3.3 (Non-proprietary) Lozenges and sprays

Chlorhexidine 12.3.3 (Non-proprietary) Lozenges and sprays

Mouthwash , chlorhexidine gluconate 0.2%, net price 300 mL = £1.97

There is no convincing evidence that antiseptic Dose oral hygiene and plaque inhibition, oral candidiasis, gin- lozenges and sprays have a beneficial action and they

givitis, and management of aphthous ulcers, rinse mouth with sometimes irritate and cause sore tongue and sore lips.

10 mL for about 1 minute twice daily Some of these preparations also contain local anaes-

Denture stomatitis, cleanse and soak dentures in mouthwash thetics which relieve pain but may cause sensitisation.

solution for 15 minutes twice daily Dental prescribing on NHS Chlorhexidine Mouthwash may be prescribed

Chlorohex 12.3.4 c Mouthwashes, gargles, (Colgate-Palmolive)

Chlorohex 1200 c mouthwash and dentifrices , chlorhexidine

gluconate 0.12% (mint-flavoured). Net price 300 mL = £2.00

Superficial infections of the mouth are often helped by Dose oral hygiene and plaque inhibition, rinse mouth with 15 mL warm mouthwashes which have a mechanical cleansing

for about 30 seconds twice daily effect and cause some local hyperaemia. However, to be

effective, they must be used frequently and vigorously. A Corsodyl c (GSK Consumer Healthcare)

, chlorhexidine gluconate 1%. Net price warm saline mouthwash is ideal and can be prepared

Dental gel

50 g = £1.21

either by dissolving half a teaspoonful of salt in a glassful Dose oral hygiene and plaque inhibition and gingivitis, brush on of warm water or by diluting compound sodium chlor-

the teeth once or twice daily ide mouthwash with an equal volume of warm water.

Oral candidiasis and management of aphthous ulcers, apply to Mouthwash solution-tablets are used to remove

affected areas once or twice daily unpleasant tastes.

Dental prescribing on NHS May be prescribed as Chlor- hexidine Gluconate Gel 1%

Mouthwashes containing an oxidising agent, such as hydrogen peroxide, may be useful in the treatment of

Mouthwash , chlorhexidine gluconate 0.2%. Net price acute ulcerative gingivitis (Vincent’s infection) since the

300 mL (original or mint) = £1.93, 600 mL (mint) = organisms involved are anaerobes. It also has a mechan-

Dose ical cleansing effect arising from frothing when in con- oral hygiene and plaque inhibition, oral candidiasis, gin- givitis, and management of aphthous ulcers, rinse mouth with tact with oral debris.

10 mL for about 1 minute twice daily Chlorhexidine is an effective antiseptic which has the

Denture stomatitis, cleanse and soak dentures in mouthwash advantage of inhibiting plaque formation on the teeth. It solution for 15 minutes twice daily

Oral spray , chlorhexidine gluconate 0.2% (mint-fla- rynx does not, however, completely control plaque deposi- tion and is not a substitute for effective toothbrushing. voured). Net price 60 mL = £4.10 Moreover, chlorhexidine preparations do not penetrate

Dose oral hygiene and plaque inhibition, oral candidiasis, gin-

or significantly into stagnation areas and are therefore of

opha

givitis, and management of aphthous ulcers, apply as required to

tooth, gingival, or ulcer surfaces using up to 12 actuations little value in the control of dental caries or of period-

(approx. 0.14 mL/actuation) twice daily

and ontal disease once pocketing has developed. Chlorhexi- Dental prescribing on NHS May be prescribed as Chlor- dine mouthwash is used in the treatment of denture

e, hexidine Oral Spray

stomatitis. It is also used in the prevention of oral nos candidiasis in immunocompromised patients. Chlor-

With chlorobutanol

, hexidine mouthwash reduces the incidence of alveolar Eludril c (Fabre)

Ear osteitis following tooth extraction. Chlorhexidine Mouthwash or gargle, chlorhexidine gluconate 0.1%, mouthwash should not be used for the prevention of

chlorobutanol 0.5% (mint-flavoured), net price 90 mL

12 endocarditis in patients undergoing dental procedures.

= £1.36, 250 mL = £2.83, 500 mL = £5.06 Chlorhexidine can be used as a mouthwash, spray or gel

Dose oral hygiene and plaque inhibition, use 10–15 mL (diluted for secondary infection in mucosal ulceration and for with warm water in measuring cup provided) 2–3 times daily Denture disinfection, soak previously cleansed dentures in controlling gingivitis, as an adjunct to other oral hygiene

mouthwash (diluted with 2 volumes of water) for 60 minutes measures. These preparations may also be used instead

of toothbrushing where there is a painful periodontal condition (e.g. primary herpetic stomatitis) or if the patient has a haemorrhagic disorder, or is disabled.

HEXETIDINE

Chlorhexidine preparations are of little value in the Indications oral hygiene control of acute necrotising ulcerative gingivitis.

Side-effects local irritation; very rarely taste distur- There is no convincing evidence that gargles are effec-

bance and transient anaesthesia tive.

Oraldene c (McNeil)

Mouthwash CHLORHEXIDINE GLUCONATE or gargle, red or blue-green (mint-fla-

voured), hexetidine 0.1%. Net price 100 mL = £1.31; Indications see under preparations below

200 mL = £2.02

Side-effects mucosal irritation (if desquamation Dose ADULT and CHILD over 6 years, use 15 mL undiluted 2–3 occurs, discontinue treatment or dilute mouthwash

times daily

with an equal volume of water); taste disturbance; reversible brown staining of teeth, and of silicate or composite restorations; tongue discoloration; parotid

HYDROGEN PEROXIDE

gland swelling reported Note

Chlorhexidine gluconate may be incompatible with Indications oral hygiene, see notes above

some ingredients in toothpaste; leave an interval of at least Side-effects hypertrophy of papillae of tongue on 30 minutes between using mouthwash and toothpaste

prolonged used

BNF 57

12.3.5 Treatment of dry mouth 613

Hydrogen Peroxide Mouthwash, BP

ACBS approval for dry mouth associated only with Mouthwash , consists of Hydrogen Peroxide Solution

radiotherapy or sicca syndrome. Salivix c pastilles, which 6% (= approx. 20 volume) BP

act locally as salivary stimulants, are also available and Dose rinse the mouth for 2–3 minutes with 15 mL diluted in half

have similar ACBS approval. SST tablets may be a tumblerful of warm water 2–3 times daily

prescribed for dry mouth in patients with salivary Dental

Mouthwash may be prescribed c gland impairment (and patent salivary ducts). Salinum

prescribing on NHS Hydrogen

Peroxide

may also be prescribed for relief of symptoms of dry (Colgate-Palmolive)

Peroxyl c

mouth.

Mouthwash , hydrogen peroxide 1.5%, net price 300 mL = £2.95

Pilocarpine tablets are licensed for the treatment of Dose rinse the mouth with 10 mL for about 1 minute up to 4

xerostomia following irradiation for head and neck times daily (after meals and at bedtime)

cancer and for dry mouth and dry eyes (xerophthalmia) in Sjo¨gren’s syndrome. They are effective only in