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Antibacterial mouthwash is often prescribed by dentists to reduce microbes in the mouth that cause gingivitis, a common gum disease. A non-prescription version uses high amounts of alcohol instead of antibiotics and has more an antiseptic effect. While most of these oral drugs are safe, side effects can occur. Antiseptic non-prescription rinses are available for those without serious conditions who wish to avoid alcohol.
Most people use mouthwash for halitosis, or bad breath, caused mostly by the action of bacteria on plaque deposits or particles. They release sulfur compounds that cause an unpleasant odor. Halitosis can also be the result of a very dry mouth, smoking, or health conditions such as diabetes and respiratory diseases. People with persistent halitosis should see a doctor to make sure an underlying problem can be treated.
For more serious conditions like gingivitis, dentists may prescribe antibacterial mouthwash along with a regimen of improved oral hygiene. These rinses may contain tetracycline, an antibiotic to kill the bacteria, hexetidine which reduces irritation and bleeding, and sometimes an anesthetic agent for pain. Nystatin is an antifungal that is often prescribed for Candida, a yeast organism that causes thrush.
Chlorhexidine gluconate, an antiseptic in both antibacterial mouthwash and the non-prescription type, has been found to inhibit the growth of plaque germs. The results only last a few hours. An antiseptic rinse should supplement good oral hygiene, such as regular brushing and flossing, not replace it. Regular care will help reduce the instance of halitosis that is not caused by another health condition. Antibacterial mouthwash containing antibiotic agents is rarely needed, however, to treat the more common causes of bad breath.
Many non-prescription mouthwashes contain alcohol that does kill germs but dries out mucous membranes in the mouth. Some scientists believe alcoholic mouthwash contributes to oral cancer, as higher than average rates are seen in chronic drinkers. It is known that chronic alcoholics sometimes abuse mouthwash when alcohol in another form is unavailable and may ingest more than the average user. As of 2011, a definitive link between the use of high-alcohol mouthwash and oral cancer has not been proven.
Antibacterial mouthwash can have the same side effects as an oral medication in pill form. Some people are allergic to tetracycline and other antibiotics. They can experience a serious reaction with swelling in the face and throat and breathing problems. Chlorhexidine has been known to stain teeth with prolonged use. Patients may also have an upset stomach, diarrhea and a bad taste in the mouth.
If patients don't need an antibacterial mouthwash, there are alternatives to alcohol-based antiseptics. Herbal preparations available in health food stores contain herbs or Xylitol®, a natural sweetener with a lower glycemic index than sugar. Many people swear by a solution of one teaspoon of salt in one cup of warm water as an economical and effective rinse to treat a sore throat or mild mouth injuries and infections. Dentists can also recommend safe alcohol-free preparations for children.