v16F_mouthrinsetable_Layout 1 3/28/14 11:04 AM Page 30

FOCUSonMOUTHRINSES This informative table provides details about the therapeutic and cosmetic mouthrinses currently available.

Do patients truly understand how mouthrinses work? Some may think of them as “magic bullets” that will cure their dental ailments with just a swish and spit. Oral health professionals, however, know that this is not the case. Patients still need advice on the proper usage and selection of mouthrinses, and the best resource for mouthrinse information is you—their dental hygienist. As the dental team member whose focus is prevention, your knowledge of mouthrinses is paramount to providing excellent patient care. With so many different mouthrinses on the market today, keeping up to date on the prod- ucts available is challenging. This Dimensions of Dental Hygiene mouthrinse guide is intended to help you sort through both the therapeutic and cosmetic mouthrinse options. When consider- ing over-the-counter therapeutic mouthrinses, noting which products have received the American Dental Association’s Seal of Acceptance is also helpful, as they have been evaluated for safety and efficacy. We hope you find this guide useful when making product recommen- dations to patients who wish to add rinsing to their daily oral care regimens. —Jill Rethman, RDH, BA Editor in Chief

Note: Mouthrinse manufacturers in the United States were invited to submit information for this table. This list includes those companies that responded to our request for information. There may be inadvertent product omissions.

Manufacturer Product Active Indications Contraindications Name Name Ingredients 3M ESPE Preventive Care PerioMed™ 0.63% Stannous 0.63% Stannous fluoride Gingival , caries, hypersensitivity Any known allergies to ingredients Fluoride Oral Rinse Concentrate PERIDEX™ Chlorhexidine 0.12% Chlorhexidine Gingivitis and periodontal bleeding Any known allergies to ingredients Gluconate 0.12% Oral Rinse gluconate or chlorhexidine OrthoWash™ Daily Rinse 0.044% Sodium fluoride in an Decalcification, caries Any known allergies to ingredients acidulated rinse ACT/Chattem Inc ACT® Total Care Anticavity Dry 0.02% Sodium fluoride Prevents caries, soothes dry mouth, moisturizes mouth None Mouth tissue, strengthens teeth, freshens breath ACT Total Care Anticavity 0.05% Sodium fluoride Prevents caries, rebuilds enamel, strengthens teeth, None Fluoride Mouthwash freshens breath ACT Braces Care™ Anticavity 0.02% Sodium fluoride Prevents caries, helps prevent white spots, strengthens None Fluoride Mouthwash teeth, -free, contains xylitol and aloe BEYOND Dental and Health Inc BEYOND Restoring Whitening Hydrogen peroxide Whitens teeth, provides tartar control, restores minerals Any known allergies to hydrogen Mouthwash to strengthen enamel, freshens breath peroxide BEYOND Antiseptic Mouthwash Cetylpyridinium chloride, Aids in the prevention of caries, gingivitis, and tartar In the case of fluoride intake from sodium fluoride build-up; freshens breath other sources, consult a dentist or physician BEYOND Mouthwash for Kids Tocopherol Improves oral health by aiding in caries prevention and None reducing free radicals CariFree/Oral BioTech CariFree® CTx3 Rinse 0.05% Sodium fluoride For daily use; alcohol-free fluoride rinse combined with None a high level of xylitol at an elevated pH; reduces caries while promoting remineralization; pH of 8 neutralizes acidic oral environment CariFree CTx4 Treatment Rinse 0.05% Sodium fluoride 0.2% Sodium hypochlorite dissolves biofilm and is a None broad spectrum antimicrobial for treatment of caries infection; pH of 10 neutralizes acidic oral environment Cetylite Industries Inc Protexin® Oral Rinse Zinc chloride Cleans the mouth of debris and ropy saliva; refreshes None breath after operative procedures; also available in a spray

30 Dimensions OF DENTAL HYGIENE dimensionsofdentalhygiene.com APRIL 2014 v16F_mouthrinsetable_Layout 1 3/28/14 11:04 AM Page 32

Manufacturer Product Active Indications Contraindications Name Name Ingredients

Colgate Colgate® Total® Advanced 0.075% Cetylpyridinium chlo- Significantly reduces plaque, helps prevent gingivitis Not for children younger than 12 Pro-Shield™ ride Colgate Periogard® Rinse (Rx 0.12% Chlorhexidine glu- For use between dental visits as part of a professional Should not be used by those who only) conate program for treating gingivitis as characterized by red- are hypersensitive to chlorhexidine ness and swelling of the gingivae, including gingival gluconate or other formula ingredi- bleeding on probing; has not been tested on patients ents with acute necrotizing ulcerative gingivitis; for patients with existing gingivitis and periodontitis, see precautions

Peroxyl® Rinse 1.5% Hydrogen peroxide For use in cleansing canker sores, minor mouth None wounds, and minor gum inflammation Dental Herb Co Tooth & Gums Tonic® Cinnamon bark, eucalyptus, For daily use; nonalcohol, nonstaining antimicrobial Allergy to any product ingredient lavender, peppermint, and rinse for reducing gingival inflammation, periodontal essential oils; echi- bleeding, and breath malodor; also indicated for post- nacea and gotu kola herbal surgical and post-implant care extracts

DENTSPLY Professional Oris® Chlorhexidine Gluconate 0.12% Chlorhexidine For use between dental visits as part of a professional Should not be used by individuals 0.12% Oral Rinse gluconate program for the treatment of gingivitis as characterized who are known to be hypersensi- by redness and swelling of the gingivae, including gingi- tive to chlorhexidine gluconate or val bleeding on probing; for patients with coexisting other formula ingredients; not gingivitis and periodontitis, see precautions tested among patients with acute necrotizing ulcerative gingivitis

Dr. Fresh Inc FireFly® Angry Birds Mouth 0.05% Sodium fluoride Anticaries rinse; alcohol and sugar free; no mess cup Consult a dentist or physician for Rinse and pump use in children younger than 6

FireFly Hello Kitty Mouth Rinse 0.05% Sodium fluoride Anticaries rinse; alcohol and sugar free; no mess cup Consult a dentist or physician for and pump use in children younger than 6 SmileGuard Mouth Rinse 0.05% Sodium fluoride Anticaries rinse; alcohol and sugar free Consult a dentist or physician for use in children younger than 6 Dr. Harold Katz LLC TheraBreath Oral Rinse OXYD-8 (proprietary stabilized Treats breath malodor and eliminates sour, bitter, and None

ClO2) metallic tastes in the mouth; also indicated for those with xerostomia

PerioTherapy Oral Rinse PeriO2 (proprietary stabilized Treats the anaerobic bacteria that allow the initiation of None Oxychlor compounds), zinc periodontal diseases, xerostomia, breath malodor, and gluconate (ZincRx), melaleuca taste disorders alternifolia (tea tree) leaf oil TheraBreath PLUS Oral Rinse OXYD-8, zinc gluconate, Formulated to combat chronic breath malodor; also None camellia sinensis leaf extract, works on: coffee breath, cigar and smokers’ breath, bad aloe barbadensis leaf juice, breath due to medication-induced xerostomia, odor xylitol, melaleuca alternifolia from post-nasal drip, morning breath, dry mouth symp- leaf oil toms, and persistent gum irritation

GlaxoSmithKline Biotene Dry Mouth Oral Rinse Glycerin, xylitol, sorbitol Relief of xerostomia symptoms; alcohol free None solution

Biotene PBF Propylene glycol, xylitol, Relief of oral dryness; helps loosen plaque-biofilm Contains milk and egg derivatives Oral Rinse sodium benzoate, benzoic (with brushing); alcohol free acid, mutanase, fisodium phosphate, zinc gluconate, lactoferrin, lysozyme, lac- toperoxidase, potassium thiocyanate, aloe vera gel, calcium lactate ProNamel® Fluoride Rinse Fluoride 225 ppm Helps protect against the effects of acid erosion; None provides extra protection against the effects of acid erosion when used in conjunction with twice-daily brushing with a fluoride Henry Schein ACCLEAN® Mouthwash 70% Sorbitol Use as part of an effective program Do not swallow; only administer to children under adult supervision Johnson & Johnson Healthcare LISTERINE® ZERO™ Mouthwash Four essential oils: eucalyp- A less intense, zero-alcohol formula that cleans deep to Not for patients younger than 12 Products, Division of tol, , methyl salicy- kill breath malodor bacteria for a clean, fresh mouth McNeil-PPC Inc late, LISTERINE Antiseptic Four essential oils: eucalyp- Kills bacteria that cause breath malodor, plaque, and Not for patients younger than 12 Mouthwash tol, menthol, gingivitis; available in regular, less intense, and tartar , thymol control LISTERINE TOTAL CARE & Sodium fluoride 0.02% Helps prevent caries; restores enamel; strengthens Not for patients younger than 12 TOTAL CARE ZERO Mouthwash (0.01% w/v fluoride ion) teeth; kills breath malodor bacteria; freshens breath; (LISTERINE TOTAL CARE) cleans the whole mouth Not for patients younger than 6 (LISTERINE TOTAL CARE ZERO)

32 Dimensions OF DENTAL HYGIENE dimensionsofdentalhygiene.com APRIL 2014 v16F_mouthrinsetable_Layout 1 3/28/14 11:14 AM Page 33

Mouthrinse Guide

Manufacturer Product Active Indications Contraindications Name Name Ingredients NOWsystem Inc TRIOLOGY™ Professional Oral Tritiserum™ (a patent-pending Cleanses and reduces pain associated with infected gin- Contains almond oil, not for use Cleansing & Care Debriding biologic blend of aloe vera, gival tissue from periodontal diseases; mouth sores by individuals with nut allergies; Rinse sweet almond oil, and chloro- from dentures, orthodontic appliances, accidental not for children younger than 2 phyll-rich wheatgrass), 4% car- injury, or other irritation of the mouth and gums; bamide peroxide wounds or gum inflammation resulting from dental procedures; canker sores; also available in a spray Oasis Consumer Healthcare Oasis® Moisturizing Mouthwash Glycerin, sorbitol Moisturizes the mouth, freshens breath, fights odors, Keep out of reach of children, not alcohol free harmful if accidentally swallowed

OraSoothe MCMP None For healing and comfort following scaling and root None; safe if swallowed planing, prophylaxis, laser treatment, and hygiene procedures; use as preprocedural or post-proce- dural rinse

OraTec Corp TheraSol Ethoxylated tertiary amine, Microbial control None capryl/capramidopropyl betaine

Oxyfresh Lemon-Mint Power Rinse Oxygene® (sodium chlorite), Effective and gentle formula ideal for those with moder- None xylitol, aloe vera gel, zinc ate to severe chronic breath malodor and xerostomia; no artificial flavors; alcohol, paraben, and gluten free

Fresh Mint with Fluoride Oxygene (sodium chlorite), Effective formula ideal for those with caries risk, Not for children younger than 6 Mouthrinse xylitol, 0.05% Sodium fluoride cosmetic support for natural or restorative surfaces, unless exposed root surfaces, and sensitive teeth and gums; no recommended by a dentist or artificial flavors; alcohol, paraben, and gluten free pediatrician

Fresh Mint without Fluoride Oxygene (sodium chlorite), Effective formula ideal for cosmetic support for natural None Mouthrinse xylitol or restorative surfaces, exposed root surfaces, and sensi- tive teeth and gums; no artificial flavors; alcohol, paraben, and gluten free Pascal International StanGard® Perio Rinse 0.63% Stannous fluoride Used in the treatment of periodontal diseases; None reduces gingival inflammation and bleeding; great for oral irrigation units when diluted with water; well suited for patients with disabilities who may find brushing difficult; mint flavor

APRIL 2014 dimensionsofdentalhygiene.com Dimensions OF DENTAL HYGIENE 33 v16F_mouthrinsetable_Layout 1 3/28/14 3:38 PM Page 34

Mouthrinse Guide

Manufacturer Product Active Indications Contraindications Name Name Ingredients PerioSciences AO ProRinse Triple antioxidants (ferulic -based antioxidants to counteract free radicals None acid, curcuminoids, green in the oral cavity tea catechins) Philips Oral Healthcare BreathRx® Anti-Bacterial Cetylpyridinium chloride, For daily use; 100% alcohol free; kills the bacteria None Mouth Rinse Zytex™ (eucalyptus oil, thy- that cause breath malodor; neutralizes odors; pre- mol, zinc gluconate) vents plaque that leads to gingivitis PerioRx® Chlorhexidine 0.12% Chlorhexidine Treatment for gingivitis, gingival redness and swelling, Should not be used by those hyper- Gluconate Oral Rinse gluconate and bleeding gums sensitive to chlorhexidine gluco- nate; short-term use only (up to 3 months) Fluoridex Daily Renewal® 0.63% Stannous fluoride Ideal for post-periodontal surgery, periodontal mainte- None 0.63% Stannous Fluoride Rinse nance, caries prevention, and hypersensitivity Prevention Laboratories LLC Prevention Antibacterial Natural glycerin, chelated zinc, Patented anti-inflammatory that helps controls plaque Allergy to any ingredients Non-Alcohol Rinse peppermint oil-menthol build-up and gingivitis; kills bad bacteria without harm- crystals ing the probiotics; helps heal canker and cold sores Prevention Oncology Mouth USP natural glycerin, Treats oral complications due to chemotherapy, bone Allergy to any ingredients Rinse chelated zinc, peppermint oil- marrow transplants, or other treatment associated menthol crystals with cancer; helps soothe and heal sore, inflamed, or ulcerated tissue during treatment Prevention Periodontal Mouth Chelated zinc, natural glyc- Maximum strength formulation for rapidly responding Allergy to any ingredients Rinse erin, hydrogen to severe conditions found in the mouth including peroxide (1.5%) periodontal diseases; does not discolor teeth, tongue, or gums; available over the counter Procter & Gamble Crest® Pro-Health 0.07% Cetylpyridinium chlo- Helps prevent and reduce plaque and gingivitis, Not for children younger than 6 Multi-Protection Rinse ride controls plaque bacteria that contribute to the development of gingivitis and bleeding gums; alco- hol free; freshens breath Crest Pro-Health Complete 0.0219% Sodium fluoride Anticaries fluoride rinse; fights bad breath; alcohol free Consult a dentist or physician for use Rinse (0.01% w/v fluoride ion) in children younger than 6 Crest Pro-Health 0.022% Sodium fluoride Anticaries fluoride rinse; alcohol free; freshens Consult a dentist or physician for use For Me Rinse (0.01% w/v fluoride ion) breath in children younger than 6 Rowpar Pharmaceuticals Inc ClōSYS® Oral Health Rinse Stabilized, buffered chlorine Alcohol free, nonstaining, sulfate free, triclosan free; None dioxide effective against volatile sulfur compounds; compares ® Rethink Oral Health Care to chlorhexidine; helps to disrupt biofilm and prevent growth; aids in periodontal procedures; freshens breath; use for preprocedural or post-procedural rins- ing; safe to use in scalers/equipment Sunstar Americas GUM® Paroex™ Alcohol Free 0.12% Chlorhexidine Gingivitis and periodontal bleeding Any known allergies to ingredients or Chlorhexidine Gluconate gluconate chlorhexidine GUM PerioShield™ Delmopinol 0.2% Helps remove and prevent biofilm build-up; inhibits Not recommended for those with biofilm formation in patients with gingivitis; and serves hypersensitivity to ingredients; for as an adjunct to normal mechanical oral hygiene prac- children younger than 12 or preg- tices where this has proved inadequate nant patients, contact a dentist or physician before use Tom’s of Maine Natural Children’s Anticavity 0.0442% Sodium fluoride Alcohol, sodium lauryl sulfate, and dye free; strong None Fluoride Mouthwash caries protection for a healthy smile; comes in Juicy Mint flavor Natural Long-Lasting Wicked None Dye free and 99% alcohol free; natural mineral zinc None Fresh! Mouthwash chloride neutralizes odor from breath malodor bacteria without the burn; comes in Cool Mountain Mint and Peppermint Wave flavors Xlear Inc Spry® Spearmint Oral Rinse Xylitol, calcium glycerophos- Use up to twice daily; rinse in mouth for at least 30 None phate, aloe vera seconds Spry Coolmint Oral Rinse Xylitol, calcium glycerophos- Use up to twice daily; rinse in mouth for at least 30 None phate, aloe vera seconds Spry Wintergreen Oral Rinse Xylitol, calcium glycerophos- Use up to twice daily; rinse in mouth for at least 30 None phate, aloe vera seconds Zila Pharmaceuticals Inc ProDenRx® 0.12% 0.12% Chlorhexidine Chlorhexidine rinse with antimicrobial benefits to sig- Not for those who are hypersensitive Chlorhexidine Gluconate Oral gluconate nificantly reduce gingival inflammation and bleeding to chlorhexidine gluconate or other Rinse due to gingivitis; sodium lauryl sulfate and dye free formula ingredients ProDenRx 0.63% Stannous 0.63% Stannous fluoride Once daily rinse to prevent caries, inhibit plaque, and Not for children younger than 6 unless Fluoride Rinse reduce sensitivity in gums; can be used as a rinse or with recommended by a dentist or physician an irrigator; available in three flavors; sodium lauryl sul- fate and dye free ProDenRx 0.2% Neutral 0.2% Neutral sodium Home fluoride rinse for caries prevention; plaque-con- Not for children younger than 6 unless Sodium Fluoride Rinse fluoride trolling formula is great for cosmetic patients; available recommended by a dentist or physi- in three flavors; sodium lauryl sulfate and dye free cian

34 Dimensions OF DENTAL HYGIENE dimensionsofdentalhygiene.com APRIL 2014