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Oral hygiene maintenance is very important for people suffering from gum disease. The use of the right mouthwash can help patients prevent the occurrence, spread, or relapse of gum disease. We help you choose the right one.

Periodontitis, or pyorrhea as it is commonly called, is a chronic disease of the gums. It involves the slow destruction of the supporting structures of the teeth. These structures include the bone around the teeth, the ligament which binds the tooth to its socket, the gums, and the layer covering the root [1].

The end result of the progress of gum disease is bleeding from the gums, an appearance of spaces in between the teeth, teeth becoming shaky, and eventually falling out [2]. Pain is not one of the symptoms that are directly related to gum disease and that is why most cases are diagnosed when the patient goes to the dentist for bleeding gums treatment.

The only way to prevent gum disease from occurring or progressing is to practice excellent oral hygiene. For people that have been diagnosed with periodontitis or have received treatment for it, maintenance of oral hygiene becomes even more important and a mouthwash plays a very important role in that.

Best mouthwash for people with gum disease

There are a number of mouthwashes that are available over the counter, most of which claim to be the best and revolutionary in their action. It will not surprise people that most of these claims are marketing gibberish that is trying to sell you the same thing.

That does not mean that the mouthwashes are not good for oral health, though.

The active ingredient in mouthwashes can vary as per their intended use. For gum disease, the gold standard is chlorhexidine, a molecule that has been around for a long time and has shown no signs of being displaced from its position as the best option of helping maintain gum health [3].

Most mouthwashes sold around the world for the purpose of improving gum health have chlorhexidine. The percentage of the active ingredient may vary (0.2% or 0.12%) but no difference in the benefit has been reported within this range [3].

Advantages of chlorhexidine use in gum disease

There are several unique properties which make chlorhexidine the wonder molecule it is. The first is that it is the only molecule which binds to the tooth surface and continues to keep working for about 12 hours after it has been used [4].

Used in the correct concentration, chlorhexidine both destroys the disease-causing bacteria inside the mouth and prevents the colonization of the teeth with further populations. This property makes it perfect for people that are suffering from gum disease as well as those that want to prevent it from progressing further [5].

Chlorhexidine has been around for a long time and has been extensively studied. Mouthwashes that contain this molecule reduce bleeding from the gums, reduce the accumulation of plaque on the surface of the teeth, help maintain gum health in patients that are suffering from gum disease, and help reduce the risk of progression of gum disease [6].

There is enough evidence to definitively say that chlorhexidine containing mouthwashes are the best kind available right now and form an important part in the non-surgical treatment of gum disease.

Disadvantages of chlorhexidine

There are some drawbacks to the use of chlorhexidine as well. The first is the taste. Mouthwashes that contain chlorhexidine are not the most pleasant to taste. A lot of people find the taste difficult to tolerate and thus end up diluting the solution with water which essentially makes it useless [7].

Chlorhexidine also causes stains on the teeth. This is, in fact, the biggest reason why the molecule is not used more commonly in dental hygiene products. For patients that have healthy teeth and gums, using chlorhexidine may not be worth the stains that it causes but for people suffering from gum disease, it should be a no-brainer [8].

Regular scaling will help remove the stains from teeth anyway.

The last disadvantage of long-term chlorhexidine is the alteration in the taste sensation that occurs in some people. Evidence has shown that stopping chlorhexidine use can help reverse these effects but it is obviously something that can affect the quality of life in the long run [9].

How to use chlorhexidine mouthwash?

The mechanism of action of chlorhexidine is such that it needs to be used on clean surfaces. That means the ideal time to use it is immediately after brushing so that the active molecule can bind to as much of the tooth surface as possible [10].

If you are someone that has really poor oral hygiene then getting a scaling before starting chlorhexidine use is recommended. The mouthwash is going to be quite ineffective if the teeth are caked with plaque and tartar.

Chlorhexidine-containing mouthwashes should also always be used undiluted. The active ingredient is already present in the concentration that it functions best at and further dilution is going to reduce its efficiency markedly.

 Most dentists recommend a 30-second rinse after brushing and then spitting out the solution. There is no problem in eating or drinking after having used the mouthwash.

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