacteria depends largely on what stage of plaque formation and the location where plaque is accumulated.
Many of you would ask how micro bacterial mouth rinse products can effect reduction of plaque biofilm and how they exactly work? Mouth rinses contain chemical products like phenolic compounds that interfere with bacteria by destroying their membrane layer preventing their metabolic system to develop. Phenolic compounds include oils from plants (eucalyptol menthol) that contain antiseptic properties. These oils are found in almost every mouth rinse product.
Many surveys not only in USA but Europe as well indicate that there are a considerable large number of people that do not use the appropriate oral self care aids to mechanically control plaque leading them to gingivitis or periodontitis, therefore the need for micro bacterial mouth rinses is absolutely necessary to prevent the advancement of periodontal disease. We have to understand that it is not enough to mechanically remove plaque from the tooth surfaces through daily brushing or flossing, but the oral mucosa (especially tongue) as well. Mouth rinses have numerous advantages in maintaining good control of the plaque biofilm. For example some areas that might be missed during regular brushing are not visible, so using a mouthwash rinse will help decrease the possibility of any acid attack that could be caused but the remains of food debris.
Conclusion
Despite these benefits we as dental professionals should keep in mind that clinically speaking there is no existing proves to show that any antimicrobial mouthrinse product is efficient in destroying subgingival bacteria (especially gram negative). This is due to incapability of the rinse to penetrate subgingivally. In conclusion I would like to stress the point made by the Canadian Dental Hygiene Association that we as Dental Hygienists must focus our attention on the information provided with every mouth rinse product and keep ourselves up to date with the information provided by many researches worldwide in order to provide good quality care for the patients.
