Mouth Rinses Flashcards
1
Q
Harmful to patient:
A
Adverse effect
2
Q
May be harmful, useful, or beneficial:
A
Side effect
3
Q
Ability of patient to follow through/ motivation to use product:
A
Compliance
4
Q
Ability of an agent to absorb to teeth and surfaces and be released at therapeutic levels:
A
Substantivity
5
Q
Pleasant taste/sensation, decrease microorganisms, halitosis control:
A
Cosmetic
6
Q
The quality in being successful in producing an intended result:
A
Efficacy
7
Q
Cosmetic mouth rinses are available:
A
OTC
8
Q
Therapeutic mouth rinses are available:
A
OTC or prescription
9
Q
A mouth rinse that helps to enhance taste in mouth (i.e. minty, fresh breath):
A
cosmetic mouth rinse
10
Q
A mouth rinse that helps to reduce/control plaque, gingivitis, halitosis, caries, or xerostomia:
A
Therapeutic mouth rinse
11
Q
Describe the effects of a cosmetic mouth rinse on plaque/caries/xerostomia, etc:
A
No real beneficial effects
12
Q
List the purposes of mouth rinses: (5)
A
- flush out food debris from oral cavity
- freshen breath
- deposit fluoride on teeth (if fluoridated)
- available in liquid form
- primarily cosmetic benefit (freshening breath)
13
Q
Why should you wait 30 min to eat or drink following use of mouth rinse?
A
If not it will inactivate sodium hypochlorite
14
Q
What was the traditional purpose for mouth rinse?
A
Freshen breath
15
Q
What contributes to halitosis?
A
Bacteria & plaque accumulation on the tongue
16
Q
_____% of halitosis originates from the oral cavity; ____ from systemic or nonoral cause
A
90% ; 10%
17
Q
Describe the effect of mouth rinses on breath after 3-5 hours:
A
no effect
18
Q
Mouth rinses _____ odors/provide little _____
A
“mask” ; antibacterial function
19
Q
What is the best treatment for bacterial & plaque accumulation on the tongue?
A
Tongue scraper
20
Q
List the active ingredients in mouth rinse: (8)
A
- sanguinarine
- ammonium compounds
- phenolic compounds
- fluoride
- chlorhexadine
- stannous fluoride
- essential oils
- triclosan
21
Q
Why are ammonium compounds added to mouth rinse? Give an example of one:
A
Added to reduce bad breath; CPC
22
Q
Describe the substantivity of the active ingredient “phenolic compounds” in mouth rinses:
A
Low substantivity
23
Q
What is the purpose of fluoride as an active ingredient in mouth rinses?
A
Reduces incidence of caries
24
Q
What is the of chlorhexadine as an active ingredient in mouth rinses?
A
Helps control plaque and gingivitis
25
What is the purpose of stannous fluoride as an active ingredient in mouth rinses?
helps control plaque and gingivitis
26
What is the purpose of essential oils as active ingredients in mouth rinses?
Helps control plaque and gingivitis
27
What is the purpose of Triclosan as an active ingredient in mouth rinses?
Reduces production of plaque and gingivitis
28
What active ingredients of mouth rinses are beneficial and do have chemotherapeutic effects? (4)
1. Chlorhexadine
2. Stannous fluoride
3. essential oils
4. Triclosan
29
What are the beneficial effects of Chlorhexadine, Stannous fluoride & essential oils?
Chemotherapeutic effect against plaque/biofilm accumulation as they DECREASE the amount of free-floating planktonic bacteria
30
How do Chlorhexadine, Stannous fluoride & essential oils work to DECREASE the amount of free-floating planktonic bacteria?
By binding their positive ions to the bacterias negative ions resulting in cell lysis
31
Describe the mechanism of action of Triclosan in mouth rinses:
Chemical inhibitor of fatty acid synthesis which is required for lipid production in the bacteria, which in turn eventually kills the cell
32
When biofilm forms, before it becomes an organized mass it is composed of:
Planktonic (free-floating) bacteria
33
Why might alcohol be incorporated as an ingredient in mouth rinses?
Used as a solvent, taste enhancer, and agent providing aftertastes (burn)
34
What are the negative effects of an alcohol being used in a mouth rinse?
1. burning mouth
2. drying of oral tissues
3. risk of oral cancer
35
What category of patient should NEVER be recommended an alcohol-based mouth rinse, why?
Previous/Recovering alcoholics; could serve as a stumbling block
36
What are the levels of regulation for prescription & over the counter products in regards to mouth rinses?
1. government level
2. professional level
37
The government level of regulation to oral care products:
FDA
38
The professional level of regulation to oral care products:
ADA
39
1. protects consumers from useless/harmful products
2. therapeutic claims must have research to support claims
3. evaluates prescription/OTC products
Food & Drug Administration (FDA)
40
Council on the scientific affairs of the American dental Association:
ADA- professional level regulations
41
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 $3,500 to maintain
ADA
42
The ADA seal is found on:
consumer products only
43
What is required in order to turn in product to ADA for review?
Controlled studies to demonstrate effectiveness/safety of product
44
Does Oral-B products have ADA seal?
yes
45
Does Sonicare products have ADA seal?
no- they don't want to pay that fee
46
Do we recommend based only on ADA?
Not necessarily- some products have evidence to support claims and do not have ADA seal (example- sonicare tooth brush)
47
T/F: Toothpastes without fluoride do NOT have ADA seal
True
(which she says is crazy because plenty of beneficial toothpaste without fluoride that contain hydroxyapatite)
48
What signifies if Listerine mouth rinse has no alcohol present?
If product has "zero" in its name
49
Describe what active ingredients are found in listerine mouth rinses:
Dependent upon product claim
50
If Listerine product claim is "gum health" or "tartar control" the the active ingredients are:
essential oils
51
If Listerine product claim is "cavity protection" then the active ingredients are:
sodium fluoride (0.02%)
52
How many different Listerine products are listed on the website?
18
53
Professor discussed this mouth rinse as "a good OTC option for patients with moderate risk for caries":
ACT mouth rinse
54
How many different formulas of mouth rinse are provided by ACT?
6 (ranging from basic mouth wash to kids' formulated mouthwash, and mouthwash for dry mouth)
55
What is the active ingredient in ACT mouth rinse (generic)?
Sodium fluoride (0.05%)
56
What is the active ingredient in ACT whitening mouth rinse?
Sodium fluoride (0.02%)
*note this is less than their typical (generic) mouth rinse
57
Professor states that whitening mouth rinses:
Do not actually work
58
T/F: The Crest website provides a comprehensive of active & inactive ingredients
False- Crest website does not provide information defining active & nonactive ingredients
59
The Crest brand includes:
Scope brand
60
Professor states that Crest brand mouth rinses _________ more than any other brand
stains teeth
61
What type of mouth rinse would you recommend to a patient with mouth sores:
Colgate Peroxyl
62
Colgate whitening mouth rinses typically utilize ______ as whitening agent
Hydrogen peroxide
63
Why is Colgate Peroxyl mouth rinse helpful for patients with mouth sores?
Contains 1.5% hydrogen peroxide
64
What is the active ingredient in Colgate Ortho defense?
Sodium fluoride (0.04%)
65
What is the professors favorite mouth rinse due to not having lots of active ingredients?
Closys
66
What are the active ingredients in Closys mouth rinse?
CPC (0.075%) or Sodium Fluoride (0.05%)
67
What is the best OTC option for a mouth rinse according to Professor?
Closys
68
Mouth rinses and sprays for Xerostomia include:
1. biotene mouth rinse
2. Oasis mouth rinse
3. Spry mouth spray
69
If a patient presents with Xerostomia, what mouth rinse/spray might you recommend to them?
1. biotene mouth rinse
2. Oasis mouth rinse
3. Spry mouth spray
70
Spry mouth moisturizing spray for Xerostomia utilizes what ingredients?
Xylitol & aloe
71
How do mouth rinses and sprays for xerostomia function?
All are very viscous and coat the oral tissues to help alleviate dryness
72
Considered the gold standard of mouth rinses & prescription only:
Chlorhexadine Gluconate
73
Proved to the the most effective antiplaque oral rinse:
Chlorhexadine Gluconate
74
Chlorhexadine Gluconate is a _____ compound that binds to _____ of tooth enamel, pellicle, plaque, ECM of plaque & mucous membrane:
Cationic; hydroxyapatite
75
Chlorhexadine Gluconate is a cationic compound that binds to hydroxyapatite of:
tooth enamel, pellicle, plaque, ECM of plaque & mucous membrane
76
Chlorhexadine Gluconate absorbed to hydroxyapatite is believed to:
Inhibit bacterial colonization & prevent pellicle formation
77
What is the substantivity of Chlorhexadine Gluconate?
8-12 hours
78
Chlorhexadine Gluconate is used most often during ______ however not proved beneficial as:
Perio therapy; SOLE method of treating perio with deep pockets
79
T/F: CHX has been proven to be the SOLE method of treating perio with deep pockets
False- although its advantageous with perio therapy, mouth rinses do alone will not go deep into perio pockets and will only go about 2mm
80
CHX is used to irrigate perio pockets following SRP which can help:
Decrease inflammation & subG plaque accumulation
81
What is the alcohol concentration of CHX with alcohol?
12%
82
The alcohol-free formulation of CHX is comprised of:
0.12% CHX
83
T/F: Evidence reveals that the alcohol-free CHX formulation is less effective than the alcohol-based CHX formulation
False- evidence suggest the alcohol-free formulation is just as effective
84
Discuss the approvals of CHX alcohol-based & alcohol-free version:
Both have FDA approval; ADA seal of approval not given due to changes in the program
85
What mouth rinse may be beneficial to use if you feel a sore throat coming on?
CHX
86
How would you write the prescription for CHX?
RX: Peridex (Chlorhexadine Gluconate) 0.12% mouthwash
Dispense: 15mL
Sig: apply 1 tbsp as directed twice per day for 30 sec
Refills: none
87
Home care instructions for CHX include:
1. brushing/flossing should be done PRIOR to rinsing
2. DO NOT rinse with water immediately after rinsing with CHX, wait 30 min
88
Why should brushing and flossing be done prior to rinsing with CHX?
CHX mechanism of action is inactivated by toothpaste
89
What are the PROS of CHX? (3)
1. antimicrobial effect on bacteria, fungi & viruses
2. aids in management of periodontitis, caries, peri-implantitis, & infections associated with extractions
3. gold standard following most oral surgeries
90
What are are the CONS of CHX? (6)
1. stains teeth with prolonged used
2. can cause metallic taste with excessive use
3. can cause black hairy bogie appearance
4. may aid in formation of supragingival calculus
5. requires prescription
6. may not be used long-term
91
What mouth rinse is very similar to CHX?
Saltwater mouth rinse
92
Has been determined to be as efficient as 0.12% CHX in reducing inflammation following minimally invasive perio therapy (SRP or surgery):
Saltwater mouth rinse
93
What are the benefits of saltwater mouth rinse over CHX?
Inexpensive & easily accessible
94
If you were to give directions to a patient on how to make & use saltwater mouth rinse what would they be?
1 cup of warm water to 1 tsp of salt, mix well, rinse in mouth for 30 seconds, then expectorate
95
When to use mouth rinses: (4)
1. based upon need (caries/gingivitis/perio/surgery)
2. Pts who have manual dexterity issues (plaque control)
3. Pre/Post surgery
4. Mouth sores (Colgate Peroxyl)
96
What are the negative outcomes of mouth rinses? (in general) (6)
1. alters natural microbiome that occurs the oral cavity
2. dries out oral mucosal tissues (especially alcohol-based)
3. causes imbalance sin pH levels
4. may worsen halitosis
5. may cause ulcers/increased risk for oral cancer
6. max contribute to development of gingivitis
97
What mouth rinse would you not prescribe to someone with xerostomia?
Alcohol-based
98
Why might mouth rinse may contribute to development of gingivitis?
Because we are altering the microflora
99
