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Patient Care III > Mouth Rinses > Flashcards

Mouth Rinses Flashcards

1
Q

Harmful to patient:

A

adverse affect

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2
Q

May be harmful, useful, or beneficial:

A

side effect

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3
Q

Ability of patient to follow through/motivation to use product

A

compliance

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4
Q

Ability of an agent to absorb to teeth and surfaces and be released at therapeutic levels:

A

substantivity

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5
Q

Pleasant taste/sensation, decrease microorganisms, halitosis control:

A

cosmetic

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6
Q

The quality of being successful in producing an intended result

A

efficacy

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7
Q

Cosmetic mouth rinses are available:

A

OTC

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8
Q

Therapeutic mouth rinses are available:

A

OTC or prescription

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9
Q

A mouth rinse that helps to enhance taste in mouth (i.e. minty fresh breath):

A

cosmetic mouth rinse

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10
Q

A mouth rinse that helps to reduce/control plaque, gingivitis, halitosis, caries, and xerostomia:

A

therapeutic mouth rinse

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11
Q

Describe the effects of a cosmetic mouth rinse on plaque/caries/xerostomia etc.

A

no real beneficial effects

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12
Q

List the purposes of mouth rinses: (5)

A
  1. flush out food debris from the oral cavity
  2. freshen breath
  3. deposit fluoride on teeth (if fluoridated)
  4. available in liquid form
  5. primarily cosmetic benefit (Freshening breath)
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13
Q

Why should you wait 30 minutes to eat or drink following use of mouth rinse?

A

if not, it will inactivate sodium hypochlorite

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14
Q

What was the traditional purpose for mouth rinse?

A

freshen breath

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15
Q

What contributes to halitosis?

A

bacteria and plaque accumulation on the tongue

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16
Q

____% of halitosis originates from the oral cavity; ____% from systemic or nonoral cause

A

90%; 10%

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17
Q

Describe the effect of mouth rinses on breath after 3-5 hours

A

no effect

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18
Q

Mouth rinses ___ odors/ provide little ___

A

“mask”; antibacterial function

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19
Q

What is the best treatment for bacteria and plaque accumulation on the tongue?

A

tongue scraping

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20
Q

List the active ingredients in mouth rinse: (8)

A
  1. sanguinarine
  2. amonium compounds
  3. phenolic compounds
  4. fluoride
  5. chlorhexidine
  6. stannous fluoride
  7. essential oils
  8. triclosan
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21
Q

Why are ammonium compounds added to mouth rinse? Give an example of one:

A

added to reduce bad breath; CPC

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22
Q

Describe the substantivity of the active ingredient “phenolic compounds” in mouth rinses:

A

low substantivity

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23
Q

What is the purpose of fluoride as an active ingredient in mouth rinses?

A

reduces incidence of caries

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24
Q

What is the purpose of chlorhexidine as an active ingredient in mouth rinses?

A

helps control plaque and gingivitis

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25
Q

What is the purpose of stannous fluoride as an active ingredient in mouth rinses?

A

helps control plaque and gingivitis

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26
Q

What is the purpose of essential oils as active ingredients in mouth rinses?

A

helps control plaque and gingivitis

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27
Q

What is the purpose of triclosan as an active ingredient in mouth rinses?

A

reduces production of plaque and gingivitis

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28
Q

What active ingredients of mouth rinses are beneficial and DO have chemotherapeutic effects?

A
  1. chlorhexidine
  2. stannous fluoride
  3. essential oils
  4. triclosan
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29
Q

What beneficial effects of chlorhexidine, stannous fluoride and essential oils?

A

chemotherapeutic effect against plaque/biofilm accumulation as they DECREASE the amount of free-floating planktonic bacteria

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30
Q

How do hlorhexidine, stannous fluoride and essential oils work to DECREASE the amount of free-floating planktonic bacteria?

A

By binding their positive ions to the bacteria’s negative ions resulting in cell lysis

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31
Q

Describe the mechanism of action of triclosan in mouth rinses:

A

chemical inhibitor of fatty acid synthesis which is required for lipid production in the bacteria, which in turn, eventually kills the cell

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32
Q

When biofilm forms, before it becomes an organized mass, it is composed of:

A

planktonic (free-floating) bacteria

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33
Q

Why might alcohol be incorporated as an ingredient in mouth rinses?

A

used as a solvent, taste enhancer, and agent providing aftertaste (burn)

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34
Q

What are the negative effects of alcohol used in a mouth rinse?

A
  1. burning mouth
  2. drying of oral tissues
  3. risk of oral cancer
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35
Q

What category of patients should NEVER be recommended an alcohol-based mouth rinse? Why?

A

previous/recovering alcoholics; could serve as a stumbling block

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36
Q

What are the levels of regulations for prescription and overt counter products (regarding mouth rinses):

A
  1. government level
  2. professional level
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37
Q

The government level of regulation to oral care products:

A

FDA

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38
Q

The professional level of regulation to oral care products:

A

ADA

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39
Q
  1. protects consumers from useless/harmful products
  2. therapeutic claims must have research to support claims
  3. evaluates prescription/ OTC products
A

Food and Drug Administration (FDA)

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40
Q

Council on Scientific affairs of the American dental association:

A

ADA (Professional level regulation)

41
Q
  1. voluntary program that companies pay into
  2. helps consumers “make wise choices”
  3. products submitted must have controlled studies to demonstrate effectiveness/safety of product
  4. seal is only found on consumer products
  5. new submission cost $14,500 to evaluate product; if approved, yearly fee of $3500 to mainitain
A

ADA

42
Q

The ADA seal is found on:

A

consumer products only

43
Q

What is required in order to turn in product to ADA for review?

A

controlled studies to demonstrate effectiveness/safety of product

44
Q

Does oral B products have ADA seal?

A

Yes

45
Q

Does sonicare products have ADA seal?

A

No- they don’t want to pay that fee

46
Q

Do we recommend based ONLY on ADA?

A

not necessarily- some products have evidence to support claims and do not have ADA seal (for example sonicare toothbrush)

47
Q

T/F: Toothpastes without fluoride do NOT have ADA seal

A

true (Which she says is crazy because plenty of beneficial tooth paste without fluoride that contain hydroxyapatite)

48
Q

What signifies if a listerine mouth rinse has NO alcohol present?

A

if product has “zero” in its name

49
Q

Describe what active ingredients are found in listerine mouth rinses:

A

dependent on product claim

50
Q

If listerine product claim is “gum health” or “tartar control” then the active ingredients are:

A

essential oils

51
Q

If listerine product claim is “cavity protection” then active ingredients are:

A

sodium fluoride (0.02%)

52
Q

How many different listerine products are listed on the website?

A

18

53
Q

Professor discussed this mouth rinse as a “good OTC option for patients with moderate risk for caries”

A

ACT mouth rinse

54
Q

How many different formulas of mouth rinse are provided by ACT? (ranging from basic mouthwash to kid’s formulated mouthwash and mouthwash for dry mouth)

A

6

55
Q

What is the active ingredient in ACT mouth rinse? (generic)

A

sodium fluoride (0.05%)

56
Q

What is the active ingredient in ACT Whitening Mouth wash?

A

sodium fluoride (0.02%) - note this is less than the other ACT mouth rinses

57
Q

Professor states that whitening mouth rinses:

A

do not actually work

58
Q

T/F: The crest website provides a comprehensive list of active and inactive ingredients.

A

False- crest website does NOT provide information defining active and inactive ingredients

59
Q

The Crest brand includes:

A

Scope brand

60
Q

Professor states that crest brand mouth rinses ____ more than any other brand:

A

stains teeth

61
Q

What type of mouth rinse would you recommend to a patient with mouth sores?

A

Colgate Peroxyl

62
Q

Colgate whitening mouth rinses typically utilize ____ as a whitening agent

A

hydrogen peroxide

63
Q

Why is Colgate peroxyl helpful for patients with mouth sores?

A

contains 1.5% hydrogen peroxide

64
Q

What is the active ingredient in Colgate ortho defense?

A

sodium fluoride (0.04%)

65
Q

What is the professors favorite mouth rinse due to to having a lot of active ingredients?

A

Closys

66
Q

What are the active ingredients in Closys mouth rinse?

A

CPC 0.75% OR sodium fluoride 0.05%

67
Q

What is the best over the counter option for a mouth rinse according to professor?

A

Closys

68
Q

Mouth rinses and sprays for xerostomia include:

A
  1. biotin mouth rinse
  2. oasis mouth rinse
  3. spry mouth spray
69
Q

If a patient presents with xerostomia, what mouth rinse/srpay might you recommend?

A
  1. biotin mouth rinse
  2. oasis mouth rinse
  3. spry mouth spray
70
Q

Spry mouth moisturizing spray for xerostomia, utilizes what ingredients?

A

xylitol and aloe

71
Q

How do mouth rinses and sprays for xerostomia function?

A

All are very viscous and coat the oral tissues to help alleviate dryness

72
Q

Considered the gold standard of mouth rinses and prescription only:

A

chlorhexidine gluconate

73
Q

Proved to me the most effect anti plaque oral rinse:

A

chlorhexidine gluconate

74
Q

Chlorhexidine gluconate is a ____ compound that binds to ___ of tooth enamel, pellicle, plaque, extracellular matrix of plaque and mucous membrane

A

cationic; hydroxyapatite

75
Q

chlorhexidine gluconate is a cationic compound that binds to hydroxyapatite of:

A

tooth enamel, pellicle, plaque, ECM of plaque and mucous membrane

76
Q

chlorhexidine gluconate absorbed to hydroxyapatite is believed to:

A

inhibit bacterial colonization and prevent pellicle formation

77
Q

What is the substantivity of chlorhexidine gluconate?

A

8-12 hours

78
Q

chlorhexidine gluconate is used most often during ____, however not proved beneficial as:

A

perio therapy; SOLE method of treating perio with deep pockets

79
Q

T/F: CHX has been proven to be the sole method of treating perio with deep pockets

A

False- although its advantages with perio therapy, mouth rinses alone will not go deep into perio pockets and will only go about 2 mm

80
Q

CHX is used to irrigate perio pockets following SRP which can help:

A

decrease inflammation and SubG plaque accumulation

81
Q

What is the alcohol concentration of CHX w/ alcohol

A

12%

82
Q

The alcohol free formulation of CHX is comprised of

A

0.12% CHX

83
Q

T/F: Evidence reveals that the alcohol free CHX formulation is less effective than the alcohol-based CHX formulation:

A

False- evidence suggests the alcohol free formulation is just as effective

84
Q

Discuss the approvals of CHX alcohol and non alcohol version:

A

Both have FDA approval; ADA seal of approval not given due to changes in the program

85
Q

What mouth rinse can be used if you feel a sore throat coming on?

A

CHX

86
Q

How would you write the prescription for CHX?

A

Rx: Peridex (chlorhexidine gluconate) 0.12% mouthwash

Dispense: 15ml

Sig: Apply 1 tablespoon as directed twice per day for 30 seconds

Refills: none

87
Q

Homecare instructions for CHX include:

A
  1. brushing/flossing should be done PRIOR to rinsing
  2. DO NOT rinse with water immediately after rinsing with CHX. wait 30 min
88
Q

Why should brushign and flossing be done PRIOR to rinsing with CHX?

A

CHX mechanism of action is inactivated by toothpaste

89
Q

What are the PROS of CHX? (3)

A
  1. Antimicrobial effect on bacteria, fungus, and viruses
  2. Aids in management of periodontitis , caries, peri-implantitis, & infections associated with extractions
  3. Gold-standard following most oral surgeries
90
Q

What are the CONS of CHX? (6)

A
  1. Stains teeth with prolonged use
  2. Can cause metallic taste with excessive use
  3. Can cause black hairy tongue appearance
  4. May aid in formation of supra gingival calculus
  5. Requires prescription
  6. Should not be used long-term
91
Q

What mouth rinse is very similar to CHX?

A

saltwater mouth rinse

92
Q

Has been determined to be as efficient as 0.12% CHX in reducing inflammation following minimally invasive perio therapy (SRP or surgery):

A

Saltwater mouthrinse

93
Q

What are the benefits of saltwater mouth rinse over CHX:

A

inexpensive and easily accessible

94
Q

If you were to give directions to a patient on how to make & use saltwater mouth rinse, what would they be?

A

1 cup of warm water to 1 teaspoon of salt, mix well, rinse in mouth for 30 seconds, then expectorate

95
Q

When to use mouth rinses: (4)

A
  1. based upon need (caries/gingivitis/perio/surgery)
  2. patients who have manual dexterity issues (plaque control)
  3. pre/post surgery
  4. mouth sores (Colgate Peroxyl)
96
Q

What are the negative outcomes of mouth rinses (in general) (6):

A
  1. alters natural microbiome that occurs in the oral cavity
  2. dries out oral mucosal tissues (especially alcohol based)
  3. causes imbalances in pH levels
  4. may worsen halitosis
  5. may cause ulcers/increased risk for oral cancer
  6. may contribute to development of gingivitis
97
Q

What mouth rinse would you not prescribe to someone with xerostomia?

A

alcohol based - as this may further dry out the mouth

98
Q

Why may a mouth rinse contribute to the development of gingivitis?

A

because of its ability to alter the micro flora

99
Q
A

Patient Care III (16 decks)

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